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Rodrigues SM, Shin SS, Pinto MD, Bounds DT, Terry J, Burton CW. Parenting Expectations, NICU Experiences, and Maternal Psychological Outcomes: An Exploratory Mixed-Methods Study. Adv Neonatal Care 2024; 24:195-207. [PMID: 38215024 DOI: 10.1097/anc.0000000000001139] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2024]
Abstract
BACKGROUND Infant neonatal intensive care unit (NICU) hospitalization increases maternal risk for psychological distress. However, no universal screening standards exist and predicting maternal risk remains challenging. Reconceptualizing maternal distress in relation to differences between parenting expectations and NICU experiences may illuminate commonalities across a range of experiences. PURPOSE This study explored parenting expectation-experience differences (EEDs) among NICU mothers and assessed correlations between EED scores and psychological outcomes 1 to 5 years post-NICU hospitalization. METHODS A 3-phase explanatory sequential mixed-methods design was used. Pearson's correlation coefficients were used to measure relationships between EED scores and maternal psychological outcomes. Reflexive thematic analysis of one-on-one, semi-structured interviews contextualized EED scores. RESULTS Most participants (92.9%) reported negative EED scores, indicating NICU experiences fell short of parenting expectations. Significant inverse correlations were found between EED scores and maternal outcomes, including depression ( r = -0.25, P < .01), anxiety ( r = -0.25, P < .01) and posttraumatic stress disorder symptoms ( r = -0.41, P < .001), and perceived parenting self-efficacy ( r = -0.28, P < .01). Major qualitative themes included unexpected versus prepared, lost parenting experiences, and surviving and thriving. Data synthesis contextualized EED scores and revealed key differences in meaning ascribed to unmet parenting expectations. IMPLICATIONS FOR PRACTICE AND RESEARCH Preparing mothers for infant NICU hospitalization and creating a NICU parenting environment, which better supports mothers and their engagement in parenting tasks, may help to reduce differences between parenting expectations and NICU experiences. Further research is needed to elucidate the impacts of parenting EEDs in this population.
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Affiliation(s)
- Sarah M Rodrigues
- Author Affiliations: Sue & Bill Gross School of Nursing, University of California, Irvine (Drs Rodrigues, Shin, Pinto, and Bounds); Department of Gender & Sexuality Studies, University of California, Irvine (Dr Terry); and School of Nursing, University of Nevada, Las Vegas (Dr Burton)
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Rodrigues SM, Bounds DT, Terry J, Pinto MD, Shin S, Burton CW. Application of Trauma-Informed Care Principles to Care Needs Identified by Mothers of NICU-Hospitalized Children. Issues Ment Health Nurs 2024; 45:142-151. [PMID: 37699105 DOI: 10.1080/01612840.2023.2250000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/14/2023]
Abstract
Systematic uptake of family-centered care (FCC) interventions remains challenging and frequently suboptimal in many neonatal intensive care units (NICUs). Across NICUs in the United States, integrating family members as partners in infant caregiving and decision-making has not been well supported and routine screening and provision of psychological support for parents remains inadequate. Trauma-informed care (TIC) may offer a more comprehensive approach to NICU care which can encompass FCC principles and promote family recovery and resilience by recognizing and responding to the traumas experienced by NICU infants and families. The current paper aimed to understand needs identified by mothers of NICU-hospitalized children and reports a focused analysis of one-on-one interview data (n = 13 mothers) collected during a larger mixed methods study. Reflexive thematic analysis was used to understand needs identified by mothers and to explore how these needs aligned with TIC principles. Six themes were identified and subsequently examined in the context of the principles of TIC: I Just Had No Control, That Really Caught Us Off Guard, So Much Was Already Taken Away, We're People and There Needs To Be More Support and Practices Which Helped. Mothers' care needs were found to align with TIC principles. Findings suggest that implementation of TIC principles in NICU settings can support parental presence, participation in infant care, and mental health and support the potential of TIC as a more comprehensive approach to meeting the needs of NICU parents.
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Affiliation(s)
- Sarah M Rodrigues
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
| | - Dawn T Bounds
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
| | - Jennifer Terry
- Department of Gender & Sexuality Studies, University of California, Irvine, California, USA
| | - Melissa D Pinto
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
| | - Sanghyuk Shin
- Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
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Bounds DT, Rodrigues SM, Balsam D, Lennan N, Rodriguez KR, Milburn NG. Creating Space for Adolescents and Families With Lived Experience of Homelessness to Build Familial Empathy, Communication, and Emotional Regulation: A Qualitative Study of Facilitators of Implementation. J Psychosoc Nurs Ment Health Serv 2024; 62:27-35. [PMID: 37379121 DOI: 10.3928/02793695-20230622-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/30/2023]
Abstract
Youth experiencing homelessness are vulnerable to commercial sexual exploitation (CSE). Structural racism disproportionately entraps marginalized youth into CSE while simultaneously obscuring their identification as victims. Adaptation and tailoring of effective interventions to mitigate associated sequelae and inequities is warranted. Support To Reunite, Involve, and Value Each Other (STRIVE) is a strengths-based dyadic intervention with demonstrated efficacy in reducing delinquency, substance use, and high-risk sexual behaviors among marginalized adolescents experiencing homelessness. The adapted STRIVE+ was piloted to explore potential for reducing youth risk factors for CSE. The current article reports findings from interviews exploring participants' experiences with STRIVE+. Youth and caregivers reported increased empathy, communication, and emotional regulation post-STRIVE+ and found relevance and meaning through participating in the adapted intervention. Feasibility of recruitment, engagement, and retention of minoritized adolescents and their caregivers were also demonstrated. Findings warrant larger scale implementation trials of STRIVE+ among minoritized youth at highest risk for CSE. [Journal of Psychosocial Nursing and Mental Health Services, 62(1), 27-35.].
