Leadership in Nursing Science: Four Scholarly Journeys Rooted in Historically Black College and University Excellence

The intricacies of the unique educational and leadership development trajectories of Black PhD-prepared nurse scientists are largely invisible in nursing faculty development literature. A broadened understanding of nursing leadership development and science mentorship can facilitate support for the next generation of Black nurse scientists. Historically Black Colleges and Universities (HBCUs) can serve as formative launch pads for nurse scientist development. However, the role of HBCUs and strategies for supporting robust educational and mentor/training opportunities for Black PhD-prepared nurse scientists require thoughtful description and application. Incorporating an intrapersonal, interpersonal, and integrative leadership framework, we describe and synthesize four Black nurse scientists and HBCU graduates' experiences to highlight early science mentorship and leadership resilience through the excellent educational foundations provided at HBCUs.

National Institute on Aging Butler-Williams Scholars Program: The first 30 years

The development of a skilled research workforce in aging is fundamental to understanding conditions associated with growing older and extending healthy, active years of life. The National Institutes of Health (NIH) supports the training of health scientists, and its National Institute on Aging (NIA) prioritizes the professional development of investigators with an interest in aging. Since 1987, NIA's Summer Institute on Aging Research, renamed the Butler-Williams (B-W) Scholars Program in 2013, has offered an intensive one-week experience on issues, opportunities, and challenges of research on aging, with emphasis on disparities and health equity. The first 30 years of the Program are described in this report, including its history, selected curriculum highlights, Scholar outcomes, and qualitative data from faculty, and the program's impact on the training, growth, and development of scientists in aging research. Questions raised over a decade ago by the Committee on the Future Health Care Workforce for Older Americans Board on Health Care Services are revisited, and recommendations for the future are provided. This important Program remains an exemplar for the training and development of health scientists for careers that advance biomedical research and emphasize an equitable understanding of factors related to extending healthy years of life.

Tailoring Stroke Counseling for Risk Reduction Intervention to African American Men

Early life course achievement and maintenance of ideal cardiovascular health is associated with reduced risk of developing stroke later in life. The Stroke Counseling for Risk Reduction (SCORRE) intervention is an age-and-culturally relevant intervention originally designed to correct inaccurate stroke risk perceptions and improve lifestyle behaviors to reduce stroke risk in AAs age 20-35. In a study testing SCORRE, fewer men participated, but most were not at a stage of readiness for behavior change; many did not think they were at risk despite averaging three modifiable risk factors, and while improvements in outcomes were observed in women they were not in men. These differences led to tailoring SCORRE to young AA men. The methods for tailoring SCORRE and resulting strategies for attracting, engaging, and empowering them towards stroke risk reduction, including hypotheses concerning food supply, housing, economic and social relationships, education, and mental health care will be raised for discussion.

The National Hartford Center of Gerontological Nursing Excellence: An Evolution of a Nursing Initiative to Improve Care of Older Adults

The mission of the John A. Hartford Foundation is to improve the health of older Americans. This mission has been realized throughout the evolution of the National Hartford Center of Gerontological Nursing Excellence-an international collaboration between Schools of Nursing and Sigma Theta Tau International Honor Society of Nursing-whose goal is to support research, education, and practice to provide better nursing care for our aging society. The National Hartford Center is the focus of this supplement and an example of the Foundation's grant-making to prepare the nursing workforce to be competent to care for our aging society. This article traces the innovative origin and inception of the National Hartford Center, first as the Building Academic Geriatric Nursing Capacity (BAGNC) Initiative in 2000 under the leadership of two groundbreaking scholars in nursing and aging sciences: Claire M. Fagin, PhD, RN, and Patricia G. Archbold, DNSc. We continue through to today's leadership and culminate by describing the Center's influence on the gerontological nursing workforce and clinical practice; the paper also includes a brief introduction to the articles, highlighting advances in gerontological nursing science. With funding from the John A. Hartford Foundation, The Atlantic Philanthropies, The Mayday Fund, and a number of creative public and nonprofit partnerships, the National Hartford Center celebrates two decades and its greatest asset-the nearly 300 gerontological nursing leaders, including Archbold nursing pre-docs, Fagin nursing post-docs, and expert faculty, along with its Hartford Centers of Gerontological Nursing Excellence across the country. We trace the transition of BAGNC to the membership-based National Hartford Center and its move to The Gerontological Society of America to become a self-sustaining, autonomous unit. Current needs, challenges, lessons learned, and strategies of the National Hartford Center are examined within the context of sustainability, which has become paramount as Hartford Foundation funding ends in 2016. Despite the auspicious beginnings of the National Hartford Center, system change has been slow. There remains a strong need to continue to grow the field of gerontological nursing and aging sciences. We are working diligently to drive health system reform, and develop and support gerontological nursing leaders and members of the National Hartford Center as exemplars for innovation in care of older adults. The contributing authors of this supplement are from member schools of the National Hartford Center or are current or past program Scholars or Fellows. Herein these authors showcase innovation for older adults through their research that addresses an array of diseases and conditions affecting human systems, embedded in a variety of environments, including in-home care, subsidized housing communities, nursing homes, assisted living facilities, memory care units, and rural community environs.

