Carol Roye - Academia.edu (original) (raw)

Papers by Carol Roye

Public Health Nursing, Jun 3, 2014

Objectives: A core competency model for family planning public health nurses has been developed, ... more Objectives: A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. Design and Sample: The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via Survey-Monkey. Results: Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. Conclusions: Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance.

Journal of American College Health, May 20, 2020

Abstract Objective Male involvement in contraceptive practice remains low. Family planning and pe... more Abstract Objective Male involvement in contraceptive practice remains low. Family planning and pediatric health associations have recommended an emphasis on long-acting reversible contraceptives (LARC) in clinical counseling with adolescents and young adults, raising concerns about the resulting adverse impact on sexually transmitted infection (STI) rates. Participants: College-attending men responded to an internet based questionnaire (n=31) and a phone-based qualitative interview (n=25). Methods: Our survey solicited attitudes toward and knowledge of contraceptive methods and assessed communication practices with sexual partners regarding use of contraception and disease prevention. Results: Knowledge about female methods of contraception was low, with a comparatively high level of knowledge about Plan B. Parents and health care providers were cited as the most helpful sources of information. Conversations about protection with sexual partners were reported by most men, due mainly to fear of unplanned pregnancy, not STI. Conclusion: Addressing couple communication and dual protection among college-attending men needs greater emphasis.

Journal of Pediatric Nursing, 2017

Immigration from the Dominican Republic to the United States has grown rapidly. Yet, although ado... more Immigration from the Dominican Republic to the United States has grown rapidly. Yet, although adolescent pregnancy and obesity are common concerns among Hispanics, little is known specifically about Dominican adolescent health. This study was undertaken to assess Dominican-American adolescents' health concerns and their perceptions about their health promotion needs. Design and methods: Dominican-American adolescents (N = 25) were recruited in a pediatric clinic in New York City which primarily serves a Dominican population. Eligibility criteria included age 13-21 years, self-identifying as Dominican ethnicity, and able to speak and read English. They completed a questionnaire, with demographic questions and questions about their risk behaviors including sexual and substance use. After completing the questionnaire, they participated in a semi-structured interview addressing their health education experiences and suggestions for such programs. Quantitative data were analyzed using frequencies to provide a demographic and behavioral profile. Qualitative data were analyzed using thematic analysis. Results: Twenty-five adolescents, ages 13-21 years, (female N = 19, male N = 6) participated in the study. Most were in school (92%) and were sexually experienced (68%). Programmatic preferences included inperson programs rather than online. They spontaneously addressed the importance of cultural issues, and the need to address several issues in addition to sexuality, including obesity and substance use. Conclusions: Programming for this population should address a broad conceptualization of health, and incorporate Dominican cultural issues. Practice implications: Nurses working with adolescents of Dominican origin, should provide health education that incorporates the specific needs of this population, including culturally congruent face-to-face interventions.

Journal of Pediatric Health Care, Sep 1, 1993

Cervical cytologic abnormalities are increasingly prevalent in teenagers. Adolescents are at grea... more Cervical cytologic abnormalities are increasingly prevalent in teenagers. Adolescents are at greater risk for cervical neoplasia than adult women because of the biologic changes occurring in the cervix during puberty, the prevalence of human papillomavirus, and the behavioral risk factors in this age group. Two behavioral risk factors are early age at first coitus and multiple sex partners. Human papillomavirus is widely believed to be the etiologic agent associated with the spectrum of cervical neoplasias. Papanicolaou smear technique, reporting, and management of abnormal smears in teens is explained. J PEDIATR

Journal of Adolescent Health, Aug 1, 1996

This article reviews the literature on the relationship of partner support to outcomes for teenag... more This article reviews the literature on the relationship of partner support to outcomes for teenage mothers and their children. It discusses the changing alliance over time between men who father their babies and the young mothers and their children. This report considers both adults and adolescents who father children with adolescent women. The discussion focuses on the relationship between partner support and three outcomes for the mothers: educational outcomes, economic outcomes, and psychological well-being. The general association between partner support and the children's development is also examined. In addition, partner support is viewed within the context of the teenager's family system, providing a framework for assessing key features of support for teenage mothers. The article outlines suggestions for future research.

