Publications by authors named "Martha Ann Terry"

15 Publications

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Reducing Risk for Gestational Diabetes Mellitus (GDM) Through a Preconception Counseling Program for American Indian/Alaska Native Girls: Perceptions From Women With Type 2 Diabetes or a History of GDM.

Diabetes Educ 2019 04 2;45(2):137-145. Epub 2019 Jan 2.

Centers for American Indian and Alaska Native Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado.

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http://dx.doi.org/10.1177/0145721718821663DOI Listing
April 2019

Exploring the Experiences, Challenges, and Approaches of Parish Nurses in Their Community Practice.

J Holist Nurs 2019 Jun 29;37(2):121-129. Epub 2018 Sep 29.

University of Pittsburgh.

Purpose: To explore the personal experiences, challenges, and practices of parish nurses in their communities.

Method/design: The overall study used a mixed methods concurrent embedded design to describe parish nurses' experiences with diabetes education and preconception counseling in their practice. Also included were descriptions of generalized practices. Therefore, this current report will focus on these broader experiences. Focus group data were collected using face-to-face, teleconference, and video conferencing formats with 48 nurses who consider themselves to be parish nurses and analyzed with content analysis.

Findings: Four qualitative themes were identified in the data: (1) Gaining Entry Through Trust, (2) Enhanced Focus on Spiritual Caring, (3) Accomplishing Much Despite Challenges, and (4) Practice Making a Difference. Parish nurses are uniquely situated to provide holistic care for the mind, body, and spirit of their patients. Despite the many positive aspects, parish nurses experience unique challenges, such as funding their practice and working independently.

Conclusions: The parish nurses can play a vital role in providing holistic care to patients in a faith-based community. Future work is needed to address the challenges of parish nurses such as access to continuing education programs related to health topics of concern to their community members.
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http://dx.doi.org/10.1177/0898010118801414DOI Listing
June 2019

"Sex Will Make Your Fingers Grow Thin and Then You Die": The Interplay of Culture, Myths, and Taboos on African Immigrant Mothers' Perceptions of Reproductive Health Education with Their Daughters Aged 10-14 Years.

J Immigr Minor Health 2018 Jun;20(3):697-704

Department of Health Promotion & Development, School of Nursing, University of Pittsburgh, 440 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA.

This paper examines the convergence of culture, myths, and taboos surrounding reproductive health issues African immigrant women, living in the United States, learned during childhood in their countries of origin. We also discuss how mothers' perceptions of reproductive health education (RHE) influenced the education of their own daughters aged 10-14 years. This was a qualitative descriptive study. Data were collected via interviews and demographic survey. The sample size was 20 African immigrant mothers living in a mid-sized city in the U.S. Interviews were transcribed verbatim. Qualitative data was analyzed using qualitative content analysis. Myths and taboos related to menstruation, sexual intercourse, pregnancy, and HIV/AIDS were reported by the women interviewed. Discussion of these issues was largely taboo, and most myths the mothers learned growing up pertained to sexual intercourse, pregnancy prevention, and pregnancy termination using non-hormonal ingested substances. Myths and taboos about sexual issues are widespread in Africa and are propagated to control sexual behavior, especially that of unmarried people, particularly women. By examining these myths and taboos, we are able to somewhat contextualize the mothers' immigrant experience regarding RHE. Although myths were reported, the majority of mothers did not appear to believe them. The most significant taboo reported was sexual intercourse. This in turn led to mothers' overemphasis on abstinence for their daughters. It is also noteworthy that this sample contained mainly African women who overall were highly educated, spoke English, and could adequately navigate life in the U.S. It is unclear what the results would be if we were to examine African immigrant women with less achievements in these areas.
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http://dx.doi.org/10.1007/s10903-017-0675-4DOI Listing
June 2018

Experiences of Parish Nurses in Providing Diabetes Education and Preconception Counseling to Women With Diabetes.

J Obstet Gynecol Neonatal Nurs 2017 Mar - Apr;46(2):248-257. Epub 2017 Jan 17.

Objective: To explore the role and experiences of the parish nurse in providing diabetes education and preconception counseling to women with diabetes.

Design: Mixed-methods concurrent embedded design.

Setting: Focus groups of community-based parish nurses accessed from a regional database (Pennsylvania, Florida, Ohio, New York, Arizona, and Minnesota).

Participants: Forty-eight parish nurses recruited from the Parish Nurse and Health Ministry Program database in Western Pennsylvania.

