A Qualitative Study of Role Transition from RN to APN

Role transition from registered nurse to advanced practice nurse is a difficult process. A qualitative thematic analysis guided the integration of various experiences of 24 students in a twocredit, web-based role development course in a Master’s of Science in Nursing program at a large Midwestern university. Findings supported that students had developed an understanding of the core competencies and complexity of the advanced practice nurse role, and that beginning role transition had occurred. An overarching theme, ‘the essence of nursing’ was evident. Three subthemes supported the occurrence of role transition, which included the importance of: a) building a framework for nursing practice, b) direct patient care, and c) comprehension and exemplification of professional responsibilities. This study has implications for nurse educators interested in promoting advanced practice nurse role transition early in the educational process

Psychosocial determinants of physical activity in children attending afterschool programs : a path analysis.

Background: Physical activity (PA) is important for controlling childhood obesity, but a comprehensive PA model for school-aged children is lacking. Objectives: Guided by the youth PA promotion (YPAP) model, this study estimated the direct and indirect effects of self-efficacy, enjoyment, parental influence, and environment on self-reported PA and pedometer steps. A secondary purpose was to explore the association between self-reported PA and pedometer steps. Methods: An observational and prospective study was conducted among 133 children, aged 8–11 years old, from 10 elementary schools with afterschool programs in a Midwestern U.S. school district from August through October 2013. PA was assessed by a 7-day recall scale and pedometers. Other variables were assessed by validated questionnaires. Results: Approximately 65 (49%) children were overweight or obese—only 17 (13%) met national PA recommendations—and body mass index z score was negatively correlated with pedometer steps (r = .18, p = .042). A path analysis showed that self-efficacy had a direct effect on self-reported PA and pedometer steps, enjoyment had only a direct effect on self-reported PA, and parental influence had a direct effect on pedometer steps and an indirect effect on self-reported PA through self-efficacy and enjoyment. The association between self-reported PA and pedometer steps was not significant. Discussion: Because this study only partially supports the YPAP model, studies with a larger sample size and longitudinal design are essential to further examine this model. The nonsignificant relationship of self-reported PA with pedometer steps may be due to the systematic error resulted from a common method artifact of self-report. Given the importance of parental influence, enjoyment, and self-efficacy, targeting these three determinants in future interventions to increase PA among children is recommended

Girls on the Move Program to Increase Physical Activity Participation

Background: Because physical inactivity poses serious health risks, interventions are urgently needed to reverse the increasingly sedentary lifestyles of adolescent girls. Objective: The aim of this study was to determine the feasibility of Girls on the Move, an individually tailored computerized physical activity (PA) program plus nurse counseling intervention, in increasing PA. Methods: A pretest-posttest control group design was used with 77 racially diverse sedentary girls in Grades 6, 7, and 8 from two middle schools. Each of the instructional grades was randomly assigned to either an intervention or control condition. After completing computerized questionnaires, each girl in the control group received a handout listing the PA recommendations. To encourage PA, each girl in the intervention group received computerized, individually tailored feedback messages based on her responses to the questionnaires, individual counseling from the school\u27s pediatric nurse practitioner (PNP), and telephone calls and mailings from a trained research assistant. At 12 weeks, girls in both groups responded to the questionnaires. Results: No differences in self-reported PA emerged between the intervention and control groups at Weeks 1 (baseline) and 12 (postintervention). Repeated measures ANOVA showed a significant interaction between group and time for social support for PA, F(1, 69) = 5.73, p = .019, indicating that the intervention group had significantly greater social support across time than did the control group. From baseline to postintervention, social support increased for the intervention group but decreased for the control group. Discussion: Reasons for the lack of significant differences between the groups on the PA measures were cited. Important information that could inform subsequent studies that test interventions to increase youth PA was acquired from conducting this study. Future efforts to increase PA participation might include this approach for enhancing social support for PA

Demographic differences in and correlates of perceived body image discrepancy among urban adolescent girls: a cross-sectional study

