Publications by authors named "Jeannette O Andrews"

36 Publications

Rebuilding the research enterprise of a historical research intensive college of nursing.

Nurs Outlook 2019 May - Jun;67(3):232-243. Epub 2019 Jan 20.

University of South Carolina, College of Nursing, Columbia, SC.

Background: Maintaining a productive research enterprise within a college of nursing is multifaceted and complex. It is especially challenging when a college's mission transitions to address other priorities, and later attempts to re-emerge in the competitive funding environment and re-establish a productive research portfolio.

Purpose: To describe how a college is rebuilding the research enterprise to meet the established research mission after a decade of marginal research productivity.

Strategies: Targeted multi-level strategies at the university, college, and individual levels are being implemented to enhance the research infrastructure and faculty capacity to increase research productivity.

Impact: In the past five years, compared to the previous five years, annual faculty publications have doubled, annual extramural funding per tenure track faculty increased by 72%, and the College's average extramural sponsored award funding per year increased 118%. National Institutes for Research rankings moved from no ranking (2013) to top 31 (2017).

Discussion: Early results are positive and efforts to maintain and further grow the research enterprise will require sustained effort to meet ongoing challenges.
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http://dx.doi.org/10.1016/j.outlook.2019.01.002DOI Listing
October 2019

Parental Smoking Cessation: Impacting Children's Tobacco Smoke Exposure in the Home.

Pediatrics 2018 01;141(Suppl 1):S96-S106

Colleges of Medicine and Nursing, Medical University of South Carolina, Charleston, South Carolina.

Objectives: There is no safe or risk-free level of tobacco use or tobacco smoke exposure. In this randomized controlled trial, we tested a tobacco control intervention in families and specifically evaluated a tailored cessation intervention for the parents and/or caregivers (Ps/Cs) who were smokers while their children were simultaneously enrolled in tobacco prevention.

Methods: Ps/Cs and children were recruited from 14 elementary schools across rural and urban settings. Approximately one-fourth (24.3%; = 110) of the total Ps/Cs enrolled in the randomized controlled trial ( = 453) were smokers, predominantly women (80.9%), with a mean age of 37.7 years. (SD 12.2); 62.7% were African American, 44% had less than a high school education, and 58% earned <$20 000 annually. P/C smokers were offered a tailored cessation intervention in years 1 and 2. Self-report smoking status and saliva cotinine were obtained at baseline, the end of treatment (EOT) and/or year 2, and in the year 4 follow-up.

Results: Ps/Cs in the intervention group showed a larger increase in self-reported smoking abstinence over time (EOT: 6.5% [SE = 5.7%]; year 4: 40.6% [SE = 5.7%]) than the control group (EOT: 0.0% [SE = 6.5%]; year 4: 13.2% [SE = 6.4%]; = 4.82; = .0306). For cotinine, the intervention group showed a decrease from baseline (239.9 [SE = 1.3]) to EOT 99.3 [SE = 1.4]) and then maintenance through year 4 (109.6 [SE = 1.4]), whereas the control group showed increases from baseline (221.1 [SE = 1.4]) to EOT (239.0 [SE = 1.4]) to year 4 (325.8 [SE = 14]; = 5.72; = .0039).

Conclusions: This study provides evidence that tailored cessation offered to Ps/Cs in their children's schools during their children's enrollment in tobacco prevention may contribute to more robust success in P/C cessation and a reduction of tobacco smoke exposure in children.
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http://dx.doi.org/10.1542/peds.2017-1026MDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5745674PMC
January 2018

Tobacco Use and Smoke Exposure in Children: New Trends, Harm, and Strategies to Improve Health Outcomes.

Curr Allergy Asthma Rep 2017 Aug;17(8):55

Department of Pediatrics, Georgia Prevention Institute, Medical College of Georgia, Augusta University, HS-1755, 1499 Walton Way, Augusta, GA, 30912, USA.

Purpose Of Review: Every day in the USA, approximately 4000 adolescents begin smoking and the adolescent brain is particularly susceptible to nicotine addiction. We present current pediatric trends on tobacco use and exposures, various new products used by adolescents, the adverse biological and behavioral effects of tobacco use and exposures, and tobacco control strategies to eliminate tobacco-related illnesses and deaths in the pediatric population.

Recent Findings: Twelve-20% of women continue to smoke during pregnancy. New research reveals cognitive differences and behavior-control disorders are seen in elementary school children from prenatal and postnatal exposures. Traditional cigarette smoking has decreased in adolescents; novel and appealing tobacco products have captured their attention, particularly electronic cigarettes, and rates double and often triple from middle to high school. Children with asthma and those living in multi-housing units have higher rates of secondhand smoke exposure than non-asthmatics and children living in single-home dwellings. There is no "safe or risk-free" level of tobacco use or exposure. Tobacco use and exposure in childhood and adolescence must be decreased using evidenced-based strategies to improve child health.
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http://dx.doi.org/10.1007/s11882-017-0723-0DOI Listing
August 2017

Physician Advice for e-Cigarette Use.

