Digital Commons Network^™

Parent–Child Responses To A Digital Cancer Prevention Game: Pre–Post Changes In Hpv-Related Outcomes, Angela Chia-Chen Chen, Michael Todd, Elizabeth Reifsnider, Ashish Amresh

International Nursing Research Congress (INRC)

Purpose: This presentation examined pre–post changes among parent–child dyads who received HPV Detective, a digital game promoting HPV vaccination and cancer prevention. We compared intervention effects between parents and children to understand how digital tools influence family-centered determinants of HPV vaccination.

Methods: Thirty-one parent–child dyads (n=62) completed online surveys at baseline (T0) and immediately post-intervention (T1) while playing the 10–15-minute game in pediatric clinics before seeing the provider. Surveys included sociodemographic characteristics and validated scales assessing HPV knowledge, attitudes, behavioral control, subjective norms, and vaccination intention. Paired t-tests and descriptive analyses assessed within-person changes, with results confirmed using nonparametric tests. …

Machine Learning In Pediatric Surgery: Validation For Ambulatory Screening, Mary Beth Bass, Jill Kinch, Kimberly Isenberg

International Nursing Research Congress (INRC)

Accurate screening for anesthesia eligibility criteria is crucial for pediatric ambulatory surgery centers (ASCs) to ensure patient safety and optimization of resources [1,3]. Traditional manual chart review by advanced practice providers (APPs) is labor-intensive and subject to variability [2, 3, 7]. Continued growth of the ASC patient volume creates challenges for the APP team to meet the patient safety needs without adding additional support. To address these challenges, we partnered with Brim Analytics (Brim), an Artificial Intelligence (AI) powered chart review tool built on a large language model. Brim interprets unstructured electronic medical record (EMR) data and applies our institutional …

Ai-Enabled Nudging For Nursing-Led Prevention And Health Equity, Pattama S. Ulrich, Katherine M. Pallas, Michael Joseph Dino, Jean W. Davis

International Nursing Research Congress (INRC)

Health systems face escalating burdens from physical inactivity, poor nutrition, and related noncommunicable diseases (NCDs), which disproportionately affect socioeconomically and clinically susceptible populations [1], [2]. Concurrently, artificial intelligence (AI), digital health technologies, and wearable devices are increasingly shaping health decision making and behavior change interventions [3], [4]. Nudge theory, grounded in behavioral economics, offers a noncoercive approach to influencing behavior through choice architecture while preserving individual autonomy [5], [6]. As AI enables nudges to become more personalized and scalable, conceptual clarity is needed to guide ethical, nurse-led applications that advance prevention and health equity [7], [8].

This work conceptually examines …

Immigrant Women’S Experiences Of Living In An Abusive Relationship: A Narrative Inquiry, Fay M. Dastjerdi, Sassan Issari, Zipora Rahmanov, Elizabeth Sombilon

International Nursing Research Congress (INRC)

Immigration has become a reality in most parts of the world for different reasons. Iranian immigrants ranked sixth in acquiring Canadian citizenship and eighth in being admitted as permanent residents (Bains, 2024; Risdon, 2024). Most immigrants experience some degree of loss and disassociation after being dislocated. Intimate Partner Violence (IPV) impacts people of all genders, ages and socioeconomic, racial, educational, ethnic, religious and cultural backgrounds; however,women experience this form of gender-based violence at much higher rates, most often perpetrated by men (Statistics Canada, 2023 & 2025). IPV presents a significant public health challenge affecting diverse demographic groups, including immigrant women …

Advance Care Planning In Practice: Hospital Nurses’ Experiences With Known And Unknown Goals Of Care, Ashley Hebert, Genevieve Thompson, Diana Mcmillan, Katarina Lee-Ameduri

International Nursing Research Congress (INRC)

Background: Hospital continues to be the place of death for the majority of Canadians, despite the common preference for a less aggressive comfort-focused plan of care at the end-of-life. Advance care planning (ACP) is recognized as a means to prevent unwanted care for patients. However, ACP is often not occurring in acute care settings before patients lose the capacity to participate. This means that a patient’s goals of care are frequently left unknown, which may not only lead to overtreatment and patient harm, but also to moral distress in nurses.

