Michelle T. Dang

Perception of Barriers to Immunization Among Parents of Hmong Origin in California

OBJECTIVES We explored factors associated with perception of barriers to immunization among parents of Hmong origin in California, whose children experience persistent immunization inequities even with health insurance. METHODS A partnership of academic researchers and members of the Hmong community conducted a community-based participatory research project. We collected data in naturalistic settings with a standardized instrument. We analyzed responses from 417 parents and caregivers and created a structural equation model to determine factors that contributed to perceived barriers. RESULTS Of 3 potential contributing factors to perceived barriers-nativity, socioeconomic position, and use of traditional Hmong health care (i.e., consulting shamans and herbalists)-the latter 2 significantly predicted higher perceived barriers to immunization. Nativity, indicated by years in the United States, age of arrival in the United States, and English language fluency, did not predict perceived barriers. CONCLUSIONS Interventions aimed at reducing immunization inequities should consider distinct sociocultural factors that affect immunization rates among different refugee and immigrant groups.

A School-Based Approach to Early Identification and Management of Students with ADHD

Attention-deficit/hyperactivity disorder (ADHD) is one of the most challenging chronic conditions for children, families, schools, and physicians. Because symptoms of ADHD can be mistaken for other health conditions and misdiagnosis can occur, accurate diagnosis and treatment require comprehensive evaluation. This article introduces a school-based framework—ADHD Identification and Management in Schools (AIMS)—developed by a multidisciplinary team composed of a pediatrician, school nurses, and school psychologists that sought to improve communication between school personnel and physicians, standardize practice, and improve the quality of care for children with ADHD. The framework provides school nurses with an evidence-based, systematic method for early identification and management of children with ADHD.

Social Connectedness and Self-Esteem: Predictors of Resilience in Mental Health among Maltreated Homeless Youth

The purpose of this cross-sectional study was to explore social connectedness and self-esteem as predictors of resilience among homeless youth with histories of maltreatment. Connectedness variables included family connectedness, school connectedness, and affiliation with prosocial peers. The sample included 150 homeless youth aged 14 to 21 (mean age = 18 years) with the majority being an ethnic minority. Participants completed surveys using audio-CASI. Results revealed that youth with higher levels of social connectedness and self-esteem reported lower levels of psychological distress. When all predictor variables were controlled in the analysis, self-esteem remained significant for predicting better mental health.

A web-based personal health information system for homeless youth and young adults

Runaway and homeless youth face multiple challenges to their health and experience inadequate access to health care services. This article describes a web-based personal health information system (PHIS) called Healthshack that was specifically designed to improve health care access and health outcomes for runaway and homeless youth at a community-based agency that served homeless youth and young adults up to age 24. The program was developed in partnership with homeless youth and piloted by public health nurses. Preliminary findings from the program indicate that a PHIS is acceptable to runaway and homeless youth and feasible to incorporate into the flow of a youth agency. Thus, a PHIS may be an innovative model of service delivery for other marginalized populations.

The history of legislation and regulations related to children with developmental disabilities: implications for school nursing practice today.

A significant number of children in the United States have developmental disabilities. Historically, many children with developmental disabilities were institutionalized and rarely seen in public. Currently, children with developmental disabilities are entitled to education and health-related support services that permit them access to public education and community services. To understand current laws related to children with developmental disabilities, it is important to consider past legislation and landmark court cases that have significantly affected the lives of children with disabilities and school nursing practice. This article presents an overview of historical legislation and court cases as they pertain to children and individuals with developmental disabilities and of current issues that require further attention and inquiry.

A Youth Participatory Project to Address STIs and HIV among Homeless Youth

ABSTRACT The purpose of this study was to conduct a youth participatory action research project to address the disparities in sexually transmitted infection (STI) and HIV rates among homeless youth. Four youth served as co-investigators and cultural informants for the project. The team conducted focus groups (N = 22; ages 16–22) and in-depth interviews (N = 20; ages 18–24) with homeless youth to explore decisions about condomless sex, knowledge of STIs and HIV, health-care access for STI-related services, and perceptions about STI testing. Findings revealed that homeless youth have good general knowledge about STIs, are receptive to STI testing for themselves and their sexual partners, and have heightened concerns about being HIV positive and peers knowing their STI status. Results from the current study could contribute to the development of youth-informed tailored interventions to increase protective sexual behavior, reduce health disparities, and improve access to and the quality of health-care services for homeless youth.