Methods: The primary method was focus groups using face-to-face, teleconference, and videoconferencing formats. A secondary method used a quantitative descriptive design with three self-report measures (demographic, preconception counseling self-efficacy, and preconception counseling knowledge). Qualitative content analysis techniques were conducted and combined with descriptive analysis.

Results: Forty-eight parish nurses participated in 1 of 11 focus groups. Eight qualitative themes emerged: Awareness, Experience, Formal Training, Usefulness, Willingness, Confidence, "Wise Women," and Preconception Counseling Tool for Patients. Participants provided recommendations for training and resources to increase their knowledge and skills. Parish nurses' knowledge scores were low (mean = 66%, range = 40%-100%) with only moderate levels of self-efficacy (mean = 99, range = 27-164). Self-efficacy had a significantly positive association with knowledge (r = .29, p = .05).

Conclusion: Quantitative results were consistent with participants' qualitative statements. Parish nurses were unaware of preconception counseling and lacked knowledge and teaching self-efficacy as it related to preconception counseling and diabetes education. Understanding parish nurses' experiences with women with diabetes and identifying their needs to provide education and preconception counseling will help tailor training interventions that could affect maternal and fetal outcomes.
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http://dx.doi.org/10.1016/j.jogn.2016.10.010DOI Listing
February 2018

Exploring the Experience of African Immigrant Mothers Providing Reproductive Health Education to Their Daughters Aged 10 to 14 Years.

J Transcult Nurs 2018 03 12;29(2):123-130. Epub 2016 Dec 12.

3 University of Pittsburgh, Pittsburgh, PA, USA.

Introduction: Adolescents have disproportionate rates of unplanned pregnancies and sexually transmitted infections when compared with all other age groups. Mothers are gatekeepers and providers of reproductive health education, which can prevent teen pregnancy and sexually transmitted infections. Reproductive health education provided by African immigrant mothers is influenced by cultural experiences and cultural contexts that are not well understood and have not been studied. This study sought to describe the experience of African mothers living in the United States providing reproductive health education to their daughters aged 10 to 14 years.

Method: A qualitative descriptive design was used. Twenty African immigrant mothers were interviewed in a community setting. Qualitative content analysis approach was used for analysis.

Results: Three main themes emerged: (1) mothers' reproductive health education in their country of origin, (2) mothers' reproductive health communication with their daughters, and (3) changes due to the move to the United States.

Discussion: Mothers believed daughters were too young for reproductive health education, leading to conversations with limited content that were frequently triggered by daughters' exposure to reproductive health education outside the home.

Implications: African immigrant mothers may benefit from culturally congruent discussions with health care providers about the reproductive health information they give their daughters.
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http://dx.doi.org/10.1177/1043659616681848DOI Listing
March 2018

Associations Between Internet-Based Professional Social Networking and Emotional Distress.

Cyberpsychol Behav Soc Netw 2016 Oct;19(10):601-608

Center for Research on Media, Technology, and Health, University of Pittsburgh , Pittsburgh, Pennsylvania.

Professional social networking websites are commonly used among young professionals. In light of emerging concerns regarding social networking use and emotional distress, the purpose of this study was to investigate the association between frequency of use of LinkedIn, the most commonly used professional social networking website, and depression and anxiety among young adults. In October 2014, we assessed a nationally representative sample of 1,780 U.S. young adults between the ages of 19-32 regarding frequency of LinkedIn use, depression and anxiety, and sociodemographic covariates. We measured depression and anxiety using validated Patient-Reported Outcomes Measurement Information System measures. We used bivariable and multivariable logistic regression to assess the association between LinkedIn use and depression and anxiety, while controlling for age, sex, race, relationship status, living situation, household income, education level, and overall social media use. In weighted analyses, 72% of participants did not report use of LinkedIn, 16% reported at least some use, but less than once each week, and 12% reported use at least once per week. In multivariable analyses controlling for all covariates, compared with those who did not use LinkedIn, participants using LinkedIn at least once per week had significantly greater odds of increased depression (adjusted odds ratio [AOR] = 2.10, 95% confidence interval [CI] = 1.31-3.38) and increased anxiety (AOR = 2.79, 95% CI = 1.72-4.53). LinkedIn use was significantly related to both outcomes in a dose-response manner. Future research should investigate directionality of this association and possible reasons for it.
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http://dx.doi.org/10.1089/cyber.2016.0134DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5067824PMC
October 2016

Association between Self-Weighing and Percent Weight Change: Mediation Effects of Adherence to Energy Intake and Expenditure Goals.

