JoAnn S. Oliver

Does religiousness and spirituality moderate the relations between physical and mental health among aging prisoners

We examined positive and negative religious coping as moderators of the relation between physical limitations, depression, and desire for hastened death among male inmates incarcerated primarily for murder.

Disparities in colorectal cancer screening behaviors: implications for African American men.

Guidelines published by the American College of Gastroenterologists suggest that African Americans (AA) begin preventive screening at the age of 45 years due to increased risk of colorectal cancer. This study examines characteristics associated with having fecal occult blood tests (FOBT), sigmoidoscopy, and colonoscopy among adults aged 45–75 years. Using cross-sectional data from the 2007 Health Information National Trends Survey, the sample included 3,725 participants (mean age = 59.01 ± 8.41), with 59.8% female, 88.8% Caucasian, and 11.2% AA. Binary logistic regression with interactions between race, gender, and age entered in block 2 revealed that odds of having FOBT, colonoscopy, or sigmoidoscopy were increased among older individuals with higher education. Fecal occult blood test was higher among women and those with insurance. Colonoscopy was higher among those with insurance and higher income. Having a sigmoidoscopy was more likely among those with higher income but was lower among AA men. Understanding the characteristics of individuals who participate in colorectal cancer screenings may contribute to the development of interventions geared toward those who do not, particularly AA men who are at greatest risk for colorectal morbidity and mortality.

Treatment for older prostate cancer patients: disparities in a southern state.

Background:Black prostate cancer patients are less likely to receive aggressive therapy (AT) than Whites: reported rates for patients ≥65 years old are about 55% versus 65%. Little is known about treatment rates in socioeconomically deprived states with large Black populations like Alabama. Study Design:Medicare claims and Alabama Statewide Cancer Registry records were linked for Alabamian men in Medicare fee-for-service diagnosed with loco-regional prostate cancer in 2000–2002. The association between race and likelihood of: (1) AT (prostatectomy or external beam radiation therapy [EBRT] or brachytherapy); (2) hormone therapy (primary androgen deprivation therapy [ADT] or orchiectomy); (3) <30 days of EBRT; and (4) <6 months of ADT, was investigated adjusting for age, clinical tumor stage, grade, Comorbidity Index, and census tract proportion of Black residents, of persons living below poverty and with ≤ high school. Results:Of 3561 patients, 71.2% received AT and 38.3% hormone therapy. Blacks were less likely to receive AT (64.3% vs. 73.0%, adjusted [adj.] OR: 0.80, CI: 0.67–0.96). There was no difference between Blacks and Whites in the likelihood of receiving hormone therapy (40.8% vs. 37.7%, adj. OR: 1.10, CI: 0.91–1.34), <30 days of EBRT (30.5% vs. 31.5%, adj. OR: 0.98, CI: 0.72–1.32) or <6 months of ADT (50.7% vs. 54.0%, adj. OR: 0.84, CI: 0.63–1.12). Conclusions:In Alabama, there were racial differences in utilization of aggressive treatment for locoregional prostate cancer. Research should investigate factors associated with prostate cancer treatment among older men, such as patient behavior and access to care.

Gender Differences in Colon Cancer Treatment

UNLABELLED Abstract Background: Despite women suffering a disproportionate burden of colon cancer mortality, few studies have examined gender differences in evidence-based treatment, especially in poorer states like Alabama. OBJECTIVE To describe colon cancer treatment in older patients diagnosed in Alabama by gender. METHODS Colon cancer patients 65 years and older diagnosed in 2000-2002 were identified from the Alabama Statewide Cancer Registry (N=1785). Treatment was identified from Medicare claims for 1999-2003. Outcomes were (1) receipt of surgery and adjuvant 5-fluorouracil chemotherapy (5FU) and (2) 5FU treatment duration (0-4, 5-7, and >7 months). Generalized Estimating Equation (GEE) models were used to determine significant gender differences, adjusting for clustering at the reporting hospital level, and controlling for race, age, stage, comorbid conditions, census tract-level socioeconomic variables, and adverse chemotherapy effects (when analyzing 5FU duration). RESULTS Overall, 93.9% of the patients received surgery. Of stage II-III patients undergoing surgery, 60.4% stage III and 25.6% stage II patients received 5FU. Compared with men, women were more likely to have surgery (95.5% vs. 92.2%, p=0.003), less likely to have 5FU (38.6% vs. 45.2%, p=0.02), and more likely to have 0-4 months of 5FU (32.9% vs. 24.9%, p=0.05). Gender differences were significant for having chemotherapy (adjusted odds ratio [aOR] 0.78, confidence interval [CI] 0.61-1.00, p=0.049), but not for having 0-4 months of 5FU when adjusting for adverse effects (aOR 1.36, CI 0.95-1.94, p=0.09). CONCLUSIONS In Alabama, some gender differences in stage-specific colon cancer treatment are worth further scrutiny.

Using data from the internet to teach ethical principles for critiquing research studies.

