Rebecca C. Lee

The Culture of Pregnancy and Infant Care in African American Women: An Ethnographic Study

In Hamilton County, Ohio, the infant mortality rate for African American infants in 2002 was 18.1 per 1,000 live births compared with 14.4 for the United States. It is essential to engage community residents and leaders in identifying the underlying cultural factors contributing to this disparity. The purpose of the study was to explore the cultural contexts of prenatal and infant care practices among African American women of childbearing age living in an urban community located in Hamilton County, Ohio. This was an ethnographic community-based participatory research study. Seven participants were recruited for the study. Family support from mothers and sisters in obtaining needed resources related to pregnancy and child care emerged as the central theme. A strong family-based social network was core to the culture of pregnancy and infant care for these women. Nurses should consider developing family-centered interventions to reduce disparity in infant health.

Designing and Evaluating a Health Belief Model-Based Intervention to Increase Intent of HPV Vaccination among College Males

Since 2009, HPV vaccine has been approved by the FDA for use in boys and young men, but less than 1% of eligible males in the United States have taken this vaccine. This study developed and evaluated a Health Belief Model (HBM)-based intervention to increase vaccination rates in college men. In a randomized controlled trial, HBM-based intervention was compared with a traditional knowledge-based intervention in 90 U.S. college-aged men ages 18–25 years. Repeated measures of ANOVA indicated significant positive changes in the intervention group for knowledge and HBM constructs. Results from the pretest/posttest regression analysis indicated self-efficacy for taking the vaccine (p = 0.000), perceived barriers (p = 0.007), and perceived severity (p = 0.004) were significant positive predictors of vaccine acceptability. The model had an adjusted R2 of 0.351. Overall, the intervention proved to be effective in creating positive change toward HPV vaccine acceptability.

Using the health belief model in qualitative focus groups to identify HPV vaccine acceptability in college men.

This study determines predictors of HPV vaccine acceptability among college-aged male students through the qualitative data collection strategy of focus groups. Over the course of 2 months, six focus groups were conducted with 50 participants, with approximately 10 participants in each focus group. Participants were predominately single, heterosexual, about 20 years old, Caucasian males attending a large Midwestern University. The Health Belief Model (HBM) was used as a guide in developing questions for the focus groups. Each question related to a construct of the HBM. A lack of perceived susceptibility, perceived severity of HPV, and barriers toward taking the HPV vaccine were major themes identified from the focus groups. Overall, the focus group proved to be effective in understanding predictors toward HPV vaccine acceptability. Results enabled the researchers to develop an understanding of content needed for effective interventions. This study indicates a need for more qualitative studies exploring attitudes, beliefs, and behaviors related to HPV vaccine acceptability among at-risk populations.

The Influence of the Metaparadigm of Nursing on Professional Identity Development Among RN-BSN Students

This paper is a report of an interview about the metaparadigm of nursing and the influence of the metaparadigm on the professional identity development of students enrolled in an online RN-BSN program.

Employment Maintenance and Intimate Partner Violence

Intimate partner violence (IPV) is a major public health problem in the United States. Negative outcomes of IPV affect women’s attainment and maintenance of employment. The purpose of this study was to develop a theoretical framework that described and explained the process by which women who have experienced IPV attain and maintain employment. Grounded theory methodology was used to analyze interviews of 34 women who had experienced IPV. Analysis suggested that women who had experienced IPV could attain employment; however, they had difficulty maintaining employment. Entanglement of work and IPV was experienced by all 34 participants because of the perpetrator controlling their appearance, sabotaging their work, interfering with their work, or controlling their finances. Some women described ways in which they disentangled work from IPV through a dynamic unraveling process, with periods of re-entanglement, resulting in job security and satisfaction.

Recruiting and Keeping African American Women in an Ethnographic Study of Pregnancy: The Community-Based Partnership Model

The authors report here on the application of the community-based participatory research (CBPR) model to recruit and retain African American women in an ethnographic study of how urban African American women learn mothering skills and experience pregnancy. The project facilitated collaboration among academics, neighborhood leaders, and community agencies. Using the CBPR strategy, seven participants were recruited to and were retained in the study through two interviews, an average of 6 weeks apart.

Family homelessness viewed through the lens of health and human rights.

Families with children, many of whom are headed by a single mother, are the fastest growing segment of the homeless population. Guided by Leiningers Culture Care Theory and the ethnonursing research method, the purpose of this study was to discover the care meanings and expressions for a group of 12 Appalachian mothers living with their children in an urban homeless shelter. Reflected in each mothers words and embedded within the 3 universal themes that emerged was the need to be treated with human dignity and respect. This need was seen as vital to the health and well being of these families.

Understanding the health of veterans who are homeless: A review of the literature

The United States Department of Housing and Urban Development estimates that almost 50,000 veterans are homeless on any given night. Homeless veterans are at greater risk of health disparities than their housed counterparts due to the multifactorial nature of their health and social needs. The Department of Veterans Affairs, in collaboration with more than a dozen other federal agencies, has concentrated efforts to improve the health of this vulnerable population while enacting a plan to eliminate veteran homelessness within the near future. Understanding the unique health needs of veterans who are homeless allows the profession of nursing to better support these efforts. The purpose of this literature review was to provide comprehensive knowledge to nurses about the health of homeless veterans for their use in clinical practice, research, and in contributing to the positive health outcomes for this vulnerable population.

Pursuing the Mission: How Homeless Veterans Manage Chronic Disease

The purpose of this study was to describe and explain the process by which homeless veterans manage their chronic health problems. In the United States, over 550,000 people experience homelessness on any given night. Of these, over 11% are veterans of the military, many whom suffer from at least one chronic disease. Study participants included male homeless veterans with at least one chronic health problem recruited at a Veterans Affairs emergency department, a homeless shelter, and a soup kitchen. Semi-structured interviews with 32 veterans from the Vietnam/post-Vietnam era were audio-recorded, verified, and coded resulting in a theory entitled “pursuing the mission,” which describes and explains four ways (deferring, exploring, embarking, embracing) they manage their chronic health problems. The findings from this study provide insight from individuals living this experience and will help guide the future delivery of health care to homeless veterans.