J Acad Nutr Diet 2016 Apr 25;116(4):660-6. Epub 2015 Dec 25.

Background: To date, no investigators have examined electronically recorded self-weighing behavior beyond 9 months or the underlying mechanisms of how self-weighing might impact weight change.

Objective: Our aims were to examine electronically recorded self-weighing behavior in a weight-loss study and examine the possible mediating effects of adherence to energy intake and energy expenditure (EE) goals on the association between self-weighing and weight change.

Design: This was a secondary analysis of the self-efficacy enhancement arm of the Self Efficacy Lifestyle Focus (SELF) trial, an 18-month randomized clinical trial.

Participants/setting: The study was conducted at the University of Pittsburgh (2008-2013). Overweight or obese adults with at least one additional cardiovascular risk factor were eligible.

Intervention: Participants in the self-efficacy enhancement arm were given a scale (Carematix, Inc) and instructed to weigh themselves at least 3 days per week or every other day. The scale date- and time-stamped each weighing episode, storing up to 100 readings.

Main Outcome Measures: Weight was assessed every 6 months. Adherence to energy intake and EE goals was calculated on a weekly basis using paper diary data.

Statistical Analyses Performed: Linear mixed modeling and mediation analyses were used.

Results: The sample (n=55) was 80% female, 69% non-Hispanic white, mean (standard deviation) age was 55.0 (9.6) years and body mass index (calculated as kg/m2) was 33.1 (3.7). Adherence to self-weighing declined over time (P<0.001). From baseline to 6 months, there was a significant mediation effect of adherence to energy intake (P=0.02) and EE goals (P=0.02) on the association between adherence to self-weighing and percent weight change. Mediation effects were not significant during the second and third 6-month periods of the study.

Conclusions: Objectively measured adherence to self-weighing declined over 18 months. During the first 6 months, self-weighing directly impacted weight change and indirectly impacted weight change through changes in energy intake and EE.
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http://dx.doi.org/10.1016/j.jand.2015.10.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4808617PMC
April 2016

Attitudes and Beliefs of African Immigrant Mothers Living in the US Towards Providing Comprehensive Sex Education to Daughters Aged 12-17 Years: A Pilot Study.

J Immigr Minor Health 2016 10;18(5):1053-1059

Department of Health Promotion and Development, School of Nursing, University of Pittsburgh, 440 Victoria Building, 3500 Victoria Street, Pittsburgh, PA, 15261, USA.

The literature currently contains no comprehensive sex education (CSE) interventions targeting the African immigrant population. African immigrant mothers have been inhibited by several factors from providing their daughters with CSE. The primary aim of this study was to identify attitudes and beliefs of Sub-Saharan immigrant mothers living in the United States towards providing comprehensive sex education to their daughters aged 12-17 years. The study utilized a one-time anonymous nine-question survey. Fifteen women who met the inclusion criteria completed the study survey online or via paper format. African immigrant mothers are willing to allow comprehensive sex to be taught in schools and at home. Accepted education appears to range from religious and moral teaching to some factual information. This research will potentially assist in the designing of more culturally appropriate comprehensive sex education programs for African immigrant mothers and their daughters.
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http://dx.doi.org/10.1007/s10903-015-0292-zDOI Listing
October 2016

Nursing students' experiences with screening, brief intervention, and referral to treatment for substance use in the clinical/hospital setting.

J Addict Nurs 2014 Jul-Sep;25(3):122-9

Betty J. Braxter, PhD, RN, CNM, Kathy Puskar, DrPH, RN, FAAN, and Ann M. Mitchell, PhD, RN, FAAN, University of Pittsburgh School of Nursing, Pennsylvania. Holly Hagle, PhD, Institute for Research, Education, and Training in Addictions, Pittsburgh, Pennsylvania. Heather Gotham, PhD, University of Missouri-Kansas City. Martha Ann Terry, PhD, University of Pittsburgh Graduate School of Public Health, Pennsylvania.

