Bill Buron

Community-Driven Research Agenda to Reduce Health Disparities.

This paper describes how a new regional campus of an academic health center engaged in a community‐based participatory research (CBPR) process to set a community‐driven research agenda to address health disparities. The campus is situated among growing Marshallese and Hispanic populations that face significant health disparities. In 2013, with support from the Translational Research Institute, the University of Arkansas for Medical Sciences Northwest began building its research capacity in the region with the goal of developing a community‐driven research agenda for the campus. While many researchers engage in some form of community‐engaged research, using a CBPR process to set the research agenda for an entire campus is unique. Utilizing multiple levels of engagement, three research areas were chosen by the community: (1) chronic disease management and prevention; (2) obesity and physical activity; and (3) access to culturally appropriate healthcare. In only 18 months, the CBPR collaboration had dramatic results. Ten grants and five scholarly articles were collaboratively written and 25 community publications and presentations were disseminated. Nine research projects and health programs were initiated. In addition, many interprofessional educational and service learning objectives were aligned with the community‐driven agenda resulting in practical action to address the needs identified.

Diabetes and Hypertension in Marshallese Adults: Results from Faith-Based Health Screenings

BackgroundThe Pacific Islander population in the USA is growing rapidly. However, research on Pacific Islanders in the USA is limited, or sometimes misleading due to aggregation with Asian Americans. This project seeks to add to the dearth of health literature by conducting a health assessment of Marshallese in northwest Arkansas.MethodsUsing a community-based participatory research approach, nine health screening events were conducted at local Marshallese churches. Participants completed the Behavioral Risk Factors Surveillance Survey core questionnaire and diabetes module if applicable. Biometric data, including Hemoglobin A1c, blood pressure, and body mass index, were gathered by an interprofessional team.ResultsFour hundred one participants completed health screenings. High proportions of diabetes, obesity, and hypertension were found. A high percentage of participants were uninsured, and multiple barriers to health care were found within the sample.DiscussionThis project represents one of the first broad health assessments of Pacific Islanders in the USA. Proportions of diabetes, hypertension, obesity, and uninsured found in the sample are much higher than national proportions.

Trends and Opportunities in Geropsychiatric Nursing: Enhancing Practice Through Specialization and Interprofessional Education

Forecasted changes in the demographics of the United States suggest there will be an unprecedented need for health care professionals with specific training in geropsychiatric care. An aging society, the dearth of geropsychiatric health care professionals, the shortage of educators, and the lack of interprofessional geropsychiatric education require new strategies for nursing education to address these issues. The vision of the Institute of Medicine serves as a foundation for transforming geropsychiatric nursing and interprofessional education to prepare the next generation of nurses and the geropsychiatric workforce to improve the mental health care of older adults. This article aims to describe the importance and implications of implementing the recently released Geropsychiatric Nursing Competency Enhancements and the Core Competencies for Interprofessional Collaborative Practice to improve the mental health care of older Americans. A secondary aim is to discuss how to overcome barriers in implementing interprofessional education in geropsychiatric nursing care.

The Current State of U.S. Geropsychiatric Graduate Nursing Education Results of the National Geropsychiatric Graduate Nursing Education Survey

Advanced Practice Registered Nurses (APRNs) must be prepared to care for the rapidly increasing numbers of older adults with mental health needs. All 363 graduate nursing programs in the United States were surveyed regarding the nature and extent of geropsychiatric nursing (GPN) content across program curricula and their perceptions of the influence that the APRN Consensus Model has exerted on preparing the next generation of APRNs to meet the growing needs of the older adult population. Of the 202 schools responding, 138 reported GPN content in one or more clinical programs, with the majority of content in non-PMHNP programs. Only 17 schools reported offering a GPN program, track, or minor. The majority of schools (n = 169) perceived that they were adequately well-prepared to meet the APRN Consensus Model’s guidelines regarding inclusion of aging-related didactic and clinical educational experiences in all APRN education programs; nearly two thirds (n = 132) perceived a moderate to significant influence of the Consensus Model on institutional infusion of GPN into curricula. Compared with a similar survey 10 years ago, there was little change in the proportion of schools reporting GPN in clinical programs and few schools provide GPN programs, tracks, or minors. Implications for nursing education and practice are discussed.

The Southern states: NPs made an impact in rural and healthcare shortage areas

Purpose:To investigate the distribution of nurse practitioners (NPs) in the U.S. Southern region with a focus on rural and underserved areas. Described in this study are the NP characteristics and their workforce distribution relative to rural and health professional shortage areas (HPSAs). Data sources:Method: A questionnaire was administered to NPs in 12 Southern states. Other data sources included (a) the Health Resources and Services Administration, which identified HPSAs; and (b) data from the U.S. Census Bureau, to distinguish urban and rural areas. Conclusions:Approximately 72% of NPs worked in HPSAs and less than half of the NPs worked in the rural area. Family NPs were more likely to practice in rural and HPSAs. Employment in primary care was more likely to occur in rural and HPSAs. Racial diversity was almost nonexistent within the NP population. Implication for practice:This research does demonstrate that NPs are practicing in rural and underserved areas as conceived decades ago, but there is still a great demand and gap to fill. To optimize their effectiveness, NPs need to practice to the full extent of their education. Additionally, more research and strategies to help diversify the workforce is needed.

Integrating Geropsychiatric Nursing and Interprofessional Collaborative Practice Competencies Into Adult-Gerontology Clinical Nurse Specialist Education.

Specific changes to the national clinical nurse specialist (CNS) certification are necessitating a move away the psychiatric/mental health (P/MH) CNS population focus. However, a rapidly increasing older adult population with P/MH comorbidities such as depression and anxiety means that the adult-gerontology CNS (AGCNS) will likely be coordinating much of the complex care needs of this vulnerable population. Therefore, strategies are needed to ensure AGCNSs are competent in advanced practice P/MH nursing. In addition, at this critical time in the redesign of healthcare, the Institute of Medicine has made interprofessional practice center stage for healthcare professional education. Therefore, the purpose of this manuscript is to propose aligning the current AGCNS population-focused competencies with the CNS geropsychiatric nursing competency enhancements and interprofessional collaborative practice education competencies. Examples of the proposed alignment and educational application strategies are presented. When AGCNS educational curricula encompass P/MH nursing at an advanced level from an interprofessional perspective, future AGCNSs will continue to be positioned to make significant contributions to the design of care systems and monitor and trend important outcomes, while ensuring safe and efficient, high-quality healthcare for older adults with P/MH comorbidities.

Hartford Gerontological Nursing Leaders: From Funding Initiative to National Organization

In 2000, the John A. Hartford Foundation established the Building Academic Geriatric Nursing Capacity Program initiative, acknowledging nursings key role in the care of the growing population of older adults. This program has supported 249 nurse scientists with pre- and postdoctoral awards. As a result of the programs success, several Building Academic Geriatric Nursing Capacity Program awardees formed an alumni organization to continue to advance the quality care of older adults. This group of Building Academic Geriatric Nursing Capacity Program awardees joined others receiving support from the John A. Hartford Foundation nursing initiatives to grow a formal organization, the Hartford Gerontological Nursing Leaders (HGNL). The purpose of this article is to present the development, accomplishments, and challenges of the HGNL, informing other professional nursing organizations that are experiencing similar accomplishments and challenges. This article also demonstrates the power of a funding initiative to grow an organization dedicated to impact gerontological health and health care through research, practice, education, and policy.