Janet Fraser Hale

Lifestyle behaviours and weight among hospital-based nurses

AIMS The purpose of this study was to (i) describe the weight, weight-related perceptions and lifestyle behaviours of hospital-based nurses, and (ii) explore the relationship of demographic, health, weight and job characteristics with lifestyle behaviours. BACKGROUND The obesity epidemic is widely documented. Worksite initiatives have been advocated. Nurses represent an important part of the hospital workforce and serve as role models when caring for patients. METHODS A sample of 194 nurses from six hospitals participated in anthropometric measurements and self-administered surveys. RESULTS The majority of nurses were overweight and obese, and some were not actively involved in weight management behaviours. Self-reported health, diet and physical activity behaviours were low, although variable by gender, age and shift. Reports of co-worker norms supported low levels of healthy behaviours. CONCLUSIONS Findings reinforce the need to address the hospital environment and culture as well as individual behaviours for obesity control. IMPLICATIONS FOR NURSING MANAGEMENT Nurse managers have an opportunity to consider interventions that promote a climate favourable to improved health habits by facilitating and supporting healthy lifestyle choices (nutrition and physical activity) and environmental changes. Such efforts have the potential to increase productivity and morale and decrease work-related disabilities and improve quality of life.

Step Ahead A Worksite Obesity Prevention Trial Among Hospital Employees

BACKGROUND The worksite represents a promising venue in which to address the issue of obesity. DESIGN Pair-matched, cluster-RCT. Data were collected from 2005 to 2008 and analyzed in 2008. SETTING/PARTICIPANTS A random sample of 806 employees was selected to represent the workforce of six hospitals in central Massachusetts. INTERVENTION The 2-year ecologic intervention sought to prevent weight gain through changes in worksite weight-related norms using strategies targeted at the organization, interpersonal environment, and employees. MAIN OUTCOME MEASURES The primary outcome was change in BMI at the 12- and 24-month follow-ups. Change in perceptions of organizational commitment to employee health and normative coworker behaviors were secondary outcomes. RESULTS There was no impact of the intervention on change in BMI from baseline to 12 (beta=0.272; 95% CI=-0.271, 0.782) or 24 months (beta=0.276; 95% CI=-0.338, 0.890) in intention-to-treat analysis. When intervention exposure (scale=0 to 100) was used as the independent variable, there was a decrease of 0.012 BMI units (95% CI=-0.025, 0.001) for each unit increase in intervention participation at the 24-month follow-up. Employees in intervention sites reported significantly greater improvements in perceptions of organizational commitment to employee health at 12 and 24 months compared to control sites, but there was no impact on perceptions of normative coworker behaviors. CONCLUSIONS The intervention had a dose-response relationship with BMI, with positive effects proportional to extent of participation. Although the intervention was able to change organizational perceptions, successfully improving changes in actual and perceived social norms may be needed to achieve population-level impact in complex worksite organizations.

Correctional Health Curriculum Enhancement Through Focus Groups

Background: Little has been published describing curricular experiences in correctional health (CH). Purposes: Our goal is to articulate a curriculum cognizant of the special needs of the correctional health care worker. Methods: We conducted focus groups with nurses, nurse practitioners, physician assistants, and physicians focused on content crucial to prepare competent medical professionals committed to careers in correctional health. Results: Six main themes emerged from the data, which were used to confirm and add to the growing curriculum on correctional health used in our universitys correctional health electives. The themes are (a) characteristics of the population being served; (b) prevalent conditions requiring clinical expertise; (c) public health opportunities in correctional facilities; (d) ethical considerations; (e) medical-legal issues; and (d) the CH system, structure, and administration. Conclusions: The successful provision of health care in correctional settings requires specialized knowledge, skills, and awareness not typically available in other health care training settings.

Correctional Health Primary Care: Research and Educational Opportunities

Correctional health offers unparalleled opportunities for primary care research on clinical outcomes for a unique population and setting that provide rich experiences for health professions education, training, and practice. Because all correctional facilities are part of a larger community and 95% of inmates will eventually be released back to their communities, inmate health and well-being have a direct impact on the larger community. Collaborations between academic and correctional medicine can significantly affect the publics health by providing care to one of its most vulnerable populations, one with significant pathology and health disparities.

Managing a disaster scene and multiple casualties before help arrives.

As the largest group of health care professionals in the United States and a component of almost every community, nurses may be called upon to initiate the emergency response and provide initial planning for health care until local, national, or federal assistance arrives. This article will assist nurses in anticipating, preparing for, and responding to multi-casualty, high-impact events. It concludes with a discussion of triage of multi-casualties in the face of scarce resources. It includes resources for more in-depth information on prevention, preparedness and planning, and the health systems response.

Academic–Correctional Health Partnerships Preparing the Correctional Health Workforce for the Changing Landscape—Focus Group Research Results

Providing health care in corrections is challenging. Attracting clinicians can be equally challenging. The future holds a shortage of nurses and primary care physicians. We have a unique opportunity, now, to develop and stabilize our workforce, create a positive image, and enhance quality before the health care landscape changes even more dramatically. Focus groups were conducted with 22 correctional health care professionals divided into three groups: physicians (6), nurses (4), and nurse practitioners/physician assistants (12). Content focused on curricular themes, but additional themes emerged related to recruitment and retention. This article describes recruitment challenges, strategic themes identified, and the proposed initiatives to support a stable, high-quality correctional health workforce.