Symposium Exemplar
Symposium Title: Research methods to promote the health of minority individuals, groups, and communities.
Author List:
Maren J. Coffman, Janet Wang, Tami Thomas, Carolyn Jenkins
Presenting Author:
Maren J. Coffman, PhD, RN
Assistant Professor of Nursing
University of North Carolina at Charlotte
9201 University City Blvd
Charlotte, NC 28223
Ph/Fax: 704-687-7979/866-298-0360
Email:
Additional Author:
Janet F. Wang, PhD, RN, FAAN
Professor, School of Nursing
West Virginia University
Morgantown, WV 26506-9610
Ph/Fax: 304-293-1596/304-293-2546
Email:
Additional Author:
Tami Thomas, PhD, CPNP, RNC
Robert Wood Johnson Foundation Nurse Faculty Scholar
Assistant Professor of Nursing
Medical College of Georgia
3002 Vassar Drive
Augusta, GA 30909
Ph: 706-993-5650
Email:
Additional Author:
Carolyn Jenkins, DrPH, APRN-BC-ADM, RD, LD, FAAN
Professor and Ann Darlington Edwards Endowed Chair
College of Nursing
Medical University of South Carolina
99 Jonathan Lucas MSC 160
Charleston, SC 29464
Ph/Fax: 843-792-4625/843-792-5822
Email:
Presentation Preference: Competitive Symposium
Abstract Categories:
Research Interest Groups (RIGs): Minority Health
Abstract Overview:
There is a profound disparity in the health status of racial and ethnic minorities including African American, Aisan, and Latino. In the US, these minority groups have higher mortality, higher incidence of chronic diseases, and poorer health outcomes. In order to address these disparities, women and minority groups need to be equally represented in research. The purpose of this symposium is to present research methods that promote the health of minority individuals, groups, and communities. Findings from four original research studies will be highlighted including: 1) recruiting and retaining Latina women with diabetes in intervention research, 2) assessing the cross-cultural equivalence of an English and Chinese language measure of pregnancy stress, 3) developing and testing an instrument to examine correlates of HPV vaccination in urban and rural Southeastern US counties, and 4) using community-based participatory action to implement and evaluate the Expanded Community Chronic Care Model in African Americans with diabetes. To eliminate health disparities, vulnerable individuals, groups, and communities must engage in preventive practices and have access to quality health care services. Health care providers need culturally relevant and effective interventions, measures that are valid across cultural groups, and supportive policies and systems.
Abstract 1: Recruitment and Retention of Latina Women with Diabetes for a Short-Term Diabetes Self-Management Intervention (2,213)
Presenting Author:
Maren J. Coffman PhD, RN
Assistant Professor of Nursing
University of North Carolina at Charlotte
9201 University City Blvd
Charlotte, NC 28223
Ph/Fax: 704-687-7979/866-298-0360
Email:
Abstract:
Introduction: The challenges of recruiting, engaging, and retaining Latino participants in preventive interventions are substantial. The purpose of this study was to evaluate recruitment and retention in a short-term diabetes self-management intervention designed for Latina women with diabetes.
Methods: After IRB approval was obtained, Latina women with self-reported type 2 diabetes (N = 27) were recruited for a 2-week diabetes self-management intervention. Four sessions were scheduled; five to ten women attended each session. The women were taught to increase vegetable intake, use pedometers, and complete daily nutrition and physical activity logs. The program had a 96% completion rate. After the intervention, a semi structured telephone survey was conducted by a bilingual research assistant. The survey included 5-point Likert type and open-ended questions regarding recruitment and retention. Numerical data were analyzed by calculating means and standard deviations. Qualitative data were analyzed and grouped into common themes.
Results: Of the 26 participants who completed the intervention, 23 participated in the telephone survey. Two community agencies that served as research sites recruited 16 participants through direct invitation or flyer placement, community contacts recruited 7 participants, and snowballing yielded 3 participants. A free community events newspaper advertisement yielded 2 participants and a paid newspaper advertisement was not productive. The women felt they were treated with respect (M = 4.9), were very satisfied with the educational content (M = 5.0), and with the classes overall (M = 4.9). According to the open ended questions, 15 of the women stated that they enjoyed learning from their peers, making new friends, and feeling that they were not alone in their struggles. Three women expressed gratitude to the researchers for listening to them and demonstrating concern. Six women stated that they liked the materials and how the information was taught, another 6 women stated that they enjoyed learning nutrition management concepts, and 3 women liked the physical activity education and pedometers.
