Publications by authors named "Mary E Cramer"

The goal of this study was to assess the utility of participatory needs assessment processes for continuous improvement of developing clinical and translational research (CTR) networks. Our approach expanded on evaluation strategies for CTR networks, centers, and institutes, which often survey stakeholders to identify infrastructure or resource needs, using the case example of the Great Plains IDeA-CTR Network. Our 4-stage approach (i.

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We conducted a social network analysis (SNA) of Central States Center for Agricultural Safety and Health (CS-CASH) to describe stakeholder networks for agricultural Research and Education/Outreach. This was a two-phase study. First, the went to N = 9 CS-CASH leaders to identify their key stakeholders.

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A convenience sample of skilled nursing facilities was selected from a sample of graduates of an online training program for RNs who subsequently achieved board certification in gerontological nursing (RN-BC). Facilities that employed one or more RN-BC were pair-matched using 11 organizational characteristics with facilities that did not employ a RN-BC. Facility data were collected at two time points, and differences between time points and between facility type (RN-BC versus non-RN-BC) were analyzed.

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Cancer-related fatigue (CRF) is an important public health issue that involves millions of community-dwelling cancer survivors. CRF is the most debilitating patient reported symptom related to cancer therapies and exacts a significant economic and social toll. It adversely impacts patients' work, social relationships, and overall quality of life.

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Objectives: (1) Assess feasibility of a smartphone platform intervention combined with Community Health Worker (CHW) reinforcement in rural pregnant women; (2) Obtain data on the promise of the intervention on birth outcomes, patient activation, and medical care adherence; and (3) Explore financial implications of the intervention using return on investment (ROI).

Sample: A total of 98 rural pregnant women were enrolled and assigned to intervention or control groups in this two-group experimental design.

Intervention: The intervention group received usual prenatal care plus a smartphone preloaded with a tailored prenatal platform with automated texting, chat function, and hyperlinks and weekly contact from the CHW.

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Background: Maternity care and women's health are measured, in part, by the stillbirth rate of a country. The purposes of this pilot project were to: a) establish a baseline of health care provider knowledge regarding stillbirth risk factors based on geographic distribution (urban/rural) and provider licensure (MD, APRN, PA, CNM) and b) evaluate the utility of a Stillbirth Risk Factor Toolkit and its effects on provider knowledge.

Methods: Evaluative research using a retrospective pre-posttest survey design was completed.

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Agricultural Centers are a coalition of organizations and individual members with a common purpose: to improve the health and safety of the agricultural community. Successful leadership and governance are essential in accomplishing these goals. This article examined the effectiveness of a midwestern Agricultural Health and Safety Center (Ag Center) leadership and governance structure.

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This case study examines the perspectives of rural community advisory board (CAB) members regarding the opportunities and challenges of partnering with academic investigators on funded research. We used a sequential exploratory design to evaluate the phenomena. Qualitative and quantitative data from CAB members were integrated to gain better understanding.

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The purpose of this article is to present a case study of one midwestern Agricultural Center (Ag Center) that used social network analysis (SNA) to (1) evaluate its collaborations with extramural stakeholders and (2) strategically plan for extending outreach for goal achievement. An evaluation team developed a data collection instrument based on SNA principles. It was administered to the Ag Center's intramural stakeholders (N = 9), who were asked to identify the key extramural stakeholders with whom they had collaborated within the previous 12 months.

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Objective: The purpose of this study was to assess knowledge, attitudes, and practices for hearing and respiratory health/safety among farmers in seven Midwestern states served by a federally funded Agricultural Center. Findings provided a baseline to longitudinally track the Agricultural Center's program outcomes and to design community education to improve safety and health among farmers.

Design And Sample: This was a cross-sectional study using a 30 item mailed survey to describe farmers' operations, demographics, health conditions, related information sources, and knowledge/attitude/practices for personal protective equipment (PPE) (i.

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Medicare patients seeking care from nurse practitioners (NPs) increased 15-fold from 1998 to 2010, and a 2.5-fold patient increase was recorded in states that have eased the regulatory environment for NPs. It is increasingly important that state regulatory and licensing boards-charged with protecting the public through the assurance of a qualified health-care workforce-examine whether their state regulatory environment restricts or promotes public access to quality health care.

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Coalitions that are effectively organized and led are more likely to achieve their intended program outcomes and impacts, as well as achieve sustainability. External evaluation of the coalition's governance and leadership can help identify strengths and areas for improvement. This article describes the evaluation of the Children's Agricultural Safety Network (CASN)-a national coalition, or network of 45 organizational members.