J Am Board Fam Med 2016 11;29(6):741-747

From the Department of Health and Human Performance, College of Charleston, Charleston, SC (CK-C); the Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia (JFT, AO); the University of South Carolina College of Nursing (JOA); and the Department of Family and Preventive Medicine, University of South Carolina School of Medicine (SMS).

Purpose: To determine characteristics of smokers discussing e-cigarette use with their physician and receiving recommendations from their physician to use e-cigarettes for smoking cessation.

Methods: US adult smokers who had visited a physician in the previous 12 months (n = 2671) were surveyed. Logistic generalized estimating equation models were used to assess the characteristics of smokers who (1) talked to a physician about e-cigarettes, and (2) received physician advice to use e-cigarettes for smoking cessation.

Results: 15% (n = 406) of smokers who visited a physician talked with their physician about e-cigarettes. Among those asked whether their physician recommend e-cigarettes for smoking cessation (n = 257), 61% responded affirmatively. Current e-cigarette users were more likely to talk to their physicians about e-cigarettes (nondaily users vs never users: OR, 2.70; 95% CI, 1.79-4.05; daily users vs never users: OR, 4.29; 95% CI, 2.34-7.84) and have their physician recommend e-cigarettes for smoking cessation (daily users vs never users: OR, 9.40; 95% CI, 2.54-34.71).

Conclusions: The majority of smokers who talk to their physician about e-cigarettes report that they received advice to use e-cigarettes to quit smoking, despite limited evidence for their efficacy. More studies are needed to better understand e-cigarette recommendations in clinical settings.
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http://dx.doi.org/10.3122/jabfm.2016.06.160092DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6143900PMC
November 2016

Tobacco-Cessation Interventions and Attributes of Individual and Organizational Excellence in Acute Care.

Am J Crit Care 2016 12;26(1):53-61

is dean and Warwick Professor of Nursing, University of Kentucky College of Nursing, Lexington, Kentucky. Karen M. Butler is an associate professor, an assistant dean, and a faculty associate for BREATHE, University of Kentucky College of Nursing. Joel G. Anderson is an assistant professor, University of Tennessee College of Nursing, Knoxville, Tennessee. Sarah Craig is an assistant professor, University of Virginia School of Nursing. Claudia Barone is a professor, University of Arkansas for Medical Sciences, Little Rock, Arkansas. Jeannette O. Andrews is dean and professor of nursing, University of South Carolina, Columbia, South Carolina.

Background: Despite years of reducing tobacco use, few studies describe to what extent evidence-based tobacco-cessation interventions are a standard of acute and critical care nursing practice using the US Public Health Service 5 A's framework: ask, advise, assess, assist, and arrange.

Objectives: To identify relationships between the 5 A's framework, attributes of individual and organizational excellence, and intention to integrate tobacco-cessation interventions as a standard of daily practice among nurses.

Methods: Nurses attending the American Association of Critical-Care Nurses National Teaching Institute were invited to complete a 21-item survey. Data were gathered in Boston, Orlando, and Chicago in a 3-year period. Descriptive statistics and logistic regression were used for data analysis.

Results: Among 1773 completed surveys, nurses from organizations with standing orders for tobacco dependence were 5 times more likely to have high confidence in their 5 A's skills (odds ratio, 5.037; 95% CI, 3.429-7.400; P < .001) and 3.4 times more likely to have high intentions to integrate tobacco cessation into their daily practice (odds ratio, 3.421; 95% CI, 1.765-6.628; P < .001). Nurses with certifications were more likely to want to learn how to integrate tobacco-cessation interventions (odds ratio, 1.676; 95% CI, 0.990-2.836; P = .05).

Conclusions: Opportunities abound to create strategies leveraging attributes of nursing and organizational excellence to promote evidence-based approaches to improve health outcomes in acutely and critically ill tobacco-dependent populations.
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http://dx.doi.org/10.4037/ajcc2017373DOI Listing
December 2016

A Community-Engaged Assessment of Barriers and Facilitators to Rapid Stroke Treatment.

Res Nurs Health 2016 Dec 22;39(6):438-448. Epub 2016 Aug 22.

Dean and Professor, College of Nursing, University of South Carolina, Columbia, SC.

Treatment for acute ischemic stroke must be initiated within hours of stroke symptom onset, and the sooner it is administered, the better. In South Carolina, 76% of the population can access expert stroke care, and rural hospitals may provide specialized treatment using telemedicine, but many stroke sufferers seek care too late to achieve full benefit. Using a community-engaged approach in a southern rural community, we explored barriers and facilitators to early stroke care and implications for improvement. The Community-Engaged Assessment to facilitate Stroke Elimination (CEASE) study was guided by a community advisory group to ensure community centeredness and local relevance. In a qualitative descriptive study, eight focus groups were conducted including 52 individuals: recent stroke survivors, family members, emergency medical personnel, hospital emergency department staff, primary care providers, and community leaders. From analysis of focus group transcripts came six themes: lack of trust in healthcare system and providers; weak relationships fueled by poor communication; low health literacy; financial limitations related to health care; community-based education; and faith as a message of hope. A hierarchy model for improving early community-based stroke care was developed through consensus dialogue by community representatives and the research team. This model can be used to inform a community-partnered, stakeholder-informed intervention to improve stroke care in a rural southern community with the goal of improving stroke education, care, and outcome. © 2016 Wiley Periodicals, Inc.
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http://dx.doi.org/10.1002/nur.21749DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5118187PMC
December 2016

Effect of a smoking cessation intervention for women in subsidized neighborhoods: A randomized controlled trial.