American Journal of Nursing, Apr 1, 1997

1. Am J Nurs. 1997 Apr;97(4):45. Emergency! Adolescent rape. Roye CF, Coonan PR. Columbia Univers... more 1. Am J Nurs. 1997 Apr;97(4):45. Emergency! Adolescent rape. Roye CF, Coonan PR. Columbia University School of Nursing, New York, NY, USA. PMID: 9103923 [PubMed - indexed for MEDLINE] Publication Types: Case Reports. MeSH Terms: ...

Nursing Economics, Sep 1, 2010

Journal of Pediatric Nursing, 2017

off of the train and are standing on the platform as the train pulls out of the station. Tayja re... more off of the train and are standing on the platform as the train pulls out of the station. Tayja resumes reading her magazine occasionally rubbing her abdomen as she turns the pages. The train picks up speed again and jerks as it moves through the tunnel to the next stop. After exiting the train, many questions go through my mind. What will happen with the trigonometry test? What will happen with Tayja's pregnancy and baby? What is going through the mind of Tayja as she goes through this pregnancy? How does she feel about this pregnancy and what factors in her life led to this? Additionally, I asked myself how would a girl around their same age who had never been pregnant view the same scene. What would be going through her mind?

Issues in Mental Health Nursing, Jun 25, 2014

Understanding the context of anal sex behavior among ethnic minority adolescent women has public ... more Understanding the context of anal sex behavior among ethnic minority adolescent women has public health implications for behavioral sexual health promotion and risk reduction interventions. African-American (n = 94) and Mexican-American (n = 465) women (14-18 years of age) enrolled in a clinical trial completed semi-structured interviews to assess psychosocial and situational factors and relationships to sexual risk behavior, substance use, sexually transmitted infection/HIV acquisition, and violence. Bivariate analyses with comparisons by anal sex experiences identified differences by ethnicity and higher self-reported histories of sexual risk behaviors, substance use, violence, and stressful psychosocial and situational factors among adolescent women experiencing anal sex. Predictors of anal sex identified through logistic regression included Mexican-American ethnicity, ecstasy use, methamphetamine use, childhood sexual molestation, oral sex, and sex with friends for benefits. The purpose of this article is to describe the context of sexual behavior among African and Mexican-American adolescent women with a history of sexually transmitted infection (STI), high risk sexual behavior, or violence, using comparisons by self-reported experience of anal sex. Conceptualization of sexual behavior within these sexual partner relationships is important for the modification of evidence-based, behavioral, sexual risk reduction interventions. The information from this study can be used with these interventions to enhance efficacy for the prevention of violence, substance use, unintended pregnancy, and STIs, including HIV, among ethnic minority adolescent women. BACKGROUND HIV poses a substantial risk to the health of women, who represent more than 20% of new HIV infections and 25% of all infections in the US.

Journal of Adolescent Health, Dec 1, 1992

This article reviews the literature on the subject of cervical cytological abnormalities in teena... more This article reviews the literature on the subject of cervical cytological abnormalities in teenagers, defined as a Papanicolaou (Pap) smear result more severe than inflammation. There is discussion of the increasing prevalence of this problem in adolescents. Behavioral and biologic risk factors are examined. The role of the human papillomavirus, widely believed to be the etiologic agent, is addressed. Atypia, its relationship to cervical malignancies, and its management are reviewed. The possible role of the human immunodeficiency virus in the increasing prevalence of cytological abnormalities in teens is considered.

Nursing Outlook, Nov 1, 2017

Background: Nursing science is essential to advance population health through contributions at al... more Background: Nursing science is essential to advance population health through contributions at all phases of scientific inquiry. Multiple scientific initiatives important to nursing science overlap in aims and population focus. Purpose: This paper focused on providing the American Academy of Nursing and nurse scientists in the US with a blueprint of nursing science priorities to inform a shared vision for future collaborations, areas of scientific inquiry, and resource allocation. Methods: The Science Committee convened four times and using Delphi methods identified priorities with empirical evidence and expert opinion for prioritization, state of the science, expert interest, and potential target stakeholders. Results: Nursing science priorities for 2017 were categorized into four themes including: 1) Precision science; 2) Big data and data analytics; 3) Determinants of health; and 4) Global health. Conclusions: Nurse scientists can generate new knowledge in priority areas that advances the health of the world's populations.

