Publications by authors named "Cynthia S Darling-Fisher"

Background: Agencies and clinical practices are beginning to provide trauma-informed care (TIC) to their clients. However, there are no measures to assess clients' perceptions of and satisfaction with the TIC care they have received. A 20-item questionnaire, the TIC Grade, was developed, based on the National Center for Trauma-Informed Care principles of TIC, to assess the patient or client perception of the TIC provided in settings that serve adolescents and emerging adults.

View Article and Find Full Text PDF

Lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) persons account for 3.5% of the population. Nursing programs in the United States provide a median of 2.

View Article and Find Full Text PDF

Background: Trauma has significant effects on individuals' health. Nurses are well-positioned to deliver trauma-informed care; however, there is a lack of trauma nursing education. The development of trauma education in nursing is just beginning; therefore, it is unclear what details should be integrated into nursing courses.

View Article and Find Full Text PDF

Background And Purpose: This article provides foundational information about 1) the significant health disparities LGBT individuals face, which are associated with persistent discrimination, oppression, and stigmatization in both societal and healthcare settings; and 2) how cultural humility can help nurses to create safe spaces and provide optimal care for all patients.

Methods: CINAHL, Medline, PsychInfo, and GoogleScholar databases were searched to identify theoretical and empirical literature regarding LGBT health, health disparities, barriers to accessing care, unconscious bias, cultural humility, and creating safe spaces to better meet the healthcare needs of the LGBT population.

Conclusions: LGBT patients' health needs are not being adequately met in many healthcare settings due to inadequate education and preparation of healthcare providers, including nurses.

View Article and Find Full Text PDF

The Modified Erikson Psychosocial Stage Inventory (MEPSI) is an 80-item, comprehensive measure of psychosocial development based on Erikson's theory with published reliability and validity data. Although designed as a comprehensive measure, some researchers have used individual subscales for specific developmental stages as a measure; however, these subscale reliability scores have not been generally shared. This article reviewed the literature to evaluate the use of the MEPSI: the major research questions, samples/populations studied, and individual subscale and total reliability and validity data.

View Article and Find Full Text PDF

Background And Purpose: Trauma comes in many forms, including interpersonal, community, and institutional trauma. The adverse childhood event (ACE) studies demonstrated that adverse experiences in childhood can have a profound, cumulative impact on the course of health and development over a lifetime. It is critical for healthcare providers, such as nurse practitioners (NPs), working in primary care to screen adolescents and emerging adults for a history of ACEs and trauma.

View Article and Find Full Text PDF

Introduction: The purpose of this study was to examine the effect of a youth-centered assessment, the Sexual Risk Event History Calendar (SREHC), compared with the Guidelines for Adolescent Preventive Services (GAPS) assessment, on sexual risk attitudes, intentions, and behaviors.

Methods: The Interaction Model of Client Health Behavior guided this participatory research-based randomized control trial. Youth participants recruited from university and community clinics in the Midwestern United States were randomized to a health care provider visit using either the SREHC or GAPS and completed surveys at baseline, postintervention, and 3, 6, and 12 months.

View Article and Find Full Text PDF

Research informed by individuals' lived experiences is a critical component of participatory research and nursing interventions for health promotion. Yet, few examples of participatory research in primary care settings with adolescents and young adults exist, especially with respect to their sexual health and health-risk behaviors. Therefore, we implemented a validated patient-centered clinical assessment tool to improve the quality of communication between youth patients and providers, sexual risk assessment, and youths' health-risk perception to promote sexual health and reduce health-risk behaviors among adolescents and young adults in three community health clinic settings, consistent with national recommendations as best practices in adolescent health care.

View Article and Find Full Text PDF

Background: Patient-centered communication is fundamental to individualizing healthcare, but there has been limited evaluation of provider communication with youth.

Objectives: The aim was to compare communication outcomes after use of an event history calendar (EHC) and Guidelines for Adolescent Preventive Services (GAPS) to structure interactions during a clinic visit. Patient and provider descriptions of EHC and GAPS communication experiences were also obtained.

View Article and Find Full Text PDF

Introduction: The purpose of this study was to evaluate health providers' use of the Rapid Assessment for Adolescent Preventive Services (RAAPS) screening tool to identify adolescent high-risk behaviors, its ease of use and efficiency, and its impact on provider/patient discussions of sensitive risk behaviors.

Method: This mixed methods descriptive study used an online survey to assess providers' use of the RAAPS and their perspectives on its implementation and effect on adolescent-provider communication. The survey was completed by providers from a variety of settings across the United States (N = 201).

View Article and Find Full Text PDF

Introduction: The purpose of this study was to explore male and female adolescents' perceptions of and differences in Event History Calendar (EHC) sexual risk assessment in a clinical setting.

Method: This study is a secondary analysis exploring male and female qualitative data from a mixed methods study of adolescent and provider communication. Participants included 30 sexually active 15- to 19-year-old male (n = 11) and female (n = 19) patients at a school-linked clinic.

View Article and Find Full Text PDF

Introduction: The purpose of this study is to describe the development and clinical use of Rapid Assessment for Adolescent Preventive Services (RAAPS), a time-efficient screening tool to assess for multiple adolescent risk behaviors.

Method: A retrospective chart audit was conducted to obtain descriptive data of middle school (N = 106) and alternative high school (N = 39) adolescents who completed the 17- to 18-item RAAPS questionnaire. Surveys assessed providers' evaluations of the RAAPS.

View Article and Find Full Text PDF

The purpose of this study was to elicit beliefs and attitudes about increasing physical activity in the workplace among staff and faculty in an academic setting as the first phase of a three-phase pilot study. Focus groups were conducted using the Theory of Planned Behavior as the basis for exploratory questions regarding workplace physical activity. The responses were tallied and themes emerged from the qualitative analysis.

View Article and Find Full Text PDF

Purpose: The incidence of fetal alcohol spectrum disorders (FASD) is increasing, even though it is 100% preventable. This study examined use of, knowledge about, and attitudes toward alcohol of women requesting emergency contraception (EC) and/or a pregnancy test, and evaluated whether a brief intervention would be effective in educating them about the risks of FASD.

Data Sources: Fifty women from two outpatient clinics participated.

View Article and Find Full Text PDF