Prev Med 2016 09 14;90:170-6. Epub 2016 Jul 14.

Augusta University, Medical College of Georgia, 1120 Fifteenth Street, HS-1755, Augusta, GA 30912, USA.

Objective: To evaluate the effectiveness of a community based participatory research (CBPR) developed, multi-level smoking cessation intervention among women in subsidized housing neighborhoods in the Southeastern US.

Methods: A total of n=409 women in 14 subsidized housing neighborhoods in Georgia and South Carolina participated in this group randomized controlled trial conducted from 2009 to 2013. Intervention neighborhoods received a 24-week intervention with 1:1 community health worker contact, behavioral peer group sessions, and nicotine replacement. Control neighborhoods received written cessation materials at weeks 1, 6, 12, 18. Random coefficient models were used to compare smoking abstinence outcomes at 6 and 12months. Significance was set a p<0.05.

Results: The majority of participants (91.2%) were retained during the 12-month intervention period. Smoking abstinence rates at 12months for intervention vs. control were 9% vs. 4.3%, p=0.05. Additional analyses accounting for passive smoke exposure in these multi-unit housing settings demonstrated 12month abstinence rates of 12% vs. 5.3%, p=0.016. However, in the multivariate regression analyses, there was no significant effect of the intervention on the odds of being a non-smoker (OR=0.44, 95% CI: 0.18-1.07). Intervention participants who kept coach visits, attended group sessions, and used patches were more likely to remain abstinent.

Conclusions: This CBPR developed intervention showed potential to engage smokers and reduce smoking among women in these high-poverty neighborhoods. Effectiveness in promoting cessation in communities burdened with fiscal, environmental and social inequities remains a public health priority.
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http://dx.doi.org/10.1016/j.ypmed.2016.07.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5871346PMC
September 2016

Recruiting family dyads facing thoracic cancer surgery: Challenges and lessons learned from a smoking cessation intervention.

Eur J Oncol Nurs 2016 Feb 8;20:199-206. Epub 2015 Sep 8.

University of South Carolina College of Nursing, 1601 Greene Street, Columbia, SC 29208, USA. Electronic address:

Purpose: Persistent smoking after a cancer diagnosis has adverse effects. Most smoking cessation interventions focus on individual behaviors; however, family members who smoke are major barriers to success. This article describes challenges and lessons learned related to recruitment and retention to a longitudinal, dyadic-centered smoking cessation intervention study for individuals confronting a new diagnosis of thoracic cancer and their family members who smoke.

Methods: A prospective, one-group repeated measures, mixed-method feasibility study measured recruitment, retention, adherence, and acceptability over a 6-month period in a thoracic surgery clinic at a university cancer center. A multidisciplinary, multi-component decision aid-"Tobacco Free Family"-was used to intervene with the dyads. Study recruitment occurred preoperatively with a thoracic surgery team member assessing smoking status.

Results: During the 6-month recruitment period, 50 patients who smoked were screened, and 18 eligible families were approached to participate. Sixteen participants (8 dyads) enrolled. Patients were all male, and participating family members were all female-either spouses or long-term girlfriends. Others types of family members declined participation.

Conclusion: Recruitment was lower than anticipated (44%), retention was high (100%), and maximizing convenience was the most important retention strategy. Oncology nurses can assess the smoking status of patients and family members, facilitate understanding about the benefits of cessation, refer those willing to stop to expert resources, and help motivate those unwilling to quit. Research is needed to continue developing strategies to help patients with thoracic cancer and their families facing surgery as an impetus for stopping smoking. Novel intervention delivery and communication need further exploration.
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http://dx.doi.org/10.1016/j.ejon.2015.08.006DOI Listing
February 2016

The association of individual and neighborhood social cohesion, stressors, and crime on smoking status among African-American women in southeastern US subsidized housing neighborhoods.

J Urban Health 2014 Dec;91(6):1158-74

University of South Carolina, Columbia, SC, USA,

The purpose of this study was to examine the associations between individual and neighborhood social contextual factors and smoking prevalence among African-American women in subsidized neighborhoods. We randomly sampled 663 adult women in 17 subsidized neighborhoods in two Southeastern US states. The smoking prevalence among participants was 37.6%, with an estimated neighborhood household prevalence ranging from 30 to 68%. Smokers were more likely to be older, have lower incomes, have lower BMI, and live with other smokers. Women with high social cohesion were less likely to smoke, although living in neighborhoods with higher social cohesion was not associated with smoking prevalence. Women with higher social cohesion were more likely to be older and had lived in the neighborhood longer. Women with high stress (related to violence and disorder) and who lived in neighborhoods with higher stress were more likely to smoke. Younger women were more likely to have higher stress than older women. There were no statistically significant associations with objective neighborhood crime data in any model. This is the first study to examine both individual and neighborhood social contextual correlates among African-American women in subsidized neighborhoods. This study extends findings about smoking behaviors and neighborhood social contexts in this high-risk, urban population. Future research is needed to explore age and residential stability differences and perceptions of social cohesion, neighborhood disorder, and perceived violence in subsidized housing. Further research is also warranted on African-American women, subsidized housing, smoking, social context, health disparities' effective strategies to address these individual and contextual factors to better inform future ecological-based multilevel prevention, and cessation intervention strategies.
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http://dx.doi.org/10.1007/s11524-014-9911-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4242849PMC
December 2014

