Abstract
Poverty, along with other factors such as unemployment, work and life stressors, interpersonal violence, and lack of access to high quality health and/or social services all play a role in determining who develops a mental illness and for whom those symptoms persist or worsen. Senior nursing student preparing to enter the field and working in a service learning capacity may be able to influence early recovery and symptom abatement among those most vulnerable to mental illness. A consortium of community stakeholders and researchers collaboratively designed a 10-week mental health promotion project called the Health Advocacy Project (HAP). The project combines case management and system navigation support delivered by trained and highly supervised nursing students to individuals experiencing major depressive disorder (MDD) and/or post-traumatic stress disorder (PTSD). In this article, we present the findings of a qualitative fidelity evaluation that examines the effectiveness of nursing students in delivering the health advocacy intervention at the level and with the intensity originally intended. The findings demonstrate how the services of senior nursing students may be optimized to benefit our healthcare system and populations most at risk for developing MDD and PTSD.
References
Allen, N. E., Larsen, S., Trotter, J., & Sullivan, C. M. (2013). Exploring the core service delivery processes of an evidence-based community advocacy program for women with abusive partners. Journal of Community Psychology, 41(1), 1–18.10.1002/jcop.21502Search in Google Scholar
Barbra Schlifer Commemorative Clinic. (2015). Advocacy and social change. Retrieved from http://schliferclinic.com/advocacy-and-social-change/Search in Google Scholar
Brand, J. (2015). What is service learning or community engagement? Retrieved from http://cft.vanderbilt.edu/guides-sub-pages/teaching-through-community-engagement/Search in Google Scholar
Browne, A. J., Varcoe, C. M., Wong, S. T., Smye, V., Lavoie, J., Littlejohn, D., … Lennox, S. (2012). Closing the health equity gap: Evidence-based strategies for primary health care organizations. International Journal of Equity in Health, 11(1). doi:10.1186/1475-9276-11-59Search in Google Scholar
Browne, G., Byrne, C., Roberts, J., Gafni, A., & Whittaker, S. (2001). When the bough breaks: Provider-initiated comprehensive care is more effective and less expensive for sole-support parents on social assistance. Social Science & Medicine, 53(12), 1697–1710. doi:10.1016/S0277–9536(00)00455–XSearch in Google Scholar
Bybee, D. I., & Sullivan, C. M. (2002). The process through which an advocacy intervention resulted in positive change for battered women over time. American Journal of Community Psychology, 30(1), 103–132. doi:10.1023/A:1014376202459Search in Google Scholar
Bybee, D., & Sullivan, C. M. (2005). Predicting re-victimization of battered women 3 years after exiting a shelter program. American Journal of Community Psychology, 36(1–2), 85–96. doi:10.1007/s10464-005-6234-5Search in Google Scholar PubMed
Canadian Community Health Nursing: Professional Practice Model and Standards of Practice. (2011). Toronto, Ontario: Community Health Nurses of Canada. Retrieved from http://www.chnc.ca/documents/CHNC-ProfessionalPracticeModel-EN/index.htmlSearch in Google Scholar
Canadian Nurses Association. (2010). Social justice...A means to an end, an end in itself. Retrieved fromhttp://www.cna-aiic.caSearch in Google Scholar
Canadian Nurses Association. (2009). Ethics in practice for registered nurses: Public health nursing practice and ethical challenges. Retrieved from https://www.cna-aiic.ca/~/media/cna/page-content/pdf-en/ethics_in_practice_april_2009_e.pdf?la=enSearch in Google Scholar
