Problem statement: Lack of engagement of nurses and public health workforce in the Public Health Nursing (PHN) Section of the Michigan Public Health Association (MPHA).

Approach: To address the problem, the Public Health Nursing Section launched a series of free book discussions. This approach allowed us to engage individuals while addressing critical issues for public health nurses and other public health professionals of various disciplines.

Product/Outcome: The PHN section offered discussions of relevant books in a virtual format to encourage meaningful dialogue and wide participation. Selected books focused on diversity, social justice, and trust in science. Because the book discussions were successful, the discussions evolved from three to four per year. In the second year of offering book discussions, we partnered with Michigan State University College of Nursing to offer continuing education credit, including state mandated implicit bias credit when applicable. The book discussions are open to all public health professionals and students. The PHN Section purchases books and offers complimentary copies to participants on a first-come basis. Attendance varied from 8-40 participants. Evaluation results showed a high level of satisfaction with discussions; several participants joined MPHA.

Implications: This strategy demonstrates one successful approach for engaging PHN members and attracting new members. Book discussions provide a stimulating approach for adult learners to engage in dialogue about public health issues in collegial sharing format. In addition, this is a low-cost approach for engaging the public health community in developing and enhancing knowledge about significant public health issues.

Background Transitions of care increase risk of adverse health events among older adults. This results in costly readmissions to hospital care, where the individual’s goals and preferences may not align with what happens. Consequently, a gap in understanding exists between the healthcare approach and the human experience. Recognizing the need, community organizations have implemented programs hoping to bridge that gap. Likewise, Public Health Nursing (PHN) has long understood these challenges and delivered interventions across the continuum of care.

Methods This project uses community-engaged approaches. Two in-person interviews with community-based agencies were completed. The first captured programmatic descriptions of existing programs supporting transitions of care. The second utilized semi-structured questions organized using the 4M’s Framework (Mentation, Mobility, Medication and what Matters)¹ to capture community context. Main themes are discussed with participants, influencing later focus groups with older adults receiving services from the agencies.

Results Interview data analysis is in process. The meeting with participating agencies to describe and discuss results is scheduled in May 2024. This collaboration will identify factors that describe the transitions of care experience from the agency perspective. Focus groups are planned for summer, with final results ready for dissemination fall 2024.

Conclusion Age-friendly, community engaged approaches hold potential to reveal what matters most to older adults during times of transition. Without this contextual knowledge, health systems will struggle to provide client-centered care leading to desired health outcomes. PHN is uniquely situated to navigate and translate this conversation, telling an important story from multiple perspectives.

Background/Issue: Baccalaureate nursing graduates need to be prepared to address population health needs of diverse populations with a goal of reducing health inequities (NASEM, 2021). Nursing programs need to prepare students with entry-level population health competencies (AACN, 2021) to help achieve this goal. An evidence-based Community Assessment Project (CAP) has been designed to meet these challenges.

Description: Nursing students conduct CAPs in collaboration with community partners. The CAP has five phases based on the nursing process and the NACCHO MAPP (2022): mobilization, assessment, prioritization, planning, and action cycle. A Holistic Health Determinants Model (Schoon & Krumwiede, 2022) based on socio-ecological and intersectionality theories provides a framework for assessment and intervention. PHN interventions from the evidence-based Public Health Intervention Wheel (MDH, 2019) are employed. The rationale for PHN interventions is based on a best practice triad of credible evidence, clinical expertise, and client preferences and values (Schoon & Kumpula in Schoon & Porta, 2024). A CAP Workbook is posted on the Henry Street Consortium website for public use.

Lessons Learned: The CAP student learning activities have reciprocal benefits. The outcomes benefit vulnerable populations, community partners, and nursing students who learn to take the lead in making a difference in their communities.

Implications/Recommendations: Student nurses develop population health competencies while addressing population health needs in their communities. This motivates students to continue leadership and advocacy actions in their nursing practice. The CAP is replicable in any nursing curriculum. Holistic evidence-based models like the CAP should be integrated into BSN and ELMSN Programs.

Background: Phillips neighborhood in Hennepin County, MN is a community that has been plagued with health inequities and environmental stressors for decades. In response, nurse educators, students and community partners developed a community-based prevention clinic with a focus on fostering conversations for health and wellbeing, called Partners in Prevention (PIP).

Methods: PIP clinic development was a collaboration between nurse educators and community partners using a modified partnership engagement model. The clinic provides free prevention services, incentives, resources, and experiential learning for nursing students. Student orientation included training on PHN foundations of practice, and a tutorial for identifying and changing “unconscious” bias in building trusting and caring relationships with the community.

An intake form was used for de-identified demographics, health screening metrics, and a satisfaction survey. Students’ clinical performance was evaluated using on-site debriefing, and a post clinical self-reflection report.

Results: Results are pending and will be reported at the 2024 American Public Health Association annual conference.

Conclusion: The Partners in Prevention clinic was designed using a modified partnership engagement model as being mutually beneficial to community partners and a local nursing program. The clinic offers a traditional PHN model of care addressing the SDOH, health promotion and disease prevention at the community level of practice. The PIP clinic has gained the interest of Minnesota stakeholders from the private sector and local and state health departments who became champions and key supporters of the clinic. The PIP clinic is featured in the Minnesota State Health Plan 2035 and received two awards.

Background: The relationship between individuals' trust in various healthcare information sources and their healthcare-seeking behavior has gained attention, particularly in the context of the COVID-19 pandemic. This study explored the association between trust in various healthcare information sources and healthcare service utilization among LGBT individuals.

