Nursing turnover in a large, rural health system.

Purpose: Nursing turnover is a leading cause of inefficiency in health care delivery. Few studies have examined turnover among nurses who work in rural areas.

Methods: We accessed human resources data that tracked hiring and terminations from a large health system operating in South Dakota, North Dakota, and Minnesota between January 2016 and December 2017.

The IDeaS initiative: pilot study to assess the impact of rare diseases on patients and healthcare systems.

Background: Rare diseases (RD) are a diverse collection of more than 7-10,000 different disorders, most of which affect a small number of people per disease. Because of their rarity and fragmentation of patients across thousands of different disorders, the medical needs of RD patients are not well recognized or quantified in healthcare systems (HCS).

Methodology: We performed a pilot IDeaS study, where we attempted to quantify the number of RD patients and the direct medical costs of 14 representative RD within 4 different HCS databases and performed a preliminary analysis of the diagnostic journey for selected RD patients.

Using Electronic Medical Records and Health Claim Data to Develop a Patient Engagement Score for Patients With Multiple Chronic Conditions: An Exploratory Study.

The study objective was to (1) develop a statistical model that creates a novel patient engagement score (PES) from electronic medical records (EMR) and health claim data, and (2) validate this developed score using health-related outcomes and charges of patients with multiple chronic conditions (MCCs). This study used 2014-16 EMR and health claim data of patients with MCCs from Sanford Health. Patient engagement score was created based on selected patients' engagement behaviors using Gaussian finite mixture model.

Recommendations for strengthening the role of embedded researchers to accelerate implementation in health systems: Findings from a state-of-the-art (SOTA) conference workgroup.

Background: Traditional research approaches do not promote timely implementation of evidence-based innovations (EBIs) to benefit patients. Embedding research within health systems can accelerate EBI implementation by blending rigorous methods with practical considerations in real-world settings. A state-of-the-art (SOTA) conference was convened in February 2019 with five workgroups that addressed five facets of embedded research and its potential to impact healthcare.

Predicting unplanned medical visits among patients with diabetes: translation from machine learning to clinical implementation.

Background: Diabetes is a medical and economic burden in the United States. In this study, a machine learning predictive model was developed to predict unplanned medical visits among patients with diabetes, and findings were used to design a clinical intervention in the sponsoring healthcare organization. This study presents a case study of how predictive analytics can inform clinical actions, and describes practical factors that must be incorporated in order to translate research into clinical practice.

Smoking is associated with a higher risk of unplanned medical visits among adult patients with diabetes, using retrospective electronic medical record data from 2014 to 2016.

Background: Smoking exacerbates the complications of diabetes, but little is known about whether patients with diabetes who smoke have more unplanned medical visits than those who do not smoke. This study examines the association between smoking status and unplanned medical visits among patients with diabetes.

Methods: Data were drawn from electronic medical records (EMR's) from a large healthcare provider in the Northern Plains region of the US, from adult (≥18 years old) patients with type 1 or type 2 diabetes who received care at least once during 2014-16 (N = 62,149).

Rasch calibration of the 25-item Connor-Davidson Resilience Scale.

Rasch modeling was used to examine the 25-item Connor-Davidson Resilience Scale within adults ( = 410) in a weight management program. Rasch analysis assessed model-data fit, item difficulty and person's resilience level, an item-person map to evaluate relative distribution items and persons, and rating scale function. Four misfit items were identified and removed.

Genetic Counseling in Middle School Science Club: A Pilot Study.

Compared to demographic data from other healthcare professions, genetic counselors (GCs) are more likely to be Caucasian females. Many current underrepresented in genetic counseling (URGC) professionals in the field found genetic counseling later in their careers due in part to their lack of awareness. A pilot study consisting of equal numbers of male and female sixth grade science club students was conducted to explore the impact that direct teaching might have on students' awareness of and interest in genetic counseling.

Cultivating Native American scientists: an application of an Indigenous model to an undergraduate research experience.

With growing evidence demonstrating the impact of undergraduate research experiences on educational persistence, efforts are currently being made to expand these opportunities within universities and research institutions throughout the United States. Recruiting underrepresented students into these programs has become an increasingly popular method of promoting diversity in science. Given the low matriculation into postsecondary education and completion rates among Native Americans, there is a great need for Native American undergraduate research internships.