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Balsam D, Bounds DT, Rahmani AM, Nyamathi A. Evaluating the Impact of an App-Delivered Mindfulness Meditation Program to Reduce Stress and Anxiety During Pregnancy: Pilot Longitudinal Study. JMIR Pediatr Parent 2023; 6:e53933. [PMID: 38145479 PMCID: PMC10775027 DOI: 10.2196/53933] [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] [Received: 10/31/2023] [Revised: 12/05/2023] [Accepted: 12/06/2023] [Indexed: 12/26/2023] Open
Abstract
BACKGROUND Stress and anxiety during pregnancy are extremely prevalent and are associated with numerous poor outcomes, among the most serious of which are increased rates of preterm birth and low birth weight infants. Research supports that while in-person mindfulness training is effective in reducing pregnancy stress and anxiety, there are barriers limiting accessibility. OBJECTIVE The aim of this paper is to determine if mindfulness meditation training with the Headspace app is effective for stress and anxiety reduction during pregnancy. METHODS A longitudinal, single-arm trial was implemented with 20 pregnant women who were instructed to practice meditation via the Headspace app twice per day during the month-long trial. Validated scales were used to measure participant's levels of stress and anxiety pre- and postintervention. Physiological measures reflective of stress (heart rate variability and sleep) were collected via the Oura Ring. RESULTS Statistically significant reductions were found in self-reported levels of stress (P=.005), anxiety (P=.01), and pregnancy anxiety (P<.0001). Hierarchical linear modeling revealed a statistically significant reduction in the physiological data reflective of stress in 1 of 6 heart rate variability metrics, the low-frequency power band, which decreased by 13% (P=.006). A total of 65% of study participants (n=13) reported their sleep improved during the trial, and 95% (n=19) stated that learning mindfulness helped with other aspects of their lives. Participant retention was 100%, with 65% of participants (n=13) completing about two-thirds of the intervention, and 50% of participants (n=10) completing ≥95%. CONCLUSIONS This study found evidence to support the Headspace app as an effective intervention to aid in stress and anxiety reduction during pregnancy.
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Affiliation(s)
- Donna Balsam
- School of Nursing, San Diego State University, San Diego, CA, United States
| | - Dawn T Bounds
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Amir M Rahmani
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
| | - Adeline Nyamathi
- Sue & Bill Gross School of Nursing, University of California, Irvine, Irvine, CA, United States
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Jones-Patten A, Shin SS, Bounds DT, Nyamathi A. Discrimination, Mental Health, and Readiness to Quit Smoking. Clin Nurs Res 2023; 32:1081-1091. [PMID: 37365813 PMCID: PMC10504822 DOI: 10.1177/10547738231183210] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2023]
Abstract
We conducted a cross-sectional study, examining the mediation effects of depression and anxiety on the association between discrimination and readiness to quit cigarette smoking among African American adult cigarette smokers experiencing homelessness. Using a convenience sample, participants were recruited from a homeless shelter in Southern California. Scores of discrimination, depressive, and anxiety symptoms, and readiness to quit smoking were analyzed using linear regression modeling. We enrolled 100 participants; 58 participants were male. In the final model, discrimination had no association with readiness to quit (b = 0.02; 95% CI [-0.04, 0.08]; p = 0.47). The indirect effects of depression (b = 0.04, [0.01, 0.07]; p = 0.02) and anxiety (b = 0.03; [0.01, 0.05]; p = 0.04) reached statistical significance; the direct effects of depression (b = -0.01; [-0.09, 0.04]; p = 0.70) and anxiety (b = -0.00; [-0.09, 0.06]; p = 0.86) did not. Future studies should explore these associations to enhance smoking cessation programs for this population.
