IU Indianapolis ScholarWorks :: Browsing by Author "Hardin, Heather K."

Browsing by Author "Hardin, Heather K."

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An integrative review of adolescent trust in the healthcare provider relationship
(Wiley, 2021-04) Hardin, Heather K.; Bender, Anna E.; Hermann, Carla P.; Speck, Barbara J.
Aim: To conduct an integrative review of empirical studies examining factors affecting trust in the healthcare provider (HCP) relationship among adolescents. Design: An integrative review was conducted. Data sources: The keywords adolescent, trust, healthcare provider and related words were searched in multiple online research databases. The results were limited to research published between 2004 and 2019. Seventeen primary sources were identified and synthesized in the final review. Review method: Guided by the Whittemore and Knafl integrative review method, a data-based convergent synthesis design was used to explore the key research question in both qualitative and quantitative research. Results: This integrative review found that health care provider behaviours, such as confidentiality, honesty, respect, and empathy, promote adolescent's trust of the HCP. Notable gaps in the literature were also identified, including a lack of diversity among adolescent samples and HCP types and underdeveloped measures of adolescent trust of HCP. Conclusion: This integrative review informed the development of a new conceptual definition of adolescent trust of HCP, which embodies the key findings of the importance of HCP confidentiality, honesty, respect, and empathy. This definition can be used to develop instruments, interventions and policies that promote HCP trust among adolescents. Future research is needed to develop instruments to measure adolescents' trust of HCPs, evaluate trust of HCPs among diverse samples of adolescents and evaluate adolescent trust of HCPs with a variety of HCP types. Impact: The new conceptual definition of adolescent trust of HCP can be used to enhance nursing practice and design behavioural interventions to improve trust of HCP. To foster adolescent trust of HCP, policies should be enacted in healthcare institutions to explain confidentiality, provide notification of reporting mandates and formalize consent, assent and dissent for adolescents seeking health care.
Associations between trust of healthcare provider and body mass index in adolescents
(Taylor & Francis, 2021-07-03) Hardin, Heather K.; Moore, Shirley M.; Moore, Scott E.; Uli, Naveen K.
Adolescent obesity continues to be a serious concern around the world, placing young people at risk for chronic conditions and early death. Research has shown that social relationships are important in making health behavior changes, such as following health-care recommendations for eating and physical activity. Specifically, the trust of health-care providers has been shown to be important in making health behavior change. Evidence suggests that obese young adults are less trusting of health-care providers than their healthy weight peers, but it is not known if this also applies to obese adolescents. The purpose of this secondary analysis study was to determine relationships between the trust of health-care providers and body mass index percentile in adolescents. Participants were 224 adolescents aged 14-19 years attending a public high school in the Midwestern United States. The Wake Forest Physician Trust scale measured the trust of health-care providers. Height and weight were collected at a school screening; body mass index percentile categories were determined according to age- and sex-adjusted body mass index percentiles. One-way analysis of variance and post hoc Tukey tests showed trust scores varied significantly between body mass index percentile categories of girls. Results suggest it may be necessary for health-care providers to make additional efforts to build trust with obese adolescent girls than with other groups of adolescents.
Depressive symptoms and trust of healthcare provider in rural adolescents: Relationships and predictors
(Taylor & Francis Online, 2021-03) Hardin, Heather K.; Alchami, Hana K.; Connell, Arin
The purpose of this study was to evaluate associations among depressive symptoms, trust of healthcare provider, and health behavior in adolescents who live in a rural area. Two hundred twenty-four adolescents aged 14-19 years old attending public high school in the Midwestern United States were surveyed. Results showed a diagnosis of depression, trust of healthcare provider, health awareness, and stress management predicted depressive symptoms in adolescents living in a rural area. Healthcare providers should take extra care to promote trust in the healthcare provider-patient relationship with adolescents and to follow guidelines for annual screening of adolescents for depressive symptoms. Nursing implications include adolescent psychoeducation to improve health awareness and stress management.
Diminished trust of healthcare providers, risky lifestyle behaviors, and low use of health services: A descriptive study of rural adolescents.
(Sage Publications, 2018-12) Hardin, Heather K.; McCarthy, Valerie Lander; Speck, Barbara J.; Crawford, Timothy N.
The purpose of our study was to determine the extent to which individual characteristic variables predict trust of healthcare provider (HCP), lifestyle behaviors, and use of health services among adolescents attending public high school in rural Indiana. The sample included 224 individuals surveyed in 9th grade or 12th grade required courses. Trust of HCP and lifestyle behaviors were predicted using hierarchical multiple regression; number of HCP visits and emergency department (ED) visits in the past 12 months were predicted using negative binomial regression. This sample of adolescents living in a rural area reported riskier lifestyle behaviors than another sample of adolescents, lower trust of HCP than adults in general, and fewer HCP and ED visits than adolescents in general. Our study supports the need for school-based health services in rural areas and the opportunity for school nurses to act as care coordinators for marginalized youth.
Integration of the 5A’s Framework in Research on Obesity and Weight Counseling: Systematic Review of Literature
(Sage, 2024-12-09) Shieh, Carol; Hardin, Heather K.; Doerstler, Mandelle Dreu; Jacobsen, Anna Liss; School of Nursing