A community-based participatory research approach to the development of a Peer Navigator health promotion intervention for people with spinal cord injury.

Disabil Health J 2014 Oct 9;7(4):478-84. Epub 2014 May 9.

University of South Carolina College of Nursing, USA.

Background: Recent trends indicate research targeting outcomes of importance to people with disabilities, such as spinal cord injury (SCI), may be best informed by those individuals; however, there are very few published rehabilitation intervention studies that include people with disabilities in the research process in a role beyond study participant.

Objective: To describe a community-based participatory research (CBPR) approach to the development and pilot testing of an intervention using community-based Peer Navigators with SCI to provide health education to individuals with SCI, with the goal of reducing preventable secondary conditions and rehospitalizations, and improving community participation.

Methods: A CBPR framework guides the research partnership between academic researchers and a community-based team of individuals who either have SCI or provide SCI-related services. Using this framework, the processes of our research partnership supporting the current study are described including: partnership formation, problem identification, intervention development, and pilot testing of the intervention. Challenges associated with CBPR are identified.

Results: Using CBPR, the SCI Peer Navigator intervention addresses the partnership's priority issues identified in the formative studies. Utilization of the framework and integration of CBPR principles into all phases of research have promoted sustainability of the partnership. Recognition of and proactive planning for challenges that are commonly encountered in CBPR, such as sharing power and limited resources, has helped sustain our partnership.

Conclusions: The CBPR framework provides a guide for inclusion of individuals with SCI as research partners in the development, implementation, and evaluation of interventions intended to improve outcomes after SCI.
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http://dx.doi.org/10.1016/j.dhjo.2014.04.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4166442PMC
October 2014

An integrative review: application of self-efficacy instruments for walking in populations with peripheral arterial disease.

J Vasc Nurs 2013 Sep;31(3):118-30

Medical University of South Carolina, College of Nursing, Charleston, SC 29425, USA.

Objective: The study objective was to identify which self-efficacy measurement instruments are being used for walking in patients with peripheral arterial disease (PAD), the psychometrics of these instruments, and recommendations for use in research on patients with PAD.

Background: PAD is a common problem for individuals with similar risk factors as cardiovascular disease (CVD). Experts recommend a supervised walking program with incremental increases in speed and distance as an initial treatment for patients with intermittent claudication. Because patients may experience pain while walking, there is a tendency to be nonadherent with exercise therapy, and many limit or avoid walking all together, resulting in a sedentary lifestyle. Self-efficacy plays a role in determining a person's confidence in his or her ability to participate in an exercise program. Data sources for this study were PubMed, Cumulative Index of Nursing and Allied Health Literature, PsycINFO, and the Cochrane database.

Methods: The integrative review method described by Wittemore and Knafl was used for this review (Wittemore R, Knafl K. The integrative review: updated methodology. J Adv Nurs 2005;52:546-53.). Publications were retrieved electronically and reviewed for inclusion on the basis of studies that measured self-efficacy for walking in populations with PAD, peripheral vascular disease, and CVD. The analysis consisted of 9 publications.

Results: Only 2 studies were specific to the population with PAD. The remaining studies addressed self-efficacy issues in CVD or congestive heart failure. The analysis identified 4 instruments based on Bandura's Social Cognitive Theory that were used to assess self-efficacy: (1) the Self-Efficacy Expectation Scale, (2) the Self-Efficacy for Managing Chronic Disease Scale, (3) the Performance-Based Efficacy Scale, and (4) the Barriers Self-Efficacy Scale. The Self-Efficacy Expectation Scale was most frequently used in these studies.

Conclusions: The use of the Self-Efficacy Expectation Scale instruments for walking in patients with PAD is limited because reliability and validity have been demonstrated in an older, mostly white population with CVD and congestive heart failure. Instruments that encompass the key constructs of self-efficacy, including physical, personal, and environmental aspects, would allow full evaluation with identification of potential explanations for success or failure for the chosen outcome. This should be taken into consideration in future studies when using instruments of self-efficacy.
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http://dx.doi.org/10.1016/j.jvn.2013.01.002DOI Listing
September 2013

Assessment of oral health needs and barriers to care in a Gullah community: Hollywood smiles.

Prog Community Health Partnersh 2013 ;7(2):201-8

Division of Periodontics, College of Dental Medicine, Medical University of South Carolina.

Objectives: To assess the oral health (OH) needs and barriers to OH care in Gullah African American communities.

