Recruitment and retention of low-income African Americans in clinical trials is challenging. This paper reports recruitment and retention strategies that yielded high rates for both in a clinical trial pilot to improve hypertension self-management among low-income African Americans. The study successfully recruited 96.7% (59 of 61 participants) within a seven month period. Retention rates for the 1, 3, and 6-month post-baseline assessment visits were 91.5%, 88.1%, and 83.1%, respectively. Recruitment and retention strategies include two grounded in previous literature: a culturally sensitive and diverse research team and use of incentives. Four additional strategies were developed for this study to meet the needs of the study site and participants, which included: study site collaboration; ongoing communications; responding to the clinical environment; and addressing participants' health literacy levels. A discussion of key recruitment and retention strategies and suggestions for future studies focused on low-income African American participants ensues.

Background: There is limited evidence on the association between psychological distress, academic stress, and burnout among Saudi nursing students. Clarifying such an association is crucial to understanding the factors associated with psychological distress and developing interventions to prevent it. Aim: To explore the prevalence and association of psychological distress with academic stress and burnout among Saudi nursing students. Methods: A cross-sectional design was used, and 237 students participated from a nursing college in Riyadh, Saudi Arabia. Students’ demographics; the Depression, Anxiety, and Stress Scale; the Academic Stress Inventory; and the Maslach Burnout Inventory were used for data collection. Results: Most of the participants reported no-to-mild depression, anxiety, and stress. Stress related to studying in groups, time management, emotional exhaustion, depersonalization, and personal accomplishment were the significant predictors of psychological distress, explaining 52.1% of the variance. Conclusions: This study suggest implementing tailored mental health screenings and support services for nursing students, embedding mental health professionals in the program, and using telehealth or mobile apps for remote monitoring to ensure comprehensive care for nursing students. Future research should consider these predictors while designing strategies to decrease psychological distress among students.

Background: Caring behavior is a major focus of the nursing profession and an important dimension of nursing practice that sets nurses apart from other healthcare professionals. Effective patient-centered care requires ensuring nurses have the emotional intelligence and happiness to address the daily demands of practice. The purpose of this study is to examine the emotional intelligence and happiness among nursing students and their relationship with caring behaviors. Methods: A cross-sectional, descriptive correlational study was conducted on nursing students (n = 363) from Riyadh, Kingdom of Saudi Arabia, via an online survey. Measures include demographic data survey, Oxford Happiness Questionnaire, Trait Emotional Intelligence Questionnaire, and Caring Behaviors Inventory scale. Descriptive and multiple regression analyses were conducted for this study. Results: Nursing students reported their highest degree of caring was in terms of ‘respectful differences to others’, while their lowest was in ‘knowledge and skills’. Emotional intelligence and happiness were significant predictors of caring behaviors and explained the variance in assurance of human presence (17.5%), knowledge and skills (17.5%), respectful differences to others (18%), and positive connectedness (12.9%). In the final regression model, emotional intelligence and happiness were significant predictors of caring behaviors and explained 19.5% of the variance. Conclusions: Emotional intelligence and happiness among nursing students were found to be important factors to improve their caregiving behaviors. Therefore, nursing educators should consider integrating emotional intelligence and happiness interventions for students into their curriculum.

Sarcopenia is a major source of disability in older adults. However, limited data are available about sarcopenia components (i.e., muscle mass, strength, and function) and their relationship to psychosocial factors among older adults living in residential care apartment complexes (RCACs). The current study examined muscle mass, strength, and function and explored their relationship to self-efficacy for exercise, depressive symptoms, and social support in 31 RCAC residents. RCAC residents had lower muscle mass, strength, and function compared to values reported in studies of community-dwelling older adults. Men had higher muscle mass and strength than women. The current findings showed a trend for individuals with high self-efficacy, without depressive symptoms, and with strong social support to present numerically greater muscle mass, strength, and function. Further studies with larger samples are needed to confirm the current study findings and inform development of interventions implemented in RCAC settings. [Res Gerontol Nurs. 2018; 11(5):238–248.]

Malnutrition–sarcopenia syndrome (MSS) might put older adults at higher risk for disability, frailty, and mortality. This study examined the prevalence and association of the self-management-process factors (i.e., self-efficacy and aging expectations) and behaviors (protein and caloric intake and sedentary and physical-activity behaviors) to MSS among older adults living in continuing care retirement communities (CCRCs). Using a cross-sectional correlational design, data of 96 CCRC residents (82.4 ± 7.4 years) were analyzed. Muscle mass, strength, function, nutritional status, sedentary time, physical activity levels, protein and caloric intake, self-efficacy for physical activity, aging expectations, and physical and mental health-related quality of life were measured. Results show that 36 (37.5%) had sarcopenia, 21 (21.9%) had malnutrition risk, 13 (13.4%) had malnutrition, and 12 (12.5%) had MSS. We also found that high time spent in sedentary behaviors (OR = 1.041; 95% CI: 1.011–1.071) was associated with higher odds of having MSS and high expectations regarding aging (OR = 0.896; 95% CI: 0.806–0.997) were associated with less likelihood of having MSS. Findings suggest that CCRC residents should be screened for MSS. Self-management interventions that consider the self-management-process factors are needed to prevent MSS and mitigate its negative outcomes among CRCC residents.