Caron, J., & Liu, A. (2010). A descriptive study of the prevalence of psychological distress and mental disorders in the Canadian population: Comparison between low-income and non-low-income populations. Chronic Disease in Canada, 30(3), 84–94.10.24095/hpcdp.30.3.03Search in Google Scholar
Cauce, A. M., Domenech-Rodríguez, M., Paradise, M., Cochran, B. N., Shea, J. M., Srebnik, D., & Baydar, N. (2002). Cultural and contextual influences in mental health help seeking: A focus on ethnic minority youth. Journal of Consulting and Clinical Psychology, 70(1), 44–55. doi:10.1037//0022-006X.70.1.44Search in Google Scholar PubMed
Ciliska, D., Mastrilli, P., Ploeg, J., Hayward, S., Brunton, G., & Underwood, J. (2001). The effectiveness of home visiting as a delivery strategy for public health nursing interventions to clients in the prenatal and postnatal period: A systematic review. Primary Health Care Research and Development, 20(1), 41–54. Retrieved from http://old.hamilton.ca/phcs/ephpp/Research/Full-Reviews/98-99/Prenatal-&-Postnatal-Home-Visiting-review.pdf10.1191/146342301671753098Search in Google Scholar
Colleges of Nurses of Ontario. (2014). Competencies for entry-level Registered Nurse practice. Retrieved from http://www.cno.org/globalassets/docs/reg/41037_entrytopracitic_final.pdfdoi:10.1002/jcop.21502Search in Google Scholar
Collins English Dictionary – Complete & Unabridged 10th Edition.Retrieved December 17, 2015from Dictionary.com website http://dictionary.reference.com/browse/memorandum-of-understandingSearch in Google Scholar
Durbin, A., Bondy, S. J., & Durbin, J. (2012). The association between income source and met need among community mental health service users in Ontario, Canada. Community Mental Health Journal, 48(5), 662–672. doi:10.1007/s10597-011-9469-7Search in Google Scholar PubMed
Eymard, A., Breaux, P., & Dozar, K. (2013). Transformative learning in nursing students through a service learning project with a vulnerable community. Journal of Nursing Education and Practice, 3(3), 35–43. doi:10.5430/jnep.v3n3p35Search in Google Scholar
Fleury, M. J., Grenier, G., Bamvita, J. M., Perreault, M., Kestens, Y., & Caron, J. (2012). Comprehensive determinants of health service utilisation for mental health reasons in a Canadian catchment area. International Journal Equity Health, 11, 20. doi:10.1186/1475–9276–11–20Search in Google Scholar
Ford-Gilboe, M., Wuest, J., Varcoe, C., & Merritt-Gray, M. (2006). Developing an evidence-based health advocacy intervention for women who have left an abusive partner. Canadian Journal of Nursing Research, 38(1), 147. Retrieved from http://www.ingentaconnect.com/content/mcgill/cjnr/2006/00000038/00000001/art00009?crawler=trueSearch in Google Scholar
Gillis, A., & Mac Lellan, M. (2010). Service learning with vulnerable populations: Review of the literature. International Journal of Nursing Education Scholarship, 7. Epub, Article41-923X.204. doi:10.2202/1548-923X.2041Search in Google Scholar
Goodman, L. A., Glenn, C., Bohlig, A., Banyard, V., & Borges, A. (2009). Feminist relational advocacy processes and outcomes from the perspective of low-income women with depression. The Counseling Psychologist, 37(6), 848–876. doi:10.1177/0011000008326325Search in Google Scholar
Groh, C. J., Stallwood, L. G., & Daniels, J. J. (2011). Service-learning in nursing education: Its impact on leadership and social justice. Nursing Education Perspectives, 32(6), 400–405.10.5480/1536-5026-32.6.400Search in Google Scholar