Purpose: The purpose of this thesis study is (1) to …

Childbirth Self-Efficacy And Factors Influencing Labor And Birth In The Dominican Republic, Lori Hubbard, Thomas P. Mccoy, Katherine Aquino, Franceska Charles, Julia Ricker, Gabrielle Carlson

International Nursing Research Congress (INRC)

At 58.1%, the cesarean birth rate in the Dominican Republic (DR) is the highest in the world (1). The World Health Organization cites the overuse of elective cesareans as a global health priority, but states reduction efforts should utilize educational interventions that incorporate local determinants of health (2,3). This descriptive, cross-sectional, convergent mixed methods study examined childbirth self-efficacy, demographics, and beliefs about labor and birth in expectant and newly postpartum parents from low resourced communities in the Dominican Republic. A demographic survey, researcher-designed items grounded in the theory of planned behavior, and the 62-item Spanish version (4) of the 4 …

Community Strengths: A Global Partnership To Support Children With Disabilities In Ghana, Christine Rae Platt, Michael Thomas, Brandon Thatcher, Ashlee Johnson

International Nursing Research Congress (INRC)

Purpose: To conduct a community-based needs assessment with Ghanaian caregivers of children with disabilities and collaboratively develop strategies to address identified gaps.

Methods: A community-based participatory action research approach, between a U.S. university’s global health initiative and the Africa Interdisciplinary Research Group, was used to engage Ghanaian community members including mothers from a cerebral palsy support group, a schoolteacher, a school board representative, pediatric and community health nurses, a psychiatric nurse practitioner, an orphanage caregiver, and a reverend overseeing the orphanage. Data were collected through focus groups or individual interviews. Thematic analysis identified core themes reflecting needs and community strengths, …

The Npso Model Decreased Hospital-Acquired Infections And Sustained The Clinical Outcomes, Hsin-Mei Chen, Shannan Hamlin, Vaibhav Unhelkar, Lydia Kavraki

International Nursing Research Congress (INRC)

The study revealed that patients with hospital-acquired infections (HAIs) experienced a length of stay (LOS) that increased from 3 days to 30 days (Stewart et al., 2021). Another study shows that a CAUTI case incurs an additional cost of $13,793, while a CLABSI case incurs an additional cost of $48,108 to the care (Forester et al., 2022).

In October 2021, our department received a request to mitigate the surge in CAUTI and CLABSI rates in Q3 2021. We reviewed the literature and designed standardized tools for skill validation. Then, we observed the nursing practice, identified the fallouts, and prepared an …

Leading Change In Healthcare: Building Systems, Retaining Nurses, And Creating Healthy Workplaces, Kaynabess Freda, Lisa A. Seldomridge, Crystal Devance-Wilson, Kimberly Hampton, Abigail Johnson

International Nursing Research Congress (INRC)

Nurse retention remains a significant international challenge, especially in acute care hospitals where workplace culture, belonging, and professional growth strongly influence retention (Lal, 2024; NursingSolutions, Inc., 2024). The need for effective retention strategies is amplified by factors such as the limited supply of experienced nurses causing hiring delays, declining enrollment in nursing programs, and an aging nursing workforce (AACN, 2024; WHO, 2025).

This presentation shares results from a collaboration among the Maryland Nursing Workforce Center, Lead Nursing Forward, and the Maryland Action Coalition to assess retention strategies in acute care hospitals. Two surveys were developed using the six Nurse Staffing …

Home-Based Digital Exergame For Children With Developmental Disabilities: Protocol Of A Pilot Study, Jaeeun Kang, Yoomi Shin, Naeun Park, Youngeun Lee, Anna Lee

International Nursing Research Congress (INRC)

Background: Compromised sensory integration, reflecting disruptions in neuroplasticity and commonly observed among children with developmental disabilities (DDs), is associated with difficulties in daily functioning and motor and social skills (Rodríguez-Armendariz et al., 2024). Interventions including sensory integration and exergame approaches have demonstrated benefits for enhancing neuroplasticity and functional outcomes (Cardenas et al., 2022). However, clinic-based sensory integration therapy often limits family involvement. We aim to develop and evaluate a home-based digital exergame for children with DDs and their families.

Purpose: This study describes the procedures for developing and assessing the feasibility and preliminary effectiveness of the digital exergame.