American Journal of Nursing, Apr 1, 1997

How to provide physical and emotional comfort while gathering the necessary evidence. (C) Lippinc... more How to provide physical and emotional comfort while gathering the necessary evidence. (C) Lippincott-Raven Publishers.

Journal of the Association of Nurses in AIDS Care, Jul 1, 2010

Anal intercourse (AI) is a recognized HIV risk behavior, yet little is known about AI among femal... more Anal intercourse (AI) is a recognized HIV risk behavior, yet little is known about AI among female adolescents. We studied the prevalence and correlates of heterosexual AI (HAI) among Black and Latina female adolescents. The data come from two randomized clinical trials (RCTs) of HIVprevention interventions with Black and Latina female adolescents. In the second RCT, a Sexual Relationship Power (SRP) Scale was added to the questionnaire. Thirty-five percent of participants in the first RCT (N = 244) and 23% of those in the second RCT (N = 101) reported engaging in HAI, most without a condom. Significant correlations existed between HAI and a high-risk sexual history. HAI is prevalent in this population. Nurses must educate adolescent female patients about risks associated with HAI.

Aids Education and Prevention, Apr 1, 2003

40th Annual Meeting, Apr 3, 2014

Nursing Outlook, Nov 1, 2018

The Patient Protection and Affordable Care Act (PPACA, 2010), further referred to in this policy ... more The Patient Protection and Affordable Care Act (PPACA, 2010), further referred to in this policy brief as the Affordable Care Act (ACA), provides women and girls access to affordable sexual and reproductive healthcare services that were not otherwise provided prior to the ACA becoming law in 2010. The change in political Administration in January 2017 brought about many accompanying policy changes, including measures to repeal or disassemble, in whole or in part, the Affordable Care Act. Access to many healthcare services provided to women and girls under the ACA is now in jeopardy due to these proposed measures. If women and girls cannot access care, their overall health and the health of the nation will suffer (MacDorman & Declercq, 2018). Policies and practice protocols following enactment of the ACA are facing reduced funding, dismantlement, and restrictions (Olshansky, Taylor, Johnson-Mallard, Halloway, & Stokes, 2018). A number of sexual and reproductive health services are negatively targeted by changes in legislation and regulations. These include services funded by Title X, Private, Medicaid, and marketplace options that provide coverage for sexual and reproductive health, such as the human papilloma virus (HPV) vaccinations to prevent cancer, cervical cancer screening, family planning, abortion care, and preventive services for women. Policy decisions, funding, and clinical care must be guided by evidenced-based data, which clearly demonstrate the need for continued access to this care by women and girls. Consumers of health care look to the American Academy of Nursing (Academy) to address current shifts in policies that affect the health of the nation.

Nursing Science Quarterly, 2008

Skepticism, in the form of healthy intellectual questioning from someone who maintains an open, i... more Skepticism, in the form of healthy intellectual questioning from someone who maintains an open, inquisitive perspective and looks forward to reviewing all possible sides to an issue, is highly useful. No one should accept anything, including research, without evaluating its merits. However, when healthy skepticism and objective evaluation criteria are replaced with political ideology or religious zeal, science becomes dysfunctional, and possible strides in healthcare are lost. References

Nursing Outlook, Jul 1, 2020

Background:Chronic diseases, such as opioid use disorder (OUD) require a multifaceted scientific ... more Background:Chronic diseases, such as opioid use disorder (OUD) require a multifaceted scientific approach to address their evolving complexity. The Council for the Advancement of Nursing Science’s (Council) four nursing science priority areas (precision health; global health, determinants of health, and big data/data analytics) were established to provide a framework to address current complex health problems.Purpose:To examine OUD research through the nursing science priority areas and evaluate the appropriateness of the priority areas as a framework for research on complex health conditions.Method:OUD was used as an exemplar to explore the relevance of the nursing science priorities for future research.Findings:Research in the four priority areas is advancing knowledge in OUD identification, prevention, and treatment. Intersection of OUD research population focus and methodological approach was identified among the priority areas.Discussion:The Council priorities provide a relevant framework for nurse scientists to address complex health problems like OUD.