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Bounds DT, Rodrigues SM, Milburn NG. Strengthening Families to Disrupt Intergenerational Health Inequities With Adolescents at Risk for Commercial Sexual Exploitation, Substance Use, and HIV. Am J Public Health 2023; 113:S124-S128. [PMID: 37339412 PMCID: PMC10282847 DOI: 10.2105/ajph.2023.307284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/13/2023] [Indexed: 06/22/2023]
Affiliation(s)
- Dawn T Bounds
- Dawn T. Bounds is with the Sue & Bill Gross School of Nursing at the University of California Irvine and, at the time of this study, was in the section of Community Behavioral Health in the Department of Psychiatry and Behavioral Sciences and College of Nursing at Rush University Medical Center, Chicago, IL. Sarah M. Rodrigues is a graduate student researcher and PhD candidate in the Sue & Bill Gross School of Nursing at the University of California Irvine. Norweeta G. Milburn is with the Department of Psychiatry and Biobehavioral Sciences at the University of California Los Angeles Semel Institute Center for Community Health and the Nathanson Family Resilience Center at the University of California Los Angeles. She is also a guest editor of this special issue
| | - Sarah M Rodrigues
- Dawn T. Bounds is with the Sue & Bill Gross School of Nursing at the University of California Irvine and, at the time of this study, was in the section of Community Behavioral Health in the Department of Psychiatry and Behavioral Sciences and College of Nursing at Rush University Medical Center, Chicago, IL. Sarah M. Rodrigues is a graduate student researcher and PhD candidate in the Sue & Bill Gross School of Nursing at the University of California Irvine. Norweeta G. Milburn is with the Department of Psychiatry and Biobehavioral Sciences at the University of California Los Angeles Semel Institute Center for Community Health and the Nathanson Family Resilience Center at the University of California Los Angeles. She is also a guest editor of this special issue
| | - Norweeta G Milburn
- Dawn T. Bounds is with the Sue & Bill Gross School of Nursing at the University of California Irvine and, at the time of this study, was in the section of Community Behavioral Health in the Department of Psychiatry and Behavioral Sciences and College of Nursing at Rush University Medical Center, Chicago, IL. Sarah M. Rodrigues is a graduate student researcher and PhD candidate in the Sue & Bill Gross School of Nursing at the University of California Irvine. Norweeta G. Milburn is with the Department of Psychiatry and Biobehavioral Sciences at the University of California Los Angeles Semel Institute Center for Community Health and the Nathanson Family Resilience Center at the University of California Los Angeles. She is also a guest editor of this special issue
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Gamboa CJ, Julion WA, Fogg L, Bounds DT, Sumo J, Barnes LL. Perceptions of Caring Recruitment Among Older Adults: African Americans and Non-Latinx Whites. Nurs Res 2023; 72:114-122. [PMID: 36598918 PMCID: PMC9991987 DOI: 10.1097/nnr.0000000000000640] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
BACKGROUND African Americans (AAs) are underrepresented in health-related research studies. Few studies have investigated how behaviors of study recruiters affect recruitment of older AAs versus non-Latinx Whites (NLWs). OBJECTIVES The aim of this study was to explore whether caring behaviors influence AA and NLW older adults' decision to participate in hypothetical, high-commitment, health-related research studies and differences in participants' enrollment decisions by race. METHODS Using a descriptive, cross-sectional study design, guided by Kristen Swanson's middle-range theory of caring, a research-savvy sample of 60 AA and 60 NLW adults (age > 65 years) were randomly assigned one of two written vignettes. The concept of caring behaviors was manipulated and illustrated in a hypothetical recruitment scenario. A participant feedback survey was used to assess (a) participants' perceptions of caring and uncaring behaviors exhibited by the fictitious research recruiter, (b) differences in their willingness to participate based on vignette type, and (c) participants' judgment of the research recruiter as being caring or uncaring. A chi-square test assessed the association among categorical variables (caring behavior and participants' race). RESULTS Participants who received the vignette with the high caring recruiter were more than twice as likely to agree to participate in the study than those who received the vignette with the low caring recruiter. AA and NLW participants did not differ in their likelihood to agree to participate. Participants who received the caring vignette and judged the recruiter as caring were 5 times as likely to agree to participate in the high-commitment study than those who received the uncaring vignette ( p < .001). Associations did not vary by race. DISCUSSION This experimental study of equally recruited older adults from an existing longitudinal study revealed that caring behaviors in recruitment strategies are associated with an increased likelihood of participation in high-commitment research with older adults. The research-savvy AA participants were just as likely to participate in the hypothetical high-commitment research as their NLW peers when the fictional research recruiter was perceived as having caring behaviors. When targeting specific populations, it is essential to employ nuanced recruitment approaches where the study recruiters are attuned to caring behaviors.
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Affiliation(s)
- Charlene J. Gamboa
- Rush University Medical Center, Rush Alzheimer’s Disease Center, Office of Research Affairs, Chicago, IL
| | | | - Louis Fogg
- Rush University, College of Nursing, Chicago, IL
| | - Dawn T. Bounds
- The University of California, Irvine, Sue, and Bill Gross School of Nursing, Irvine, CA
| | - Jen’nea Sumo
- Rush University, College of Nursing, Chicago, IL
| | - Lisa L. Barnes
- Rush University, Rush Alzheimer’s Disease Center, Chicago, IL
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Bounds DT, Stiles-Shields C, Schueller SM, Odgers CL, Karnik NS. Ethical considerations for developing pediatric mhealth interventions for teens with socially complex needs. J Child Adolesc Psychiatr Nurs 2023; 36:7-16. [PMID: 36134754 PMCID: PMC9898213 DOI: 10.1111/jcap.12396] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 08/03/2022] [Accepted: 09/11/2022] [Indexed: 02/06/2023]
Abstract
TOPIC Mobile Health (mHealth) stands as a potential means to better reach, assess, and intervene with teens with socially complex needs. These youth often face overlapping adversities including medical illness and a history of experiencing adverse childhood experiences (ACEs). Clinicians are faced with navigating ethical decisions when developing mHealth tools for teens who have socially complex needs. Many tools have been developed for adults from the general population. However, despite the development of thousands of mHealth interventions, developers tend to focus on designing for usability, engagement, and efficacy, with less attention on the ethical considerations of making such tools. PURPOSE To safely move mHealth interventions from research into clinical practice, ethical standards must be met during the design phase. In this paper we adapt the Four Box Model (i.e., medical indications, preferences of patients, quality of life, and contextual features) to guide mHealth developers through ethical considerations when designing mHealth interventions for teens who present with a medical diagnosis and a history of ACEs. SOURCES A review of language, inclusive features, data sharing, and usability is presented using both the Four Box Model and potential scenarios to guide each consideration. CONCLUSIONS To better support designers of mHealth tools we present a framework for evaluating applications to determine overlap with ethical design and are well suited for use in clinical practice with underserved pediatric patients.