Methods: This …

Strengthening Community Health Nursing: A Scoping Review To Update National Practice Standards, Shannan Macnevin, Ruth Schofield, Manal Fseifes, Josephine B. Etowa

International Nursing Research Congress (INRC)

Community health nursing has evolved substantially since the Canadian Community Health Nursing Standards of Practice were last updated in 2019. Increasing health inequities, climate-related health challenges, expanded roles, and greater emphasis on culturally safe, trauma- and violence-informed, anti-racist, and equity-oriented approaches have reshaped how community health nurses support individuals, families, and communities (1–7). The COVID-19 pandemic further accelerated digital and hybrid models of care (8, 9), underscoring the need for updated Standards that reflect current practice realities. This review synthesized recent evidence to guide revisions.

A scoping review was conducted using Arksey and O’Malley’s framework (10) and reported according to …

The Influence Of Exercise On Cardiometabolic Risk In Perimenopause: A Systematic Review, Bibha Gautam, Deborah J. Clegg, Mary Madeline Rogge, Jeni Page

International Nursing Research Congress (INRC)

Purpose: Perimenopause is a biologically vulnerable period characterized by hormonal fluctuations, visceral fat accumulation, and increasing insulin resistance, factors that elevate cardiometabolic risk and contribute to the development of cardiometabolic syndrome (CMS), defined as the presence of three or more metabolic abnormalities. These changes reflect a continuum of metabolic vulnerability that may emerge before CMS becomes clinically detectable. Although regular exercise can mitigate this risk, limited evidence clarifies which exercise modalities are most effective in reducing metabolic risk and CMS prevalence among women undergoing the perimenopausal transition. Despite facing a distinct and often underrecognized vulnerability to CMS, perimenopausal women remain …

Leveraging Data To Facilitate Purposeful Culture Change, Felesia Bowen, Michele H. Talley, Nevette Sample, Maria Shirey

International Nursing Research Congress (INRC)

Background: Academic nursing environments face persistent challenges related to incivility and inclusivity (Bowen, Talley, Sample & Shirey, 2025) and recent studies have revealed negative correlations between incivility and inclusivity (Githens, 2011). Climate studies provide valuable insights into faculty, staff, and student experiences (Test, 2022), yet translating these findings into meaningful culture change requires intentional strategies.

Methods: Guided by principles of organizational change and healthy academic settings (Saunders, Sridaromont, & Gallegos, 2021), we analyzed climate study results to identify priority areas. A multidisciplinary team developed targeted interventions, including faculty and staff development workshops, student engagement forums, and policy revisions to address …

Stress, Stimulant Use, And Hypertension Among Lifetime Users With High Biobehavioral Dysregulation, Wonkyung Kniffen, Cory Crane, Victoria Pezzino, Caroline Easton

International Nursing Research Congress (INRC)

Stimulant use disorders are associated with cardiovascular morbidity, yet risk factors within users remain unclear. This study used latent class analysis (LCA) to identify biobehavioral dysregulation patterns and examine associations with perceived stress, stimulant use, hypertension, and comorbidity burden. Sequential associations from stress to stimulant use to hypertension were explored among individuals with high dysregulation.

We conducted a secondary analysis of NIH All of Us Research Program data from participants with lifetime stimulant use who completed surveys and had biometric and electronic health record data (N=1,480). Missing data were handled using multiple imputation. LCA identified dysregulation profiles based on sleep …

Can Ai-Generated Music Interventions Improve Health Outcomes? A Systematic Review, Nguyen Thi Khanh, Huu-Thanh Nguyen, Vi Do Pham Nhat, Carmen Wing Han Chan

International Nursing Research Congress (INRC)

Music interventions are effective for physical, psychological, cognitive and social well-being [1-3]. Artificial Intelligence (AI) can generate personalised therapeutic music instantly, creating a novel, accessible intervention. However, the effectiveness of these AI-generated interventions has not been systematically reviewed [4, 5]. This systematic review aimed to evaluate the efficacy of AI-generated music interventions for improving health outcomes.

A systematic search was conducted across eight electronic databases (Cochrane, Medline, APA PsycINFO, PubMed, Scopus, Web of Science, IEEE Xplore, ACM Digital Library) from inception to September 2025. After screening, eight studies (N=1,267 participants) met the inclusion criteria, comprising four randomised controlled trials (RCTs) …

A Grounded Theory Study Of Confidence Building Among Newly Graduated Nurses, Justin Fontenot, Fuqin Liu, Jincy Immanuel, Laura Kubin, Niki Fogg

International Nursing Research Congress (INRC)

Aim: To develop a grounded theory explaining how newly graduated nurses build professional confidence during their transition to practice.