Guruge, S., Ford-Gilboe, M., Samuels-Dennis, J. A., Varcoe, C., Wuest, J., & Wilk, P. (2012). Rethinking social support and conflict: Lessons from a study of women who have separated from abusive partners. Nursing Research and Practice, 1–10. (Article ID 738905). doi:10.5480/1536-5026-32.6.400Search in Google Scholar
Kaukinen, C. E., Meyer, S., & Akers, C. (2013). Status compatibility and help-seeking behaviors among female intimate partner violence victims. Journal of Interpersonal Violence, 28(3), 577–601. doi:10.1177/0886260512455516Search in Google Scholar
Lazear, K. J., Pires, S. A., Isaacs, M. R., Chaulk, P., & Huang, L. (2008). Depression among low-income women of color: Qualitative findings from cross-cultural focus groups. Journal of Immigrant Minor Health, 10(2), 127–133. doi:10.1007/s10903-007-9062-xSearch in Google Scholar
Lincoln, Y. S., & Guba, E. G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage Publication.10.1016/0147-1767(85)90062-8Search in Google Scholar
Lucea, M. B., Stockman, J. K., Mana-Ay, M., Bertrand, D., Callwood, G. B., Coverston, C. R., … Campbell, J. C. (2013). Factors influencing resource use by African American and African Caribbean women disclosing intimate partner violence. Journal of Interpersonal Violence, 28(8), 1617–1641. doi:10.1177/0886260512468326Search in Google Scholar PubMed PubMed Central
Milne, J., & Oberle, K. (2005). Enhancing rigor in qualitative description: A case study. Journal of Wound Ostomy & Continence Nursing, 32(6), 413–420. doi:10.1097/00152192-200511000-00014Search in Google Scholar
Neergaard, M. A., Olesen, F., Andersen, R. S., & Sondergaard, J. (2009). Qualitative description – the poor cousin of health research? BMC Medical Research Methodology, 16(9), 52. doi:10.1186/1471–2288–9–52Search in Google Scholar
Patten, S. B., Wang, J. L., Williams, J. V., Currie, S., Beck, C. A., Maxwell, C. J., & El-Guebaly, N. (2006). Descriptive epidemiology of major depression in Canada. Canadian Journal of Psychiatry, 51(2), 84–90.Retrieved from http://search.proquest.com/docview/222812247?accountid=1153010.1177/070674370605100204Search in Google Scholar
Province of Ontario. 2011. Open minds, healthy minds Ontario’s comprehensive mental health and addictions strategy. Ottawa, ON: Queen’s Printer for Ontario. Report nr 016277.Search in Google Scholar
Ramsay, J., Carter, Y., Davidson, L., Dunne, D., Eldridge, S., Hegarty, K., et al. (2009). Advocacy interventions to reduce or eliminate violence and promote the physical and psychosocial well-being of women who experience intimate partner abuse. The Cambell Systematic Reviews, 8, 1–121. doi:10.1002/14651858.CD005043Search in Google Scholar
Reising, D. L., Shea, R. A., Allen, P. N., Laux, M., Hensel, D., & Watts, P. A. (2008). Using service-learning to develop health promotion and research skills in nursing students. International Journal of Nursing Education Scholarship, 5. Article 29,923X.1590. doi:10.2202/1548-923X.1590Search in Google Scholar
Reimer Kirkham, S., Hoe Harwood, C., & Van Hofwegen, L. (2005). Capturing a vision for nursing: Undergraduate nursing students in alternative clinical settings. Nurse Educator, 30(6), 263–270.10.1097/00006223-200511000-00012Search in Google Scholar
Reimer Kirkham, S., van Hofwegen, L., & Hoe Harwood, C. (2005). Narratives of social justice: Learning in innovative clinical settings. International Journal of Nursing Education Scholarship, 2(1), 1–14. doi:10.2202/1548-923X.1166Search in Google Scholar
Reutter, L., & Kushner, E. (2011). Health equity through action on the social determinants of health: Taking up the challenge in nursing. Nursing Inquiry, 17(3), 269–278. doi:10.1111/j.1440-1800.2010.00500.xSearch in Google Scholar