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Affiliation(s)
- Dawn T Bounds
- Irvine, Sue & Bill Gross School of Nursing, University of California, Irvine, California, USA
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
| | - Colleen Stiles-Shields
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
- Institute for Juvenile Research, University of Illinois at Chicago, Illinois, USA
| | - Stephen M Schueller
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
| | - Candice L Odgers
- Department of Psychological Science, University of California-Irvine, Irvine, California, USA
- Social Science Research Institute, Duke University, Durham, North Carolina, USA
| | - Niranjan S Karnik
- Department of Psychiatry and Behavioral Sciences, Section of Community Behavioral Health, Rush University, Chicago, Illinois, USA
- Institute for Juvenile Research, University of Illinois at Chicago, Illinois, USA
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Bounds DT, Posey PD. A Resistance Framework for Racially Minoritized Youth Behaviors During the Transition to Adulthood. J Res Adolesc 2022; 32:959-980. [PMID: 35980807 PMCID: PMC9543550 DOI: 10.1111/jora.12792] [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] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
The transition from adolescence to adulthood is a challenging time marked by rapid changes in relational connections, housing status, and academic or work trajectories. We emphasize how structural inequality shapes racially minoritized youth behaviors and center the potential for resistance, arguing that a resistance lens allows us to deepen our understanding of the transition to adulthood for racially minoritized youth. Throughout the paper, we include research on how racially minoritized youth experience marginalizing institutional structures concurrently across multiple systems and their resulting behaviors. We end with the clinical and research implications of a resistance framework to illuminate resistance-informed responses such as rethinking risk and creating spaces for youth-led self-making, youth-adult partnerships to scaffold transitions, and cultivating youth activism.
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Gamboa CJ, Julion WA, Fogg L, Bounds DT. Using Vignette-Based Methodology to Examine Study Recruitment in Older African American Adults: A Methods Paper. J Urban Health 2021; 98:103-114. [PMID: 34322834 PMCID: PMC8501170 DOI: 10.1007/s11524-021-00567-6] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/15/2021] [Indexed: 10/20/2022]
Abstract
This study's objective was to assess which caring recruitment behaviors correlate with the successful recruitment of older African-American adults-a two-step cross-sectional design employing a vignette-based survey methodology. Kristen Swanson's middle-range theory of caring was used to guide the examination of African-American adults' (65 years of age and older) perceptions of research-study-recruiter recruitment behaviors. This study's main findings are twofold: Step 1: Seven of ten invited experts identified major revisions of the two core vignettes, written at an eighth-grade reading level and high school comprehension. Step 2: A 51% response rate yielded findings that this methodology successfully captured older African-American adults' perception of research study recruiters' behavioral characteristics during the recruitment process. Older African-Americans who received the hypothetical caring vignette were twice as likely to indicate their willingness to enroll in a research study with a high commitment (i.e., brain donation) compared to their counterparts who received the hypothetical uncaring recruitment scenario. Vignette-based survey methodology holds promise as a tool for informing the recruitment of older African-American adults and other minorities into federally funded health-related research studies.
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Affiliation(s)
- Charlene J Gamboa
- College of Nursing, Rush University Medical Center, 600 S. Paulina Street | Suite 1080, Chicago, Illinois, 60612, USA.
| | - Wrenetha A Julion
- College of Nursing, Rush University Medical Center, 600 S. Paulina Street | Suite 1080, Chicago, Illinois, 60612, USA
| | - Louis Fogg
- College of Nursing, Rush University Medical Center, 600 S. Paulina Street | Suite 1080, Chicago, Illinois, 60612, USA
| | - Dawn T Bounds
- University of California, Irvine, Sue & Bill Gross School of Nursing, California, CA, USA
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Winiarski DA, Glover AC, Bounds DT, Karnik NS. Addressing Intersecting Social and Mental Health Needs Among Transition-Age Homeless Youths: A Review of the Literature. Psychiatr Serv 2021; 72:317-324. [PMID: 33397145 PMCID: PMC7920918 DOI: 10.1176/appi.ps.201900498] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [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: 11/30/2022]
Abstract
Homelessness among youths is a poorly understood and complex social phenomenon. The authors examined the risk factors for homelessness among transition-age young adults, including the unique mental health concerns that often perpetuate the cycle of poverty and housing instability among these youths. The authors discuss the treatment gaps for mental health conditions in this population and identify potential solutions for reducing existing barriers to care. A literature review revealed that many studies report high rates of trauma and subsequent mental health problems among homeless youths. Intervention studies are challenging to conduct with this population and often have high attrition rates. Youths who are homeless desire mental health services and are especially enthusiastic about programs that address interpersonal difficulties and emotion regulation. Clinical data suggest that future interventions should address trauma more directly in this population. Technology-based interventions may help address the needs of homeless youths and may maximize their access to care. Because youths strongly prefer technology-based platforms, future research should integrate these platforms to better address the mental health needs identified as most salient by homeless youths. The authors discuss proposed policy changes at local, state, and federal levels to improve uptake of this proposed strategy.
