Ann Garwick

University of Minnesota | UMN · School of Nursing

The family social environment is the first environment that a child experiences and has implications for children’s health. However, the majority of family social environment measures do not account for its complexity. There is a need for novel approaches for assessing the family social environment that transcends the traditional way of measuring f...

Objective: Medical factors that put adolescents and young adults (AYA) with epilepsy at risk for poor health-related quality of life (HRQOL) are well-established. Less known is whether medical risk is associated with decreases in global psychological well-being and how self-management self-efficacy might contribute to resilience. The current study...

The family social environment is the first environment that a child experiences and has implications for children’s health. However, the majority of family social environment measures do not account for its complexity. There is a need for novel approaches for assessing the family social environment that transcends the traditional way of measuring f...

Rising levels of severe obesity among children, worsening disparities by race and ethnicity and reluctance of primary care clinicians’ to provide obesity management to children are compelling reasons to consider alternatives to primary care management of childhood obesity. The Students Nurses and Parents Seeking Healthy Options Together (SNAPSHOT)...

The purpose of this study was to explore school nurse perceptions of the nurse–family relationship in the care of elementary students with asthma and attention-deficit hyperactivity disorder (ADHD). A cross-sectional survey design was used to collect data from 97 school nurses in Minnesota. The Family Nursing Practice Scale measured nurses’ percept...

Background: Beliefs have been found to have an effect on how people deal with illness. Therefore, knowing healthcare practitioners' beliefs about specific high frequency illnesses are vital when caring for vulnerable populations such as school-age children with chronic illnesses or disorders. Aim: To psychometrically test the Iceland Health Care...

Background Research has demonstrated a significant positive association between frequent family meals and children’s dietary intake; however, the promotion of healthful family meals has not been rigorously tested for key food environment and nutrition-related behavioral outcomes in a randomized trial. Objective To describe family home food environ...

This research examined the experiences of families living with a child with severe autism. There is limited literature on the experiences of families when a child has severe autism as distinct from milder autism and includes the voices of multiple family members. Van Manen's phenomenological approach was used for data collection and analysis. This...

Aims: To evaluate predictors of healthcare satisfaction for parents whose children received hospital-based healthcare services at the Children's hospital at Landspitali University Hospital. Methods: In this cross-sectional study, data on perceived family support, family quality of life, expressive family functioning, coping strategies and health...

Family meal frequency has been shown to be strongly associated with better dietary intake; however, associations with weight status have been mixed. Family meals-focused randomized controlled trials with weight outcomes have not been previously conducted. Therefore, this study purpose was to describe weight-related outcomes of the HOME Plus study,...

The purpose of this study was to examine the likelihood of discussing health-related behaviors with health care providers (HCPs), comparing youth with and without mobility limitations (MLs). Analyses were conducted using baseline data from the MyPath study. Adolescents and young adults between the ages of 16 and 24 years completed a survey about th...

Involvement in meal preparation and eating meals with one's family are associated with better dietary quality and healthy body weight for youth. Given the poor dietary quality of many youth, potential benefits of family meals for better nutritional intake and great variation in family meals, development and evaluation of interventions aimed at impr...

The purpose of this study was to evaluate the effect of advanced practice registered nurse (APRN) telehealth care coordination for children with medical complexity (CMC) on family caregiver perceptions of health care. Families with CMC ages 2 to 15 years (N = 148) were enrolled in a three-armed, 30-month randomized controlled trial to test the effe...

Parents can play an important role in reducing their children's risk for teenage pregnancy and sexually transmitted infections, and in promoting sexual health during adolescence. The purpose of this study was to explore communication between parents, family members and young people and how it influences their romantic and sexual behaviours. Semi-st...

Little is known about the continuation of family meals from childhood to parenthood. This study aims to examine associations between parents' report of eating family meals while growing up and their current family meal frequency, routines, and expectations. Baseline data were used from the Healthy Home Offerings via the Mealtime Environment (HOME)...

Effective care coordination is a key quality and safety strategy for populations with chronic conditions, including children with medical complexity (CMC). However, gaps remain in parent report of the need for care coordination help and receipt of care coordination help. New models must close this gap while maintaining family-centered focus. A thre...

AimTo identify and compare how school nurses in Reykjavik, Iceland and St. Paul, Minnesota coordinated care for youth with asthma (ages 10–18) and to develop an asthma school nurse care coordination model.Background Little is known about how school nurses coordinate care for youth with asthma in different countries.DesignA qualitative descriptive s...

ContextEvidence about long-term effects of preventive health services for youth with complex needs is lacking. Prime Time, a youth development intervention, aims to reduce pregnancy risk among vulnerable adolescent females seeking clinic services.Methods In a randomized trial, 253 sexually active females aged 13–17 who were at high risk for pregnan...

Informed and engaged parents and healthful home environments are essential for the health of youth. Although research has shown health benefits associated with family meals, to date, no randomized controlled trial (RCT) has been developed to examine the impact of a family meals intervention on behavioral and health outcomes. Methods/Design The Heal...

