Mary Lou Bond

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.

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.

Moving Toward Greater Diversity A Review of Interventions to Increase Diversity in Nursing Education

Purpose: To report the results of a comprehensive review of interventions used by nursing programs to increase the success of underrepresented minority nursing students graduating from prelicensure programs. Design/Method: This review used the five stages of review methodology described but Whittemore and Knafl to extract data, summarize, and synthesize findings of 11 studies included in this review. Intervention strategies were organized using concepts of Jeffreys’s Nursing Undergraduate Retention and Success model. Findings: Interventions were designed to improve recruitment, retention, and academic performance through a variety of innovative activities. Conclusions: This review highlighted the necessity for future researchers to report in-depth and detailed information about the implementation of interventions. Comprehensive information about the program, faculty, setting, interventions, and challenges faced during implementation were often missing from these reports, making replication difficult.

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.

Distance education programs: defining issues of assessment, accessibility, and accommodation.

Identification and resolution of a variety of issues is imperative to establishing effective distance education via telecommunications. In this first-hand experience, the authors describe selected issues and possible responses inherent in the development and implementation of a new teaching modality. The decision to pursue distance education by telecommunications should be made only after a thorough examination of the needs, the required resources, and the changes to be expected. Advance planning is essential for problem solving.

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.

Institutional support for diverse populations: perceptions of Hispanic and african american students and program faculty.

Using the Adapted Model of Institutional Support as a framework, data were collected from 90 minority students, 80 faculty members, and 31 administrators from schools of nursing in Texas to determine perceived barriers and needed supports for program completion. Findings illustrate similar and differing perceptions of Hispanic and African American students, faculty, and program administrators. The data provide a baseline for making improvements and establishing “best practices” for minority recruitment and retention.

Family planning patterns and acculturation level of high-risk, pregnant Hispanic women.

This article describes acculturation level and family planning patterns among a convenience sample of 100 Hispanic women experiencing high-risk pregnancies. The majority were having a second pregnancy and had complications secondary to gestational diabetes or pregnancy-induced hypertension. Most were from Mexico, married, had little formal education, and were very Mexican oriented in their beliefs and values. Almost 75 percent returned for a postpartum visit compared with 14 percent who returned for the family planning visit at one year after giving birth. Age and gravidity were inversely correlated with return for family planning visits; gravidity was a significant predictor of number of post-birth visits.

Meeting Tomorrow's health care needs through local and global involvement

Strengthened efforts to achieve the United Nations Millennium Development Goals by 2015 are urgently needed. A fundamental step toward achieving these goals is strengthening global partnerships for development. This article describes critical challenges and opportunities in global health and the social responsibility of the nursing profession in this area. Examples and suggestions for nursing action are provided for consideration by those interested in influencing global health. Engaging in global health activities such as study abroad programs, interprofessional exchanges, continuing education workshops, and seminars with a global health focus can have significant implications for nursing education, research, policy, and practice. Equipping nurses with the leadership skills, knowledge, and attitudes needed to advance global health is integral in the delivery of effective, culturally relevant health care.

Maternal-infant clinical nurse specialist performance assessment: reliability and validity of an evaluation tool.

The Maternal-Infant Clinical Nurse Specialist Performance Evaluation Tool was used to evaluate the clinical performance of two classes of graduate students (n = 7, n = 4) enrolled in maternal-infant clinical practicians. When used by raters very familiar with the tool, i.e., those paruetpating in its development, it yielded valid [90] and reliable (.93) ratings of performance. When used by raters with limited familiarity with the tool, both validity and reliability declined but were still quite acceptable (.68 and .81, respectively) Better training for such raters should produce even more useful results. These results warrant continued cautious, monitored use of the tool in maternal-infant nursing The generic content of the tool offers the possibility of its generalization to other specialties.