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Affiliation(s)
- Dominika A Winiarski
- Department of Psychiatry and Behavioral Sciences, Rush University, Chicago (all authors); Department of Psychology, Fordham University, New York City (Glover); Sue & Bill Gross School of Nursing, University of California, Irvine (Bounds)
| | - Angela C Glover
- Department of Psychiatry and Behavioral Sciences, Rush University, Chicago (all authors); Department of Psychology, Fordham University, New York City (Glover); Sue & Bill Gross School of Nursing, University of California, Irvine (Bounds)
| | - Dawn T Bounds
- Department of Psychiatry and Behavioral Sciences, Rush University, Chicago (all authors); Department of Psychology, Fordham University, New York City (Glover); Sue & Bill Gross School of Nursing, University of California, Irvine (Bounds)
| | - Niranjan S Karnik
- Department of Psychiatry and Behavioral Sciences, Rush University, Chicago (all authors); Department of Psychology, Fordham University, New York City (Glover); Sue & Bill Gross School of Nursing, University of California, Irvine (Bounds)
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Bounds DT, Winiarski DA, Otwell CH, Tobin V, Glover AC, Melendez A, Karnik NS. Considerations for working with youth with socially complex needs. J Child Adolesc Psychiatr Nurs 2020; 33:209-220. [PMID: 32691491 PMCID: PMC7970826 DOI: 10.1111/jcap.12288] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Revised: 06/26/2020] [Accepted: 07/05/2020] [Indexed: 12/01/2022]
Abstract
TOPIC The presence of adverse childhood experiences offers a glimpse into the social complexity in the lives of youth. Thus far, youth have been categorized as "at-risk" or "vulnerable,"-identifiers which highlight a deficits-based framework and continue to stigmatize youth. To combat this systemic marginalization, we propose using the term youth with socially complex needs. These youth, often minority ethnic/racial and/or sexual/gender minorities, experience repeated adversity and discrimination. PURPOSE The purpose of this paper is to conceptualize the unique considerations of working with youth with socially complex needs-who have an increased vulnerability for social marginalization. SOURCES USED Given the adversity experienced and challenges inherent in working with youth with socially complex needs, ethical principles, and relevant care delivery models were explored. CONCLUSIONS Delivering mental health care and/or conducting research in collaboration with youth with socially complex needs requires thoughtful consideration of ethical principles and models of care. In conclusion, we propose a strengths-based, individualized approach to working with youth with socially complex needs that requires a dynamic, fluid, multisystemic approach to care and research.
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Affiliation(s)
- Dawn T. Bounds
- Rush University College of Nursing, Chicago, IL, USA
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Dominka A. Winiarski
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Caitlin H. Otwell
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Valerie Tobin
- Rush University College of Nursing, Chicago, IL, USA
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Angela C. Glover
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Adrian Melendez
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
| | - Niranjan S. Karnik
- Rush University Medical Center, Department of Psychiatry & Behavioral Sciences, Chicago, IL USA
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Stiles-Shields C, Potthoff LM, Bounds DT, Burns MTS, Draxler JM, Otwell CH, Wolodiger ED, Westrick J, Karnik NS. Harnessing Phones to Target Pediatric Populations with Socially Complex Needs: Systematic Review. JMIR Pediatr Parent 2020; 3:e19269. [PMID: 32845244 PMCID: PMC7481873 DOI: 10.2196/19269] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/20/2020] [Accepted: 08/11/2020] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Mobile and smartphones are owned and accessed by many, making them a potentially optimal delivery mechanism to reach pediatric patients with socially complex needs (ie, pediatric populations who face overlapping adversities). OBJECTIVE To address the specialized needs of youth from such groups, this review synthesized the literature exploring the use of phone-based delivery to access pediatric populations with socially complex needs, targeting mental and behavioral health outcomes. The purpose of this synthesis was to provide recommendations for future research developing phone-based interventions for youth with socially complex needs. METHODS A trained medical librarian conducted the search strategy in the following databases: PubMed, Scopus, CINAHL, PsycINFO, Cochrane CENTRAL Register of Controlled Trials, Cochrane Database of Systematic Reviews, and Google Scholar. Studies targeting youth with socially complex needs were defined by recruiting samples that were primarily from traditionally underserved populations (ie, sex/gender minorities, racial/ethnic background, low socioeconomic status, rural/remote location, and sexual orientation). A systematic narrative framework was utilized and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed (registration number CRD42020141212). RESULTS A total of 14 studies met the inclusion criteria, with 3 depicting the use of phones to complete assessment and tracking goals and 11 to intervene on mental and behavioral health targets. CONCLUSIONS The literature indicates important directions for future research, including (1) involving diverse and representative teens (ie, the likely users of the interventions), stakeholders, and clinical/research staff; (2) integrating evidence-based therapies with minority-focused theories; (3) harnessing mobile device capabilities; and (4) considering and assessing for potential costs in phones as delivery mechanisms. TRIAL REGISTRATION PROSPERO CRD42020141212; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=141212.
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Affiliation(s)
- Colleen Stiles-Shields
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Lauren M Potthoff
- Department of Gastroenterology, Pritzker Department of Psychiatry and Behavioral Health, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL, United States
| | - Dawn T Bounds
- Sue & Bill Gross School of Nursing, University of California Irvine, Irvine, CA, United States
| | | | - Janel M Draxler
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Caitlin H Otwell
- Autism Assessment, Research, Treatment & Services Center, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Emily D Wolodiger
- Autism Assessment, Research, Treatment & Services Center, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
| | - Jennifer Westrick
- Library of Rush University Medical Center, Chicago, IL, United States
| | - Niranjan S Karnik
- Section of Community Behavioral Health, Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, United States
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Bounds DT, Otwell CH, Melendez A, Karnik NS, Julion WA. Adapting a family intervention to reduce risk factors for sexual exploitation. Child Adolesc Psychiatry Ment Health 2020; 14:8. [PMID: 32099581 PMCID: PMC7029494 DOI: 10.1186/s13034-020-00314-w] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/30/2020] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Sexually exploited youth are disconnected from societal tethers and need support systems, which makes them some of the most vulnerable of youth. This heightened level of vulnerability increases their risk for violence, abuse, ongoing sexual exploitation and all its sequelae. The purpose of this study was to examine an evidence-based intervention called STRIVE (support to reunite, involve and value each other) that has been a successful family re-engagement strategy with newly homeless youth. We sought to explore its contextual relevance for youth with risk factors for sexual exploitation and identify necessary adaptations to reduce risk factors for sexual exploitation. We deliberately took an intersectional approach in conducting this study. METHODS Six community-based focus groups were conducted with youth at risk for sexual exploitation and their service providers. Each group was recorded, transcribed, coded, and thematically analyzed. RESULTS Results from 29 youth and 11 providers indicate that there are unique considerations that must be taken into account while working with youth at risk for sexual exploitation to ensure effective service delivery and/or ethical research. Emergent themes included: setting the stage by building rapport and acknowledging experiences of structural violence, protect and hold which balances youth's need for advocacy/support with their caregivers' need for validation/understanding, and walking the safety tightrope by assessing risks and safety planning. DISCUSSION Focus groups are an effective methodology when working with traditionally disempowered populations particularly in gaining a range of perspectives to meet unique needs/preferences. Youth at risk for commercial sexual exploitation needs require strengths-based, individualized, multi-systemic approaches.