Methods: A community advisory board (CAB) was formed to guide the research study. Five focus groups (n = 27 participants) were conducted to explore the OH needs/barriers. Participants completed demographic surveys and participated in discussions facilitated by open-ended questions. All sessions were audio-recorded, transcribed and analyzed using NVivo8.

Results: Facilitators of OH included positive experiences and modeling. Fear and access to care were the most cited barriers. Tooth extraction was the dental treatment of choice. Intervention recommendations included improving clinic access, using the churches to socially influence receipt of OH care, providing group educational sessions with OH specialists, and having local "lay people" to provide support and help to navigate OH care systems.

Conclusions: The design of a multilevel, culturally and locally relevant intervention may lead to a decrease in OH disparities in Gullah communities.
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http://dx.doi.org/10.1353/cpr.2013.0016DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4097834PMC
September 2013

Development and pilot testing of a video-assisted informed consent process.

Contemp Clin Trials 2013 Sep 6;36(1):25-31. Epub 2013 Jun 6.

Medical University of South Carolina, Charleston, SC 29425, USA.

The informed consent process for research has come under scrutiny, as consent documents are increasingly long and difficult to understand. Innovations are needed to improve comprehension in order to make the consent process truly informed. We report on the development and pilot testing of video clips that could be used during the consent process to better explain research procedures to potential participants. Based on input from researchers and community partners, 15 videos of common research procedures/concepts were produced. The utility of the videos was then tested by embedding them in mock-informed consent documents that were presented via an online electronic consent system designed for delivery via iPad. Three mock consents were developed, each containing five videos. All participants (n = 61) read both a paper version and the video-assisted iPad version of the same mock consent and were randomized to which format they reviewed first. Participants were given a competency quiz that posed specific questions about the information in the consent after reviewing the first consent document to which they were exposed. Most participants (78.7%) preferred the video-assisted format compared to paper (12.9%). Nearly all (96.7%) reported that the videos improved their understanding of the procedures described in the consent document; however, the comprehension of material did not significantly differ by consent format. Results suggest videos may be helpful in providing participants with information about study procedures in a way that is easy to understand. Additional testing of video consents for complex protocols and with subjects of lower literacy is warranted.
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http://dx.doi.org/10.1016/j.cct.2013.05.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3769445PMC
September 2013

Author response.

Am J Prev Med 2013 May;44(5):e51-3

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http://dx.doi.org/10.1016/j.amepre.2013.02.007DOI Listing
May 2013

Access, use and completion of a brief disaster mental health intervention among Hispanics, African-Americans and Whites affected by Hurricane Ike.

J Telemed Telecare 2013 Feb 20;19(2):70-4. Epub 2013 Mar 20.

Medical University of South Carolina, Charleston SC 29425, USA.

African-Americans and Hispanics are disproportionally affected by disasters. We evaluated differences in the use and completion of a web-based mental health intervention, Disaster Recovery Web (DRW), by White, African-American and Hispanic adults in the aftermath of Hurricane Ike. Approximately one year after the hurricane, a telephone survey was carried out with adults from Galveston and Chambers counties. A total of 1249 adults participated in the survey (80% White, 14% African-American and 6% Hispanic). Mental health and mental health service utilization were assessed. Whites were more likely to have previously used the Internet to obtain general health information than African-Americans or Hispanics (P < 0.001). A logistic regression was used to identify differences in the use of the Internet intervention after controlling for covariates. There were no differences in rates of non-use and dropout attrition between Whites, African-Americans and Hispanics. Thus the findings suggest that web-based mental health interventions can be used to reach African-American, Hispanic and White adults at similar rates after a disaster.
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http://dx.doi.org/10.1177/1357633x13476230DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3676648PMC
February 2013

Comparison of enrollment rates of African-American families into a school-based tobacco prevention trial using two recruitment strategies in urban and rural settings.

Am J Health Promot 2013 Mar-Apr;27(4):e91-e100

Child Health Discovery Institute, Georgia Prevention Institute, Medical College of Georgia, Georgia Health Sciences University, Augusta, GA 30912, USA.

Purpose: This study evaluated similarities and differences of enrollment rates using two different recruitment strategies for a tobacco control trial in rural and urban African-American (AA) elementary school families.

Design: A comparative study, nested within a larger randomized controlled trial, was used to test the effectiveness of two recruitment approaches on enrollment rates in rural and urban AA families.

Setting: The study was conducted in 14 Title 1 elementary schools in the southeastern United States: 7 rural and 7 urban.

Subjects: There were 736 eligible AA families, and 332 (45%) completed informed consent and were enrolled into the study.

Intervention: The Facilitate, Open and transparent communication, Shared benefits, Team and tailored, Educate bilaterally, and Relationships, realistic and rewards (FOSTER) approach guided the two recruitment strategies: (1) written informational packets provided to fourth graders to take home to parents; and (2) proactive, face-to-face family information sessions held at schools.

Measures: Enrollment rates were based on responsiveness to the two recruitment strategies and completion of the informed consent process.

Analysis: Chi-square, Cochran-Mantel-Haenszel, and Breslow-Day tests were performed.