Journal of Health Education, Dec 1, 1997

Journal of Pediatric Health Care, 2002

The United States continues to experience an unacceptably high rate of teenage pregnancies, espec... more The United States continues to experience an unacceptably high rate of teenage pregnancies, especially when compared with other industrialized nations (Singh & Darroch, 2000). Although the rate of teen pregnancy in the United States has been decreasing for the past few years (Kahn, Brindis & Glei, 1999; Kann et al., 2000), it is still very high, notably among Black and Hispanic teens (Donovan, 1998). In the 1999 Youth Risk Behavior Survey, nationwide, half of all high school students reported having had sexual intercourse, and 6.3% of high school students reported that they had become pregnant or gotten their partner pregnant (Kann et al., 2000). Other statistics suggest that each year, almost 1 million teenage women, that is, 11% of all young women aged 15 to 19 years, become pregnant (Alan Guttmacher Institute [AGI], 1998). Between 78% and 85% of teen pregnancies are unplanned (AGI, 1998). Although somewhat fewer teens are having sex (Donovan, 1998) the primary explanation for the decrease in the teen pregnancy rate is believed to be increased contraceptive use (Kahn et al., 1999). However, teenagers are less likely than older women to practice contraception without interruption over the course of a year and are more likely to practice contraception sporadically (Glei, 1999). In addition, contraceptive failure rates are high. Estimates are that close to 50% of unintended pregnancies are the result of contraceptive failure (Chiou, Shrier, & Emans, 1998). Contraceptive failure rates appear to be higher for teens from poor homes (less than 200% of the federal poverty rate) than for teens whose family incomes were higher (Kahn et al., 1999). Of note, a study of 147 teens who experienced an unplanned pregnancy found that 80% had used contraception at the time of conception, and 80% of these young women could explain why their method failed (Chiou et al., 1998). Mathematical estimates suggest that the commonly used Yuzpe method of emergency contraception (EC), described below, results in a 75% reduction in pregnancies. Therefore, if these young P H C

Public Health Nursing, Jun 3, 2014

Objectives: A core competency model for family planning public health nurses has been developed, ... more Objectives: A core competency model for family planning public health nurses has been developed, using a three stage Delphi Method with an expert panel of 40 family planning senior administrators, community/public health nursing faculty and seasoned family planning public health nurses. Design and Sample: The initial survey was developed from the 2011 Title X Family Planning program priorities. The 32-item survey was distributed electronically via Survey-Monkey. Results: Panelist attrition was low, and participation robust resulting in the final 28-item model, suggesting that the Delphi Method was a successful technique through which to achieve consensus. Conclusions: Competencies with at least 75% consensus were included in the model and those competencies were primarily related to education/counseling and administration of medications and contraceptives. The competencies identified have implications for education/training, certification and workplace performance.

Journal of American College Health, May 20, 2020

Abstract Objective Male involvement in contraceptive practice remains low. Family planning and pe... more Abstract Objective Male involvement in contraceptive practice remains low. Family planning and pediatric health associations have recommended an emphasis on long-acting reversible contraceptives (LARC) in clinical counseling with adolescents and young adults, raising concerns about the resulting adverse impact on sexually transmitted infection (STI) rates. Participants: College-attending men responded to an internet based questionnaire (n=31) and a phone-based qualitative interview (n=25). Methods: Our survey solicited attitudes toward and knowledge of contraceptive methods and assessed communication practices with sexual partners regarding use of contraception and disease prevention. Results: Knowledge about female methods of contraception was low, with a comparatively high level of knowledge about Plan B. Parents and health care providers were cited as the most helpful sources of information. Conversations about protection with sexual partners were reported by most men, due mainly to fear of unplanned pregnancy, not STI. Conclusion: Addressing couple communication and dual protection among college-attending men needs greater emphasis.

