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You W, Donnelly F. A greater nurse and midwife density protects against infant mortality globally. J Pediatr Nurs 2024:S0882-5963(24)00122-2. [PMID: 38614819 DOI: 10.1016/j.pedn.2024.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 04/01/2024] [Accepted: 04/01/2024] [Indexed: 04/15/2024]
Abstract
PURPOSE As the largest profession within the health care workforce, nurses and midwives play a critical role in the health and wellness of families especially children and infants. This study suggests those countries with higher nurse and midwife densities (NMD) had lower infant mortality rates (IMR). DESIGN AND METHODS With affluence, low birthweight and urbanization incorporated as potential confounders, this ecological study analyzed the correlations between NMD and IMR with scatterplots, Pearson r correlation, partial correlation and multiple linear regression models. Countries were also grouped for analysing and comparing their Pearson's coefficients. RESULTS NMD inversely and significantly correlated to IMR worldwide. This relationship remained significant independent of the confounders, economic affluence, low birthweight and urbanization. Explaining 57.19% of IMR variance, high NMD was implicated in significantly reducing the IMR. PRACTICE IMPLICATIONS Countries with high NMD had lower IMRs both worldwide and with special regard to developing countries. This may interest healthcare policymakers, especially those from developing countries, to consider the impacts of global nursing and midwifery staffing shortages. Nurses and midwives are the group of healthcare professionals who spend most with infants and their carers. This may be another alert for the health authorities to extend nurses and midwives' practice scope for promoting infant health.
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Affiliation(s)
- Wenpeng You
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia; Acute and Urgent Care, Royal Adelaide Hospital, Adelaide, Australia; Adelaide Medical School, the University of Adelaide, Adelaide, Australia; School of Nursing and Midwifery, Western Sydney University, Sydney, Australia.
| | - Frank Donnelly
- Adelaide Nursing School, the University of Adelaide, Adelaide, Australia
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Medin AC, Vik FN, Helle C, Helland SH, Wills AK, Osorio NG, Lian H, Ersfjord TI, Van Daele W, Bjørkkjær T, Valen EN, Gebremariam MK, Grasaas E, Kiland C, von Thiele Schwarz U, Abel MH, Love P, Campbell K, Rutter H, Barker ME, Hillesund ER, Øverby NC. Scaling up evidence-based digital early life nutrition interventions in a county setting: an implementation trial - protocol for Phase 2 of the Nutrition Now project. Front Public Health 2024; 11:1326787. [PMID: 38264256 PMCID: PMC10803599 DOI: 10.3389/fpubh.2023.1326787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 12/13/2023] [Indexed: 01/25/2024] Open
Abstract
Background Few effective health interventions transition from smaller efficacy or effectiveness studies to real-world implementation at scale, representing a gap between evidence and practice. Recognising this, we have developed Nutrition Now - a tailored digital resource building on four efficacious dietary interventions, aiming to improve nutrition in the important first 1,000 days of life. Nutrition Now targets and guides expectant parents and parents of 0-2 year olds, serves as a reliable source of evidence-based information for midwives and public health nurses at maternal and child healthcare (MCH) centres, and offers pedagogical tools for early childhood education and care (ECEC) staff. The aim of this study is to implement Nutrition Now at scale and evaluate the impact of different sets of multifaceted implementation strategies on implementation outcomes. Methods A quasi-experimental design with three study arms will be used, providing either low, medium or high implementation support, when rolled out in 50 municipalities in 2 counties in Norway. Nutrition Now will be implemented in MCH and ECEC settings and made available to expectant parents and parents of 0-2 year olds through social media and MCH. The implementation support builds on strategies described in the Expert Recommendations for Implementing Change (ERIC) implementation framework and is informed by dialogues with stakeholders. Impact of the different degree of implementation support will be assessed by examining reach, adoption, fidelity, and sustainability using usage data generated from the Nutrition Now resource, publicly available municipal data and qualitative interviews with MCH and ECEC staff. Discussion Nutrition Now Phase 2 will break new ground by scaling up successively delivered and complementary dietary interventions in the first 1,000 days of life in a real-life context. The project also seeks to identify what level of implementation support is most effective when implementing digital, scalable, evidence-based early-life nutrition interventions in community settings. The project will inform implementation research and provide knowledge about effective implementation strategies to be used in a national scale-up of Nutrition Now. Trial registration The study is registered prospectively (submitted 14/06/2022, registration date: 19/06/2022) in the International Standard Randomised Controlled Trial Number registry (ISRCTN): reg. Number: ISRCTN10694967, https://doi.org/10.1186/ISRCTN10694967.
