Marie Anne S. Rosemberg

Questioning Photovoice Research Whose Voice

Photovoice is an important participatory research tool for advancing health equity. Our purpose is to critically review how participant voice is promoted through the photovoice process of taking and discussing photos and adding text/captions. PubMed, Scopus, PsycINFO, and Web of Science databases were searched from the years 2008 to 2014 using the keywords photovoice, photonovella, photovoice and social justice, and photovoice and participatory action research. Research articles were reviewed for how participant voice was (a) analyzed, (b) exhibited in community forums, and (c) disseminated through published manuscripts. Of 21 studies, 13 described participant voice in the data analysis, 14 described participants’ control over exhibiting photo-texts, seven manuscripts included a comprehensive set of photo-texts, and none described participant input on choice of manuscript photo-texts. Photovoice designs vary in the advancement of participant voice, with the least advancement occurring in manuscript publication. Future photovoice researchers should expand approaches to advancing participant voice.

“Maybe This Generation Here Could Help the Next Generation”: Older African American Women's Perceptions on Information Sharing to Improve Health in Younger Generations

The prevalence of hypertension is highest among African American women, who often occupy caregiving roles. The purpose of the current study is to describe intergenerational caregiving and communication themes that emerged during focus groups with African American older adult women (mean age = 73 years) on information sharing and self-management of hypertension. Thematic analysis revealed two overarching themes: Caregiving Responsibilities and Improving the Health of Younger Generations. Women wanted to help younger generations better manage their blood pressures. These findings suggest that intergenerational relationships may have an important role in managing health conditions, such as hypertension. Further examination of intergenerational relationships as targets for blood pressure self-management intervention is warranted to: (a) address the need for women to share their wisdom, and (b) help improve blood pressure management among African American individuals across the lifespan. [Res Gerontol Nurs. 2018; 11(1):39-47.].

Career Cartography: From Stories to Science and Scholarship

PURPOSE To present four case scenarios reflecting the process of research career development using career cartography. ORGANIZING CONSTRUCTS Career cartography is a novel approach that enables nurses, from all clinical and academic settings, to actively engage in a process that maximizes their clinical, teaching, research, and policy contributions that can improve patient outcomes and the health of the public. METHODS Four early-career nurse researchers applied the career cartography framework to describe their iterative process of research career development. They report the development process of each of the components of career cartography, including destination statement, career map, and policy statement. CONCLUSIONS Despite diverse research interests and career mapping approaches, common experiences emerged from the four nurse researchers. Common lessons learned throughout the career cartography process include: (a) have a supportive mentorship team, (b) start early and reflect regularly, (c) be brief and to the point, (d) keep it simple and avoid jargon, (e) be open to change, (f) make time, and (g) focus on the overall career destination. CLINICAL RELEVANCE These four case scenarios support the need for nurse researchers to develop their individual career cartography. Regardless of their background, career cartography can help nurse researchers articulate their meaningful contributions to science, policy, and health of the public.

Allostatic load: A theoretical model for understanding the relationship between maternal posttraumatic stress disorder and adverse birth outcomes

BACKGROUND Adverse birth outcomes such as preterm birth and low birth weight are significant public health concerns and contribute to neonatal morbidity and mortality. Studies have increasingly been exploring the predictive effects of maternal posttraumatic stress disorder (PTSD) on adverse birth outcomes. However, the biological mechanisms by which maternal PTSD affects birth outcomes are not well understood. Allostatic load refers to the cumulative dysregulations of the multiple physiological systems as a response to multiple social-ecological levels of chronic stress. Allostatic load has been well documented in relation to both chronic stress and adverse health outcomes in non-pregnant populations. However, the mediating role of allostatic load is less understood when it comes to maternal PTSD and adverse birth outcomes. OBJECTIVE To propose a theoretical model that depicts how allostatic load could mediate the impact of maternal PTSD on birth outcomes. METHOD We followed the procedures for theory synthesis approach described by Walker and Avant (2011), including specifying focal concepts, identifying related factors and relationships, and constructing an integrated representation. We first present a theoretical overview of the allostatic load theory and the other 4 relevant theoretical models. Then we provide a brief narrative review of literature that empirically supports the propositions of the integrated model. Finally, we describe our theoretical model. FINDINGS/CONCLUSIONS The theoretical model synthesized has the potential to advance perinatal research by delineating multiple biomarkers to be used in future. After it is well validated, it could be utilized as the theoretical basis for health care professionals to identify high-risk women by evaluating their experiences of psychosocial and traumatic stress and to develop and evaluate service delivery and clinical interventions that might modify maternal perceptions or experiences of stress and eliminate their impacts on adverse birth outcomes.