A review of our roots: blacks in gerontology

The historical underpinnings in the field of gerontology rest on the contributions of scholars across a myriad of racial and ethnic backgrounds. With the increasing diversity of the adult population, there is a need to increase the number of researchers who study older adults from diverse racial and ethnic populations in general and Black elderly people in particular. Furthermore, it is important to document the participation of Black older adults in our earliest and continuing research efforts. Understanding the historical context and the foundational influence of Black scholars in this field is critical. To realize its humble beginnings, one must become aware of the contributions by Black scholars who have a vested interest in the aging process. With universal similarities and unique differences among older adults, there is a need to acknowledge the past and current scholarship of those who study the aging processes of Blacks while marveling over the future possibilities. The purpose of this review is to elucidate the legacy and current contributions, philosophies, and research of Black scholars in the field of gerontology. In addition, exploration of the theoretical and conceptual frameworks used to establish national and organizational initiatives is reviewed. The impetus in initiating and continuing this work requires a "knowledge of our roots" while moving into the future. It is important to learn the history and significance of Black scholars in gerontology, the contributions of older Blacks, and appreciate the resiliency and marveled life course of this unique population.

NIA outreach to minority and health disparity populations can a toolbox for recruitment and retention be far behind?

The ability to locate the right research tool at the right time for recruitment and retention of minority and health disparity populations is a challenge. This article provides an introduction to a number of recruitment and retention tools in a National Institute on Aging Health Disparities Toolbox and to this special edition on challenges and opportunities in recruitment and retention of minority populations in Alzheimer disease and dementia research. The Health Disparities Toolbox and Health Disparities Resource Persons Network are described along with other more established resource tools including the Alzheimer Disease Center Education Cores, Alzheimer Disease Education and Referral Center, and Resource Centers for Minority Aging Research. Nine featured articles are introduced. The articles address a range of concerns including what we know and do not know, conceptual and theoretical perspectives framing issues of diversity and inclusion, success as a result of sustained investment of time and community partnerships, the significant issue of mistrust, willingness to participate in research as a dynamic personal attribute, Helpline Service and the amount of resources required for success, assistance in working with Limited English Proficiency elders, and sage advice from social marketing and investigations of health literacy as a barrier to recruitment and retention. Finally, an appeal is made for scientists to share tools for the National Institute on Aging Health Disparity Toolbox and to join the Health Disparities Resource Persons Network.

American Academy of Nursing Expert Panel report: developing cultural competence to eliminate health disparities in ethnic minorities and other vulnerable populations

The members of the Expert Panel on Cultural Competence of the American Academy of Nursing (AAN) envisioned this article to serve as a catalyst to action by the Academy to take the lead in ensuring that measurable outcomes be achieved that reduce or eliminate health disparities commonly found among racial, ethnic, uninsured, underserved, and underrepresented populations residing throughout the United States. The purposes of this article are to (a) assess current issues related to closing the gap in health disparities and achieving cultural competence, (b) discuss a beginning plan of action from the Expert Panel on Cultural Competence for future endeavors and continued work in these areas beyond the 2002 annual conference on Closing the Gap in Health Disparities, and (c) provide clearly delineated recommendations to assist the Academy to plan strategies and to step forward in taking the lead in reshaping health care policies to eliminate health care and health disparities.

Fictive Kin: Friends as Family Supporting Older Adults as They Age

Assessing social support or social capital is receiving renewed attention in health care. A search of the nursing literature revealed limited attention to a potential resource in the care of older adults--fictive kin. Transdisciplinary searches indicated that "fictive kin" or "chosen kin" are increasingly important as family size shrinks and older adults live longer lives. Fictive kin are common across cultural groups and some have designated special names for these quasi-family members. The purpose of this article is to advance the concept of fictive kin as a resource for older adults and to provide strategies to promote engagement of fictive kin in health care planning by nurses.

Meeting the challenge of the new millennium: caring for culturally diverse patients

The world is shrinking, and as a consequence, the United States is changing rapidly. In this new environment, health care providers must navigate a new cultural terrain and develop new skills to provide appropriate care for patients from increasingly diverse backgrounds. The new millennium demographic data of the United States and the essential elements of cultural assessment are necessary to understand how patient care should be approached in an increasingly diverse population.

Millennium milestones: looking back, moving forward in your research career

The author discusses the mission of the National Institute on Aging (NIA), Office of Special Populations, the trends in appropriations, use of census data and the need to disentangle the social and political meaning of race from the presumed biological meaning, the potential effect of slavery on the health of African Americans, Federal racial and ethnic minority initiatives, definitions of race, culture, ethnicity, class and racism; formal recommendations from the NIA review of minority aging research; and NIA training and career development opportunities for minorities. Lastly, the author discusses minority aging research, health disparities and strategies for recruiting minorities into aging research.

Avoiding gender and minority barriers to NIH funding

PURPOSE

To inform investigators of the National Institutes of Health (NIH) guidelines for the inclusion of women and minorities as subjects in clinical research and provide tips on avoiding barriers to federal funding.

METHODS

Information about gender and minority barriers to funding was obtained by reviewing NIH policies, information submitted by applicants, and comments provided by NIH reviewers.

ORGANIZING FRAMEWORK

A brief history of the goals of U.S. federal legislation to increase opportunities for obtaining information to help enhance health and disease treatment for all Americans and to detect and account for ethnic and gender differences is described. Examples were derived from NIH Summary Statement comments of initial review groups.

CONCLUSIONS

Applications submitted to NIH are being barred from initial funding, even with excellent priority scores, if the plan for inclusion of women and minorities is judged to be scientifically unacceptable by the initial review group. This situation is correctable and avoidable.

Breast reconstruction using an innovative flap procedure

Most patients consider breast reconstruction an essential part of total breast cancer management. In the wake of the silicone-gel implant controversy, more women are considering breast reconstruction using their own tissue. Since 1982, the transverse rectus abdominis myocutaneous (TRAM) flap has become a well-established and popular method of reconstruction. For many women, TRAM flap reconstruction is the surgery of choice following mastectomy. It offers victims of breast cancer the potential for soft, natural-appearing breast mounds without the risks associated with other types of flaps or manufactured implants. A description of autogenous tissue grafting using the TRAM flap for breast reconstruction is provided with associated perioperative nursing care guidelines and potential complications.