Dental insurance and dental service use by U.S. women of childbearing age

ABSTRACT Objectives: Oral health has a significant effect on health, and for women, poor oral health can lead to poor birth outcomes and can affect their child's health. Nursing interventions to improve the oral health of at‐risk women have the potential to increase maternal and child systemic and oral health. The identification of women at a high risk for poor oral health is a necessary to develop and evaluate these interventions. Design and Sample: This study examined the factors related to dental insurance and dental service use for women of childbearing age in the United States. A secondary analysis of the 2003–2004 National Health and Nutrition Examination Survey was completed to examine the predisposing, enabling, and need variables associated with dental insurance status and dental service use in a representative random sample of 1,071 women. Results: The results showed that over 40% of women had no dental insurance. Women with less education, lower income, and dental need were significantly less likely to have dental insurance. Dental utilization by the uninsured was low and a racial/ethnic disparity was noted. Conclusion: A lack of dental insurance and dental service utilization is a significant concern. Nurses working with low‐income women should educate the population about oral health and advocate for policies to increase dental insurance coverage.     

Research Article: Culturally sensitive health counseling to prevent lifestyle‐related diseases in Japan

This study explored the methods that are used by public health nurses to provide culturally sensitive health counseling to elderly Japanese farmers in order to motivate them to adopt healthy behaviors. Fourteen elderly farmers (eight men and six women) from three rural communities underwent health counseling and then changed their habits to prevent lifestyle‐related diseases. Qualitative and inductive analyses were conducted to determine the effects of the culturally sensitive counseling. Five methods for providing culturally sensitive counseling were identified: (i) showing an interest in, and respect for, the local culture; (ii) stimulating the participants' awareness of the health risks inherited in their local cultural practices through the use of familiar examples; (iii) accepting and understanding the participants' ambivalence about their local culture; (iv) connecting the reasons for the participants to change their lifestyle with their local culture; and (v) adjusting the health‐promoting behaviors of the participants to fit their local culture. Public health nurses should consider the pride that elderly farmers have in their background and their resistance to change and use these factors to point out the discrepancies in their lifestyle and promote more quality‐of‐life‐oriented and practical self‐care behaviors.     

Results of a Nurse‐Led Workshop Designed to Prevent Fetal Alcohol Spectrum Disorder

ABSTRACT Preventing the negative consequences of prenatal exposure to alcohol remains an unmet challenge. This paper presents the results of a workshop, designed to increase the implementation of fetal alcohol spectrum disorders (FASD) prevention interventions in 8 counties of New York. The workshop was based on constructivist learning theory and used the Population‐Based Public Health Nursing Intervention Model as the structure for discussing potential interventions. The number and type of FASD interventions implemented were determined by surveys sent out postworkshop to 167 participants. At 4 months postworkshop, 37 participants reported implementing 226 primary, secondary, and tertiary interventions in 74 different worksites. The results indicate that incorporation of constructivist learning theory shows promise for future public health and continuing education programs aimed at changing or enhancing practice.     

Adaptation of a Best Practice Guideline to Strengthen Client‐Centered Care in Public Health

Best practice guidelines (BPGs) were developed by the Registered Nurses Association of Ontario (RNAO) to support evidence‐based nursing practice. One Ontario public health unit chose to implement the BPG on client‐centered care (CCC). A critical review of this BPG revealed issues that would hinder successful implementation within a public health setting. These included a focus on the client as an individual, the predominance of acute care exemplars and training resources that were not representative of public health nursing practice, and the need to reconcile the enforcement roles of public health with the BPG principles. The purpose of this article is to describe the process of adapting the CCC BPG to more accurately reflect the broad scope of public health nursing practice. A model for CCC in public health nursing context is presented and processes for implementing, evaluating, and sustaining CCC are described.     

U.S. Public Health Service Response to the 2014–2015 Ebola Epidemic in West Africa: A Nursing Perspective

The 2014–2015 Ebola epidemic in West Africa has been the deadliest Ebola epidemic to date. In response to this deadly epidemic, the U.S. government declared this a top national security priority and members of the Commissioned Corps of the United States Public Health Service were tasked to provide direct patient care to Ebola virus disease patients. Commissioned Corps nurses provided the highest level of care under the most austere conditions. This article discusses the training, ethical dilemmas, and constant risk for potential exposure while working in an Ebola Treatment Unit.