Background: Professional confidence is crucial for newly graduated nurses, particularly when handling uncertainty, advocating for patients, and remaining in the workforce; however, confidence is often viewed as an individual trait or outcome, which limits understanding of how it develops in practice.

Methods: Constructivist grounded theory was employed. Twelve recently graduated nurses in acute care settings participated in in-depth semi-structured interviews. Data collection and analysis occurred simultaneously, utilizing constant comparison, line-by-line and focused coding, memo writing, and theoretical integration.

Results: The core …

The Influence Of Employment And Education On Contraceptive Use Among Women Of Childbearing Age, Shamoi K. Brown, Anatassia Harris, Kriss-Ann Wilson, Nicholai Levy, Pauline Anderson-Johnson

International Nursing Research Congress (INRC)

Background: Although the majority of women of child-bearing age utilize a modern contraceptive method, there is a significant gap in family planning highlighted by 164 million women having an unmet contraceptive need. The unmet need for contraception is attributed to multiple factors, with education and employment remaining key determinants of contraceptive use. This results in a steady rise in unintended pregnancies, unsafe abortions and maternal death.

Purpose: The purpose of this study was to determine the influence of employment and education level on contraceptive use among females aged 15–49 years in Jamaica.

Method: A secondary analysis was conducted using data …

Virtual Reality Training: Recognize Implicit Bias And Address Microaggressions In Nursing Education, Paige Ricca, Kathryn Vanderzwan, Antoinette Rosa, Rose Hernandez

International Nursing Research Congress (INRC)

Virtual reality (VR) simulations are gaining prominence as a method for diversity, equity, and inclusion (DEI) training in medical education but are seldom used in nursing programs. Although health-related programs in academic institutions have begun to address inclusion and bias, data suggest that racial climate remains a challenge in academic medical and nursing institutions. The main purpose of the study was to determine the feasibility and impact of DEI training for nursing students, faculty and clinical instructors. Two-10-minute VR simulations in a clinical and a classroom setting tailored for nursing faculty and students were developed to provide an immersive and …

Tending To Emotional Wellness Needs In A Baccalaureate Second-Degree Accelerated Nursing Program, Paulette Dorney, Shirley Guider, Elise M. Colancecco, Taylor L. Grube, Karen Diance Groller, Shelly Strauss

International Nursing Research Congress (INRC)

Background: Baccalaureate second-degree accelerated nursing (ABSN) programs have grown substantially as a response to needs for a qualified workforce. These programs are designed to prepare prelicensure nurses to enter the workforce in as little as 11 to 18 months. To maintain the rigor of traditional nursing programs, ABSN programs have demanding, compressed schedules. Recent literature has brought attention to the impact of academic demands on the emotional wellness experienced by traditional four-year prelicensure nursing students (Bernier-Carney, 2025; Vo et al., 2023) but has failed to review its impact in ABSN cohorts.

Aim: This qualitative descriptive research study aimed to describe …

The Equipp Framework: Achieving Quality Through Lnterprofessional Synergy, Lynn Gallagher-Ford, Lee Ann Strait, Cynthia D. Beckett, Karey Dufour

International Nursing Research Congress (INRC)

The purpose of the workshop is to introduce interprofessional clinicians, evidence-based practice (EBP) experts, and process improvement (Pl) experts to a new framework titled: Evidence-based Quality in Practice and Process Framework (EQUiPP). It is uniquely designed to provide structure and guidance to synergistically align EBP and Pl work to effectively improve and sustain outcomes. Use of the EQUiPP Framework decreases the frequency of implementing ineffective changes, saves time and money, and improves care and outcomes. The EQUiPP Framework integrates evidence-based practice and process improvement methods for sustained quality.

