Nancy Campbell-Heider

Contraceptive Implant Use Among Inner City Teens

PURPOSES This study develops a clinical profile of urban teens who selected Norplant for contraception; determines which variables identify the subjects most likely to be compliant with the method; and determines the most common reasons for early termination of use. METHODS Demographic and health history data and reasons for termination of use were collected prospectively for 122 inner city teens who received Norplant. Life table analysis and the Mantel-Haenszel procedure were used to investigate differences between Norplant retainers and terminators. RESULTS The sample consisted of black and Hispanic teens between the ages of 13-19 years, the majority of whom had one or more children and were in school. One and two year retention rates were 71% and 62%. The highest removal rates occurred during the 3-6 month interval after insertion. A significant finding was that teens who have experienced induced abortion were more likely to retain Norplant. Common reasons for termination of use included general and social concerns, including pregnancy desire. CONCLUSIONS Norplant retention rates for this teen sample were greater than the compliance rates reported for other conventional methods. Similar to noncompliance with oral contraceptives, discontinuance of the method was most likely to occur in the first 6 months of use. A history of induced abortion identifies those teens most likely to retain Norplant, suggesting that these teens might evaluate contraceptive risks and benefits differently than those with no abortion history. Pregnancy desire was a common reason for terminating Norplant use.

The Effect of Positive Adolescent Life Skills Training on Long Term Outcomes for High-Risk Teens

&NA; This paper reports on long term follow‐up data—12 months post intervention—from a clinical trial of an intervention designed to enhance teen resilience by supporting the development of social skills needed to make positive connections and overcome the influence of negative environmental influences. Sixteen adolescents aged 12 to 16 (10 boys and 6 girls) attending an inner city urban secondary school participated in a 32 week intervention study. Subjects were randomly assigned within sex to Teen Club plus Positive Adolescent Life Skills (PALS) or Teen Club intervention groups. The Problem Oriented Screening Instrument for Teenagers (POSIT) was used to measure the dependent variables (problems related to substance use, health, mental health, family relations, peer relations, education status, vocational status, social skills, leisure and recreation, and aggression). The small sample size limited the ability to determine statistical differences between the POSIT sub‐scale scores for PALS plus Teen Club or Teen Club only interventions. Descriptive data suggest mixed results for both interventions and sex groups. Most important were reductions in mental health problems for all boys in both groups and only slightly increased numbers of problems in substance use for PALS boys and girls over time. Other trends by group and sex are reported.

Survey on Addictions: Toward Curricular Change for Family Nurse Practitioners

The purpose of this paper is to describe the results of a survey of advanced practice nurses (APNs) to determine the activities they perform related to caring for patients with addictions and or co-occurring mental health disorders, the amount of addictions education in their graduate programs, and their perceptions of the value of addictions education for their role. Data were obtained from 233 APNs in New York State using a tool adapted from a previous job analysis survey. APNs reported the greatest amount of experience in history taking for various types of addictions and co-occurring mental health disorders and least amount of experience in performing objective exams, using standardized screening tools, ordering related diagnostic tests, prescribing pharmacological treatments, and making referrals for addiction treatment. Respondents reported a mean of less than three hours addictions education in their graduate programs in contrast to their high perceived importance of this clinical area.

Norplant use among urban minority women in the United States.

The aim of this study was to develop a profile of urban American women who chose Norplant(R), determine factors associated with retention and early termination of implants, and to determine reasons for early removal. A total of 197 adult black and Hispanic women who had Norplant inserted were followed prospectively for up to 5 years. Interval and cumulative termination rates were calculated. Data were stratified by race and analyzed to include lost-to-follow-up (LTFU) subjects. Multivariate survival analysis was used to determine variables independently associated with termination. Cumulative continuation rates were 68% after year 1 and 13% after year 4. Significant predictors of retention included black race and lower parity. Probability of early termination increased with higher parity and Hispanic race. For black subjects, recent use of hormonal contraception was a predictor of retention. Menstrual changes and weight concerns were common reasons for removal. The Norplant 1-year continuation rate is lower than previously reported, but is higher than reported for oral contraceptives and Depo-Provera(R). Future studies should stratify by age, race, and parity, and use standardized terminology to report intervals of use.

The Buffering Effects of Connectedness: Teen Club Intervention for Children of Substance Abusing Families

&NA; This paper will trace the clinical evolution and demonstrated efficacy of Teen Club—a community-based nursing intervention designed to reduce high-risk behaviors in female teens who are children of substance abusing families. Special emphasis is on the relevance of connectedness as a theoretical underpinning for support group interventions. The paper also describes the clinical applications of this research for practice and the teams plans for further testing the Teen Club program in other inner city high-risk adolescent populations.

