Working with an environmental justice community: Nurse observation, assessment, and intervention

Use of Social Determinants of Health Screening among Primary Health Care Nurses of Developed Countries: An Integrative Review

The aims of the study are to evaluate and synthesise research that has investigated social determinants of health screening by primary healthcare nurses; how and when primary health care nurses perform social determinants of health screening; and implications for advancing nursing practice. Systematic searches in electronic databases identified fifteen published studies which met the inclusion criteria. Studies were synthesised using reflexive thematic analysis. This review found little evidence of primary health care nurses using standardised social determinants of health screening tools. Eleven subthemes were identified and collapsed into three main themes: organisation and health system supports are required to enable primary health care nurses; primary health care nurses are often reluctant to perform social determinants of health screening; and the importance of interpersonal relationships for social determinants of health screening. The social determinants of health screening practices of primary health care nurses are poorly defined and understood. Evidence suggests that primary health care nurses are not routinely using standardised screening tools or other objective methods. Recommendations are made for valuing therapeutic relationships, social determinants of health education and the promotion of screening by health systems and professional bodies. Overall, further research examining the best social determinant of health screening method is required.

Planetary Health Nursing

ABSTRACT

Planetary health is focused on the interconnectedness of the health of humans, other species, and the physical environment. Disruption of the Earth's natural ecosystems due to human overconsumption; disregard for sustainable practices; and the domination of other humans, species, and natural systems has led to an urgent moment in which humans must act to preserve these ecosystems, which support life on this planet. Restoring planetary health requires new directions for nursing. The pragmatic implications for nursing research, education, advocacy, and practice are explored in this article.

Community-Based Participatory Research to Improve Cardiovascular Health Among US Racial and Ethnic Minority Groups

Purpose of Review

This review aims to assess the contemporary community-based participatory research (CBPR) literature seeking to improve the cardiovascular health of racial and ethnic minority groups in the USA with a higher burden of cardiovascular risk factors and social determinants of health. It summarizes recent CBPR studies based on the American Heart Association Life's Simple 7 (LS7) framework, delineating seven modifiable health behaviors and clinical factors to promote cardiovascular health.

Recent Findings

Although limited in quantity, studies demonstrated preliminary effectiveness in improving individual and a composite of LS7 indicators by employing strategies centered around fortifying social networks, integrating group activities, leveraging technology, incorporating faith-based and spiritual practices, and implementing changes to the built environment.

Summary

Future directions for investigators engaged in CBPR include building on the existing body of evidence through more comprehensive studies, scaling effective interventions, and translating CBPR findings to influence health policy to better address health disparities.

Nursing strategies for environmental justice: A scoping review

OBJECTIVE

To describe types of strategic actions nurses take to promote environmental justice (EJ) through research, education, advocacy, and practice (REAP) reported in peer-reviewed literature.

DESIGN AND SAMPLE

A scoping review of literature was conducted that described EJ nursing strategies and included nurses listed as authors, subjects, partners, or organizational members. The sample consisted of 35 articles, representing 24 primary research studies and 11 nonresearch articles. Data were separately analyzed by research and nonresearch articles for a clearer understanding of evidence-based strategies within domains of REAP.

RESULTS

Articles in the sample highlighted the importance of authentic community partnership and represented diversity of nursing strategies that addressed a range of environmental exposures and subsequent health and racial inequities. Climate justice, a concept that emerged from the EJ movement and intersects with planetary health, is a recent focus in professional nursing.

CONCLUSIONS

This scoping review establishes an understanding of the extent of nursing knowledge and research in EJ and lays the groundwork for further research on effective EJ nursing strategies. Community-Based Participatory Research/Participatory Action Research methods are fundamental for EJ research, and further theoretical development is needed to guide evaluation of EJ nursing strategies for education, advocacy, and practice.

Applying the NIEHS translational research framework (NIEHS-TRF) to map clinical environmental health research trajectories

Background:

There is a need for comprehensive planning tools and exemplars for clinical environmental health research programs. The National Institute of Environmental Health Sciences Translational Research Framework (NIEHS-TRF), as a comprehensive research activity mapping framework, promises to fill this gap in program planning and communication tools.