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Affiliation(s)
- Dawn T. Bounds
- grid.240684.c0000 0001 0705 3621Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, College of Nursing, Community, Systems, & Mental Health Nursing, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Caitlin H. Otwell
- grid.240684.c0000 0001 0705 3621Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Adrian Melendez
- grid.240684.c0000 0001 0705 3621Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Niranjan S. Karnik
- grid.262743.60000000107058297Department of Psychiatry & Behavioral Sciences, Rush Medical College, Rush University, 1645 W. Jackson Blvd. Suite 600, Chicago, IL 60612 USA
| | - Wrenetha A. Julion
- grid.240684.c0000 0001 0705 3621College of Nursing, Department of Women, Children and Family Nursing, Rush University Medical Center, 600 S. Paulina St. Suite 1080, Chicago, IL 60612 USA
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15
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Winiarski DA, Rufa AK, Bounds DT, Glover AC, Hill KA, Karnik NS. Assessing and treating complex mental health needs among homeless youth in a shelter-based clinic. BMC Health Serv Res 2020; 20:109. [PMID: 32046711 PMCID: PMC7014693 DOI: 10.1186/s12913-020-4953-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2019] [Accepted: 02/04/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Rates of homelessness have been increasing in recent years, thereby necessitating a more direct approach to treating this complex social problem. Homeless youth have disproportionately high rates of untreated mental health problems and are therefore particularly vulnerable to the effects of homelessness during the transition period from adolescence to adulthood. METHODS The study team developed a shelter-based clinic and collected clinical measures on youth who attended this clinic from October 2016 through June 2018. RESULTS Youth attended an average number of three sessions, but there was a significant drop in follow-up after the first (intake) appointment. Depression, anger, and adjustment disorder emerged as the most common presenting mental health concerns identified by clinicians in the intake appointment, and trauma was identified as a significant complaint for those youth who returned for a second session. CONCLUSION Mental health care is needed in this population, but future studies should explore alternative approaches to retaining homeless youth in treatment and in designing targeted trauma-informed interventions.
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Affiliation(s)
- Dominika A. Winiarski
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
| | - Anne K. Rufa
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
| | - Dawn T. Bounds
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
- College of Nursing, Department of Community, Systems, & Mental Health Nursing, Rush University Medical Center, Chicago, IL USA
| | - Angela C. Glover
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
| | - Kristin A. Hill
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
| | - Niranjan S. Karnik
- Department of Psychiatry and Behavioral Sciences, Section of Population Behavioral Health, Rush University Medical Center, 1645 W. Jackson Blvd., Suite 302, Chicago, IL 60612 USA
- College of Nursing, Department of Community, Systems, & Mental Health Nursing, Rush University Medical Center, Chicago, IL USA
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Abstract
Positive father involvement is critical to the healthy social, emotional, and academic outcomes of children at all stages of development. The purpose of this integrative review was to identify, categorize, and evaluate the potential impact of fatherhood interventions on father and child outcomes. A systematic search of four major research databases yielded 44 studies published between 1988 and 2018 that met study inclusion criteria. The most effective interventions were delivered in the community, with fathers convened in groups. Content focused on promoting positive parenting, co-parenting, and father/child relationships. Consequently, father involvement and child cognitive and socioemotional development were improved. Academic settings were underutilized in the fatherhood interventions in this review. We conclude that in order to optimize healthy child development, school officials must adopt a more inclusive stance toward the involvement of fathers in their children's education. Future randomized trials of fatherhood interventions delivered within school-based settings are warranted.