Journal of Pediatric Nursing, 2017

Immigration from the Dominican Republic to the United States has grown rapidly. Yet, although ado... more Immigration from the Dominican Republic to the United States has grown rapidly. Yet, although adolescent pregnancy and obesity are common concerns among Hispanics, little is known specifically about Dominican adolescent health. This study was undertaken to assess Dominican-American adolescents' health concerns and their perceptions about their health promotion needs. Design and methods: Dominican-American adolescents (N = 25) were recruited in a pediatric clinic in New York City which primarily serves a Dominican population. Eligibility criteria included age 13-21 years, self-identifying as Dominican ethnicity, and able to speak and read English. They completed a questionnaire, with demographic questions and questions about their risk behaviors including sexual and substance use. After completing the questionnaire, they participated in a semi-structured interview addressing their health education experiences and suggestions for such programs. Quantitative data were analyzed using frequencies to provide a demographic and behavioral profile. Qualitative data were analyzed using thematic analysis. Results: Twenty-five adolescents, ages 13-21 years, (female N = 19, male N = 6) participated in the study. Most were in school (92%) and were sexually experienced (68%). Programmatic preferences included inperson programs rather than online. They spontaneously addressed the importance of cultural issues, and the need to address several issues in addition to sexuality, including obesity and substance use. Conclusions: Programming for this population should address a broad conceptualization of health, and incorporate Dominican cultural issues. Practice implications: Nurses working with adolescents of Dominican origin, should provide health education that incorporates the specific needs of this population, including culturally congruent face-to-face interventions.

Journal of Pediatric Health Care, Sep 1, 1993

Cervical cytologic abnormalities are increasingly prevalent in teenagers. Adolescents are at grea... more Cervical cytologic abnormalities are increasingly prevalent in teenagers. Adolescents are at greater risk for cervical neoplasia than adult women because of the biologic changes occurring in the cervix during puberty, the prevalence of human papillomavirus, and the behavioral risk factors in this age group. Two behavioral risk factors are early age at first coitus and multiple sex partners. Human papillomavirus is widely believed to be the etiologic agent associated with the spectrum of cervical neoplasias. Papanicolaou smear technique, reporting, and management of abnormal smears in teens is explained. J PEDIATR

Journal of Adolescent Health, Aug 1, 1996

This article reviews the literature on the relationship of partner support to outcomes for teenag... more This article reviews the literature on the relationship of partner support to outcomes for teenage mothers and their children. It discusses the changing alliance over time between men who father their babies and the young mothers and their children. This report considers both adults and adolescents who father children with adolescent women. The discussion focuses on the relationship between partner support and three outcomes for the mothers: educational outcomes, economic outcomes, and psychological well-being. The general association between partner support and the children's development is also examined. In addition, partner support is viewed within the context of the teenager's family system, providing a framework for assessing key features of support for teenage mothers. The article outlines suggestions for future research.

American Journal of Nursing, Apr 1, 1997

1. Am J Nurs. 1997 Apr;97(4):45. Emergency! Adolescent rape. Roye CF, Coonan PR. Columbia Univers... more 1. Am J Nurs. 1997 Apr;97(4):45. Emergency! Adolescent rape. Roye CF, Coonan PR. Columbia University School of Nursing, New York, NY, USA. PMID: 9103923 [PubMed - indexed for MEDLINE] Publication Types: Case Reports. MeSH Terms: ...

Nursing Economics, Sep 1, 2010

Journal of Pediatric Nursing, 2017

off of the train and are standing on the platform as the train pulls out of the station. Tayja re... more off of the train and are standing on the platform as the train pulls out of the station. Tayja resumes reading her magazine occasionally rubbing her abdomen as she turns the pages. The train picks up speed again and jerks as it moves through the tunnel to the next stop. After exiting the train, many questions go through my mind. What will happen with the trigonometry test? What will happen with Tayja's pregnancy and baby? What is going through the mind of Tayja as she goes through this pregnancy? How does she feel about this pregnancy and what factors in her life led to this? Additionally, I asked myself how would a girl around their same age who had never been pregnant view the same scene. What would be going through her mind?

