Donna J. Biederman

Maternal Navigational Strategies: Examining Mother-Daughter Dyads in Adolescent Families of Color

Mother—daughter relationships are critical to the health and well-being of adolescent girls. Understanding mothers’ and daughters’ perspectives on the relationship can inform health promotion strategies that may benefit both. In-depth semistructured interviews were conducted with mothers (N = 12) and their adolescent daughters (N = 16). Narrative profiles were constructed to identify participants’ perceptions of each other and the relationship. Profiles were condensed into analytic poems that were compared and contrasted across roles and within and across dyads. Maternal navigational strategies of protection and preparation, and subthemes of maternal self-protection and daughter reverse protection emerged. The fabric of maternal strategies changed by girls’ developmental stage, with mothers of older daughters describing an interweaving of protection and preparation. Suggestions for future family nursing and health promotion research and campaigns are provided.

Coalition Building for Health: A Community Garden Pilot Project with Apartment Dwelling Refugees

Refugees often experience compromised health from both pre- and postmigration stressors. Coalition theory has helped guide the development of targeted programs to address the health care needs of vulnerable populations. Using the Community Coalition Action Theory as a framework, a coalition was formed to implement a community garden with apartment-dwelling refugees. Outcomes included successful coalition formation, a community garden, reported satisfaction from all gardeners with increased vegetable intake, access to culturally meaningful foods, and evidence of increased community engagement. The opportunity for community health nurses to convene a coalition to affect positive health for refugees is demonstrated.

Homeless Women's Experiences of Service Provider Encounters

Service providers are gatekeepers to health-sustaining services and resources, although little is known about service encounters from the perspective of homeless women. We conducted in-depth semistructured interviews with 15 homeless women to better understand their experiences of service encounters. Using a phenomenological method, 160 significant statements were extracted from participant transcripts; more positive than negative interactions were reported. The 10 themes that emerged fall along a dehumanizing/humanizing continuum primarily separated by the power participants experienced in the interaction and the trust they felt in the service provider. Implications for nursing practice and research are offered.

Assessing the Need for a Medical Respite: Perceptions of Service Providers and Homeless Persons

For homeless persons, posthospitalization care is increasingly provided in formal medical respite programs, and their success is now reported in the literature. However, there is a dearth of literature on posthospitalization transitional care for homeless persons in the absence of a respite program. Through this formative study, we sought to understand the process of securing posthospitalization care in the absence of a formal homeless medical respite. Results demonstrated a de facto patchwork respite process that has emerged. We describe both human and monetary costs associated with patchwork respite and demonstrate opportunities for improvement in homeless health care transitions.

Homeless women's experiences of social support from service providers

Purpose – The purpose of this paper is to examine homeless womens interactions with service providers and the degree to which these interactions are perceived as social support. Design/methodology/approach – Using a phenomenological approach, in-depth semistructured interviews were conducted with 15 homeless women recruited through a drop-in day shelter and a winter emergency shelter. Findings – Analysis revealed being “cared for” was experienced within service provider encounters and is commensurate with widely recognized sub-categories of received social support. Participants expressed expanded definitions of service providers and made clear distinctions between routine support expected from a provider and received social support, or being “cared for” by providers. Research limitations/implications – Studies with homeless persons that exclude service providers as a potential source of social support for homeless women or impose predetermined definitions of service provision may not be capturing the ful...

Ethnic and Racial Differences of Baseline Stroke Knowledge in a “Stroke Belt” Community

Acute stroke is often a treatable condition; however, intervention is time dependent and typically should ensue within 3 hr from onset of symptoms. The ability of individuals to understand stroke risk factors to reduce individual risk and to recognize warning signs and symptoms of stroke as signals to initiate medical care is paramount to decreasing stroke-related morbidity and mortality. This descriptive study presents ethnic and racial differences of baseline stroke knowledge among residents (n = 1,904) of two North Carolina counties situated in the Stroke Belt. Findings suggest a global stroke knowledge deficit that is more pronounced among Hispanics. Future community stroke education campaigns need to consider various educational mediums and outlets to ensure inclusion of persons at highest risk for stroke. Suggestions are provided for possible content of future stroke knowledge and prevention campaigns.

Promising research and methodological approaches for health behavior research with homeless persons

Abstract High-risk health behaviors have high prevalence among homeless persons prompting substantial research on health behavior and behavior change strategies within the population. Previously, much of this research focused solely on the target behavior without consideration of contextual factors that may contribute to the behavior or that may inhibit behavior change. We describe three overlapping trends in homeless health behavior research – longitudinal, qualitative, and participatory – which consider the link between the context of homelessness and health behavior. These approaches contribute to the understanding of the social determinants of health behavior and health and demonstrate opportunities for intervention beyond the individual level.

Desired Destinations of Homeless Women: Realizing Aspirations Within the Context of Homelessness

Despite recent decreases, homelessness remains a substantial problem in the United States. Homelessness is associated with poor health, and homeless women experience earlier mortality than their housed counterparts. Understanding the aspirations of homeless women may offer service providers avenues for intervention to increase well-being among this vulnerable population. This study, a secondary analysis of transcribed interviews (n = 20), provides insight into the aspirations of homeless women. Opportunities for service providers to intervene on these aspirations within the context of homelessness are offered.

Ending HIV-Related Stigma: Nursing's Opportunity to Lead

Michael V. Relf, PhD, RN, AACRN, ACNS-BC, CNE, FAAN, is an Associate Professor and the Associate Dean for Global & Community Affairs at the Duke University School of Nursing in Durham, North Carolina, USA. D. Dennis Flores, MSN, RN, ACRN, is a doctoral student at the Duke University School of Nursing in Durham, North Carolina, USA. Donna J. Biederman, DrPH, RN, is an Assistant Professor at the Duke University School of Nursing in Durham, North Carolina, USA. Throughout history, persons living with a communicable disease have been labeled as deviants, ostracized, shunned by society, and even quarantined. In her classic book, AIDS and Its Metaphors, Susan Sontag (1998) asserted that HIV . ‘‘whose charge of stigmatization, whose capacity to create a spoiled identity’’ (p. 16) is far greater than any disease before it. HIV has made clear, like many prior communicable diseases, the complex intersection of culture, law, ethics, and science that has shaped the pandemic we know today (Brandt, 1988). Therefore, whether working in one of the urban HIV epicenters, in rural America, or around the globe, nurses working with persons living with HIV must maneuver around stigma due to misinformation, ignorance, and fear. In June 2015, the HIV epidemic will enter its 34th year. Despite enormous advances over the years, one thing has not really changed – the stigma associated with HIV. In 1982, the United States public was first introduced to HIV through the NBC nightly news. The early newscasts and other early news reports that followed shaped the epidemic we know today by focusing on the ‘‘mysterious disease’’ (Colby & Cook, 1991, p. 224), emphasizing that it was ‘‘deadly’’ (Colby & Cook, 1991, p. 224) while assigning blame, indicating ‘‘gay responsibility for the disease’’ (Colby & Cook, 1991, p. 228). By June 1983, ABC News reported, ‘‘fighting the fear of AIDS, it seems, is as important as fighting the disease itself’’ (Colby & Cook, 1991, p. 232), highlighting the

Organizational Culture and University Responses to Parenting Students: A Case Study

This case study examines implications of a university’s culture on advocating for supportive policies and programs for parenting students. Four themes illuminated several key tensions within the institution that affected support for parenting students: the lack of formal policy, an emphasis on faculty practices around accommodations, concerns about differential treatment, and the problematization of parenting students. Findings are used to suggest future avenues for investigation and advocacy strategies that incorporate organizational culture.