The study of physical performance in children with cancer is emerging as an important variable in symptom research. Studies have shown that children with cancer experience deficits in physical performance during treatment that may be present years after therapy. The aim of this study was to determine if distance on the 6-minute walk test (6MWT) cha...

Care coordination is an essential component of the pediatric health care home. This study investigated the attributes of relationship-based advanced practice registered nurse care coordination for children with medical complexity enrolled in a tertiary hospital-based health care home. Retrospective review of 2,628 care coordination episodes conduct...

Introduction: Recent evidence demonstrates increasing rates of involvement with violence among adolescent girls. The objective of this study was to describe the types and sources of violence experienced within social contexts of adolescent girls at high risk for pregnancy. Method: Qualitative data for this analysis are drawn from intervention su...

Prime Time, a youth development intervention, aims to reduce multiple risk behaviors among adolescent girls seeking clinic services who are at high risk for pregnancy. The purpose of the current study was to examine whether Prime Time involvement produced changes in relational aggression, physical violence, and related psychosocial and behavioral o...

Importance Preventing early pregnancy among vulnerable adolescents requires innovative and sustained approaches. Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic services who are at high risk for pregnancy. Objective To evaluate sexual risk behaviors and related outcomes with a 24-mon...

Background: Initiation of sexual intercourse during early adolescence is a known risk factor for teen pregnancy and sexually transmitted infections. Purpose: To examine young women's stories describing peer influences on their romantic and sexual decisions and behavior during early adolescence. Methods: Semistructured ethnographic interviews were c...

Background To increase understanding of the healthcare transition (HCT) process for young people living with Juvenile Idopathic Arthritis (JIA) by examining: 1) the extent to which youth report discussing HCT topics with their rheumatologist and 2) the association between youth perceptions of autonomy support from their rheumatologist and HCT discu...

Background: In many schools, school nurses screen students' height/weight and report body mass index information to parents. However, little is known about parent interest in school-based, school nurse-led programming targeting healthy weight management. Purpose: To examine associations between parental concern about child weight and child weight s...

This qualitative study aims to identify what urban American Indian family caregivers think that health and education providers who work with children with chronic conditions should know about Indian culture. The volunteer, convenience sample included 30 American Indian families (27 Ojibwe; 2 Lakota; 1 Dakota) in a large Midwestern city who care for...

Meaningful use of electronic health records to coordinate care requires skillful synthesis and integration of subjective and objective data by practitioners to provide context for information. This is particularly relevant in the coordination of care for children with complex special healthcare needs. The purpose of this article is to present a con...

This article is a report of an international study of barriers to asthma care from the perspectives of school nurses in Reykjavik, Iceland and St. Paul, Minnesota, in the context of their schools, communities and countries. Globally, asthma affects the health and school performance of many adolescents. School nurses play a key role by providing car...

To examine self-reported use and correlates of complementary and alternative medicine (CAM) in adolescents with juvenile arthritis (JA). One hundred thirty-four adolescents with JA completed an online survey of their use of, interest in, and discussions about CAM. The PedsQL 4.0 SF15 assessed quality of life. The majority (72%) of youth reported us...

Evaluating interventions for reducing unintended adolescent pregnancy is necessary to ensure quality and efficacy. The purpose of this study was to examine core case management practices and processes for engaging high-risk girls in Prime Time, an intensive multi-component intervention from the perspectives of intervention program staff. Structured...

To explore the dietary factors that contribute to bone health among first generation Somali girls and to determine the social and cultural contexts that shape these health behaviors. Findings presented are from a larger, descriptive qualitative study that used a series of focus groups with four cohorts of 11- to 14-year-old Somali girls (n= 39) liv...

Efficiency and effectiveness of care coordination depends on a match between the needs of the population and the skills, scope of practice, and intensity of services provided by the care coordinator. Existing literature that addresses the relevance of the advanced practice nurse (APN) role as a fit for coordination of care for children with special...

Programs to support youth with chronic conditions as they transition to adulthood and from pediatric to adult healthcare are being developed and disseminated. Yet the evidence base to support these programs is generally lacking. In response to the need for theoretically grounded youth focused programs we developed Rheumtogrow.org, an internet based...

To examine the relationship between physical performance and fatigue in child and adolescent cohorts during the first three cycles of chemotherapy. Prospective, observational design. Two pediatric cancer centers in the upper Midwest region of the United States. 16 children and 14 adolescents newly diagnosed with cancer. Standardized instruments wer...

The objective of this study was to identify challenges that teens experience while living with juvenile arthritis (JA) from the perspective of youth and young adults with JA. Focus group interviews were conducted with youth (aged 14-21 years) and young adults (aged 22-29 years) with JA using a semi-structured interview protocol that included questi...

Prime Time, a youth development intervention, aims to reduce pregnancy risk among adolescent girls seeking clinic service who are at high risk for pregnancy. This article examines sexual risk behaviors and hypothesized psychosocial mediators after 12 months of the Prime Time intervention. This study was a randomized controlled trial with 253 girls...