Issues in Mental Health Nursing, Jun 25, 2014

Understanding the context of anal sex behavior among ethnic minority adolescent women has public ... more Understanding the context of anal sex behavior among ethnic minority adolescent women has public health implications for behavioral sexual health promotion and risk reduction interventions. African-American (n = 94) and Mexican-American (n = 465) women (14-18 years of age) enrolled in a clinical trial completed semi-structured interviews to assess psychosocial and situational factors and relationships to sexual risk behavior, substance use, sexually transmitted infection/HIV acquisition, and violence. Bivariate analyses with comparisons by anal sex experiences identified differences by ethnicity and higher self-reported histories of sexual risk behaviors, substance use, violence, and stressful psychosocial and situational factors among adolescent women experiencing anal sex. Predictors of anal sex identified through logistic regression included Mexican-American ethnicity, ecstasy use, methamphetamine use, childhood sexual molestation, oral sex, and sex with friends for benefits. The purpose of this article is to describe the context of sexual behavior among African and Mexican-American adolescent women with a history of sexually transmitted infection (STI), high risk sexual behavior, or violence, using comparisons by self-reported experience of anal sex. Conceptualization of sexual behavior within these sexual partner relationships is important for the modification of evidence-based, behavioral, sexual risk reduction interventions. The information from this study can be used with these interventions to enhance efficacy for the prevention of violence, substance use, unintended pregnancy, and STIs, including HIV, among ethnic minority adolescent women. BACKGROUND HIV poses a substantial risk to the health of women, who represent more than 20% of new HIV infections and 25% of all infections in the US.

Journal of Adolescent Health, Dec 1, 1992

This article reviews the literature on the subject of cervical cytological abnormalities in teena... more This article reviews the literature on the subject of cervical cytological abnormalities in teenagers, defined as a Papanicolaou (Pap) smear result more severe than inflammation. There is discussion of the increasing prevalence of this problem in adolescents. Behavioral and biologic risk factors are examined. The role of the human papillomavirus, widely believed to be the etiologic agent, is addressed. Atypia, its relationship to cervical malignancies, and its management are reviewed. The possible role of the human immunodeficiency virus in the increasing prevalence of cytological abnormalities in teens is considered.

Nursing Outlook, Nov 1, 2017

Background: Nursing science is essential to advance population health through contributions at al... more Background: Nursing science is essential to advance population health through contributions at all phases of scientific inquiry. Multiple scientific initiatives important to nursing science overlap in aims and population focus. Purpose: This paper focused on providing the American Academy of Nursing and nurse scientists in the US with a blueprint of nursing science priorities to inform a shared vision for future collaborations, areas of scientific inquiry, and resource allocation. Methods: The Science Committee convened four times and using Delphi methods identified priorities with empirical evidence and expert opinion for prioritization, state of the science, expert interest, and potential target stakeholders. Results: Nursing science priorities for 2017 were categorized into four themes including: 1) Precision science; 2) Big data and data analytics; 3) Determinants of health; and 4) Global health. Conclusions: Nurse scientists can generate new knowledge in priority areas that advances the health of the world's populations.

American Journal of Nursing, Apr 1, 1997

How to provide physical and emotional comfort while gathering the necessary evidence. (C) Lippinc... more How to provide physical and emotional comfort while gathering the necessary evidence. (C) Lippincott-Raven Publishers.

Journal of the Association of Nurses in AIDS Care, Jul 1, 2010

Anal intercourse (AI) is a recognized HIV risk behavior, yet little is known about AI among femal... more Anal intercourse (AI) is a recognized HIV risk behavior, yet little is known about AI among female adolescents. We studied the prevalence and correlates of heterosexual AI (HAI) among Black and Latina female adolescents. The data come from two randomized clinical trials (RCTs) of HIVprevention interventions with Black and Latina female adolescents. In the second RCT, a Sexual Relationship Power (SRP) Scale was added to the questionnaire. Thirty-five percent of participants in the first RCT (N = 244) and 23% of those in the second RCT (N = 101) reported engaging in HAI, most without a condom. Significant correlations existed between HAI and a high-risk sexual history. HAI is prevalent in this population. Nurses must educate adolescent female patients about risks associated with HAI.