Objective:

The objective is a proof of concept demonstration to apply the NIEHS-TRF as a research project and career trajectory cartography framework.

Methods:

We utilized case series examples to apply the NIEHS-TRF as a project/career cartography framework. After a tailored research mission statement is clarified, the four step process in the NIEHS-TRF application includes 1) identifying research categories and activities (depicted visually by rings/nodes) that link to research program deliverables, 2) within each category (visual ring), linking specific works and program outcomes to activities (visual nodes), 3) coherently depicting visually as an overall map, and 4) developing recommended improvements for the NIEHS-TRF for research program cartography utility.

Results:

Successful mapping of a research project plan in a training grant application, a summary of an individual trajectory of research, and a community-initiated project was completed with mapping visualizations. The exercise facilitated purposeful planning and communication to describe common translational goals, progress, and targeted need for interdisciplinary collaboration.

Discussion:

Utilizing the NIEHS-TRF as a mapping tool for research program planning enabled unique insights into strengths, gaps, collaboration opportunities, and applications for environmental health nursing. This research project, career, and community-initiated research program trajectory mapping communication tool promises to accelerate impact and advancement through purposeful and clear planning for ongoing research activities along the translational continuum.

Development and Evaluation of a Blood Glucose Monitoring YouTube Video for Marshallese Patients Using a Community-Based Participatory Research Approach

The purpose of this study was to (a) describe the development of a culturally appropriate glucose monitoring video using a community-based participatory research approach and (b) assess the cultural appropriateness and effectiveness of the video. The topic of the video-using a glucometer and the importance of performing blood glucose checks-was chosen by Marshallese community stakeholders. The video was produced in Marshallese with English subtitles and disseminated through YouTube. Participants were recruited from August 16, 2016 to September 12, 2016 in a diabetes clinic that serves Marshallese patients in northwest Arkansas. Fifty participants completed a survey at pre- and postintervention, with questions capturing demographic information and questions on glucose monitoring self-efficacy using an adapted version of the Stanford Patient Education Research Center's Diabetes Self-Efficacy Scale. Twenty of those participants who completed the survey also completed semistructured interviews that assessed cultural appropriateness and effectiveness of the video. Participants reported significant increases in self-efficacy related to glucometer use and the importance of performing blood glucose checks (p < .001) and a 1.45% reduction in A1C between preintervention and 12 weeks postintervention (p = .006). Qualitative results indicated the video was both culturally appropriate and effective. The findings of this study were consistent with evidence in the literature, which shows health education videos can be effective at improving health behaviors. Using a community-based participatory research approach to prioritize video topics, and including members of the community in the creation and dissemination of the videos, could aid in ensuring the videos are effective and culturally appropriate.

Advancing the symptom science model with environmental health

OBJECTIVE

Globally, indoor and outdoor pollutants are leading risk factors for death and reduced quality of life. Few theories explicitly address environmental health within the nursing discipline with a focus on harmful environmental exposures. The objective here is to expand the National Institutes of Health Symptom Science Model to include the environmental health concepts of environmental endotype (causative pathway) and environmental exposure.

DESIGN

Meleis' research to theory strategy for theory refinement was used. Research workshop proceedings, environmental health nursing research expert consensus, panelist research trajectories, and review of the literature were utilized as data sources.

RESULTS

Ongoing emphasis on the physical environment as a key determinant of health and theoretical perspectives for including environmental exposures and endotypes in symptom science are presented. Definitions of these concepts, further developed, are provided. Recommendations to strengthen environmental health nursing research and practice through capacity building/infrastructure, methods/outcomes, translational/clinical research, and basic/mechanistic research are included.

CONCLUSION

The revised model deepens theoretical support for clinical actions that include environmental modification, environmental health education, and exposure reduction. This modification will enable a middle-range theory and shared mental model to inspire the prioritization of environmental health in nursing leadership, research, practice, and education.