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Affiliation(s)
- Joi B Henry
- Rush University Medical Center, Rush University College of Nursing, Chicago, IL, USA
| | - Wrenetha A Julion
- Rush University Medical Center, Rush University College of Nursing, Chicago, IL, USA
| | - Dawn T Bounds
- Rush University Medical Center, Rush University College of Nursing, Chicago, IL, USA
| | - Jen'nea Sumo
- Rush University Medical Center, Rush University College of Nursing, Chicago, IL, USA
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Bounds DT, Edinburgh LD, Fogg LF, Saeywc EM. A nurse practitioner-led intervention for runaway adolescents who have been sexually assaulted or sexually exploited: Effects on trauma symptoms, suicidality, and self-injury. Child Abuse Negl 2019; 90:99-107. [PMID: 30772751 DOI: 10.1016/j.chiabu.2019.01.023] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Revised: 01/28/2019] [Accepted: 01/30/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Adolescent victims of sexual assault and exploitation suffer significant mental health distress including PTSD, self-harm, suicidal ideation, and attempts. OBJECTIVE This longitudinal observational study investigated the Runaway Intervention Program's influence on trauma responses at 3, 6, and 12 months for adolescents who have run away at least once and have been sexually assaulted or exploited. PARTICIPANTS Runaways (n = 362) received nurse practitioner (NP) home and community visits, intensive case management, and optional empowerment groups. SETTING An urban Midwestern city's hospital-based Children's Advocacy Center. METHODS Trauma responses were measured by the UCLA PTSD-RI index, past 30 days emotional distress scale, and self-harm, suicidal ideation, and suicide attempt questions. Repeated Measures ANOVA assessed trauma response changes over time. Growth curve analyses using intervention doses determined which aspects of the intervention predicted change. RESULTS From program entry to 3 and 6 months, mean values decreased significantly for emotional distress (-0.67, -.91) self-harm (-.30, -.55), suicidal ideation (-.45, -.57), suicide attempts (-.58, -.61), and trauma symptoms (-11.8, -16.2, all p < .001) all maintained at 12 months. In growth curve models, NP visits independently predicted declines in emotional distress (-.038), self-injury (-.020), suicidal ideation (-.025) and attempts (-.032), while empowerment groups predicted trauma symptoms (-.525) and all others except suicide attempts. CONCLUSIONS The program, especially NP community visits and empowerment group elements, decreased trauma responses in runaway youth with a history of sexual assault. Given high rates of PTSD and emotional distress among runaways, the Runaway Intervention Program offers promise for improving mental health outcomes.
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Affiliation(s)
- Dawn T Bounds
- Rush University Medical Center, College of Nursing, 600 S. Paulina St., AAC Suite 1080, Chicago, IL 60612, United States
| | - Laurel D Edinburgh
- Midwest Children's Resource Center, Children's Hospital of Minnesota, 347 N. Smith Ave., St. Paul, MN 55102, United States.
| | - Louis F Fogg
- Rush University Medical Center, College of Nursing, 600 S. Paulina St., AAC Suite 1080, Chicago, IL 60612, United States
| | - Elizabeth M Saeywc
- School of Nursing, University of British Columbia, T201-2211 Westbrook Mall, Vancouver, BC V6T 2B5, Canada
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18
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Julion W, Reed M, Bounds DT, Cothran F, Gamboa C, Sumo J. A group think tank as a discourse coalition to promote minority nursing faculty retention. Nurs Outlook 2019; 67:586-595. [PMID: 31030904 DOI: 10.1016/j.outlook.2019.03.003] [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] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 03/14/2019] [Accepted: 03/15/2019] [Indexed: 10/27/2022]
Abstract
BACKGROUND The nursing profession will need one million more nurses by 2024, yet nursing schools are turning away applicants due to insufficient numbers of nursing faculty. Likewise, minority nursing faculty are needed in order to attract diverse nursing students who can then address health care disparities. PURPOSE The purpose of this paper is to describe the use of a group think tank (GTT) as a mentoring strategy for supporting the recruitment and retention of minority nursing faculty. METHOD Guided by Kotter's theory of change, this paper describes the application of the GTT approach with 5 African American (AA) faculty, one AA doctoral student and a cross-cultural mentor. FINDINGS Results are presented based upon the metrics typically used to support career advancement, promotion and/or tenure. DISCUSSION The GTT is a promising mentoring model that can be used to integrate cross-cultural and peer mentoring into academic communities to support diversity in academia.
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Affiliation(s)
- Wrenetha Julion
- Department of Women, Children and Family Nursing, Rush University, Chicago, IL.
| | - Monique Reed
- College of Nursing, Rush University, Chicago, IL
| | | | - Fawn Cothran
- College of Nursing, Rush University, Chicago, IL
| | | | - Jen'nea Sumo
- College of Nursing, Rush University, Chicago, IL
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Julion WA, Sumo J, Bounds DT. A tripartite model for recruiting African-Americans into fatherhood intervention research. Public Health Nurs 2018; 35:420-426. [PMID: 29740854 DOI: 10.1111/phn.12411] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2017] [Revised: 02/15/2018] [Accepted: 03/15/2018] [Indexed: 11/29/2022]
Abstract
Many studies have examined factors influencing African-American (AA) participation in research studies. But none inform the recruitment of AA men into fatherhood intervention research. Our purpose is to describe the recruitment and enrollment framework of the Dedicated African American Dad (DAAD) Study, a randomized controlled trial (RCT) designed to test a fatherhood intervention against a financial literacy comparison condition. AA nonresident (AANR) fathers are fathers who do not reside with their child on a full-time basis. Fathers attended 10 group-based sessions; and father and mother informants completed research interviews at baseline, postintervention, and 12 weeks postintervention. The DAAD Study tripartite model is a system of strategies that address three factors that individually and cooperatively affect recruitment of AANR fathers into research: community partnerships; study infrastructure; and recruitment personnel. The intersection of these three components forms a recruitment nexus that can be used to guide community-based research. The DAAD study serves as an exemplar of recruitment challenges, strategies, and lessons learned.