Aids Education and Prevention, Apr 1, 2003

40th Annual Meeting, Apr 3, 2014

Nursing Outlook, Nov 1, 2018

The Patient Protection and Affordable Care Act (PPACA, 2010), further referred to in this policy ... more The Patient Protection and Affordable Care Act (PPACA, 2010), further referred to in this policy brief as the Affordable Care Act (ACA), provides women and girls access to affordable sexual and reproductive healthcare services that were not otherwise provided prior to the ACA becoming law in 2010. The change in political Administration in January 2017 brought about many accompanying policy changes, including measures to repeal or disassemble, in whole or in part, the Affordable Care Act. Access to many healthcare services provided to women and girls under the ACA is now in jeopardy due to these proposed measures. If women and girls cannot access care, their overall health and the health of the nation will suffer (MacDorman & Declercq, 2018). Policies and practice protocols following enactment of the ACA are facing reduced funding, dismantlement, and restrictions (Olshansky, Taylor, Johnson-Mallard, Halloway, & Stokes, 2018). A number of sexual and reproductive health services are negatively targeted by changes in legislation and regulations. These include services funded by Title X, Private, Medicaid, and marketplace options that provide coverage for sexual and reproductive health, such as the human papilloma virus (HPV) vaccinations to prevent cancer, cervical cancer screening, family planning, abortion care, and preventive services for women. Policy decisions, funding, and clinical care must be guided by evidenced-based data, which clearly demonstrate the need for continued access to this care by women and girls. Consumers of health care look to the American Academy of Nursing (Academy) to address current shifts in policies that affect the health of the nation.

Nursing Science Quarterly, 2008

Skepticism, in the form of healthy intellectual questioning from someone who maintains an open, i... more Skepticism, in the form of healthy intellectual questioning from someone who maintains an open, inquisitive perspective and looks forward to reviewing all possible sides to an issue, is highly useful. No one should accept anything, including research, without evaluating its merits. However, when healthy skepticism and objective evaluation criteria are replaced with political ideology or religious zeal, science becomes dysfunctional, and possible strides in healthcare are lost. References

Nursing Outlook, Jul 1, 2020

Background:Chronic diseases, such as opioid use disorder (OUD) require a multifaceted scientific ... more Background:Chronic diseases, such as opioid use disorder (OUD) require a multifaceted scientific approach to address their evolving complexity. The Council for the Advancement of Nursing Science’s (Council) four nursing science priority areas (precision health; global health, determinants of health, and big data/data analytics) were established to provide a framework to address current complex health problems.Purpose:To examine OUD research through the nursing science priority areas and evaluate the appropriateness of the priority areas as a framework for research on complex health conditions.Method:OUD was used as an exemplar to explore the relevance of the nursing science priorities for future research.Findings:Research in the four priority areas is advancing knowledge in OUD identification, prevention, and treatment. Intersection of OUD research population focus and methodological approach was identified among the priority areas.Discussion:The Council priorities provide a relevant framework for nurse scientists to address complex health problems like OUD.

Journal of Health Education, Dec 1, 1997

Journal of Pediatric Health Care, 2002

The United States continues to experience an unacceptably high rate of teenage pregnancies, espec... more The United States continues to experience an unacceptably high rate of teenage pregnancies, especially when compared with other industrialized nations (Singh & Darroch, 2000). Although the rate of teen pregnancy in the United States has been decreasing for the past few years (Kahn, Brindis & Glei, 1999; Kann et al., 2000), it is still very high, notably among Black and Hispanic teens (Donovan, 1998). In the 1999 Youth Risk Behavior Survey, nationwide, half of all high school students reported having had sexual intercourse, and 6.3% of high school students reported that they had become pregnant or gotten their partner pregnant (Kann et al., 2000). Other statistics suggest that each year, almost 1 million teenage women, that is, 11% of all young women aged 15 to 19 years, become pregnant (Alan Guttmacher Institute [AGI], 1998). Between 78% and 85% of teen pregnancies are unplanned (AGI, 1998). Although somewhat fewer teens are having sex (Donovan, 1998) the primary explanation for the decrease in the teen pregnancy rate is believed to be increased contraceptive use (Kahn et al., 1999). However, teenagers are less likely than older women to practice contraception without interruption over the course of a year and are more likely to practice contraception sporadically (Glei, 1999). In addition, contraceptive failure rates are high. Estimates are that close to 50% of unintended pregnancies are the result of contraceptive failure (Chiou, Shrier, & Emans, 1998). Contraceptive failure rates appear to be higher for teens from poor homes (less than 200% of the federal poverty rate) than for teens whose family incomes were higher (Kahn et al., 1999). Of note, a study of 147 teens who experienced an unplanned pregnancy found that 80% had used contraception at the time of conception, and 80% of these young women could explain why their method failed (Chiou et al., 1998). Mathematical estimates suggest that the commonly used Yuzpe method of emergency contraception (EC), described below, results in a 75% reduction in pregnancies. Therefore, if these young P H C