Although Screening, Brief Intervention, and Referral to Treatment (SBIRT) is an effective early intervention when used across healthcare settings, its implementation has been difficult, in part because of lack of training, healthcare providers' feelings of low self-efficacy in performing SBIRT, and negative attitudes about people who use alcohol and drugs. This study used qualitative descriptive methods to examine baccalaureate nursing students' experiences with practicing SBIRT in clinical rotations following in-depth classroom work and skill-based training. Fifty-five junior level nursing students participated in four focus groups. Three overarching themes describe students' experiences with SBIRT. Students expressed a positive impact of the training on their attitudes and feelings of self-efficacy regarding the use of SBIRT, differences in opinions about whether SBIRT should be used universally with all patients or as a targeted intervention with only some patients, and that SBIRT is a nursing responsibility. These results suggest that education and training can affect attitudes and efficacy, but that attention needs to be paid to how SBIRT is implemented within different healthcare settings.
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http://dx.doi.org/10.1097/JAN.0000000000000037DOI Listing
May 2015

Condom use among sexually active rural high school adolescents personal, environmental, and behavioral predictors.

J Sch Nurs 2013 Jun 24;29(3):212-24. Epub 2012 Sep 24.

University of Pittsburgh at Bradford, Bradford, PA 16701, USA.

Adolescents who engage in unprotected intercourse are at risk of pregnancy and sexually transmitted infection (STI). Although adolescents in rural areas participate in levels of sexual risk taking similar to that of nonrural youth, few data are available identifying factors that influence condom use among rural adolescents. The purpose of this study is to determine the predictive value of selected personal, environmental, and behavioral factors for condom use among rural adolescents in grades 9-12. A cross-sectional survey was conducted among sexually active youth (N = 613), ages 14-19, in three rural school districts in the Northeast. Using logistic regression, identified predictors for condom use include personal standards (odds ratio [OR] = 2.45; confidence interval [CI]: [2.39, 6.47]), condom use goals (OR = 1.32; CI [1.21, 1.45]), condom use at first intercourse (OR = 3.93; CI [2.39, 6.47]) and male gender. School nurses are encouraged to incorporate identified predictors of condom use when considering interventions promoting safer sexual behaviors among rural youth.
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http://dx.doi.org/10.1177/1059840512461282DOI Listing
June 2013

Financial distress and depressive symptoms among African American women: identifying financial priorities and needs and why it matters for mental health.

J Urban Health 2013 Feb;90(1):83-100

Department of Behavioral and Community Health Sciences, University of Pittsburgh, Graduate School of Public Health, Pittsburgh, PA, USA.

Prior research found that financial hardship or distress is one of the most important underlying factors for depression/depressive symptoms, yet factors that contribute to financial distress remain unexplored or unaddressed. Given this, the goals of the present study were (1) to examine the relationship between perceived financial distress and depressive symptoms, and (2) to identify financial priorities and needs that may contribute to financial distress. Surveys from 111 African American women, ages 18-44, who reside in Allegheny County, PA, were used to gather demographic information and measures of depressive symptoms and financial distress/financial well-being. Correlation and regression analyses revealed that perceived financial distress was significantly associated with levels of depressive symptoms. To assess financial priorities and needs, responses to two open-ended questions were analyzed and coded for common themes: "Imagine you won a $10,000 prize in a local lottery. What would you do with this money?" and "What kinds of programs or other help would be beneficial to you during times of financial difficulties?" The highest five priorities identified by the participants were paying bills and debt, saving, purchasing a home or making home repairs, and/or helping others. The participant's perceived needs during times of financial difficulty included tangible assistance and/or financial education. The findings from this study can be used to create new and/or enhance existing programs, services, and/or interventions that focus on the identified financial priorities and needs. Collaborative efforts among professionals in different disciplines are also needed, as ways to manage and alleviate financial distress should be considered and discussed when addressing the mental health of African American women.
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http://dx.doi.org/10.1007/s11524-012-9755-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3579302PMC
February 2013

A qualitative exploration of the role of social networks in educating urban African American adolescents about sex.

Ethn Health 2013 6;18(2):168-89. Epub 2012 Aug 6.

National Center for Juvenile Justice, Pittsburgh, PA 15203, USA.

Objective: To explore social network members' role in educating African American adolescents about sexual health issues.

Design: We conducted 21 focus groups with urban African American mothers (n=51), fathers (n=18), sons (n=20), and daughters (n=36) from Allegheny County, Pennsylvania, USA, between December 2007 and March 2008. At least one biological parent (or legal guardian) and one adolescent aged 15-17 years from each family participated. Group conversations were audio-recorded, transcribed, and analyzed using directive content analysis and the constant comparison method. Two coders independently read each transcript to identify emergent themes.

