The purpose of this study was to examine the feasibility of the Yoga for HEART (Health Empowerment and Realizing Transformation) Intervention to increase motivation for physical activity and improve cardiovascular health in older adults. A pilot randomized controlled trial design was used. The Intervention group received Yoga for HEART, a 12-week program to foster motivation for health behavior change. The Control group received a 12-week group yoga program that did not contain theory-based components. The intervention was based on Wellness Motivation Theory, conceptualizing health behavior change as dynamic process of intention formation and goal-directed behavior leading to the development of new and positive health patterns. Critical inputs (i.e., empowering education, motivational support, social network support) were designed to promote social contextual resources and behavioral change processes to increase motivation for physical activity and improve cardiovascular health.
Specific Aims were to: (a) examine intervention acceptability, demand, and fidelity, and (b) evaluate intervention efficacy in promoting physical activity and improving cardiovascular health through increased social contextual resources and behavioral change processes. Participants in the Intervention group realized a significant reduction in body mass index (BMI) from baseline to 12 weeks when compared to participants in the Control group. Intervention group participants demonstrated improvement in theoretical mechanisms (i.e., self-knowledge, motivation appraisal, self-regulation, environmental resources) and intended outcomes (i.e., body composition) when compared to Control group participants. Findings from this study support the feasibility of the Yoga for HEART Intervention in older adults.
This study sought to determine the nursing leadership competencies clinical managers expect of new nurses in an acute care setting and to identify gaps between end-of-program nursing leadership competencies, as outlined in The Essentials of Baccalaureate Education for Professional Nursing Practice, with leadership competencies identified by clinical managers in an acute-care setting.
A single, bounded case study approach was used to collect data from nurse managers and assistant nurse managers at one acute care hospital. Data from intensive interviews, focus groups, and archival records were analyzed. Seven major themes related to clinical leadership emerged, including intentional learning, communication, professional practice, advocacy, teamwork, influencing practice, and systems thinking. Traits, mentoring, and generational differences emerged as secondary themes.
Data from this study revealed a developmental sequence for clinical leadership. Certain expectations identified as antecedent to clinical leadership emerged initially, whereas other aspects of clinical leadership, developed later in the career trajectory. It was clear that accomplishing nursing care tasks was a fundamental expectation for professional nursing practice. Communication, teamwork and advocacy are crucial leadership competencies which help the new nurse to effectively manage time and provide safe, high-quality nursing care. As the new nurse continues to develop, systems thinking and influencing nursing practice emerge as significant expectations. Nurse managers have clear expectations for how new nurses should be prepared for clinical leadership. The degree to which clinical practice partners employing new nurses and academic nursing programs educating future nurses collaborate to establish expected outcomes is variable; however, academic-practice collaborations are crucial in developing educational standards for entry to practice in complex healthcare delivery systems.
The study used a multi-phase, multi-method approach. The first phase (alpha) of this study was a qualitative descriptive design to examine the intervention’s fidelity. Evaluation of performance was conducted by experts in the fields of MI, T1D, adolescence and/or online education. The second phase (beta) was a quantitative descriptive design conducted in order to evaluate feasibility by examining the acceptability (recruitment, retention and satisfaction) and implementation (diabetes self-management self-efficacy) to determine whether the intervention was appropriate for further testing.
First phase findings showed that the intervention passed all measures with the content experts (n = 6): it was functional, accurate, usable and secure. Improvements to the intervention were made based on reviewer recommendations. For the second phase 5 adolescents between 14 and 17 were enrolled. Three adolescents completed all 4 weeks of the intervention while 2 completed only 3 weeks. Participants (n = 3) rated satisfaction on a 5-point Likert-type scale ranging from “not at all” satisfied (1) to “very much” satisfied (5). There was a positive response to the intervention (M = 4.28, SD = 0.55). Implementation was measured by a pre- and post-test for diabetes self-management self-efficacy. Participants (n = 3) demonstrated overall improvements in diabetes self-management self-efficacy (Z = -2.952, p = .007).
Implications for further Can-Do-Tude research are planned at a metropolitan diabetes center using updated technology including an application platform. Although the sample was small, findings indicate that the intervention can be conducted using a web-based format and there is initial evidence of improvement in self-efficacy for diabetes self-management.
Muslim Arab immigrants are a fast-growing, under-studied, and underserved minority population in the United States. Little is known about breastfeeding practices and challenges facing this vulnerable population. Immigrant Muslim Arab mothers encounter breastfeeding challenges related to religion, language, different cultural beliefs, levels of acculturation, difficulties understanding health care information, and navigating the health care system.
A cross-sectional descriptive study was used to describe infant feeding practices, and identify contributors and barriers to adequate breastfeeding using the social ecological model of health promotion. A convenience sample of 116 immigrant Muslim Arab women with at least one child, 5 years or younger was recruited from a large metropolitan area in the Southwestern United States. The results indicated that immigrant Muslim Arab mothers demonstrate high breastfeeding initiation rates (99.2%), and lengthy breastfeeding duration (M=11.86), but low rates of exclusive breastfeeding at 6 months (21.6%). Facilitators to breastfeeding within the sample were high intentions to breastfeed, positive breastfeeding knowledge and beliefs related to the benefits of breastfeeding, religious teachings promoting breastfeeding, and encouragement to breastfeed from the mothers’ social support system. Several barriers to successful breastfeeding were related to lacking the specific knowledge of the benefits of breastfeeding, and discomfort with breastfeeding in public, and in front of strangers. High income and religious teachings encouraging breastfeeding were significantly associated with exclusive breastfeeding at six months. Greater maternal age and comfort with breastfeeding in public were associated with longer breastfeeding durations.
The socio-cultural context for support of breastfeeding is an important consideration by healthcare providers caring for Muslim Arab women. An ecological perspective needs to be applied to interventions targeting breastfeeding promotion to facilitate effectiveness in this population. Culturally tailored intervention to the specific breastfeeding concerns and needs of Muslim immigrant women could promote optimal breastfeeding in this population.
This study utilized a Convergent Mixed Methods design to identify different expressions of resilience in response to a health/familial problem. The research aimed to determine which specific expressions of resilience were significantly associated with higher levels of resilience. The findings revealed two significant effects related to social support and persistence as expressions of resilience. The High Resilience group exhibited a higher proportion of individuals mentioning persistence and social support in their coping strategies. The study concluded that social support seeking is a major coping strategy among individuals with high resilience and suggested that healthcare providers, particularly nurses, should recommend and provide resources for clients to seek social support. Furthermore, the role of persistence highlights the importance of encouraging clients to set achievable goals, develop a plan, and monitor their progress to remain motivated in resolving their difficult health-related problem.