Kathleen A. Baldwin

The Potential Influence of a Social Media Intervention on Risky Sexual Behavior and Chlamydia Incidence

The purpose of this descriptive pilot study was to evaluate an evidence-based social-networking intervention aimed at reducing the incidence of Chlamydia among 15- to 24-year-olds. The intervention consists of a Facebook site that addresses signs, symptoms, treatment, screening, and prevention of Chlamydia infection. Findings included a 23% self-reported increase in condom utilization, and a 54% reduction in positive Chlamydia cases among 15- to 17-year-olds. Study results support that social media may be an effective mechanism for information dissemination and the promotion of positive behavioral changes among this population.

Accessibility and perceived value of health services in five western Illinois rural communities.

The purpose of this study was to determine the accessibility and perceived value of health services in five selected rural communities in South Fulton County, Illinois. The Health Services Accessibility and Value Scale (HSAVS) component of the larger Fulton County Health Care Survey was used in the investigation. The 12 items comprising the HSAVS surveyed participant perceptions relative to medical, dental, nursing, and public health department services available to them as rural residents. The HSAVS was completed by 1079 subjects. The reliability of the HSAVS was assessed by computing coefficient alpha. The scale had acceptable internal consistency reliability (alpha = .7884). To examine the construct validity of the scale, a principle component factor analysis was completed. This analysis resulted in a four factor solution which accounted for 66.6% of the cumulative total variance. Item means were calculated and were used to rank the HSAVS statements. Emergency and primary medical services were valued the most by the survey participants. Relatively high in importance to the rural residents surveyed were access to pharmacy, eye care, dental care, and immunization services. Availability of home health care, transportation to and from health care facilities, and access to mental health services were considered to be of lesser value to persons living in the rural area studied. Of least importance were alcohol and other drug counseling services, prenatal care/well baby services, and family planning services. HSAVS total scores and individual statements were also analyzed by sex, age, place of residence, and income and the results were reported.

Three Population‐Patient Care Outcome Indicators for Public Health Nursing: Results of a Consensus Project

OBJECTIVES Difficulties in recruiting nurses into public health settings threaten the publics health. Gaps in existing data make determining the health impact of workforce changes numbers difficult to perform. Public health practice leaders are left to make difficult staffing and program decisions without knowing how the health of their vulnerable populations will be affected. The objective of this study was to identify indicators that could be used to document the effect of the shortage of public health nurses (PHNs) on the health of a population. DESIGN AND SAMPLE A consensus-building process was used. Nursing directors from 6 local health departments (LHDs) in 2 states participated along with 3 public health system researchers. RESULTS The findings from this collaborative process suggest that it is possible to identify outcome indicators across states and multiple LHDs that may be sensitive to PHN staffing levels and interventions. Possible connections between PHN staffing and each population-patient care indicator (rates of Chlamydia, first trimester prenatal care, early childhood immunization) are presented. CONCLUSIONS The process used here in identifying these indicators and the proposed nursing-sensitive population outcome indicators themselves provide a template for the development and analysis of additional outcome indicators sensitive to the quality of nursing and other health care.

Six to Success: Improving Primary Care Management of Pediatric Overweight and Obesity

INTRODUCTION Despite the existence of established guidelines addressing pediatric obesity, many primary care providers fail to successfully implement recommendations. This study measured the impact of Six to Success, a weight management program based on the Chronic Care Model, on primary care provider adherence to pediatric weight management guidelines. METHOD We used comprehensive pre- and postimplementation chart audits (N = 396) to conduct a quality improvement study at a hospital-based pediatric outpatient clinic. Charts of patients with a body mass index percentile at or above the 85th percentile (preimplementation, n = 90; postimplementation, n = 97) were audited for 23 identification, assessment, and prevention measures recommended in the care of the pediatric overweight/obese patient. RESULTS Statistically significant improvements to clinical guideline adherence were found in the following areas: correct diagnosis, physical examination, lifestyle assessment, use of motivational interviewing, and prevention strategies. DISCUSSION These findings suggest that Six to Success can be an effective method of improving primary care provider adherence to established pediatric weight management guidelines.

