Using the Four Ps of telehealth framework to enhance Doctor of Nursing Practice (DNP) Telehealth Curriculum.

Background: Telehealth is now a necessary component of health care delivery, and its use among health care professionals was accelerated by the COVID-19 pandemic.

Problem: Nurse practitioner (NP) programs generally incorporate telehealth competencies within their curriculum, preparing NPs to effectively deliver telehealth and improve health outcomes.

Approach: We developed and implemented a telehealth blueprint to enhance telehealth content within our clinical Doctor of Nursing Practice (DNP) program guided by the Four Ps of the Telehealth Framework planning, preparing, providing, and performance evaluation.

Assessing the Readiness of Rural Public Librarians to Implement Public Health Programs.

Although health promotion is not the primary function of public libraries, it is well documented that many libraries engage in health promotion activities, even when resources are constrained. Less understood is the readiness of the public library workforce, particularly in rural communities, to implement evidence-based health promotion programs. This study uses a modified version of the Competency Assessment for Tier 2 Public Health Professionals to assess the readiness of a small sample (n = 21) of Oregon rural library managers to implement evidence-based health initiatives.

Regional delivery in graduate nursing programs for students living in rural communities.

Oregon has a lack of primary care providers in rural areas. To address this issue, employers have indicated they plan to hire greater numbers of advanced practice registered nurses (APRNs). Oregon Health & Science University (OHSU) School of Nursing (SoN) responded to this need by developing a statewide delivery model to educate APRN students in their communities.

Factors impacting implementation of nutrition and physical activity policies in rural schools.

Background: Rural Latino children have higher rates of obesity compared to non-Latino Whites. Schools are in a unique position to address rural childhood obesity through policies. While evidence exists on factors that promote or impede school-based physical activity (PA) and nutrition policies, only a fraction has been in rural communities.

Telehealth Competencies: Leveled for Continuous Advanced Practice Nurse Development.

Background: The COVID-19 pandemic spurred a rapid uptake of telehealth utilization, with advanced practice registered nurses (APRNs) at the forefront of telehealth care delivery. To advance training of nurse practitioners and support curricular development, essential APRN student competencies in telehealth were developed.

Problem: Although telehealth competencies have been developed, little is understood about their evaluation across the curricula.

Development and validation of self-efficacy and intention measures for spending time in nature.

Purpose: The purpose of this study was to develop and evaluate the reliability and validity of self-efficacy and intentions measures for time spent in nature (TSN). TSN is related to improvement in psychological well-being and health, yet most American adults spend very little time in such settings. Theory-based interventions have been effective in increasing physical activity, a related behavior, and may be one mechanism to increase TSN.

The Effects of Major Disruptions on Practice Participation in Facilitation During a Primary Care Quality Improvement Initiative.

Background: Disruptions in primary care practices, like ownership change, clinician turnover, and electronic health record system implementation, can stall quality improvement (QI) efforts. However, little is known about the relationship between these disruptions and practice participation in facilitated QI.

Methods: We explore this relationship using data collected from EvidenceNOW in a mixed-methods convergent design.

Rural Latino parent and child physical activity patterns: family environment matters.

Background: Rural Latino children and adults are less active than urban and non-Latino counterparts. We examined physical activity (PA) patterns of rural Latino children and their parents, and explored parental beliefs about and reported barriers of Latino family physical activity. Latino families in a rural area in eastern Washington state, with children in grades 3-5 were included.

What Sets Physically Active Rural Communities Apart from Less Active Ones? A Comparative Case Study of Three US Counties.

Background: Rural US communities experience health disparities, including a lower prevalence of physical activity (PA). However, "Positive Deviants"-rural communities with greater PA than their peers-exist. The purpose of this study was to identify the factors that help create physically active rural US communities.

The Effects of Play Streets on Social and Community Connectedness in Rural Communities.

Promoting physical activity (PA) is a long-standing public health initiative to improve overall health and wellbeing. Innovative strategies such as Play Streets, temporary activation of public spaces to provide safe places for active play, are being adopted in urban and rural communities to increase PA among children. As part of these strategies, aspects of social and community connectedness may be strengthened.

Environmental Factors Associated with Physical Activity in Rural U.S. Counties.

Background: Rural U.S. adults' prevalence of meeting physical activity (PA) guidelines is lower than urban adults, yet rural-urban differences in environmental influences of adults' PA are largely unknown.

