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Fernández NB, Herrera MG, Blaustein M, Pignataro MF. Policy options and practical recommendations for determining priorities in public health research agendas in peripheral countries: insights from a collaborative work initiative in Argentina during the COVID-19 pandemic. Front Med (Lausanne) 2024; 10:1334194. [PMID: 38274453 PMCID: PMC10808489 DOI: 10.3389/fmed.2023.1334194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 12/26/2023] [Indexed: 01/27/2024] Open
Affiliation(s)
- Natalia Brenda Fernández
- Instituto de Biociencias, Biotecnología y Biología traslacional (iB3), Departamento de Fisiología, Biología Molecular y Celular (DFBMC), Facultad de Ciencias Exactas y Naturales (FCEyN), Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
| | - María Georgina Herrera
- Instituto de Biociencias, Biotecnología y Biología traslacional (iB3), Departamento de Fisiología, Biología Molecular y Celular (DFBMC), Facultad de Ciencias Exactas y Naturales (FCEyN), Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - Matías Blaustein
- Instituto de Biociencias, Biotecnología y Biología traslacional (iB3), Departamento de Fisiología, Biología Molecular y Celular (DFBMC), Facultad de Ciencias Exactas y Naturales (FCEyN), Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
| | - María Florencia Pignataro
- Instituto de Biociencias, Biotecnología y Biología traslacional (iB3), Departamento de Fisiología, Biología Molecular y Celular (DFBMC), Facultad de Ciencias Exactas y Naturales (FCEyN), Universidad de Buenos Aires (UBA), Buenos Aires, Argentina
- Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Buenos Aires, Argentina
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White BP, Abuelezam NN, Fontenot HB, Jurgens CY. Exploring Relationships Between State-Level LGBTQ Inclusivity and BRFSS Indicators of Mental Health and Risk Behaviors: A Secondary Analysis. J Am Psychiatr Nurses Assoc 2022; 29:224-231. [PMID: 36113408 DOI: 10.1177/10783903211007900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Minority Stress Theory suggests that repeated exposure to enacted stigma adversely affects mental health. States have wide authority to enact policies affecting the level of inclusivity experienced by lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) residents. The purpose of this study was to explore relationships between states' level of LGBTQ inclusivity and indicators of mental health/risk behaviors among an LGBTQ sample. METHODS The 2018 Human Rights Campaign State Equality Index (SEI) and the 2018 Behavioral Risk Factor Surveillance Survey (BRFSS) were used to examine relationships between states' levels of LGBTQ inclusivity (predictor variable) and indicators of mental health/risk behaviors (outcome variables). Relationships were explored using descriptive statistics and survey-weighted logistic regression. RESULTS Lower state inclusivity increased odds of fair/poor general health (adjusted odds ratio [AOR]: 1.22, 95% confidence interval [CI]: 1.01-1.48), increased odds of poor mental health days (AOR: 1.34, 95% CI: 1.11-1.62), increased odds of smoking (AOR: 1.62, 95% CI: 1.27-2.07), and increased odds of heavy drinking (AOR: 1.54, 95% CI: 1.26-1.86) and binge drinking (AOR: 1.23, 95% CI: 1.01-1.49). State inclusivity did not influence odds of a depressive disorder diagnosis or driving under the influence of alcohol. CONCLUSIONS LGBTQ persons in restrictive states had increased odds of experiencing several indicators of mental health and risk behaviors. More research is needed to determine whether state policies affect other domains of LGBTQ persons' health. Health care providers should be mindful of LGBTQ persons' mental health/risk behaviors and the state policy environment, and should seek to implement mitigating health care strategies such as the use of validated assessment.
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Affiliation(s)
| | | | - Holly B Fontenot
- Holly B. Fontenot, PhD, APRN, WHNP-BC, FAAN, FNAP, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Corrine Y Jurgens
- Corrine Y. Jurgens, PhD, RN, ANP, FAHA, FHFSA, FAAN, Boston College, Chestnut Hill, MA, USA
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Kurpas D, Petrazzuoli F, Szwamel K, Randall-Smith J, Blahova B, Dumitra G, Javorská K, Mohos A, Simões JA, Tkachenko V, Kern JB, Holland C, Gwyther H. The pros and cons of the implementation of a chronic care model in European rural primary care: the points of view of European rural general practitioners. Rural Remote Health 2021; 21:6509. [PMID: 34455798 DOI: 10.22605/rrh6509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
INTRODUCTION This article describes the views of European rural general practitioners regarding the strengths, weaknesses, opportunities and threats (SWOT) of the implementation of a chronic care model (CCM) in European rural primary care. METHODS This was a mixed-methods online survey. Data were collected from 227 general practitioners between May and December 2017. Categorical data were analysed using descriptive methods while free-text responses were analysed using qualitative methods. The setting was rural primary care in nine European countries (including Central and Eastern Europe). Main outcomes measures were respondents' evaluations of a chronic care model in their rural healthcare settings in terms of SWOT. RESULTS The SWOT analysis showed that the expertise of healthcare professionals and the strength of relationships and communications between professionals, caregivers and patients are positive components of the CCM system. However, ensuring adequate staffing levels and staff competency are issues that would need to be addressed. Opportunities included the need to enable patients to participate in decision making by ensuring adequate health literacy. CONCLUSION The CCM could certainly have benefits for health care in rural settings but staffing levels and staff competency would need to be addressed before implementation of CCM in such settings. Improving health literacy among patients and their carers will be essential to ensure their full participation in the implementation of a successful CCM.