Methods: April 2021 data from the Health Reform Monitoring Survey constituted the basis of this study. Employing binary logistic regression, the study examined the relationship between trust in healthcare information resources and the uptake of healthcare services among LGBT respondents.

Results: Out of 9,067 respondents, 707 (7.8%) identified as LGBT. LGBT individuals were more likely to trust their family and friends as healthcare information sources (OR= 1.161, p = .011). Moreover, LGBT individuals were less likely to seek consultation with mental health professionals (OR= .331, p < .001) and more likely to seek care from dental care providers (OR= 1.658, p = .011).

Conclusion: The study underscores the pivotal role of social networks in shaping the healthcare-seeking behavior of LGBT individuals. It also unveils a nuanced relationship between LGBT individuals and their interaction with mental health services. At the core of these findings lies the issue of mistrust in healthcare providers, which emerges as a significant barrier for many in the LGBT community. This mistrust not only impedes access to essential healthcare services but also underscores the pressing need for interventions aimed at fostering trust and enhancing healthcare utilization among LGBT populations.

Description:

People who use drugs are at increased risk for wounds. Soft tissue injury, wounds, and injection-related abscesses have long been associated with interventions drug use often resulting in emergency room visits, costly hospital stays, and limb loss. Recent trends in xylazine drug adulteration have exacerbated the problem causing increased soft tissue destruction, widespread wound development, and rapid wound deterioration.

Lessons-learned

People who use drugs are often reluctant to seek medical care due to a variety of barriers such as insurance coverage, cost, transportation, stigmatization, and fear of criminal prosecution. Research suggest that embedding wound care services in existing harm reduction service delivery can greatly increase access to wound care and reduce reliance on high-cost emergency services. A nurse-led pop-up wound assessment and first aid clinic was initiated through partnership with existing harm reduction service delivery.

Implications/recommendations

Xylazine related wounds require ongoing treatment. People who use drugs are more willing to return for follow-up care when services are provided within a low-threshold, harm reduction framework. While the nurse-led pop-up services were well received by clients and community partners, collaboration with a provider (physician, nurse practitioner etc.) could create a cost-effective model for community-based wound care service delivery for people who use drugs. Leveraging the success of existing harm reduction services such as syringe service programs, offers the opportunity to increase access to care, decrease healthcare costs, and improve population health outcomes.

The “Ask a Nurse Pop ups” events bring the services of the Azusa Pacific University, School of Nursing, Neighborhood Wellness Center (NWC) to the community. The NWC has partnered with the Azusa Unified School District (AUSD) to bring health education, wellness and prevention care, and referrals to the residents where they live. Four elementary schools throughout the Azusa community have hosted Ask a Nurse pop up events in conjunction with community resource fairs. As part of the events, the NWC is sponsoring a free vaccination clinic with Mercy Clinic. The NWC does not currently have a facility in Azusa and it is important to the School of Nursing to be able to continue providing these greatly needed services to the residents through alternate means. Families are having a difficult time being able to get their child vaccinated either due to lack of health insurance or the ability to pay. Therefore, being able to host a vaccine clinic along with the Ask a Nurse Pop up events greatly benefit the residents.

Background: Clinical rotations for community/ public health nursing (C/PHN) sections in BSN programs are often puzzling for students and frustrating for instructors. Finding appropriate sites for undergraduates pose challenges that appear to be long-standing. Why have we not made more progress?

Methods: A review of the literature on C/PHN clinical sites over the past 30 years is being conducted, using a critical-historical lens, and concentrating on US, Canadian, and UK programs. The goal is not to synthesize 'best practices', but rather to identify themes and patterns, located in historical context.

Results: Preliminary results show a persistent set of difficulties, and a recurring short-list of mitigating strategies. Placements within public health departments appear rare, and many programs rely on social-service agencies such as food banks, homeless shelters, or senior housing, supplemented recently by simulation. In contrast with other clinical rotations, which focus on skill development and job preparation, C/PHN rotations are often described in reference to ‘transformative experiences’ and the development of ‘new perspectives.’ An enduring theme is the promising but ever-receding future, in which healthcare systems will (someday) emphasize population health, prevention, and community-based care.

Conclusions: Final conclusions await further analysis; however, the difficulties with clinical sites appear stubborn, and both reflect and exacerbate the difficulties with teaching of C/PHN content. In this literature, “community” appears stronger than “public health.” Ending this cycle of repetitive problems and makeshift solutions will require more concerted and systematic efforts by educators and PHN leaders, and a willingness to ask hard questions.

Background: Climate justice connects the causes and effects of climate change to structural injustices in society. Public health nurses and community-based organizations (CBOs) partner to promote justice and health equity. This qualitative study described the partnership processes of public health nurses and CBO representatives to advance climate justice.

Methods: Data were collected from August 2022-February 2023. Public health nurses were recruited via a screening survey sent to nursing and public health organizations at state and national levels. The nurses invited their CBO partners to participate in the study. Semi-structured interview questions and deductive analysis were guided by environmental justice and public health partnership frameworks. Transcripts were then inductively coded for the pre-partnership period.

Results: Eight partnerships were identified across six states. Thematic analysis of the transcripts depicted partnerships built upon individual strengths and assets while also addressing needs and increasing the capacity of the partners. Participants balanced power and resources, increasing their ability to persevere through the long struggle for justice. Clear and open communication was an ongoing priority in the partnerships, as they strived to understand each other’s needs and self-interests and develop a common language for climate justice. The transition from individual activism to nurse-community partnership led to transformative experiences, reflection and awareness, and policy or system-level changes.

Conclusions: This study's findings could help inform public health nursing advocacy, education, policy, and practice to advance climate justice through community partnerships.