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Affiliation(s)
| | - Jen'nea Sumo
- College of Nursing, Rush University, Chicago, IL, USA
| | - Dawn T Bounds
- College of Nursing, Rush University, Chicago, IL, USA
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20
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Julion WA, Sumo J, Bounds DT, Breitenstein SM, Schoeny M, Gross D, Fogg L. Study protocol for a randomized clinical trial of a fatherhood intervention for African American non-resident fathers: Can we improve father and child outcomes? Contemp Clin Trials 2016; 49:29-39. [PMID: 27241687 DOI: 10.1016/j.cct.2016.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2016] [Revised: 05/18/2016] [Accepted: 05/26/2016] [Indexed: 11/28/2022]
Abstract
PURPOSE African American (AA) fathers who live apart from their children face multiple obstacles to consistent and positive involvement with their children. Consequently, significant numbers of children are bereft of their father's positive involvement. Intervention research that is explicitly focused on promoting the positive involvement of non-resident AA fathers with their young children is limited. The purpose of this article is to describe the study protocol of a randomized trial (RCT) designed to test the Building Bridges to Fatherhood program against a financial literacy comparison condition; and discuss early implementation challenges. METHODS Fathers (n=180) are recruited to attend 10 group meetings, reimbursed for transportation, given dinner and activity vouchers for spending time with their child, and incentivized with a $40 gift card at each data collection time point. Mothers are incentivized ($40 gift card) at data collection and must be amenable to father child interaction. Intervention targets include father psychological well-being, parenting competence, communication, problem-solving ability; father-mother relationship quality; and child behavioral and emotional/social development. RESULTS To date, 57 fathers have been randomized to study condition. Recruitment has been influenced by father and mother hesitancy and the logistics of reaching and maintaining contact with participants. Strategies to surmount challenges to father and mother recruitment and engagement have been developed. CONCLUSIONS The prospective benefits of positive father involvement to children, fathers and families outweigh the challenges associated with community-based intervention research. The findings from this RCT can inform the body of knowledge on engaging AA non-resident fathers in culturally relevant fatherhood programming.
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Affiliation(s)
- Wrenetha A Julion
- Rush University Medical Center, Rush University College of Nursing, 600 S. Paulina Suite 1080, Chicago IL, 60608, United States.
| | - Jen'nea Sumo
- Rush University Medical Center, Rush University College of Nursing, 600 S. Paulina Suite 1080, Chicago IL, 60608, United States
| | - Dawn T Bounds
- Rush University Medical Center, Rush University College of Nursing, 600 S. Paulina Suite 1080, Chicago IL, 60608, United States
| | - Susan M Breitenstein
- Rush University Medical Center, Rush University College of Nursing, 600 S. Paulina Suite 1080, Chicago IL, 60608, United States
| | - Michael Schoeny
- Rush University Medical Center, Rush University College of Nursing, 600 S. Paulina Suite 1080, Chicago IL, 60608, United States
| | - Deborah Gross
- Johns Hopkins University Acute and Chronic Care, Johns Hopkins School of Nursing, 525 N Wolfe St 531, Baltimore, MD 21205, United States
| | - Louis Fogg
- Rush University Medical Center, Rush University College of Nursing, 600 S. Paulina Suite 1080, Chicago IL, 60608, United States
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Abstract
This is the second article of a two part series about utilizing the life course perspective (LCP) in genetic counseling. Secondary data analysis was conducted on a grounded theory, longitudinal study which provided a wide focus on living with hereditary breast and ovarian cancer (HBOC) risk. The aim of this analysis was to explore the longitudinal data for both the temporal and social context of living with BRCA mutation genetic test results. Sixteen women from two previous studies were interviewed on multiple occasions over an 8 year time period. The LCP was used to direct a thematic analysis of the data. Families experience the consequences of knowing they carry a BRCA1 or BRCA2 gene mutation long after the initial diagnosis. These women's experiences across time reflect the concepts of the LCP and show how life is changed when families know they live with a genetic vulnerability to an adult-onset and potentially life-threatening disease. Different emphases on concepts from the LCP were evident across the different age groups. For example, the group of 40-50 year old women emphasized the concept of linked lives, those in their 30's focused on human agency and women in their 20's were more focused on timing of events. This study helps give direction to healthcare providers counseling women living with a BRCA mutation.
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Affiliation(s)
- Rebekah J Hamilton
- Department of Women, Children & Family Nursing, Rush University College of Nursing, 2624 Newcastle Dr., Carrollton, TX, 75007, USA.
| | - Nancy A Innella
- Department of Women, Children & Family Nursing, Rush University College of Nursing, 2624 Newcastle Dr., Carrollton, TX, 75007, USA
| | - Dawn T Bounds
- Department of Women, Children & Family Nursing, Rush University College of Nursing, 2624 Newcastle Dr., Carrollton, TX, 75007, USA
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Abstract
This is the first article in a two part series about utilizing the life course perspective (LCP) in genetic counseling. LCP can be a useful tool for genetic counselors when counseling people with a known genetic mutation. Previous theories such as Protection Motivation Theory (PMT) and Common Sense Model of Self-Regulation (CSMSR) examine current reactions to a positive genetic test result. LCP extends beyond the current time to explore temporal and contextual elements of the experience. A review of research revealed, LCP has been used to study the perspective of caregivers of people with Alzheimer's disease, referral for a family history of breast cancer, Mexican American caregivers of older adult, social class and cancer incidence and cancer and the sense of mastery. Incorporating LCP into a study explaining the experiences of people living with a positive test result for a genetic mutation such as the BRCA mutation provides a comprehensive exploration of this experience.
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Affiliation(s)
- Rebekah J Hamilton
- Department of Women, Children & Family Nursing, Rush University College of Nursing, 2624 Newcastle Dr., Carrollton, TX, 75007, USA.
| | - Nancy A Innella
- Department of Women, Children & Family Nursing, Rush University College of Nursing, 2624 Newcastle Dr., Carrollton, TX, 75007, USA
| | - Dawn T Bounds
- Department of Women, Children & Family Nursing, Rush University College of Nursing, 2624 Newcastle Dr., Carrollton, TX, 75007, USA
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