Mary Elaine Jones

Cultural Attitudes, Knowledge, and Skills of a Health Workforce

This study describes cultural attitudes, knowledge, and skill of 409 health care workers using the Ethnic Attitude Scale, the Cultural Self-Efficacy Scale, and a demographic inventory. Findings suggest cultural knowledge and educational preparation of the health worker may influence cultural skills. Workers that were most confident in their cultural skills in working with other cultural groups were more confident in knowledge of cultural concepts and had higher education levels. The results also suggest gaps in workers’ knowledge of other cultures and how to care for them in culturally sensitive ways. Educational interventions may enhance workers’ knowledge. Whether such enhanced knowledge yields improved patient care outcomes remains to be answered.

Access to preventive health care: is method of payment a barrier for immigrant Hispanic women?

This study describes the payment category of 397 low-income Hispanic women and the relationship to compliance with family planning visits the first year postbirth. Only one-fourth of the women returned for the one-year family planning visit, when they would have received well-woman care. Pay category was not a factor in identifying those who returned. Health system barriers, patient cultural beliefs, and life circumstance may explain why women enter and then leave apparently seamless systems of care. To increase preventive care, more study is needed of interventions that build on womens existing cultural prescriptions for health behavior by health professionals who portray postbirth checks as wellness checks.

Enhancing resilience, empowerment, and conflict management among baccalaureate students: outcomes of a pilot study.

To manage interpersonal conflict, nursing students need evidence-based interventions to strengthen stress resiliency, psychological empowerment, and conflict management skills. A pilot 1-group, pre-post–design, 2-semester intervention used simulated experiences to enhance these skills with 60 undergraduate nursing students. Findings suggest that integration of conflict resolution skills throughout the curriculum, with repeated opportunities to practice using a variety of styles of conflict management in relation to situational factors, may be beneficial to prepare students for the challenges of today’s healthcare environment.

Awareness of Heart Disease Among Female College Students

OBJECTIVE Awareness of heart disease as the leading cause of death in women has increased over the past 10 years, but little is known about the awareness level of college students. This study evaluated the level of awareness and knowledge of heart disease in women among college students. METHODS AND RESULTS Using a cross-sectional design, a sample of 320 women from a private university was queried. A 13-item survey assessed demographic information and awareness of cardiovascular disease (CVD). The mean age was 23 years; the majority were single and of Hispanic ethnicity. Almost one third believed breast cancer was the greatest problem facing women. One half recognized CVD as the leading cause of death among women. Students aged 18-24 years were significantly less likely to identify heart disease/heart attack as the leading cause of death in women compared with students aged 25-34 years. Significant ethnic differences in perceptions of risk were found. Family history and obesity were seen as major contributors to CVD; less than a fourth ever discussed CVD with their healthcare provider. Information was gained primarily from television, magazines, and the Internet. Exercise and maintenance of healthy blood pressure were viewed as priorities in prevention of CVD. CONCLUSIONS Results add to the body of research on CVD risk and the need for intervention to increase awareness and knowledge of heart disease risk among younger and ethnically diverse young women and raises questions about the role of colleges and universities in promotion of student health. Colleges and universities may provide the last opportunity to reach youth as a group to affect lifestyle changes.

Lessons for prevention and intervention in adolescent pregnancy: A five-year comparison of outcomes of two programs for school-aged pregnant adolescents

Adolescent fertility control has been linked with educational completion and long-term economic success. This study evaluated the effect of short-term prenatal intervention on selected maternal and child indexes with first-time pregnant adolescents. Birth patterns were examined over a 5-year period for three groups (N = 216) of adolescents who received varying amounts of prenatal intervention for the index birth. No significant differences between groups were found on number of subsequent births within 5 years, mean time between births, graduation from high school, gestational age, or mean birth weight of infants. Age at first birth was a predictor of the number of subsequent births and subsequent graduation from high school. Grade in school at first pregnancy and total number of births in 5-years were related to high school graduation. Findings support the need for continued intensive community-based collaborative intervention for adolescent mothers during the 5 years after the index birth, the peak childbearing years for these women.