Results: A broad range of people were reportedly involved in the education process. Older siblings, extended family, and peers were most commonly cited. However, unrelated adults were also described as playing important roles. Unrelated adults included the friends of an adolescent's parents and the parents of an adolescent's friends or romantic partners. Social network members were said to address three main issues: the facts about sex and sexuality, the social aspects of sexuality (e.g., appropriate dating behaviors, choosing dating partners), and promotion of family values. When educating adolescents about sex, social network members were described as playing eight functional roles, including that of a teacher, guide, challenger, confidant, shelterer, supervisor-chaperone, role model, and provider of access to reproductive health services. These roles were not mutually exclusive, meaning that social network members often assumed different roles depending on the situation. The influence of individuals who were not an adolescent's parent was highly dependent on adolescents' relationship with their parents or on their parents' comfort dealing with sexual issues.

Conclusions: African American adolescents' social networks were described by parents and adolescents as dense, complex, and routinely involved in educating adolescents about sex.
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http://dx.doi.org/10.1080/13557858.2012.708915DOI Listing
October 2013

Assessing disparities in adult vaccination using multimodal approaches in primary care offices: methodology.

J Urban Health 2008 Mar 30;85(2):217-27. Epub 2008 Jan 30.

Department of Family Medicine and Clinical Epidemiology, University of Pittsburgh School of Medicine, 3518 5th Avenue, Pittsburgh, PA 15261, USA.

Racial disparities in invasive pneumococcal disease and pneumococcal polysaccharide vaccination (PPV) persist despite significant progress. One reason may be that minority patients receive primary care at practices with fewer resources, less efficient office systems, and different priorities. The purposes of this paper are: (1) to describe the recruitment of a diverse array of primary care practices in Pittsburgh, Pennsylvania serving white and minority patient populations, and the multimodal data collection process that included surveys of key office personnel, observations of practice operations and medical record reviews for determining PPV vaccination rates; and (2) to report the results of the sampling strategy. During 2005, 18 practices participated in the study, six with a predominantly minority patient population, nine with a predominantly white patient population, and three with a racial distribution similar to that of this locality. Eight were solo practices and 10 were multiprovider practices; they included federally qualified health centers, privately owned practices and faculty and University of Pittsburgh Medical Center community practices. Providers represented several racial and ethnic groups, as did office staffs. PPV rates determined from 2,314 patients' medical records averaged 60.3 +/- 22.6% and ranged from 11% to 97%. Recruitment of practices with attention to location, patient demographics, and provider types results in a diverse sample of practices and patients. Multimodal data collection from these practices should provide a rich data source for examining the complex interplay of factors affecting immunization disparities among older adults.
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http://dx.doi.org/10.1007/s11524-007-9247-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2430112PMC
March 2008

Parents, practitioners, and researchers: community-based participatory research with early head start.

Am J Public Health 2003 Oct;93(10):1672-9

Department of Behavioral and Community Health Sciences, Graduate School of Public Health, University of Pittsburgh, PA 15261, USA.

Community-based participatory research (CBPR) is an approach to research and evaluation that is receiving increased attention in the field of public health. Our report discusses the application of this approach to research and evaluation with an Early Head Start (EHS) program in Pittsburgh, Pa. Our primary purpose is to illustrate the key elements that contributed to effective collaboration among researchers, EHS practitioners, and parents of EHS children in the conduct of the study. The focus is not on research findings but on research process. Our goal is to make the practices of CBPR visible and explicit so they can be analyzed, further developed, and effectively applied to a range of public health issues in a diversity of community contexts.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1448031PMC
http://dx.doi.org/10.2105/ajph.93.10.1672DOI Listing
October 2003

The role of qualitative methods for investigating barriers to adult immunization.

Qual Health Res 2002 Oct;12(8):1058-75

Department of Health Services Administration, Graduate School of Public Health, University of Pittsburgh, USA.

In 1999, the Agency for Healthcare Research and Quality funded a study of barriers to immunization, which included a short-term qualitative data collection to assess the organizational and cultural features of selected primary care practices and to explore their impact on adult immunization rates. The authors describe the short-term qualitative data collection system and the contributions made by the qualitative study to the parent project. They address previously held concerns about qualitative research and provide a system that can be replicated or modified for use for projects designed to assess complex attitudes and behaviors that affect health outcomes.
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http://dx.doi.org/10.1177/104973202129120449DOI Listing
October 2002
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