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Affiliation(s)
- Donata Kurpas
- Department of Family Medicine, Wroclaw Medical University, Wroclaw, Poland; and European Rural and Isolated Practitioners Association (EURIPA)
| | - Ferdinando Petrazzuoli
- Department of Clinical Sciences, Center for Primary Health Care Research, Lund University, Malmö, Sweden; and European Rural and Isolated Practitioners Association (EURIPA)
| | | | | | - Beata Blahova
- Faculty of Public Health, Slovak Medical University, Bratislava, Slovakia; and European Rural and Isolated Practitioners Association (EURIPA)
| | - Gindrovel Dumitra
- Romanian National Society of Family Medicine, Bucharest, Romania; Department of Family Medicine, University of Medicine and Pharmacy, Craiova, Romania; and European Rural and Isolated Practitioners Association (EURIPA)
| | - Kateřina Javorská
- Medical Faculty of Hradec Králové, Charles University, Hradec Králové, Czech Republic; and European Rural and Isolated Practitioners Association (EURIPA)
| | - András Mohos
- Department of Family Medicine, Faculty of Medicine, University of Szeged, Szeged, Hungary; and European Rural and Isolated Practitioners Association (EURIPA)
| | - José Augusto Simões
- Department of Medical Sciences, Faculty of Health Sciences, University of Beira Interior, Covilhã, Portugal; and European Rural and Isolated Practitioners Association (EURIPA)
| | - Victoria Tkachenko
- Department of Family Medicine, Institute of Family Medicine at Shupyk National Healthcare University of Ukraine, Kiev, Ukraine; and European Rural and Isolated Practitioners Association (EURIPA)
| | - Jean-Baptiste Kern
- General Practice Department, Faculty of Medicine, Université Grenoble Alpes, Grenoble, France; and European Rural and Isolated Practitioners Association (EURIPA)
| | - Carol Holland
- Centre for Ageing Research, Lancaster University, Lancaster, UK
| | - Holly Gwyther
- Centre for Ageing Research, Lancaster University, Lancaster, UK; and Institute of Applied Health Research, University of Birmingham, Edgbaston, Birmingham, UK
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Rice MJ, Stalling J, Monasterio A. Psychiatric-Mental Health Nursing: Data-Driven Policy Platform for a Psychiatric Mental Health Care Workforce. J Am Psychiatr Nurses Assoc 2019; 25:27-37. [PMID: 30793645 DOI: 10.1177/1078390318808368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To describe the development of a data-driven policy platform for psychiatric nurses roles and outcomes to alleviate the current mental health crisis in the United States. METHOD Drawing on census data, statistical reports, and analysis of the current psychiatric mental health nursing (PMHN) workforce, a data-driven policy platform is designed to recruit, train, and prepare psychiatric nurses for addressing the nation's mental health crises. RESULTS As noted by the Institute of Medicine's 2010 & 2016 reports on the future of nursing, the largest available health care workforce is not being used effectively, particularly to address the nation's mental health care needs. The development of a data-driven platform provides direction for psychiatric nurses in developing the workforce to meet the national mental health crisis. CONCLUSIONS From education through practice and research, psychiatric-mental health nursing must build and share a data-driven, relationship-to-care platform emphasizing how PMHN care affects patient outcomes. Using a data-based platform to grow supportive public opinion, psychiatric mental health nursing can build a workforce to modify national accreditation standards and laws supporting data-driven PMHN care. The specialty profession must also seek to modify the nursing profession's attitude toward embracing data-driven platform of care relationships to psychiatric mental health outcomes.
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Affiliation(s)
- Michael J Rice
- 1 Michael J. Rice, PhD, APRN, FAAN, University of Colorado, Anschutz Medical Center, Aurora, CO, USA
| | - Janette Stalling
- 2 Janette Stalling MA, MSN, APRN, PMHNP-BC, Great Plains Mental Health Associates, Omaha, NE, USA
| | - Andrew Monasterio
- 3 Andrew Monasterio, DNP, APRN, PMHNP-BC, University of Tennessee Health Science Center, Memphis, TN, USA
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Abstract
The Patient Protection and Affordable Care Act (ACA) will greatly increase the demand for mental health (MH) services, as 62.5 million Americans from relatively high-need populations will be newly eligible for MH benefits. Consequently, the supply of MH care provider services is expected to proportionately decrease by 18% to 21% in 2014. ACA funding does not demonstrate the ability to increase turnout of psychiatrists sufficiently to meet the need. Available data indicate that the numbers of advanced practice psychiatric nurses (APPNs) continue to increase at a much greater rate, but information from either a clinical perspective or a market perspective is complicated by the weak distinctions that are made between nurse practitioners (NPs) and other nonphysician care professionals. The following recommendations are made: (a) some of the ACA funding for research into efficient and effective care delivery systems should be allocated to acquiring data on APPNs in leadership roles or clinical settings in which they are ultimately responsible for management of MH care, as differentiated from settings in which they provide support for psychiatrists; and (b) since the available data indicate nurse practitioners achieve good outcomes and are more economically viable than psychiatrists, placement of psychiatric-mental health nurse practitioners in community settings should be recognized as a realistic solution to the shortfall of MH services.
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