Interpreting political agendas from a critical social theory perspective

A lthough there has always been ,a shortage of well-educated nurses, the 1987 staffing vacancies brought national attention to this issue. Complex problems have led to this crisis and have subtle implications for the recruitment a.nd retention of professional nurses. Nursing enrollment and availability are linked to economic and social factors that determine nurse income and status. Correcting longstanding wage compression, societal undervaluing of n.ursing, and external perceptions of nursing as a noncognitive endeavor requires some major overhauls in the health care systemincluding some readjustment in the economic and social power of physicians, who historically have encouraged creative alternatives to increasing the supply of well-educated and appropriately paid nurses. Critical social theory is the study of the dominant ideologies present in a society from within a historical context. Inherent in the analysis is the political, economic, and social perspectives that mark a given time period.

Teen Use of Electronic Cigarettes: What Does the Research Tell Us?

The Centers for Disease Control and Prevention has confirmed that, despite the decrease in conventional cigarette smoking in teens, the use of other tobacco products is on the rise (Neff et al., 2015). Thanks to the ongoing public health campaign touting the dangers of cigarette smoking, today’s tee

Outcomes of a One-Time Telephone Intervention for Smoking Cessation in Adults.

AbstractTobacco use is the single greatest cause of disease and premature death in America today. To address this major public health concern, states are required to provide smoking cessation services. The purpose of this article is to examine the effectiveness of a one-time telephone adult smoking cessation program designed by a certified addictions registered nurse–advanced practice and conducted over an 11-month period by the State of Nevada. Specifically, the program included a telephone-based counseling session and distribution of a 2-week supply of nicotine replacement therapy patches. The sample population consisted of 1471 Nevada residents, men and women, aged 18 years and over who called the Quitline for smoking cessation help. All participants in the program provided consent for a follow-up call to report on their quit rates and satisfaction with the intervention at 7 months postintervention. Although everyone who participated in the interventions was called, only 373 (25.4%) were actually reached via telephone contact. Of this group, quit rates showed that 34.6% reported continuous abstinence at 7 months, whereas 35.1% were abstinent at the 7-day point prevalence and 31.9% were abstinent at the 30-day point prevalence. Patient satisfaction with the program revealed that 87.6% (n = 373) of the participants reported being very or mostly satisfied. This program evaluation study shows that short-duration telephone counseling plus nicotine replacement therapy was associated with helping at least one third of the participants to quit using tobacco for all of the prevalence points—7 and 30 days and at 7 months postintervention.

High-Risk Situations Related to Relapse of Methamphetamine Use among Taiwanese Adolescents: An Instrumentation Study

&NA; Methamphetamine is the leading illicit substance used by adolescents in Taiwan and the rise of its production and use is a major public health concern in Southeast and East Asia. The purpose of this study was to develop and test a new instrument to identify high‐risk situations related to methamphetamine relapse among incarcerated Taiwanese adolescents. Participants in this study were arrested for methamphetamine use and mandatorily held at an abstinence center. In the instrument development phase, an item pool was generated from a qualitative study and further revised based on content evaluations by 6 clinical content experts. In the instrument analysis phase, the new tool was psychometrically tested. The intra‐class correlation coefficient showed high stability of the instrument (r = .92). Factor analysis resulted in a 6‐factor solution accounting for 66.68% of the variance in the 16‐item model. Although this instrument was developed for use with Taiwanese adolescents, it needs further testing to confirm its usefulness in other cultural groups. The identified risky situations provide a beginning assessment tool that is easy to administer and can be used to identify teens at particular risk for relapse before being released from incarceration or other mandatory treatment programs. More research is needed to target specific and culturally determined triggers that can improve the validity of this tool for non Asian adolescents at risk for methamphetamine relapse.

Re-thinking the Foundation of Primary Care Nursing

The University at Buffalo (UB), Family Nurse Practitioner (FNP) program was recently funded by a Health Resources Service Administration (HRSA), Bureau of Health Professions, Advanced Nurse Training grant to prepare graduates with a joint focus on family based primary care and addictions nursing. Graduates will be eligible for dual certification: American Nurses Credentialing Center (ANCC) FNP certification and the new Certified Addictions Registered NurseAdvanced Practice (CARN-AP) certification. This new program addresses gaps in primary care related to the spectrum of addictions and co-occurring mental health disorders and may be, the first FNP program to combine these specialties. These gaps in care are compounded by numerous studies and reports that also document the lack of addictions training for primary care providers—both nurse practitioners (NPs) and physicians (MDs) (Fornili & Haack, 2005; Haack & Adger, 2002). To underscore the need for the new FNP curriculum, a group of UB faculty and students conducted a survey of 213 New York State practicing advanced practice nurses (APNs)—primarily