Acculturation Level and Family-Planning Patterns of Hispanic Immigrant Women

Purpose To describe family-planning patterns of Hispanic women and to determine their relationship to acculturation level and to selected maternal demographic, pregnancy, and infant birth indices. Design Descriptive correlational. Methods A convenience sample of 376 Hispanic women was drawn from prenatal clinics in a large, public teaching hospital in the Southwest United States. Acculturation status was assessed during the prenatal period using the Acculturation Rating Scale for Mexican Americans II. Maternal data concerning pregnancy, infant birth, postpartum, and family planning were abstracted from the hospital record. Data were analyzed using descriptive, correlational, and multiple regression procedures. Results Most women were of Mexican origin, first generation in the United States, and oriented toward traditional Mexican cultural beliefs and values. Most were married, had less than an eighth-grade education, and experienced a first or second healthy pregnancy with healthy birth outcomes. Over 66% of the women returned for at least one visit in the first year postbirth; compliance at 1 yr declined to 28%. Five variables were significantly correlated with family-planning visit compliance: number of pregnancies, generation in the United States, acculturation level, trimester of first prenatal visit, number of prenatal visits, and gestational age of newborn. Clinical Implications Nurses are in a pivotal position to educate the Mexican immigrant woman about healthcare for herself and for her family, but need to recognize cultural influences on family-planning behavior. Effective interventions build on existing knowledge, beliefs, and practices of traditional immigrant women. It is important to include the generation in the United States as an indicator of adherence to traditional values and beliefs.

Workplace Health Promotion—Strategies for Low-Income Hispanic Immigrant Women

Addressing health disparities for vulnerable populations in the United States is a national goal. Immigrant Hispanic women, at increased risk for heart disease, face obstacles in receiving adequate health care. Health promotion, especially for Hispanic women, is hindered by language, access to care, lack of insurance, and cultural factors. Innovative health education approaches are needed to reach this population. This article describes the development and evaluation of a culturally sensitive cardiac health education program based on findings from a study of 21 older immigrant Hispanic women employed as housekeepers at a small university in south Texas. Systolic and diastolic blood pressures had decreased 17 months after the intervention.

Where does culture fit in outcomes management

The authors describe the concept of cultural competence and ways in which culture, a structure of care variable, is important to the delivery of culturally competent care. The role of culture in outcomes assessment and management is explored. The culture of the patient, the health care professional, and the organization is examined as it influences the potential to deliver culturally competent care. Strategies for developing a culturally competent work force are proposed with examples from ongoing projects in a large metroplex in the southwestern part of the United States.

Prenatal education outcomes for pregnant adolescents and their infants using trained volunteers

This study evaluated the effects of lessons taught by trained nonprofessional volunteers in community prenatal clinics. Project participants (n = 210) and comparison subjects (n = 189) were pregnant women, aged 18 years or younger. Participants were divided according to those who attended eight or more lessons (high treatment, n = 94) and those who attended fewer lessons (n = 116). A system of rewards for attendance was used. The number of prenatal visits was significantly different between the three groups (p less than 0.001), with the high-treatment participants having a significantly greater number of visits than the other groups. The groups differed on gestational age at delivery (p less than 0.006), favoring the infants of high-treatment participants; however, only 8% of gestational age variance was attributable to prenatal visits. A significantly greater proportion of high-treatment participants returned for postpartum care (p less than 0.011 vs. low-treatment participants, p less than 0.002 vs. comparison subjects). Postpartum return was not improved by a hospital visit by a volunteer. Regardless of treatment, most (99%) accepted a contraceptive method at their postpartum visit. The groups did not differ on their return for method check at 3 months. However, a significantly greater proportion of the high-treatment participants returned for an annual family planning evaluation (p less than 0.015 vs. low-treatment participants, p less than 0.005 vs. comparison subjects). Both the high- and low-treatment participants differed significantly from the comparison subjects on having taken their infants for at least one well-child visit during the first year (p less than 0.001 for both tests).(ABSTRACT TRUNCATED AT 250 WORDS)

Acculturation Status, Birth Outcomes, and Family Planning Compliance Among Hispanic Teens

This study examined acculturation status, selected demographic and pregnancy indices, and the relationship to birth outcomes and family planning patterns among a convenience sample of 63 Hispanic adolescents aged 13 to 19 years and attending community-based prenatal clinics. Findings suggest that Hispanic teenagers who are the first generation in the United States and traditional in their world view are compliant with prenatal and postpartum care and have healthy babies and birth outcomes. Gravidity and gestational age of the infant were significant predictors of birth weight, accounting for 30% of the variability in birth weight. Generation in the United States accounted for 8% of the variance in family planning compliance. Higher gravidity was associated with increased infant birth weight and a decreased likelihood for return for family planning visits during the 1st year postbirth. Teens who were first generation in the United States were more likely to return for family planning visits during the 1st year. School nurses are in a pivotal position to design intervention programs that build on traditional cultural prescriptions for healthy behaviors during and after pregnancy.