Cultural And Structural Features Of Zero-Burnout Primary Care Practices.

Although much attention has been focused on individual-level drivers of burnout in primary care settings, examining the structural and cultural factors of practice environments with no burnout could identify solutions. In this cross-sectional analysis of survey data from 715 small-to-medium-size primary care practices in the United States participating in the Agency for Healthcare Research and Quality's EvidenceNOW initiative, we found that zero-burnout practices had higher levels of psychological safety and adaptive reserve, a measure of practice capacity for learning and development. Compared with high-burnout practices, zero-burnout practices also reported using more quality improvement strategies, more commonly were solo and clinician owned, and less commonly had participated in accountable care organizations or other demonstration projects.

An Evidence-Based Walking Program in Oregon Communities: Step It Up! Survivors.

Physical activity can help mitigate the long-term symptoms and side effects of cancer and its treatment, but most cancer survivors are not active enough to achieve these benefits. An evidence-based strategy to promote physical activity among adults is a community group-based walking program. However, many evidence-based programs do not achieve intended population health outcomes because of the challenges of real-world implementation.

Attitudes and Beliefs of Older Female Breast Cancer Survivors and Providers About Exercise in Cancer Care.

Objectives: To understand breast cancer survivors' and providers' attitudes and beliefs regarding exercise counseling and structured exercise programs within cancer care.

Sample & Setting: 61 female breast cancer survivors and 11 breast cancer providers from a university cancer center in the Pacific Northwest.

Methods & Variables: Survivors completed anonymous self-report surveys, and providers participated in semistructured interviews.

Financial hardship among rural cancer survivors: An analysis of the Medical Expenditure Panel Survey.

Some cancer survivors report spending 20% of their annual income on medical care. Undue financial burden that patients face related to the cost of care is referred to as financial hardship, which may be more prevalent among rural cancer survivors. This study examined contrasts in financial hardship among 1419 rural and urban cancer survivors using the 2011 Medical Expenditure Panel Survey supplement - The Effects of Cancer and Its Treatment on Finances.

Rural-urban differences in financial burden among cancer survivors: an analysis of a nationally representative survey.

Purpose: Rural cancer survivors may disproportionately experience financial problems due to their cancer because of greater travel costs, higher uninsured/underinsured rates, and other factors compared to their urban counterparts. Our objective was to examine rural-urban differences in reported financial problems due to cancer using a nationally representative survey.

Methods: We used data from three iterations of the National Cancer Institute's Health Information and National Trends Survey (2012, 2014, and 2017) to identify participants who had a previous or current cancer diagnosis.

Specifying and comparing implementation strategies across seven large implementation interventions: a practical application of theory.

Background: The use of implementation strategies is an active and purposive approach to translate research findings into routine clinical care. The Expert Recommendations for Implementing Change (ERIC) identified and defined discrete implementation strategies, and Proctor and colleagues have made recommendations for specifying operationalization of each strategy. We use empirical data to test how the ERIC taxonomy applies to a large dissemination and implementation initiative aimed at taking cardiac prevention to scale in primary care practice.

, a Culturally Tailored Physical Activity and Nutrition Program for Rural Latinas: Findings from a Pilot Study.

In the United States, Latino adults, compared with non-Hispanic white adults, are less likely to meet physical activity and dietary recommendations, and have higher rates of obesity. There is an urgent need for culturally adapted health promotion programs that meet the needs of the growing Latino population in the United States. We systematically adapted StrongWomen-Healthy Hearts, an evidence-based physical activity and nutrition program, for rural Latinas.

Sedentary Behaviors in Today's Youth: Approaches to the Prevention and Management of Childhood Obesity: A Scientific Statement From the American Heart Association.

This scientific statement is about sedentary behavior and its relationship to obesity and other cardiometabolic outcomes in youth. A deleterious effect of sedentary behavior on cardiometabolic health is most notable for screen-based behaviors and adiposity; however, this relation is less apparent for other cardiometabolic outcomes or when sedentary time is measured with objective movement counters or position monitors. Increasing trends of screen time are concerning; the portability of screen-based devices and abundant access to unlimited programming and online content may be leading to new patterns of consumption that are exposing youth to multiple pathways harmful to cardiometabolic health.