Qualitative researchers are increasingly using the Internet to conduct their studies; however, they need to adhere to the same ethical principles used when conducting traditional research studies. Students also must be aware of these ethical principles and know how to critique research reports for adherence to them. The authors describe selected ethical principles as they relate to Internet qualitative research, what students need to know, what faculty must teach them to critique those studies, and what decisions students must make once the critique is completed.

A pilot study of prostate cancer knowledge among African American men and their health care advocates: implications for screening decisions

PurposeProstate cancer (PCa) is the second leading cause of cancer death in U.S. men [American Cancer Society (ACS)], most often affecting men age 50 and older. The study provides information about factors that influence rural AA men in their decision to undergo screening for PCa with a specific focus on PCa knowledge among AA men and their health care advocates.MethodsA longitudinal quantitative study included AA males and their health care advocates. Participants were from three Alabama rural counties. Measures included demographics, PCa knowledge, decisional conflict, and health literacy scales.ResultsThirty-three men with a mean age of 54.61 and 35 health care advocates were included in the study. PROCASE Knowledge Index measure results indicate a lack of PCa knowledge among both male primary participants and their advocates. The knowledge of AA men in the study was somewhat low, with individuals correctly answering approximately six questions out of ten at multiple time points (baseline total M = 6.42, SD = 1.52). Decisional conflict responses at 12 months (38.64) were lower than at baseline (M = 62.88) and at 6 months (M = 58.33), p < .005.ConclusionHealth care advocates of the 33 male participants were usually women, spouses, or significant others, supporting the vital role women play in men’s health specifically in rural underserved communities. Low overall PCa knowledge, including their risk for PCa, among these participants indicates a need for PCa and screening educational interventions and dialogue that include males and their significant others.

Nurse Practitioner Perceptions of a Diabetes Risk Assessment Tool in the Retail Clinic Setting

IN BRIEF This article describes a study to gain insight into the utility and perceived feasibility of the American Diabetes Association’s Diabetes Risk Test (DRT) implemented by nurse practitioners (NPs) in the retail clinic setting. The DRT is intended for those without a known risk for diabetes. Researchers invited 1,097 NPs working in the retail clinics of a nationwide company to participate voluntarily in an online questionnaire. Of the 248 NPs who sent in complete responses, 114 (46%) indicated that they used the DRT in the clinic. Overall mean responses from these NPs indicated that they perceive the DRT as a feasible tool in the retail clinic setting. Use of the DRT or similar risk assessment tools in the retail clinic setting can aid in the identification of people at risk for type 2 diabetes.

An Evidence-Based Protocol for Protecting Newborns From Pertussis

Pertussis, also known as whooping cough, is a vaccine-preventable disease most commonly affecting infants and young children. This article describes a project to develop an evidence-based protocol for implementing prenatal vaccination and cocooning in a major medical center in Georgia.

A Clinical Protocol for the Assessment of Obesity: Addressing an Epidemic.

The purpose of this article is to discuss the importance of addressing obesity, a national epidemic. Furthermore, the paper focuses on the utilization of a clinical practice protocol for identifying patients who are obese or at risk for obesity in the primary care setting. The practice protocol includes guidelines for assessment, documentation, and a consistent educational intervention for the identified priority population. The rapidly increasing incidence of obesity in our primary care practices supports the need for evidence-based approaches to ensure consistent assessment and documentation, thereby increasing the potential for weight management and obesity reduction.

Rural and Other Medically Underserved Populations.

Millions of Americans are characterized asmedically underserved given that they live in amedically underserved areawith little or no health care or that they are part of amedically underserved group or population known to experience economic, cultural, or linguistic barriers to health care. Rural and urban dwellers, low-income groups, racial and ethnic minorities, children, older adults, and individuals with special health care needs are characterized as priority populations by the National Center for Health Statistics and the Agency for Health Care Research and Quality given that they face myriad economic, social, cultural, geographic, and systemic barriers to health care access, health care delivery, and health care utilization. Nurses are highly regarded in the health care community. Likewise, given the scope of their knowledge, the breadth of their practice, and the depth of their commitment to care for all who are in need, they have been noted to be a critical lever for change relative to addressing the needs of these and other disparate groups and populations. Our understanding of the needs and concerns of rural and medically underserved populations and our experiences working in rural and other medically underserved areas, along with those of our collaborating authors, served as the impetus for this special issue of Nursing Clinics of North America. This issue highlights the work of an esteemed group of nurse clinicians, educators, and researchers whose clinical practices, research, and programs of scholarship are dedicated to improving the health condition of rural and underserved populations. Included among the work cited are reports that address hearing loss of adults with type 2 diabetes, the clinical implications of food insecurity among underserved populations; barriers to smoking cessation in rural and underserved pregnant women, best practices for establishing partnerships with indigenous populations of North America, the integration of family health history in primary care practice, the nonemergency use of emergencymedical services among rural populations, and the use of mobile devices to access information in rural a setting. We believe that insights gleaned from these