Discussion/Conclusion: Recruitment and retention strategies appeared to be effective. Using informal and familiar methods to recruit Latino participants may be most useful. The retention rate suggests interest in diabetes education and short-term interventions may be an effective approach. Though this intervention was limited in duration, it established acceptability of pedometers and logs in this population and demonstrated a need for future study.
Abstract History: This abstract has not been presented or accepted for presentation in whole or in part at the SNRS or other scientific meeting.
Financial Disclosure: The author has received grant funding from the Robert Wood Johnson Foundation; otherwise, no other financial interests or stock in a commercial company of institution related directly or indirectly to the subject of this presentation has been received
FDA Disclosure:
I will not be describing any pharmaceutical and/or medical device.
Non-Exclusive License: None
Abstract 2: Factor Structure of the Wang-34 Scale among Pregnant Women in China (2,155 characters)
Presenting Author:
Janet F. Wang, PhD, RN, FAAN
Professor, School of Nursing
West Virginia University
Morgantown, WV 26506-9610
Ph/Fax: 304-293-1596/304-293-2546
Email:
Abstract:
Introduction: Stress during pregnancy has a great influence on a woman’s subsequent adaptation to outcomes of childbirth and delivery. Primary prevention of pregnancy stress should emerge from a knowledge and understanding of the culture of interest so that health interventions are culturally appropriate. This study investigates the psychometric properties of the Wang-34 Scale in a sample of pregnant women in Beijing, China. The research questions of this study were: (1) is there evidence of cross-cultural equivalency in concepts and language in English and Chinese versions in the Wang-34 Scale?; (2) Is the Wang-34 Scale a reliable and valid tool to measure constructs of pregnancy stress in Chinese women?
Methods(s): This study was a cross-sectional, descriptive, and correlation study. The study was approved by West Virginia University Institutional Review Board. Data were collected in three hospital obstetric and gynecological clinics in Beijing, China. A total of 685 pregnant women voluntarily participated in the study. Criteria for participating in the study were that the women were (a) pregnant, (b) had no medical problems, and (c) were able to speak and read the Chinese language. Data were collected using the Wang-34 Scale.Translation and back translation were conducted by three bilingual researchers to determine the conceptual and language equivalency for cross-cultural study in pregnant women in China In order to test the Wang-34 Scale, exploratory factor analysis (EFA) and internal consistency reliability were used to examine the performance of the Wang-34 Scale.
Results: Three and-four-factor structures emerged for the Wang-34 Scale and the overall internal reliability of the Wang-34 Scale, as measured by Cronbach’s alpha is 0.905 for total scale, with alpha ranging from 0.76 to 0.88 for the subscales. The results support the construct validity of the Wang-34 Scale’s translation and scoring of the stress items.
Discussion/Conclusion:The development of the Wang-34 Scale is an important step to test and measure stress during pregnancy in Chinese women. Further studies using diverse cultural groups to investigate pregnancy stress scales should be conducted for further validating the cultural relevancy of the instrument, particularly, if it is being considered for use with other cultural groups. The Wang-34 Scale is an improved, valid, and reliable measure of pregnancy stress and can be used to prioritize interventions aimed at preventing and reducing stress during pregnancy.
Abstract History: This abstract has not been presented or accepted for presentation in whole or in part at the SNRS or other scientific meeting.
Financial Disclosure: No, I (or a member of my immediate family) have not received something of value* from or own stock (or stock options) in a commercial company or institution related directly or indirectly to the subject of my presentation.
FDA Disclosure: I will not be describing any pharmaceutical and/or medical device.
Non-Exclusive License: None
Abstract 3: Survey Methods in English and Spanish for Minority Groups in Isolated and Urban Settings (2,218)
Presenting Author:
Tami Thomas, PhD, CPNP, RNC
Robert Wood Johnson Foundation Nurse Faculty Scholar
Assistant Professor of Nursing
Medical College of Georgia
3002 Vassar Drive
Augusta, GA 30909
Ph: 706-993-5650
Email:
Abstract:
Introduction: Many minority groups suffer disproportionally from both health and geographic disparities putting these individuals and their families at risk for poor health outcomes such as cancer. The human papillomavirus (HPV) vaccine was approved in 2006 to prevent cervical cancer for all women. But the prevalence of HPV infection and subsequent cervical cancer rates continue to increase in African American and Latina women. The combination of a greater incidence of cervical cancer in rural African Americans and urban Latinas make these women an essential group to protect against HPV infection and subsequent cervical cancer because in many cases they experience both geographic and health disparities. Until 2007, no survey was available to evaluate knowledge or determine correlates of HPV vaccination in both English and Spanish. The purpose of this presentation is to describe the systematic development of an effective HPV survey tool to assess educational needs of parents, increase HPV vaccine uptake and decrease HPV related cancers such as cervical cancer in minority populations that may be hidden in both rural and urban areas.