Effort-Reward Imbalance and Work Productivity Among Hotel Housekeeping Employees: A Pilot Study:

This study explored the relationship between effort-reward imbalance (ERI) at work and work productivity among hotel housekeepers. A community-based approach was used to recruit 23 hotel housekeepers who completed the ERI and Work Performance Questionnaires. Work productivity was determined by combining self-report absenteeism and presenteeism. More than 40% of the participants reported high ERI (ERI >1). Also, 59.1% reported low work productivity. Interestingly, despite the individualized high reports of ERI and low work productivity, correlation analysis showed that high ERI was correlated with high presenteeism and work productivity as a whole. This is the first study to explore work productivity among this worker group. Despite the small sample size and the cross-sectional nature of the study, this study points to the need for organization-based interventions to not only improve employee health but also their work productivity.

High-ACE Low Wage Workers: Occupational Health Nursing Research and Praxis Through a Trauma-Informed Lens:

Individuals with a history of adverse childhood experiences (ACEs) disproportionately have poor mental and physical health outcomes. These experiences affect individuals across the life span extending beyond health with deleterious impact on work-related outcomes. Low-wage workers are particularly at risk. Social service and health organizations are becoming aware of the extent to which the populations they serve have been affected by these experiences. Employment support programs may serve high-ACE individuals but likely are unaware of their histories and the developmental or health deficits that result and can impinge on successful employment. Occupational health nurses may be well-positioned not only to implement trauma-informed care in workplaces but also to influence the ways in which employment services for this vulnerable group are delivered. The purpose of this article is to consider how ACEs could affect vulnerable workers. The need for trauma-informed research and praxis to advance occupational health nursing is discussed.

Opportunities for the Advanced Practice Nurse to Enhance Hypertension Knowledge and Self-management Among African American Women

Purpose: Despite increased awareness and the advent of methods to manage the disease, hypertension is poorly controlled among African American women. This study explored hypertension knowledge and blood pressure in a sample of African American women. Design: A descriptive, cross-sectional design was used to collect survey data on hypertension knowledge. Methods: African American women attending a church conference were invited to complete a questionnaire, which included the Check Your High Blood Pressure Prevention IQ survey, and had their blood pressures measured. Results: Of the 151 women who participated, 62% were diagnosed with hypertension. Many of the women, even those not diagnosed with hypertension, had elevated blood pressures. Although the average scores showed that the women scored well on the survey, there were 4 items on the survey that a percentage of the women had difficulty with: questions about (1) stress as a cause of hypertension, (2) symptoms associated with high blood pressure, (3) whether hypertension could be cured, and (4) the amount of exercise needed to help reduce blood pressure. Conclusion: Despite efforts to increase awareness and control of hypertension, considerable misconceptions about the disease were found in this sample of African American women. To improve self-management of hypertension among this group, advanced practice nurses need to directly address these misconceptions.

Significant Associative Factors for Hypertension Among New US Immigrants:An exploration of the 2003 New Immigrant Survey (NIS) Data

Background: Immigrants make up a large number of the US population and are at risk for poor health outcomes such as hypertension, a major public health concern. Little is known about the associating factors of hypertension among recent US immigrants. Method: Using the New Immigrant Survey (NIS) data with a subsample of 7539, we attempt to address this gap. We ran descriptive statistics and multivariate analysis to analyze the data using covariates including age, education, gender, age, weight, and smoking, with hypertension as the outcome variable. Results: Only 10% of our sample had hypertension. Controlling for other factors, employed participants had lower odds of hypertension (OR=0.77, 95% CI=0.60, 0.99). Length of stay was associated with increased odds of hypertension (OR=1.01, 95% CI =1.00-1.02). Additional factors increasing odds of hypertension included women (OR=1.52, 95% CI=1.24-1.86), older age (OR=1.08, 95% CI=1.07-1.09), and body weight (OR=1.01, 95% CI=1.01-1.02). Conclusion: This study accentuates the underreporting of hypertension among immigrant populations. The findings also indicate the need for nurses and other health providers to develop systems of care that are sensitive to the unique needs of this population. More studies are needed to explore the extent to which those associative factors identified impact hypertension development and management among new immigrants.

Transnationalism: A Framework for Advancing Nursing Research With Contemporary Immigrants.

This article advances nursing research by presenting transnationalism as a framework for inquiry with contemporary immigrants. Transnationalism occurs when immigrants maintain relationships that transcend the geographical borders of their origin and host countries. Immigrants use those relationships to experience health differently within concurrent socioeconomic, political, and cultural contexts than national situated populations. Nurse researchers are called upon to consider these trans-border relationships when exploring the health of contemporary immigrants. Such consideration is needed to develop relevant research designs, methods, analysis, and dissemination strategies.

Advancing Nursing Research in the Visual Era: Reenvisioning the Photovoice Process Across Phenomenological, Grounded Theory, and Critical Theory Methodologies.

Photovoice is a powerful research method that employs participant photography for advancing voice, knowledge, and transformative change among groups historically or currently marginalized. Paradoxically, this research method risks exploitation of participant voice because of weak methodology to method congruence. The purposes of this retrospective article are to revisit current interdisciplinary research using photovoice and to suggest how to advance photovoice by improving methodology-method congruence. Novel templates are provided for improving the photovoice process across phenomenological, grounded theory, and critical theory methodologies.