Results: Higher enrollment rates occurred during the family session for both rural and urban families (100% rural, 93.6% urban; p = .0475) than informational packets alone (28.7% rural, 22% urban; p < .0001). Rural family enrollment rates were overall higher than urban rates regardless of recruitment strategy (52.0% rural vs. 39.6% urban; p = .0008).

Conclusion: The findings suggest the FOSTER approach, although effective in both rural and urban settings, was more successful in recruiting rural families.
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http://dx.doi.org/10.4278/ajhp.110204-QUAN-53DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703455PMC
January 2014

Cigarette warning label policy alternatives and smoking-related health disparities.

Am J Prev Med 2012 Dec;43(6):590-600

Department of Health Promotion, Education, and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, SC 29208, USA.

Background: Pictorial health warning labels on cigarette packaging have been proposed for the U.S., but their potential influences among populations that suffer tobacco-related health disparities are unknown.

Purpose: To evaluate pictorial health warning labels, including moderation of their influences by health literacy and race.

Methods: From July 2011 to January 2012, field experiments were conducted with 981 adult smokers who were randomized to control (i.e., text-only labels, n=207) and experimental conditions (i.e., pictorial labels, n=774). The experimental condition systematically varied health warning label stimuli by health topic and image type. Linear mixed effects (LME) models estimated the influence of health warning label characteristics and participant characteristics on label ratings. Data were analyzed from January 2012 to April 2012.

Results: Compared to text-only warning labels, pictorial warning labels were rated as more personally relevant (5.7 vs 6.8, p<0.001) and effective (5.4 vs 6.8, p<0.001), and as more credible, but only among participants with low health literacy (7.6 vs 8.2, p<0.001). Within the experimental condition, pictorial health warning labels with graphic imagery had significantly higher ratings of credibility, personal relevance, and effectiveness than imagery of human suffering and symbolic imagery. Significant interactions indicated that labels with graphic imagery produced minimal differences in ratings across racial groups and levels of health literacy, whereas other imagery produced greater group differences.

Conclusions: Pictorial health warning labels with graphic images have the most-pronounced short-term impacts on adult smokers, including smokers from groups that have in the past been hard to reach.
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http://dx.doi.org/10.1016/j.amepre.2012.08.025DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3504356PMC
December 2012

Training partnership dyads for community-based participatory research: strategies and lessons learned from the Community Engaged Scholars Program.

Health Promot Pract 2013 Jul 22;14(4):524-33. Epub 2012 Oct 22.

Medical University of South Carolina, Charleston, SC, USA.

This article describes the development, implementation, evaluation framework, and initial outcomes of a unique campus-community training initiative for community-based participatory research (CBPR). The South Carolina Clinical & Translational Research Center for Community Health Partnerships, which functions as the institution's Clinical Translational and Science Award Community Engagement Program, leads the training initiative known as the Community Engaged Scholars Program (CES-P). The CES-P provides simultaneous training to CBPR teams, with each team consisting of at least one community partner and one academic partner. Program elements include 12 months of monthly interactive group sessions, mentorship with apprenticeship opportunities, and funding for a CBPR pilot project. A modified RE-AIM (Reach, Effectiveness, Adoption, Implementation, Maintenance) framework guides the process, impact, and outcome evaluation plan. Lessons learned include challenges of group instruction with varying levels of readiness among the CBPR partners, navigating the institutional review board process with community co-investigators, and finding appropriate academic investigators to match community research interests. Future directions are recommended for this promising and unique dyadic training of academic and community partners.
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http://dx.doi.org/10.1177/1524839912461273DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4175920PMC
July 2013

Community-based participatory research and smoking cessation interventions: a review of the evidence.

Nurs Clin North Am 2012 Mar 14;47(1):81-96. Epub 2011 Dec 14.

SCTR Center for Community Health Partnerships, Medical University of South Carolina, Charleston, SC 29425-1600, USA.

This article reviews the evidence of the use of community-based participatory research (CBPR) and smoking cessation interventions. An overview of CBPR is provided, along with a description of the search methods and quality scoring. Research questions are explored to determine if CBPR improves the quality of research methods and community involvement in cessation intervention studies and cessation outcomes when using CBPR approaches. Results of the review are provided along with a comprehensive table summarizing all the included studies. Strengths and challenges of the CBPR approach are presented with recommendations for future research.
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http://dx.doi.org/10.1016/j.cnur.2011.10.013DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3269631PMC
March 2012

The impact of the Georgia Health Sciences University nursing faculty practice on tobacco cessation rates.

Nurs Clin North Am 2012 Mar;47(1):1-12

University of Virginia School of Nursing, Claude Moore Nursing Education Building, PO Box 800826, 225 Jeanette, Lancaster Way, Charlottesville, VA 22908-0826, USA.