The content of the workshop will guide healthcare interprofessionals to effectively plan …

Strengthening Vaccine Confidence Among College Freshmen In The Post-Covid-19 Era, Karlen E. Luthy, Janelle L. B. Macintosh, Alyssa Vang, Janessa Johnson

International Nursing Research Congress (INRC)

The purpose of this study was to examine the effect of a vaccine education module (VEM) on college freshmen’s intended vaccination behaviors, vaccine-related perceptions, and vaccine knowledge. Although vaccine requirements for university students are a vital public health strategy, most institutions in the United States do not mandate all recommended immunizations. In today’s environment, where vaccine misinformation and hesitancy remain common, understanding how evidence-based education influences vaccine attitudes is increasingly important. A pre-COVID-19 study showed that a VEM improved students’ vaccine beliefs and intentions; this study assessed these outcomes in a post-COVID-19 context.

A pretest/posttest quasi-experimental design was used. Participants …

An Ai Driven Harm Response Management Tool To Prevent Adverse Events In Healthcare, Marion Claire Eckert, Greg Sharplin, Lachlan Darch, Georg Grossman

International Nursing Research Congress (INRC)

Introduction/Aim: The size, distribution, and skill mix of the nursing workforce are recognised drivers of patient outcomes, yet limited evidence exists on how workforce, clinical, and environmental variables interact to prevent harm. Despite extensive reporting systems, metropolitan hospitals continue to see rising rates of falls, medication errors, and violence, events typically identified only after they occur. This underscores the need to shift from retrospective surveillance to predictive, data-enabled harm prevention. The PreHaRM project, ‘Predictive Harm and Response Management’, aims to deliver this shift by implementing a predictive harm algorithm across South Australia’s two largest health networks, with potential for national …

Validation And Expansion Of The Hiv Care Adherence Journey Model: A Mixed Methods Research, Ryan Quintero De Torres, Floreliz V. Ngaya-An, Don Operario, Susan Cu-Uvin, Laurence Lloyd Parial, Josefina A. Tuazon

International Nursing Research Congress (INRC)

Previous models examined the cause-and-effect relationships of select constructs affecting HIV care and treatment adherence,^1,2 which may not reflect the complex, multidimensional nature of persons with HIV’s (PWH) care adherence in real-world settings, especially in the Philippines, with one of the highest rates of HIV and AIDS cases globally.³ The HIV Care Adherence Journey (HCAJ) Model⁴ presents four domains on PWH’s care adherence in relation to individual, social, and healthcare system characteristics. The present study aimed to validate this model by describing and comparing PWH’s perceived care adherence journey and adherence behaviors, and examining patterns in PWH’s …

Patterns Of Maternal Role Adaptation Among Chinese Postpartum Women: A Latent Profiles Approach, Feiyan Yi, Liping Ren, Sukhee Ahn, Xinxiang Dong, Guijun Liu

International Nursing Research Congress (INRC)

Background: Becoming a mother is a major developmental transition involving psychological, social, and behavioral adaptation, marking both identity reconstruction and changes in family dynamics [1-2], also influences infant development [3]. Existing studies in China mainly examine associations between Maternal role adaptation (MRA) and related variables, with limited attention to intra-group heterogeneity. This study applied latent profile analysis (LPA) to identify distinct MRA patterns and influencing factors among postpartum women.

Purpose: To explore latent subgroups of maternal role adaptation among Chinese postpartum women and identify associated sociodemographic, psychological, and social determinants.

Methods: A cross-sectional survey of 500 postpartum women (4–6 months …

Co-Design The “Foryou” Mhealth Survivorship Program With Colorectal Cancer Survivors, Do Pham Nhat Vi, Nguyen Thi Que Tran, Hoang Thi Xuan Huong, Zhou Shishuang, Wong Cho Lee

International Nursing Research Congress (INRC)

Despite advancements in early detection and treatment that have improved colorectal cancer (CRC) survival rates, post-treatment experiences often leave unmet needs that affect health-related quality of life. There is a pressing need for scalable approaches to provide care support for survivors who have completed primary treatment. This study aimed to involve CRC survivors and healthcare professionals in designing a mobile app named FORYOU. The co-design methodology employed a collaborative, user-centred approach to app development. Over 8 weeks, four user-centred design (UCD) sessions were conducted with five CRC survivors (end-users), four survivorship professionals, and one IT expert. Four essential design features …

Advancing Nursing Student Competence In Health Equity Through Global And Community-Based Learning, Catherine Quay, Shirley Etienne, Lori Hubbard, Jeanmarie Rampolla Koonts, Cyra Kussman

International Nursing Research Congress (INRC)

The purpose of this project was to revise and evaluate a scaffolded nursing curriculum designed to build health equity competence in prelicensure students. Responding to nursing education priorities, the curriculum prepares learners to address persistent health disparities within increasingly interconnected global and local systems. Guided by the AACN Essentials framework, the model integrates didactic coursework, community-engaged learning, and global experiential opportunities to deepen understanding of social and structural determinants of health, population health principles, and culturally responsive practice.