Delivering Sexually Transmitted Infection Education Via Text Messaging An Evidence-Based Project

Although adolescents aged 15 to 24 years represent 25% of the sexually active population, they acquire nearly half of all the incident sexually transmitted infections (STIs). Sixty-seven percent of college students report having had sexual intercourse within the last 12 months; only half of these students usually use a protective barrier. This study seeks to determine whether a short message service (SMS) intervention aimed at college students will increase knowledge of STI prevention and reduce risky sexual behaviors. The evidence-based practice question is, “Does STI prevention education delivered via text messaging decrease the incidence of risky sexual behavior and increase knowledge of STIs among college students aged 18 to 25 years?” The Health Belief model guided study development from review of literature through intervention message development and evaluation. Research suggests that SMS is commonplace among college students and may be an important tool in sexual health promotion for younger populations. However, little evidence exists suggesting that text messages with college students can be lead to increased knowledge of STIs and decreased risky sexual behavior. Each college participate (N = 241) at a Midwestern university received 18 sexual health educational text messages over 6 weeks. Messages were adapted from a previous study, Bull’s 411, as well as developed by the author. A quasi-experimental pretest/posttest design with online data collection was used for evaluation. The survey instrument was an adaption of the Sexual Risk Survey and Bull’s 411. Data analysis was accomplished through use of paired t tests. Preliminary results show significant improvement in knowledge (STI facts, how to use a condom, screening, and prevention), likelihood of behavior change (more likely to carry a condom, use condom for oral sex, and get screened for STIs), and increased confidence in refusing to have unwanted sex. Preliminary data gave credence to SMS as an effective method of not only dispersing STI information but also increasing knowledge and likelihood of behavior change.

Three Population-Patient Care Outcome Indicators for Public Health Nursing: Results of a Consensus Project: Three Population-Patient Care Outcome Indicators for Public Health Nursing

OBJECTIVES Difficulties in recruiting nurses into public health settings threaten the publics health. Gaps in existing data make determining the health impact of workforce changes numbers difficult to perform. Public health practice leaders are left to make difficult staffing and program decisions without knowing how the health of their vulnerable populations will be affected. The objective of this study was to identify indicators that could be used to document the effect of the shortage of public health nurses (PHNs) on the health of a population. DESIGN AND SAMPLE A consensus-building process was used. Nursing directors from 6 local health departments (LHDs) in 2 states participated along with 3 public health system researchers. RESULTS The findings from this collaborative process suggest that it is possible to identify outcome indicators across states and multiple LHDs that may be sensitive to PHN staffing levels and interventions. Possible connections between PHN staffing and each population-patient care indicator (rates of Chlamydia, first trimester prenatal care, early childhood immunization) are presented. CONCLUSIONS The process used here in identifying these indicators and the proposed nursing-sensitive population outcome indicators themselves provide a template for the development and analysis of additional outcome indicators sensitive to the quality of nursing and other health care.

Three Population-Patient Care Outcome Indicators for Public Health Nursing

OBJECTIVES Difficulties in recruiting nurses into public health settings threaten the publics health. Gaps in existing data make determining the health impact of workforce changes numbers difficult to perform. Public health practice leaders are left to make difficult staffing and program decisions without knowing how the health of their vulnerable populations will be affected. The objective of this study was to identify indicators that could be used to document the effect of the shortage of public health nurses (PHNs) on the health of a population. DESIGN AND SAMPLE A consensus-building process was used. Nursing directors from 6 local health departments (LHDs) in 2 states participated along with 3 public health system researchers. RESULTS The findings from this collaborative process suggest that it is possible to identify outcome indicators across states and multiple LHDs that may be sensitive to PHN staffing levels and interventions. Possible connections between PHN staffing and each population-patient care indicator (rates of Chlamydia, first trimester prenatal care, early childhood immunization) are presented. CONCLUSIONS The process used here in identifying these indicators and the proposed nursing-sensitive population outcome indicators themselves provide a template for the development and analysis of additional outcome indicators sensitive to the quality of nursing and other health care.