Nursing faculty practice groups can play a vital role in tobacco cessation in academic medical centers. Outcomes from the Georgia Health Sciences University Nursing Faculty Practice Group Tobacco Cessation Program revealed 64% abstinence outcomes at the end of treatment (N = 160) over a 2-year period from the campus-wide tobacco-free policy initiation. A nurse-led, evidence-based, interdisciplinary approach can be an effective strategy to make a difference in the lives of tobacco-dependent individuals, while at the same time integrating practice with education and research.
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http://dx.doi.org/10.1016/j.cnur.2011.10.005DOI Listing
March 2012

Demographic differences in systemic inflammatory response syndrome score after trauma.

Am J Crit Care 2012 Jan;21(1):35-41; quiz 42

Department of Physiological and Technological Nursing, College of Nursing, Georgia Health Sciences University, Augusta, 30912, USA.

Background: Demographic differences in health outcomes have been reported for chronic diseases, but few data exist on these differences in trauma (defined as acute, life-threatening injuries).

Objective: To investigate the relationship between the systemic inflammatory response syndrome score after trauma and race/ethnicity and socioeconomic status.

Methods: A retrospective chart review of 600 patients from a level I trauma center (1997-2007) was conducted. Inclusion criteria were age 18 to 44 years, Injury Severity Score 15 or greater, and admission to an intensive care unit. Exclusion criteria were use of transfusions, spinal cord injuries, comorbid conditions affecting the inflammatory response, use of nonsteroidal anti-inflammatory medications, and missing data (final sample, 246 charts/patients). Systemic inflammatory response syndrome was measured by using the systemic inflammatory response syndrome score. Race was self-reported. Socioeconomic status was defined by insurance and employment. Descriptive statistics, Wilcoxon rank sum, Kruskal-Wallis, and χ(2) tests were used for analysis.

Results: Compared with whites, African Americans (n = 94) had fewer occurrences of the syndrome (P = .04) and a 14% lower white blood cell count on admission to the intensive care unit (mean, 15,200/μL; 95% CI, 14,400/μL to 16,000/μL vs mean 17,700/μL; 95% CI, 16,700/μL to 18,700/μL; P < .001).

Conclusions: Demographic differences exist in the systemic inflammatory response syndrome score after trauma. Additional studies in larger populations of patients are needed as well as basic science and translational research to determine potential mechanisms that may explain the differences.
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http://dx.doi.org/10.4037/ajcc2012852DOI Listing
January 2012

Institutionalization of community partnerships: the challenge for academic health centers.

J Health Care Poor Underserved 2012 Nov;23(4):1512-26

College of Nursing at the Medical University of South Carolina, USA.

Current public health priorities emphasize the elimination of health disparities, translational research, and transdisciplinary and community alliances. The Center for Community Health Partnerships is a proactive initiative to address new paradigms and priorities in health care through institutionalization of community-university partnerships. This report highlights innovative strategies and lessons learned.
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http://dx.doi.org/10.1353/hpu.2012.0161DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4185923PMC
November 2012

Application of a CBPR framework to inform a multi-level tobacco cessation intervention in public housing neighborhoods.

Am J Community Psychol 2012 Sep;50(1-2):129-40

College of Nursing, Medical University of South Carolina, 99 Jonathon Lucas Street, MSC 160, Charleston, SC 29426-1600, USA.

African American women in urban, high poverty neighborhoods have high rates of smoking, difficulties with quitting, and disproportionate tobacco-related health disparities. Prior research utilizing conventional "outsider driven" interventions targeted to individuals has failed to show effective cessation outcomes. This paper describes the application of a community-based participatory research (CBPR) framework to inform a culturally situated, ecological based, multi-level tobacco cessation intervention in public housing neighborhoods. The CBPR framework encompasses problem identification, planning and feasibility/pilot testing, implementation, evaluation, and dissemination. There have been multiple partners in this process including public housing residents, housing authority administrators, community health workers, tenant associations, and academic investigators. The advisory process has evolved from an initial small steering group to our current institutional community advisory boards. Our decade-long CBPR journey produced design innovations, promising preliminary outcomes, and a full-scaled implementation study in two states. Challenges include sustaining engagement with evolving study partners, maintaining equity and power in the partnerships, and long-term sustainability of the intervention. Implications include applicability of the framework with other CBPR partnerships, especially scaling up evolutionary grassroots involvement to multi-regional partnerships.
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http://dx.doi.org/10.1007/s10464-011-9482-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4448934PMC
September 2012

Development and evaluation of a toolkit to assess partnership readiness for community-based participatory research.

Prog Community Health Partnersh 2011 ;5(2):183-8

Medical University of South Carolina, College of Nursing, USA.

An earlier investigation by academic and community co-investigators led to the development of the Partnership Readiness for Community-Based Participatory Research (CBPR) Model, which defined major dimensions and key indicators of partnership readiness. As a next step in this process, we used qualitative methods, cognitive pretesting, and expert reviews to develop a working guide, or toolkit, based on the model for academic and community partners to assess and leverage their readiness for CBPR. The 75-page toolkit is designed as a qualitative assessment promoting equal voice and transparent, bi-directional discussions among all the partners. The toolkit is formatted to direct individual partner assessments, followed by team assessments, discussions, and action plans to optimize their goodness of fit, capacity, and operations to conduct CBPR. The toolkit has been piloted with two cohorts in the Medical University of South Carolina's (MUSC) Community Engaged Scholars (CES) Program with promising results from process and outcome evaluation data.
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http://dx.doi.org/10.1353/cpr.2011.0019DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3267580PMC
July 2011

Community advisory boards in community-based participatory research: a synthesis of best processes.