Samuels-Dennis, J. A., Bailey, A., & Ford-Gilboe, M. (2011). The intersectionality model of trauma and post-traumatic stress disorder (IMT-PTSD). In O.Havinsky (Ed.), Health inequities in Canada: Intersectional frameworks and practices. Vancouver: UBC Press.Search in Google Scholar
Samuels-Dennis, J., Bailey, A., Killian, K., & Ray, S. L. (2013). The mediating effects of empowerment, interpersonal conflict, and social support on the Violence–PTSD process among single mothers. Canadian Journal of Community Mental Health, 32(1), 109–124. doi:10.7870/cjcmh–2013–009Search in Google Scholar
Sandelowski, M. (2000). Whatever happened to qualitative description? Research in Nursing & Health, 23(4), 334–340. doi:10.1002/1098-240X(200008)23:4<334::AID-NUR9>3.0.CO;2-GSearch in Google Scholar
Sareen, J., Afifi, T. O., McMillan, K. A., & Asmundson, G. J. (2011). Relationship between household income and mental disorders: Findings from a population-based longitudinal study. Archives of General Psychiatry, 68(4), 419–427. doi:10.1001/archgenpsychiatry.2011.15>Search in Google Scholar
Schuster, T. L., Kessler, R. C., & Aseltine, R. H. (1990). Supportive interactions, negative interactions, and depressed mood. American Journal of Community Psychology, 18(3), 423–438. doi:10.1007/BF00938116Search in Google Scholar PubMed
Stein, M. B., Walker, J. R., Hazen, A. L., & Forde, D. R. (1997). Full and partial posttraumatic stress disorder: Findings from a community survey. American Journal of Psychiatry, 154(8), 1114–1119. Retrieved from http://ajp.psychiatryonline.org/doi/pdf/10.1176/ajp.154.8.111410.1176/ajp.154.8.1114Search in Google Scholar PubMed
Street Health. (2015). Nursing Advocacy: Working Upstream for Positive Change. Retrieved from http://www.streethealth.ca/programs-and-services/advocacy#.VnB_YUorIdUSearch in Google Scholar
Sullivan, C. M., & Bybee, D. I. (1999). Reducing violence using community-based advocacy for women with abusive partners. Journal of Consulting and Clinical Psychology, 67(1), 43–53. doi:10.1037//0022-006X.67.1.43Search in Google Scholar PubMed
Sullivan, C. M., & Samuels-Dennis, J. A. (2014). The health advocacy project: Advocate manual. Unplished.Search in Google Scholar
Sullivan-Bolyai, S., Bova, C., & Harper, D. (2005). Developing and refining interventions in persons with health disparities: The use of qualitative description. Nursing Outlook, 53(3), 127–133. doi:10.1016/j.outlook.2005.03.005Search in Google Scholar PubMed
Sweet, M. A., & Appelbaum, M. I. (2004). Is home visiting an effective strategy? A meta-analytic review of home visiting programs for families with young children. Child Development, 75(5), 1435–1456. doi:10.1111/j.1467-8624.2004.00750.xSearch in Google Scholar PubMed
The Bridge Prison Ministry. (2010). Retrieved from http://www.thebridgeprisonministry.com/Search in Google Scholar
The Office of the Provincial Advocate for Children and Youth. (2010). Retrieved from http://www.provincialadvocate.on.caSearch in Google Scholar
Van Ameringen, M., Mancini, C., Patterson, M., & Boyle, H. (2008). Post-Traumatic stress disorder in Canada. CNS Neuroscience & Therapeutics, 14(3), 171–181. doi:10.1111/j.1755-5949.2008.00049.xSearch in Google Scholar PubMed PubMed Central
Wang, J., Williams, J., Lavorato, D., Schmitz, N., Dewa, C., & Patten, S. B. (2010). The incidence of major depression in Canada: The national population health survey. Journal of Affect Disorder, 123(1–3), 158–163. doi:10.1016/j.jad.2009.07.016Search in Google Scholar PubMed
World Health Organization. (1998). Health promotion glossary. Geneva, Switzerland: World Health Organization. Report nr WHO/HPR/HEP/98.1Search in Google Scholar
©2016 by De Gruyter
