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Over the past decade, the Agency for Healthcare Research and Quality and The Joint Commission have identified that communication problems are a root cause of most serious adverse events and that patients with limited English proficiency are more likely than others to suffer physical harm when such errors occur. It is essential to educate nursing students on the challenges of patients with limited English proficiency and empower them with tools, such as the National Culturally and Linguistically Appropriate Services standards, to minimize this phenomenon in their future nursing practice. We describe an educational intervention designed to accomplish this using Kolb’s experiential learning theory as a foundation for implementation.
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Health disparities, especially among minorities, persist; obesity is a national concern; and the combined effect can be significant for families and populations. In an effort to address obesity at an early age, the National Association of Hispanic Nurses (NAHN), developed the Muevete USA project. Muevete USA (from the Spanish verb for to move) features five lesson plans on healthy lifestyles for children and their families. This article describes Muevete USA, the partnership with a local school of nursing, the implementation of the program at the local level and the emerging program and student outcomes of a successful partnership.
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Background: Schools of nursing have moved to multiple choice test questions to help prepare students for licensure and practice. However, students can buy test banks to help them “get through” nursing school. Accurate assessment of nursing students' knowledge and judgment comprises access to test banks. Method: The purpose of this exploratory study was to gain an understanding about nursing faculty's knowledge concerning test bank security issues, to assess whether publishers were aware of this issue, and vendor's reasons for supplying test banks to students. Results: Overall, the results indicated that the majority of faculty were unaware of student access to test banks, and although most do not use test banks verbatim, general consensus existed that test bank security is a concern. Conclusion: Implications include increasing faculty awareness of test bank access by students, supporting educators to develop their own test bank items, and promoting security of all examinations.
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Background Hispanic adults with type 1 diabetes (T1D) have suboptimal access to continuous glucose monitoring (CGM). Widening access to and increasing uptake of CGM for Hispanic adults with T1D are warranted. Objective This randomized controlled trial (RCT) will evaluate the feasibility of a federally qualified health center (FQHC) CGM intervention and assess for an intervention signal in patient outcomes. Methods A mixed methods, pragmatic pilot RCT will be used. A total of 30 adult Hispanic patients with T1D will be recruited from 4 FQHC sites allocated to provide the intervention (n=2) or control (n=2) conditions. At intervention sites, participants must be willing to use CGM for 3 months and have a willing adult family member participate in the study. Guided by the socioecological model, our intervention has three levels: (1) individual (culturally sensitive CGM information, motivation, and skills acquisition), (2) family or social networks (integration of the core Hispanic values of familismo and collectivismo to leverage family and peer support for CGM uptake), and (3) health care provider levels with CGM training using Project ECHO (Extension for Community Healthcare Outcomes). Intervention participants (n=15) will receive a culturally sensitive CGM intervention with 4 weekly intervention sessions (coattended by a family member), followed by 7 peer support group sessions over 6 months. Control participants will receive a self-monitoring of blood glucose control condition over a 6-month period. Study feasibility will be assessed in terms of recruitment, enrollment, retention, adherence, study procedures and implementation, and acceptability with mixed methods. We will collect physiological (eg, glycated hemoglobin and CGM metrics) and psychosocial (eg, depression, quality of life, social support, and interpersonal processes of care) outcome data. Feasibility data will be analyzed using content analysis and univariate or bivariate statistics. Linear and generalized linear mixed modeling will assess intervention signals and clinically meaningful differences from baseline to 3 and 6 months. Results Funding for this project was secured in September 2022. As of May 2024, recruitment commenced following formative qualitative data collection on the social determinants of health and CGM uptake in Hispanic adults with T1D (N=32). Our community advisory board informed protocol modifications by reviewing qualitative findings, collaborating on related intervention refinement, and advising on cultural sensitivity methods. Conclusions Guided by the socioecological model, our novel FQHC CGM intervention will provide feasibility and outcome data to guide a full-scale RCT. Our intervention model has unique potential to widen CGM access and increase CGM uptake in low-income Hispanic adults with T1D while improving outcomes for this vulnerable population. Trial Registration ClinicalTrials.gov NCT06487962; https://clinicaltrials.gov/study/NCT06487962 International Registered Report Identifier (IRRID) PRR1-10.2196/60583
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