Abstract Background Understanding factors related to girls’ body image discrepancy, which is the difference between self-perceived current or actual and ideal body size, is important for addressing body-related issues and preventing adverse sequelae. Two aims were to: 1) examine demographic differences in body image discrepancy; and 2) determine the association of body image discrepancy with weight status, percent body fat, physical activity, sedentary behavior, and cardiovascular (CV) fitness among young adolescent girls. Methods The cross-sectional study included a secondary analysis of baseline data from a group randomized controlled trial including 1519 5th–8th grade girls in 24 U.S. schools. Girls completed physical activity and sedentary behavior surveys. To indicate perceived current/actual and ideal body image, girls selected from nine body figures the one that represented how they look now and another showing how they want to look. Girls wore accelerometers measuring physical activity. Height, weight, and percent body fat were assessed. The Progressive Aerobic CV Endurance Run was used to estimate CV fitness. Independent t-test, one- and two-way ANOVA, correlational analyses, and hierarchical linear regressions were performed. Results The majority (67.5%; n = 1023) chose a smaller ideal than current/actual figure. White girls had higher body image discrepancy than Black girls (p = .035). Body image discrepancy increased with increasing weight status (F3,1506 = 171.32, p < .001). Moderate-to-vigorous physical activity (MVPA) and vigorous physical activity were negatively correlated with body image discrepancy (r = −.10, p < .001; r = −.14, p < .001, respectively), but correlations were not significant after adjusting for race and body mass index (BMI), respectively. Body image discrepancy was moderately correlated with CV fitness (r = −.55, p < .001). After adjusting for demographics, percent body fat, but not CV fitness or MVPA, influenced body image discrepancy. Girls with higher percent body fat had higher body image discrepancy (p < .001). Conclusion This study provided important information to guide interventions for promoting a positive body image among girls. Trial registration ClinicalTrials.gov Identifier NCT01503333 , registration date: January 4, 2012.https://deepblue.lib.umich.edu/bitstream/2027.42/139721/1/12887_2017_Article_952.pd

Comparing the Psychometric Properties of Two Physical Activity Self-Efficacy Instruments in Urban, Adolescent Girls: Validity, Measurement Invariance, and Reliability

Aims: This study compared the psychometric properties of two self-efficacy instruments related to physical activity. Factorial validity, cross-group and longitudinal invariance, and composite reliability were examined.Methods: Secondary analysis was conducted on data from a group randomized controlled trial investigating the effect of a 17-week intervention on increasing moderate to vigorous physical activity among 5th–8th grade girls (N = 1,012). Participants completed a 6-item Physical Activity Self-Efficacy Scale (PASE) and a 7-item Self-Efficacy for Exercise Behaviors Scale (SEEB) at baseline and post-intervention. Confirmatory factor analyses for intervention and control groups were conducted with Mplus Version 7.4 using robust weighted least squares estimation. Model fit was evaluated with the chi-square index, comparative fit index, and root mean square error of approximation. Composite reliability for latent factors with ordinal indicators was computed from Mplus output using SAS 9.3.Results: Mean age of the girls was 12.2 years (SD = 0.96). One-third of the girls were obese. Girls represented a diverse sample with over 50% indicating black race and an additional 19% identifying as mixed or other race. Both instruments demonstrated configural invariance for simultaneous analysis of cross-group and longitudinal invariance based on alternative fit indices. However, simultaneous metric invariance was not met for the PASE or the SEEB instruments. Partial metric invariance for the simultaneous analysis was achieved for the PASE with one factor loading identified as non-invariant. Partial metric invariance was not met for the SEEB. Longitudinal scalar invariance was achieved for both instruments in the control group but not the intervention group. Composite reliability for the PASE ranged from 0.772 to 0.842. Reliability for the SEEB ranged from 0.719 to 0.800 indicating higher reliability for the PASE. Reliability was more stable over time in the control group for both instruments.Conclusions: Results suggest that the intervention influenced how girls responded to indicator items. Neither of the instruments achieved simultaneous metric invariance making it difficult to assess mean differences in PA self-efficacy between groups

“Girls on the Move” intervention protocol for increasing physical activity among low-active underserved urban girls: a group randomized trial

Abstract Background Increasing moderate to vigorous physical activity among urban girls of low socioeconomic status is both a challenge and a public health priority. Physical activity interventions targeting exclusively girls remain limited, and maintenance of moderate to vigorous physical activity during the post-intervention period has been difficult to maintain. The main aim of the 5-year “Girls on the Move” group randomized trial is to evaluate the efficacy of a comprehensive school-based intervention in increasing girls’ minutes of moderate to vigorous physical activity and improving cardiovascular fitness, body mass index, and percent body fat immediately post-intervention (after 17 weeks) and at 9-month post-intervention follow-up (9 months after end of intervention). Methods/Design A total of 24 urban middle schools in the Midwestern U.S. will be randomized to either receive the intervention or serve as a control (N = 1200 girls). The intervention, based on the Health Promotion Model and Self-Determination Theory, will include: (1) two face-to-face motivational, individually tailored counseling sessions with a registered nurse, one at the beginning and the other at the end of the intervention period; (2) an interactive Internet-based session during which each girl receives individually tailored motivational and feedback messages via iPad at 11 weeks (shortly after midpoint of intervention); and (3) a 90-minute after-school physical activity club. Racially diverse, low-active, 10- to 14-year-old 5th to 8th-grade girls will complete questionnaires and physical measures at baseline and post-intervention (n = 50 per school). Minutes of moderate to vigorous physical activity will be assessed with accelerometers. Cardiovascular fitness will be assessed by estimating VO2 max with PACER (Progressive Aerobic Cardiovascular Endurance Run) scores. Height and weight will be assessed to calculate body mass index. Percent body fat will be estimated with a foot-to-foot bioelectric impedance scale. Linear mixed effects regression analyses will be performed to assess intervention effects. Discussion This multi-component approach is expected to improve girls’ moderate to vigorous physical activity and related physical outcomes. Trial Registration ClinicalTrials.gov Identifier NCT01503333http://deepblue.lib.umich.edu/bitstream/2027.42/112470/1/12889_2013_Article_5394.pd