Examining the Prevalence and Impact of Peer Victimization and Social Support for Rural Youth.

Introduction: Peer victimization is a common experience in early adolescence often associated with psychosocial issues, following some youth into adulthood. Preliminary findings from a longitudinal study on peer victimization and protective factors were measured in rural elementary youth. Bullying is often seen as a schoolonly issue but research findings suggest the importance of systems outside the school setting as important protective factors for intervention.

Peer Victimization in Rural Youth and Why it Matters.

Peer victimization is a major public health concern due to its psychological, emotional, and physical short and potentially long-term effects on children. Research conducted with rural youth have shown heightened peer victimization rates compared to urban and suburban locales. Protective factors, such as social support, are underresearched and less emphasized compared to risk factors, particularly in the context of rural youth.

Cultural and Social Predictors of Substance Abuse Recovery among American Indian and Non-American Indian Pregnant and Parenting Women.

Substance abuse is especially undesirable among pregnant or parenting women (PPW). As such, there is a need to examine the factors impacting positive treatment outcomes, particularly among American Indian/Alaska Native (AI/AN) PPW, as they are seeking substance abuse treatment at rates considerably higher than the national average. This study aimed to identify the social and cultural mechanisms that support their recovery.

Midwest Science Festival: Exploring Students' and Parents' Participation in and Attitudes Toward Science.

Introduction: Compared to national numbers, South Dakota has a higher proportion of students interested in science, technology, engineering, and mathematics (STEM) fields. Interest in science can be influenced by exposure to science through formal and informal learning. Informal science activities (including exposures and participation) have been found to elicit higher levels of interest in science, likely impacting one's attitude towards science overall.

Applying the Theory of Reasoned Action to Understanding Teen Pregnancy with American Indian Communities.

Objectives American Indian girls have higher teen pregnancy rates than the national rate. Intervention studies that utilize the Theory of Reasoned Action have found that changing attitudes and subjective norms often leads to subsequent change in a variety of health behaviors in young adults. The current study goal is to better understand sexual decision-making among American Indian youth using the Theory of Reasoned Action model and to introduce ways to utilize attitudes and subjective norms to modify risky behaviors.

Identifying sexual health protective factors among Northern Plains American Indian youth: An ecological approach utilizing multiple perspectives.

This study examined aspects of the sociocultural context in which American Indian (AI) teen pregnancy occurs, focusing specifically on protective factors for Northern Plains AI youth. Principles of community-based participatory research guided the qualitative data collection from 185 community members (focus groups with AI youth, youth parents, and elders; interviews with health care providers and school personnel) from a reservation and an urban community. Results indicated three protective systems impacted the sexual health and behaviors of AI youth: school, family, and enculturation.

Teen Pregnancy Prevention Program Recommendations from Urban and Reservation Northern Plains American Indian Community Members.

Despite declines over the past few decades, the United States has one of the highest rates of teen pregnancy compared to other industrialized nations. American Indian youth have experienced higher rates of teen pregnancy compared to the overall population for decades. Although it's known that community and cultural adaptation enhance program effectiveness, few teen pregnancy prevention programs have published on recommendations for adapting these programs to address the specific needs of Northern Plains American Indian youth.

Understanding gender roles in teen pregnancy prevention among American Indian youth.

Objectives: To examine the impact of gender norms on American Indian (AI) adolescents' sexual health behavior.

Methods: The project collected qualitative data at a reservation site and an urban site through 24 focus groups and 20 key informant interviews.

Results: The reasons that AI youth choose to abstain or engage in sexual intercourse and utilize contraception vary based on gender ideologies defined by the adolescent's environment.

Prosocial behavior as a protective factor for children's peer victimization.

A majority of peer victimization research focuses on its associations with negative outcomes, yet efforts to understand possible protective factors that may mitigate these negative outcomes also require attention. The present study was an investigation of the potential moderating effect of prosocial behaviors on loneliness for youth who are peer victimized. Participants were fourth and fifth grade students (511 total; 49 % boys) who were primarily European American (43.