The 5A's Framework (Assess, Advise, Assist, Agree, and Arrange) has been recommended as a practice guide for obesity counseling. Its integration in research, however, is not well known. This systematic review was to find how the 5A's Framework was integrated in research on obesity and weight counseling. Methods: A systematic search of four databases was conducted combining two concepts: "5 A's Framework" and "obesity, body size, dieting/eating, exercise, weight loss." Inclusion criteria were quantitative studies with the 5A's Framework as a singular intervention or combined with others to influence patients' healthy eating, physical activity, and weight outcomes or care providers' counseling behaviors. Twenty-two studies were included in the final analysis. Results: Most studies were conducted in the primary care setting. The 5A's Framework was (1) integrated in training interventions as formal medical curricular and on-the-job education workshops to influence obesity/weight counseling skills, (2) utilized to develop assessment tools to evaluate counseling behaviors, and (3) combined with behavior change strategies to impact the patient's weight management behaviors and outcomes. Conclusion: The integration of the 5A's Framework in obesity and weight counseling research is wide-ranging. The findings have implications for clinicians to use the framework to better obesity/weight counseling.
Materials and methods for recruiting systematically marginalized youth and families for weight-management intervention trials: Community stakeholders' perspectives
(Lippincott, 2023-01-02) Hardin, Heather K.; Bender, Anna E.; Killion, Cheryl M.; Moore, Shirley M.
Rates of overweight and obesity are problematic among systematically marginalized youth; however, these youth and their families are a hard-to-reach research population. The purpose of our study was to identify facilitators and barriers for recruiting systematically marginalized families in youth weight-management intervention research. This study built upon existing evidence through involvement of youth, parents, community agency workers, and school nurses, and an exploration of both recruitment materials and processes. Seven focus groups were conducted with 48 participants from 4 stakeholder groups (youth, parents, school nurses, and community agency workers). A codebook approach to thematic analysis was used to identify key facilitator and barrier themes related to recruitment materials and processes across the stakeholder groups. Ecological systems theory was applied to contextualize the facilitators and barriers identified. Participants reported the need to actively recruit youth in the study through engaging, fun recruitment materials and processes. Participants reported greater interest in recruitment at community-based events, as compared to recruitment through health care providers, underscoring the depth of distrust that this sample group has for the health care system. Recommendations for recruitment materials and processes for weight-management intervention research with systematically marginalized families are proposed.
Strategies to engage systematically marginalized youth and their families in research using high-tech methods
(Lippincott, 2022-04-29) Hardin, Heather K.; Bender, Anna E.; Killion, Cheryl M.; Moore, Shirley M.
The purpose of this study was to identify facilitators and barriers for engaging youth and families from a historically and systematically marginalized community in high-tech research. Adapting community-based participatory research principles, 4 focus groups were conducted with 13 youth and 12 parents. Using codebook thematic analysis, 5 facilitator themes (develop skills, ensure health, build understanding, promote safety, and help others, youth-initiated interest) and 4 barrier themes (anxiety and fear, skepticism, confusion, and unfamiliar/unknown experience) were identified. Youth and parent responses informed proposed guidelines for recruiting and engaging families in research using high-tech methods, particularly those from historically and systematically marginalized communities.
Unmet health need and perceived barriers to health care among adolescents living in a rural area
(Taylor & Francis Online, 2021-01-02) Hardin, Heather K.; Alchami, Hana; Lee, David; Jones, M. Susan
This study investigated the perceived health care needs, unmet health need, and barriers to health care in 224 rural-dwelling adolescents. A cross-sectional, descriptive design was used to survey adolescents attending a public high school in a low-resource, rural Indiana community. One in five adolescents reported an unmet health need. The most common barriers to health care were related to access, apathy, anxiety, and parenting issues. Implications include confidentiality protocols in family healthcare practices, school-based health centers, and intervention research targeting adolescents’ communication skills and healthcare consumer skills.
What are key characteristics of adults with advanced heart failure discharged from ICU?
(Wiley, 2024-05) Edmiston, Elizabeth A.; Hardin, Heather K.; Dolansky, Mary A.; School of Nursing
Background As the number of people with heart failure and treatment complexity increases, many hospitals are implementing Advanced Heart Failure Intensive Care Units (AHFICU). However, little evidence concerning the clinical characteristics of people admitted to AHFICUs exists. Understanding the clinical characteristics of people admitted to the AHFICU will assist nurses with implementing tailored interventions to ensure high-quality care delivery. Aim The purpose of this study was to describe the clinical characteristics of people who are admitted to and discharged from an AHFICU. Study Design Baseline data from a longitudinal descriptive study were collected on adults (N = 43) admitted to an AHFICU. Heart failure severity, self-management ability, cognition, sleep quality, and other clinical characteristics were assessed. Results Most study participants were New York Heart Association functional class IV (n = 24) or class III (n = 14), indicating poor functional capacity. Over half had mild cognitive impairment and poor sleep quality was prevalent (92.7%). Participants had adequate levels of heart failure knowledge, but low levels of heart failure self-management decision-making and ability. Conclusions Interventions to address the unique clinical characteristics of AHFICU patients include sleep hygiene, integration of cognitive, sleep, and self-management assessments into the electronic medical record. Addressing the unique clinical needs of people with heart failure will lead to patient-centered, evidence-based, and safe care.

Browsing by Author "Hardin, Heather K."

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