Prev Chronic Dis 2011 May 15;8(3):A70. Epub 2011 Apr 15.

Medical University of South Carolina, College of Nursing, Charleston, South Carolina, USA.

Community-based participatory research (CBPR) is a paradigm to study and reduce disparities in health outcomes related to chronic disease. Community advisory boards (CABs) commonly formalize the academic-community partnerships that guide CBPR by providing a mechanism for community members to have representation in research activities. Researchers and funding agencies increasingly recognize the value of the community's contribution to research and acknowledge that community advisory boards are a key component of successful CBPR projects. In this article, we describe the best processes for forming, operating, and maintaining CABs for CBPR. We synthesize the literature and offer our professional experiences to guide formation, operation, and maintenance of CABs.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3103575PMC
May 2011

Partnership readiness for community-based participatory research.

Health Educ Res 2012 Aug 13;27(4):555-71. Epub 2010 Sep 13.

College of Nursing, Medical University of South Carolina, Charleston, SC 29466-1600, USA.

The use of a dyadic lens to assess and leverage academic and community partners' readiness to conduct community-based participatory research (CBPR) has not been systematically investigated. With a lack of readiness to conduct CBPR, the partnership and its products are vulnerable. The purpose of this qualitative study was to explore the dimensions and key indicators necessary for academic and community partnership readiness to conduct CBPR. Key informant interviews and focus groups (n = 36 participants) were conducted with academic and community participants who had experiences with CBPR partnerships. A 'framework analysis' approach was used to analyze the data and generate a new model, CBPR Partnership Readiness Model. Antecedents of CBPR partnership readiness are a catalyst and mutual interest. The major dimensions of the CBPR Partnership Readiness Model are (i) goodness of fit, (ii) capacity, and (iii) operations. Preferred outcomes are sustainable partnership and product, mutual growth, policy and social and health impact on the community. CBPR partnership readiness is an iterative and dynamic process, partnership and issue specific, influenced by a range of environmental and contextual factors, amenable to change and essential for sustainability and promotion of health and social change in the community.
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http://dx.doi.org/10.1093/her/cyq050DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3396876PMC
August 2012

Systemic inflammatory response syndrome score and race as predictors of length of stay in the intensive care unit.

Am J Crit Care 2009 Jul;18(4):339-46; quiz 347

School of Nursing, Medical College of Georgia, Augusta, GA 30912, USA.

Background: Identifying predictors of length of stay in the intensive care unit can help critical care clinicians prioritize care in patients with acute, life-threatening injuries.

Objective: To determine if systemic inflammatory response syndrome scores are predictive of length of stay in the intensive care unit in patients with acute, life-threatening injuries.

Methods: Retrospective chart reviews were completed on patients with acute, life-threatening injuries admitted to the intensive care unit at a level I trauma center in the southeastern United States. All 246 eligible charts from the trauma registry database from 1998 to 2007 were included. Systemic inflammatory response syndrome scores measured on admission were correlated with length of stay in the intensive care unit. Data on race, sex, age, smoking status, and injury severity score also were collected. Univariate and multivariate regression modeling was used to analyze data.

Results: Severe systemic inflammatory response syndrome scores on admission to the intensive care unit were predictive of length of stay in the unit (F=15.83; P<.001), as was white race (F=9.7; P=.002), and injury severity score (F=20.23; P<.001).

Conclusions: Systemic inflammatory response syndrome scores can be measured quickly and easily at the bedside. Data support use of the score to predict length of stay in the intensive care unit.
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http://dx.doi.org/10.4037/ajcc2009267DOI Listing
July 2009

Primary and secondary tobacco prevention in youth.

Annu Rev Nurs Res 2009 ;27:171-93

Department of Pediatrics, School of Medicine, Medical College of Georgia, USA.

The childhood years represent a critical time for tobacco experimentation and addiction. This chapter presents risk factors for youth smoking, state of the science of nurse-led primary and secondary tobacco prevention research in youth, and implications for future research, policy, and practice. Nursing research on both primary and secondary tobacco prevention efforts that are school-based, family-based, and community-based are presented. Interventions, including both state and community approaches, and media and policy endeavors to prevent tobacco use and foster successful cessation are discussed. The nursing profession has made an impact on primary and secondary prevention in youth regarding tobacco; however, much remains to be accomplished. As one of the largest health care professions, nurses should seize the important opportunity of positively impacting the health of children and youth through comprehensive and effective primary and secondary tobacco prevention efforts.
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http://dx.doi.org/10.1891/0739-6686.27.171DOI Listing
March 2010

Breaking the ties of nicotine dependence.

Nurse Pract 2007 Nov;32(11):36-45; quiz 45-6

Medical College of Georgia School of Nursing, Augusta, USA.

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http://dx.doi.org/10.1097/01.NPR.0000298270.16268.5eDOI Listing
November 2007