The introductory course develops foundational competence through critical self-reflection on cultural identity, implicit bias, and the influence of personal assumptions on care. …

Effects Of A Resilience-Focused Parenting Program In Childhood Cancer: A Randomized Controlled Trial, Yuna Shao, Ting Zhong, Aaron Wan Jia He, William Ho Cheung Li, Li Zhou, Ziqin Lin

International Nursing Research Congress (INRC)

Background: Caring for a child with cancer significantly impacts parents' psychological well-being [1]. Following diagnosis, parents face substantial adjustment challenges with high rates of depression, anxiety, and post-traumatic stress [2]. Although parents report extensive unmet supportive care needs, few effective approaches exist. Parental resilience, a modifiable determinant, can improve parental psychological well-being, parenting, and indirectly, child outcomes [3]. However, no rigorously developed, theory-based intervention targeting parental resilience exists in mainland China.

Objective: To develop and evaluate a parent-focused, resilience-based intervention (face-to-face or online) for Chinese parents of children aged 7-14 years newly diagnosed with childhood cancer, guided by the UK …

Nursing De-Escalation Interventions And Aggression Outcomes Using Dasa-Iv In Medical–Surgical Units, Suzanne Gervase, Heather A. Shirk, Felicia Markwordt, Theodore Bell, Bruno Saconi

International Nursing Research Congress (INRC)

Purpose: This study evaluated whether nursing de-escalation interventions implemented during routine care reduce subsequent aggression risk and aggressive behaviors among hospitalized adults on medical-surgical units.
Background: Violence toward healthcare personnel is increasingly common beyond traditional high-risk settings. Guidance encourages pairing validated aggression-risk assessments with risk-responsive, evidence-based interventions. However, evidence supporting such approaches in medical-surgical units remain limited, despite rising global attention to workforce safety.

Methods: This retrospective cohort study analyzed 277,221 Dynamic Appraisal of Situational Aggression-Inpatient Version (DASA-IV) assessments from six hospitals collected between March and December 2024. Descriptive statistics characterized intervention use across DASA-IV risk levels. Time-lagged linear mixed-effects …

Building Resilience In Public Health Centers: Outcomes Of An Enp-Led Disaster Program, Po-Hsi Su, Jun-Dai Lin, Yi-Hui Lee, Shun-Shiang Yu, Yi-Fen Liang

International Nursing Research Congress (INRC)

Taiwan, located along the Pacific Ring of Fire, experiences frequent earthquakes and typhoons while also facing geopolitical tension. Strengthening community resilience has therefore become essential. Public health centers serve as frontline agencies in disaster response, yet staff often lack formal training beyond infectious disease control. This study evaluated a disaster preparedness program developed and delivered by an emergency medicine nurse practitioner (ENP) for public health center personnel in central Taiwan.

From October 29 to November 22, 2024, five of 13 health centers in Nantou County participated. Centers selected staff expected to support post-disaster medical station operations. Participants represented six occupational …

Teaching Through Tension: Strategies For Navigating Sociopolitical Challenges In Nursing Education, Anthony Carney, Sharon Ann Taylor-Smalls, Stacia Birdsall, Donna Cill, Richard Dorritie

International Nursing Research Congress (INRC)

Nursing education is shaped by complex sociopolitical forces that challenge faculty as they teach essential yet often contested topics, including LGBTQ+ health, racism and structural inequities, reproductive care, and social determinants of health, for example. As public discourse, regulatory pressures, and cultural tensions intensify, faculty must navigate how to uphold ethical, evidence-informed teaching while cultivating psychological safety, academic rigor, and meaningful learner engagement. Guided by the Access, Community, and Engagement (ACE) priorities at NYU Rory Meyers College of Nursing, this workshop offers a globally adaptable, case-based approach for ethically and effectively facilitating sensitive or politicized content.

The session begins with …