Girls on the Move” intervention protocol for increasing physical activity among low-active underserved urban girls: a group randomized trial

Background: Increasing moderate to vigorous physical activity among urban girls of low socioeconomic status is both a challenge and a public health priority. Physical activity interventions targeting exclusively girls remain limited, and maintenance of moderate to vigorous physical activity during the post-intervention period has been difficult to maintain. The main aim of the 5-year “Girls on the Move” group randomized trial is to evaluate the efficacy of a comprehensive school-based intervention in increasing girls’ minutes of moderate to vigorous physical activity and improving cardiovascular fitness, body mass index, and percent body fat immediately post-intervention (after 17 weeks) and at 9-month post-intervention follow-up (9 months after end of intervention). Methods/Design: A total of 24 urban middle schools in the Midwestern U.S. will be randomized to either receive the intervention or serve as a control (N = 1200 girls). The intervention, based on the Health Promotion Model and Self-Determination Theory, will include: (1) two face-to-face motivational, individually tailored counseling sessions with a registered nurse, one at the beginning and the other at the end of the intervention period; (2) an interactive Internet-based session during which each girl receives individually tailored motivational and feedback messages via iPad at 11 weeks (shortly after midpoint of intervention); and (3) a 90-minute after-school physical activity club. Racially diverse, low-active, 10- to 14-year-old 5th to 8th-grade girls will complete questionnaires and physical measures at baseline and post-intervention (n = 50 per school). Minutes of moderate to vigorous physical activity will be assessed with accelerometers. Cardiovascular fitness will be assessed by estimating VO2 max with PACER (Progressive Aerobic Cardiovascular Endurance Run) scores. Height and weight will be assessed to calculate body mass index. Percent body fat will be estimated with a foot-to-foot bioelectric impedance scale. Linear mixed effects regression analyses will be performed to assess intervention effects. Discussion: This multi-component approach is expected to improve girls’ moderate to vigorous physical activity and related physical outcomes

Physical Activity Research in Nursing

Purpose: To present exemplars of physical activity research in nursing, illustrate the importance of physical activity research across the lifespan, and recommend directions for theory development and research. Methods: Studies of physical activity and exercise currently being conducted by nurse investigators were reported and critiqued by attendees of the Midwest Nursing Research Society 2000 Preconference session entitled “Promoting Physical Activity Among Diverse Groups Across the Health Continuum.” Physical activity and exercise literature during the past decade was reviewed. Databases searched included Medline, CINAHL, Wilson, and ERIC. Findings: Investigators have emphasized the need to evaluate the effects of theory-based physical activity interventions designed to alter key correlates of physical activity identified through descriptive research. Conclusions: Regular physical activity is necessary for health promotion and disease prevention for all populations. Continued research in this important area of health behavior is critical to identify the most effective interventions to increase physical activity among diverse populations

Effects of the Girls on the Move randomized trial on adiposity and aerobic performance (secondary outcomes) in low-income adolescent girls

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/151987/1/ijpo12559_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/151987/2/ijpo12559.pd

Biological and Sociocultural Differences in Perceived Barriers to Physical Activity

BACKGROUND:Inadequate physical activity (PA) contributes to the high prevalence of overweight and obesity among U.S. adolescent girls. Barriers preventing adolescent girls from meeting PA guidelines have not been thoroughly examined. OBJECTIVES: The threefold purpose of this study was to (a) determine pubertal stage, racial/ethnic, and socioeconomic status (SES) differences in ratings of interference of barriers to PA; (b) examine relationships between perceived barriers and age, body mass index, recreational screen time, sedentary activity, and PA; and (c) identify girls\u27 top-rated perceived barriers to PA. METHODS: Girls (N = 509) from eight Midwestern U.S. schools participated. Demographic, pubertal stage, perceived barriers, and recreational screen time data were collected via surveys. Height and weight were measured. Accelerometers measured sedentary activity, moderate-to-vigorous PA (MVPA), and light plus MVPA. RESULTS: Girls of low SES reported greater interference of perceived barriers to PA than those who were not of low SES (1.16 vs. 0.97, p = .01). Girls in early/middle puberty had lower perceived barriers than those in late puberty (1.03 vs. 1.24, p \u3c .001). Girls\u27 perceived barriers were negatively related to MVPA (r = -.10, p = .03) and light plus MVPA (r = -.11, p = .02). Girls\u27 top five perceived barriers included lack of skills, hating to sweat, difficulty finding programs, being tired, and having pain. DISCUSSION: Innovative interventions, particularly focusing on skill development, are needed to assist girls in overcoming their perceived barriers to PA