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This article describes the formal use of marketing concepts in a systematic approach to influence farmers to voluntarily increase respiratory protective device (RPD) use. The planning process for the project incorporated six key decision or action points, each informed by formative research or health behavior theory. The planning process included developing behavior change strategies based on a 4P model (product, price, place, and promotion).

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This article describes a project to improve nursing care quality in long-term care (LTC) by retooling registered nurses' (RN) geriatric clinical competence. A continuing education course was developed to prepare LTC RNs (N = 84) for national board certification and improve technological competence. The certification pass-rate was 98.

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Background: Influenza exposure during pregnancy can cause severe health problems for both the mother and her offspring, including an increased risk of mortality. Influenza vaccination during all trimesters of pregnancy is safe and effective, and recommended by professional organizations such as the American College of Obstetrics and Gynecology. Despite these recommendations, the U.

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The RWJF/AARP National Campaign for Action established a goal of establishing Action Coalitions in every state by 2012. Last year, a small Steering Committee formed in Nebraska and used two conceptual models to guide the organization and development of its Action Coalition. The purpose of this article is to present the Internal Coalition Outcome Hierarchy (ICOH) model that guided development of partnership and coalition building.

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Evidence links the amount of registered nurse care to improved patient outcomes in large hospitals, but little is known about registered nurse staffing in small critical access hospitals, which comprise 30% of all US hospitals. Our study findings show that the unique work environment of critical access hospitals means registered nurses are often overextended, reassigned from inpatient care, and/or interrupted creating potential safety and quality risks. Further research is needed to understand what critical access hospitals consider "safe" levels of nurse staffing and what processes are implemented to mitigate these risks.

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Objective: The study purpose was to describe multiunit landlord attitudes and behaviors toward smoke-free policies.

Design And Sample: This was a descriptive, cross-sectional survey of multiunit landlords in Douglas County (N=392).

Measures: A 25-item survey was developed and pilot tested.

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Public and professional concerns over the registered nurse shortage and its effect on quality of care have led to 18 state and 2 federal initiatives to ensure safe hospital nurse staffing. Policy analysis of registered nurses safe staffing legislation introduced by the Congress suggests that its implementation is not likely to achieve all of its stated goals. An alternative policy approach is introduced.

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Objective: This article describes the evaluation and findings of a community-based prenatal care program, Omaha Healthy Start (OHS), designed to reduce local racial disparities in birth outcomes.

Design: This evaluative study used a comparative descriptive design, and Targeting Outcomes of Programs was the conceptual framework for evaluation.

Sample: The evaluation followed 3 groups for 2 years: OHS birth mothers (N=79; N=157); non-OHS participant birth mothers (N=746; N=774); and Douglas County birth mothers (N=7,962; N=7,987).

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This article presents the development and psychometric testing of the Internal Coalition Effectiveness (ICE) instrument, which was based on the conceptual model Internal Coalition Outcome Hierarchy. Sixty-one items were derived from literature about successful coalitions, and the ICE instrument was tested for reliability and validity. A national panel of eight experts conducted content validity.

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Funding agencies are increasingly focused on community coalitions as effective entities for promoting public health programs. Yet, there has been no conceptual model for understanding how effective coalition infrastructure works to facilitate a learning environment, wherein coalition members and leaders receive ongoing training and technical assistance needed to accomplish their external programming goals. This article presents a conceptual model for measuring the internal effectiveness of coalitions [Internal Coalition Outcome Hierarchy (ICOH)].

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The objective for this formative evaluation was to establish baseline data for informing a community coalition's strategic planning in environmental tobacco smoke (ETS) risk reduction. The coalition had chosen 3 targeted settings for ETS risk reduction: restaurants, childcare facilities, and government buildings. The evaluation methodology involved telephone interviews (restaurants, n = 805; governmental buildings, n = 258) and mailed surveys (childcare facilities, n = 1,142).

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Community coalitions have become an increasingly popular means for addressing community health issues, yet evaluating their effectiveness and performance has presented formidable challenges. To meet the community's need for health program evaluation, public health nurses will need to become better prepared to deal with the complexities of evaluating coalitions and their multifaceted organizational structures. This article presents the methodology and conceptual framework, Targeting Outcomes of Programs (TOP), used to evaluate the performance and impact of a local community coalition.

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