Asthma management: an ecosocial framework for disparity research

Background: Asthma management disparities (AMD) between African and White Americans are significant and alarming. Various determinants have been suggested by research frameworks that affect the unfair distribution of resources for asthma management to groups who are more or less advantaged socially. Ecosocial models organize determinants into individual/family, healthcare, community, and sociocultural levels. Multilevel interventions can affect AMD through simultaneous actions on different levels and pathways between determinants. Objective: Provide a comprehensive summary of the known determinants of AMD. Method: Peer reviewed research frameworks of AMD from 1998-2009 were retrieved from PubMed/ Web of Science databases using (“Socioeconomic Factors”[Mesh] OR (“Healthcare Disparities”[Mesh] OR “Health Status Disparities”[Mesh])) AND “Asthma”[Mesh] AND “African Americans”[Mesh] OR “Ethnic Groups”[Mesh]). Abstracts assessed for a focus on AMD, and determinants. Articles were analyzed for ecosocial levels and determinants. Results: 13 research frameworks described 34 determinants. Compared to other levels, Individual/family levels had the most emphasis, and frameworks using healthcare and community levels were the most narrow in focus. Stress, poverty, violence/crime, quality of care, healthcare access, and indoor air quality were well described determinants. Conclusions: Multilevel investigations should include those well described determinants of AMD and increase knowledge of pathway interactions between healthcare and community levels

An exploration of social justice intent in photovoice research studies from 2008 to 2013

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/108344/1/nin12064.pd

Asthma Management Disparities: A Critical Analysis of the Discourses of African American Adolescent and Public Health Stakeholders in Washington State

Purpose: This dissertation describes the discourses of asthma management disparities (AMD) used by African American adolescents in King County and Washington State Asthma Planning (WSAP) stakeholders

Uniting Action Research and Citizen Science: Examining the Opportunities for Mutual Benefit Between Two Movements Through a Woodsmoke Photovoice Study

As an emerging movement in participatory inquiry, citizen science presents an opportunity for advancing the disciplinary reach and usefulness of action research. In this article, we explore this opportunity by considering a case study involving youth-driven air sampling, photovoice, and environmental justice in the Pacific Northwest. When combined with photovoice as an action research method, citizen scientists can be empowered through collective learning to transform themselves from data collectors into builders of community knowledge and generators of policy change

Asthma Management in Educational Settings: Implementing Guideline-Based Care in Washington State Schools

Managing asthma in the schools is complex and requires careful planning. This article highlights key steps in implementing guideline-based care for children with asthma in Washington State schools: assessing students, establishing acuity, communicating with parents, and training staff. Advance planning can improve outcomes for students, parents, and school staff in managing this complex and prevalent disease. NASN recently developed asthma management guidelines. Developing state-specific guidelines provides an opportunity to speak specifically to state laws and nurse practice acts while also reinforcing the importance of specialized practice to school nurses, school administrators and teachers, parents, and students

Opportunities in the Integration of Primary Care and Public Health Nursing: Two Case Exemplars on Physical Activity and Nutrition

OBJECTIVE: The integration of primary care and public health nursing may provide new opportunities for transforming nursing practice that addresses population health. Effective programs emphasize multilevel approaches that include both downstream (education) and upstream (policy change) actions. The purpose of this article is to identify downstream and upstream nursing actions that integrate public health and primary care practice through two case exemplars concerning disparities in physical activity and nutrition. METHODS: Describe two research case exemplars: (1) a secondary analysis of school physical activity policy for female adolescents in 36 public middle schools and (2) a focus group study of African American adults in a community kitchen program. RESULTS: In exemplar 1, school policies lacked population-based standards and presented structural disadvantages to African American girls who were already obese. In exemplar 2, participants found the community kitchen program to be more effective than the federally funded nutrition program. DISCUSSION: Integrating primary care and public health nursing could improve the tailoring of physical activity and nutrition programs to local populations by following core principles of community engagement, infrastructural sustainability, aligned leadership, and data sharing for population health improvement

An Exploration of Social Justice Intent in Photovoice Research Studies from 2008 to 2013

In an age where digital images are omnipresent, the use of participant photography in qualitative research has become accessible and commonplace. Yet, scant attention is paid to the social justice impact of photovoice amongst studies that have used this innovative method as a way to promote social justice. There is a need to review this method to understand its contributions and possibilities. This literature review of photovoice research studies (i) explores whether authors implicitly or explicitly related the methodologies to their aims of promoting social justice (methodology-method fit) and (ii) outlines the social justice research impact of photovoice findings using the framework of social justice awareness, amelioration and transformation. PubMed, Scopus, PsycINFO and Web of Science databases were searched from the years 2008-13 using the following keywords: photovoice; photonovella; photovoice and social justice; and photovoice and participatory action research. Of the 30 research studies reviewed, only thirteen identified an underlying methodology guiding the photovoice method. The social justice impacts emphasized were more related to social justice awareness (n = 30) than amelioration (n = 11) or transformation (n = 3). Future researchers using photovoice as a way to promote social justice are encouraged to assess and plan for the social justice impact desired

Applying Critical Discourse Analysis in Health Policy Research: Case Studies in Regional, Organizational, and Global Health

Critical discourse analysis (CDA) is a promising methodology for policy research in nursing. As a critical theoretical methodology, researchers use CDA to analyze social practices and language use in policies to examine whether such policies may promote or impede social transformation. Despite the widespread use of CDA in other disciplines such as education and sociology, nursing policy research employing CDA methodology is sparse. To advance CDA use in nursing science, it is important to outline the overall research strategies and describe the steps of CDA in policy research. This article describes, using exemplar case studies, how nursing and health policy researchers can employ CDA as a methodology. Three case studies are provided to discuss the application of CDA research methodologies in nursing policy research: (a) implementation of preconception care policies in the Zhejiang province of China, (b) formation and enactment of statewide asthma policy in Washington state of the United States, and (c) organizational implementation of employee antibullying policies in hospital systems in the Pacific Northwest of the United States. Each exemplar details how CDA guided the examination of policy within specific contexts and social practices. The variations of the CDA approaches in the three exemplars demonstrated the flexibilities and potentials for conducting policy research grounded in CDA. CDA provides novel insights for nurse researchers examining health policy formation, enactment, and implementation

Mi niño con asma : Hispanic/Latina Mothers, Environmental Justice, And Photovoice At The Front Lines Of The Asthma Epidemic

Asthma is an important environmental justice concern for first generation Mexican-Americans. Families experience disparities in housing conditions, access to care, and legal marginalization. Little is known about how Hispanic/Latina mothers of children with asthma navigate these oppressions. Problem: The purpose of this paper is to describe the discourses of environmental justice of a group Hispanic/Latina caregivers of children with asthma. Method: A photovoice design was used with Hispanic/Latina mothers (n=11) in Tacoma, Washington, to take, discuss, select and display phototexts to policymakers that communicated their experiences and opinions in managing asthma for their child. Using critical narrative analysis, phototexts were analyzed for the use of agency and structure in confronting environmental threats to asthma. Results: Participants produced 33 phototexts taking on the roles of teacher, parent, advocate, investigator, and storyteller. Narratives identified environmental threats (breathable, meteorological, medical, social, emotional, and ingestible) and promoted protective actions and social advocacy against such threats. Conclusion: Mothers\u27 actions as teachers and advocates in the phototexts provided opportunities for promoting empowerment and solidarity with others in the face of multiple environmental oppressions. Critical narrative analysis of photo-texts provided an opportunity to identify important opportunities for furthering environmental justice in new immigrant groups