Methods: A 41- item survey was developed in both English and Spanish to screen for correlates of HPV vaccination. The survey items were generated from literature review and mapped upon constructs from both the Theory of Reasoned Action and the Health Belief Model. The survey was then piloted in both languages and then revised to collect data in a cross sectional descriptive study. After community engagement was initiated, 218 African American, Latino and Caucasian parents living in two isolated rural counties and one urban county were surveyed using the HPV survey in either English or Spanish. All statistical analyses were performed using SAS 9.2 and statistical significance was assessed using an alpha level of 0.05. Descriptive statistics were calculated for all variables. Cronbach’s alpha was determined for the entire questionnaire, excluding demographic items, and for specific subscales of interest.
Results /Discussion: The overall Cronbach’s alpha for the Spanish survey was quite high, r=0.8277 and for the English survey, the Cronbach’s alpha was very high, 0.9652. Subscales included were Knowledge, Perceived Severity, Vulnerability, Barriers and Benefits. An item analysis was conducted and those items with a low Cronbach’s alpha were eliminated with subsequent survey revisions. The survey has now been translated into Creole and is being used in additional descriptive research and can also serve as a screening tool for nurses in primary care settings.
Abstract History: This abstract has not been presented or accepted for presentation in whole or in part at the SNRS or other scientific meeting.
Financial Disclosure: The author has received grant funding from the Robert Wood Johnson Foundation, Sigma Theta Tau International and the Florida Nurses Association; otherwise, no other financial interests or stock in a commercial company of institution related directly or indirectly to the subject of this presentation has been received
FDA Disclosure: I will not be describing any pharmaceutical and/or medical device.
Non-Exclusive License: None
Abstract 4: Processes and Progress in Implementing the Expanded Community Care Model for Improving Diabetes Outcomes in an African American Community (2,250)
Presenting Author:
Carolyn Jenkins, DrPH, APRN-BC-ADM, RD, LD, FAAN
Professor and Ann Darlington Edwards Endowed Chair
College of Nursing
Medical University of South Carolina
99 Jonathan Lucas MSC 160
Charleston, SC 29464
Ph/Fax: 843-792-4625/843-792-5822
Email:
Abstract:
Introduction: Racial and Ethnic Approaches to Community Health (REACH) across the U.S. is a Centers for Disease Control and Prevention funded program that focuses on reducing disparities for one or more racial and ethnic groups (African Americans, American Indians & Alaska natives, Asian Americans, Hispanics/Latinos, or Native Hawaiians/Pacific Islanders) related to one or more health problems (adult immunizations, AIDS/HIV, breast & cervical cancer, cardiovascular disease, diabetes, and/or infant mortality). The South Eastern African American Center of Excellence (SEA-CEED) is the only CEED (out of 18 nationwide) focused on decreasing disparities in African Americans at risk or with diabetes. The purpose of this presentation is to describe the processes and outcomes of community-based participatory action to implement and evaluate the conceptual model of action, Expanded Community Chronic Care Model.
Method(s): Mixed methods were used to identify academic and community partners’ priorities for decreasing disparities. Annual epidemiological and survey data were analyzed to identify yearly diabetes related statistics while key informant interviews and focus groups identified community needs, assets, and challenges. Data were then further analyzed, and a conceptual model and plan of action developed and implemented.
Results: The Expanded Chronic Care Model with prepared, proactive community and health systems, and informed activated community members along with social, health and economic policies and actions are needed to improve community-wide outcomes and eliminate disparities. Significant progress has been made with improved collaboration and services. Diabetes care has significantly improved in 5 health systems and countywide amputations reduced by approximately 50 percent. Several health policies for improving care were implemented.
Discussion/Conclusions: Although progress has been made, many challenges remain especially related to diabetes complications. However, the Expanded Community Chronic Care Model is an effective conceptual model for planning, implementing, and evaluating community interventions.
Abstract History: This abstract has not been presented or accepted for presentation in whole or in part at the SNRS or other scientific meeting.
Financial Disclosure: The authors have received grant funding from the Centers for Disease Control and Prevention; otherwise, no other financial interests or stock in a commercial company of institution related directly or indirectly to the subject of this presentation has been received.
FDA Disclosure: I will not be describing any pharmaceutical and/or medical device.
Non-Exclusive License: None