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Affiliation(s)
- Anine Christine Medin
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Frøydis Nordgård Vik
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Christine Helle
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Sissel Heidi Helland
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Andrew Keith Wills
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Natalie Garzon Osorio
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Henrik Lian
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Torunn Iveland Ersfjord
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Wim Van Daele
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Tormod Bjørkkjær
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Erlend Nuland Valen
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Mekdes Kebede Gebremariam
- Department of Community Medicine and Global Health, Institute of Health and Society, University of Oslo, Oslo, Norway
| | - Erik Grasaas
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Charlotte Kiland
- Department of Political Science and Management, Faculty of Social Sciences, University of Agder, Kristiansand, Norway
| | - Ulrica von Thiele Schwarz
- School of Health, Care and Social Welfare, Mälardalen University, Västerås, Sweden
- Procome, Medical Management Centre, LIME, Karolinska Institutet, Stockholm, Sweden
| | - Marianne Hope Abel
- Centre for Evaluation of Public Health Measures, Norwegian Institute of Public Health, Oslo, Norway
| | - Penny Love
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Karen Campbell
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Science, Deakin University, Geelong, VIC, Australia
| | - Harry Rutter
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
- Department of Social and Policy Sciences, University of Bath, Bath, United Kingdom
| | - Mary Elizabeth Barker
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
- School of Health Sciences, University of Southampton, Southampton, United Kingdom
- MRC Lifecourse Epidemiology Centre, University of Southampton, Southampton General Hospital, Southampton, United Kingdom
| | - Elisabet Rudjord Hillesund
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
| | - Nina Cecilie Øverby
- Department of Nutrition and Public Health, Faculty of Health and Sport Sciences, University of Agder, Priority Research Centre Lifecourse Nutrition, Kristiansand, Norway
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Collan C, Dahl L, Henström M, Nyström CD, Löf M, Andermo S. To capture the child's interest - nurses experiences of 'Saga stories in health talks'. BMC Nurs 2024; 23:8. [PMID: 38163869 PMCID: PMC10759488 DOI: 10.1186/s12912-023-01661-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 12/11/2023] [Indexed: 01/03/2024] Open
Abstract
BACKGROUND As unhealthy lifestyle habits have been found to be established early in life and often track into adulthood, early preventive initiatives are important. 'Saga Stories in health talks' is a newly developed material that is intended to be used as a support for nurses at child health care (CHC) centers in their health talks with children and parents in Sweden. The aim of this study is to explore how CHC nurses experience the usability of the 'Saga Stories in health talks' material. METHODS This study used a qualitative design. The material 'Saga Stories in health talks' was tested by 33 CHC nurses working in 11 CHC centers in three regions in Sweden. All CHC nurses were invited to participate in the interviews and 17 agreed. The interviews were transcribed and analysed using content analysis. RESULTS Three categories and eight sub-categories emerged. The categories were: (1) An appreciated tool suitable for health talks, (2) Illustrations to capture children's interest in the conversation with families, and (3) Barriers and facilitators. Saga Stories in health talks' was experienced by the CHC nurses as an appreciated tool with content highly relevant to what should be discussed during the health talks. The CHC nurses described the material as well-designed with illustrations that helped them capture the child's interest and increase their participation, while still involving the parents. Support from colleagues, the researchers, and managers were seen as important facilitators. Challenges included structural factors such as how and when to best use the material, especially concerning that the 4-year visit contained many other mandatory parts. CONCLUSIONS This pilot study show that the material 'Saga Stories in health talks' was highly appreciated by CHC nurses and facilitated their health talks with families in CHC. Important aspects with the material were the relevant content and the focus on healthy living habits, as well as the child friendly illustrations. These findings can be used when similar material is developed to facilitate health talks with families in other contexts. Our results also highlight the importance to adjust the implementation of a new material with already established practice and routines.
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Affiliation(s)
- Camilla Collan
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, 141 83, Sweden
| | - Lina Dahl
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, 141 83, Sweden
| | - Maria Henström
- Department of Biosciences and Nutrition, Karolinska Institutet, Neo, Huddinge, 141 83, Sweden
| | | | - Marie Löf
- Department of Biosciences and Nutrition, Karolinska Institutet, Neo, Huddinge, 141 83, Sweden
- Department of Health, Medicine and Caring Sciences, Division of Society and Health, Linköping University, Linköping, 581 83, Sweden
| | - Susanne Andermo
- Department of Neurobiology, Care Sciences and Society, Division of Nursing, Karolinska Institutet, Huddinge, 141 83, Sweden.
- Department of Physical Activity and Health, The Swedish School of Sport and Health Sciences, Stockholm, 114 33, Sweden.
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Øverby NC, Hillesund ER, Medin AC, Vik FN, Ostojic SM. Nutrition in a lifecourse perspective: From molecular aspects to public health approaches. Matern Child Nutr 2024; 20 Suppl 2:e13582. [PMID: 37932597 PMCID: PMC10765348 DOI: 10.1111/mcn.13582] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/08/2023]
Abstract
This Special Issue covers a variety of topics related to nutrition from a lifecourse perspective, addressing diet in sensitive periods (preconception, pregnancy and infancy/toddlerhood), in different contexts, spanning from molecular nutrition to settings and gatekeepers of diet in these sensitive periods. It highlights challenges and research gaps within the field.
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Affiliation(s)
- Nina C. Øverby
- Department of Nutrition and Public Health, UiA Priority Research Centre for Lifecourse NutritionUniversity of AgderKristiansandNorway
| | - Elisabet R. Hillesund
- Department of Nutrition and Public Health, UiA Priority Research Centre for Lifecourse NutritionUniversity of AgderKristiansandNorway
| | - Anine C. Medin
- Department of Nutrition and Public Health, UiA Priority Research Centre for Lifecourse NutritionUniversity of AgderKristiansandNorway
| | - Frøydis N. Vik
- Department of Nutrition and Public Health, UiA Priority Research Centre for Lifecourse NutritionUniversity of AgderKristiansandNorway
| | - Sergej M. Ostojic
- Department of Nutrition and Public Health, UiA Priority Research Centre for Lifecourse NutritionUniversity of AgderKristiansandNorway
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