To provide a description of Prime Time, an intervention to reduce pregnancy risk behaviors among high-risk adolescent girls. Prime Time, a clinic-based, multicomponent youth development intervention aims to reduce sexual risk behaviors, violence involvement, and school disconnection. We highlight key considerations in conceptualization, design, and...

To describe aspects of the social context that low-income, urban African American young women articulate as having influenced social messages they received during adolescence about pregnancy timing and childbearing. Individual interviews were conducted with 20 African American young women ages 18-22. Findings clustered into 5 themes: first sex; get...

To conduct focus groups to identify parents' perceptions of barriers to family meals and elucidate ideas to guide the development of interventions to overcome barriers. Focus groups were conducted with a convenience sample of 27 working parents in urban community settings. Parents reported enjoying the sharing/bonding at meals, but they reported li...

The purpose of this article is to illustrate strategies used to design and implement a family-centered, participatory action research (PAR) project to meet the asthma information needs identified by English-, Hmong-, and Spanish-speaking parents of preschool children with asthma enrolled in a multisite, urban Head Start program. PAR is an approach...

To develop an action plan based on asthma management challenges identified by Head Start teachers in a multisite program. Qualitative, participatory action research project. Three focus groups were conducted with Head Start teachers (n=14), and 1 with Center managers (n=15) in an urban Midwestern program. Brief background questionnaire and semistru...

The use of culturally sensitive research approaches is of paramount importance in conducting community-engaged research with African American communities. The purpose of this article is to describe the development and use of culturally and community sensitive research methods in a study to understand social messages about pregnancy and childbearing...

The primary objective was to develop and test the feasibility and acceptability of the Healthy Home Offerings via the Mealtime Environment (HOME) program, a pilot childhood obesity prevention intervention aimed at increasing the quality of foods in the home and at family meals. Forty-four child/parent dyads participated in a randomized controlled t...

The growing prevalence of chronic conditions in childhood underscores the urgent need to educate pediatric nurse leaders to address the complex issues these children and families face. This article describes a model of graduate education for preparing pediatric nurse leaders who are equipped to manage and advocate for these children and families. F...

The health care model presented in this paper is a non-linear, systems approach to service delivery. The model was a by-product of three ethnic-specific conferences that were convened to discuss strategies for improving access to care and the quality of services provided to children with special health care needs (CSHCN) from diverse cultural backg...

American Indian adolescent pregnancy rates are high, yet little is known about how Native youth view primary pregnancy prevention. The aim was to identify pregnancy prevention strategies from the perspectives of both male and female urban Native youth to inform program development. Native Teen Voices (NTV) was a community-based participatory action...

To determine the proportion of adolescents with arthritis who receive health care transition services and to compare the rates with those reported for adolescents with other special health care needs and adolescents with diabetes. We used data from the 2005-2006 National Survey of Children with Special Health Care Needs. A parent/guardian identifie...

We examined the correlates of having ever had sexual intercourse among American Indians aged 13 to 18 years in Minnesota. To assess key environmental, social, and individual correlates of sexual experience, we analyzed data from 4135 American Indian youths who participated in the 1998 and 2001 Minnesota Student Surveys. Forty-two percent of those a...

The purpose of this interpretive descriptive study was to describe how eight Black-White couples with school-aged children constructed their interracial family identity through developmental transitions and interpreted race to their children. Within and across-case data analytic strategies were used to identify commonalities and variations in how B...

This descriptive qualitative study compared how 18 teens (aged 14-16 years) with higher (n = 11; HiA(1c)) versus those with lower (n = 7; LoA(1c)) hemoglobin (Hb) A(1c) levels who met the standard of care viewed parental roles and involvement in diabetes management. Content analysis of the verbatim interview transcripts yielded five major themes. T...

This article describes a preliminary qualitative evaluation of risk and protective factors associated with consistent contraceptive use and healthy sexual decision-making among ten of the first participants in the Prime Time intervention study. Prime Time is an 18-month intervention including one-on-one case management and peer educator training ta...

The focus of this literature review is on family identity formation within a social cultural context for families, couples, and women who are in committed Black-White interracial relationships that include biracial children. This review and synthesis of interdisciplinary literature was limited to U.S. research studies completed between 1990 and 200...

With the current and ever-growing shortage of nurses in the United States, it is imperative that nurses find ways to prevent burnout and effectively manage compassion fatigue that can result from working with traumatized populations. The aim of this study is to identify the triggers and coping strategies that nurses who work with children with chro...

Community-based research projects are critically needed to reduce health disparities and ensure the delivery of health care that is culturally appropriate and relevant to families and communities. The purpose of this article is to share experiences and lessons learned from utilizing a participatory action approach in a series of five subprojects wi...

American Indian family caregivers of children with asthma face numerous barriers to effective management of the illness. The purpose of this qualitative, community-based study is to identify those barriers as perceived by family caregivers in a large Midwestern city. An ecological perspective and principles of family-centered care provided the theo...

Care coordination is a process that involves assessment, planning, implementation, evaluation, education, monitoring, support, and advocacy. Pediatric nurse practitioners (PNPs) are well positioned to coordinate care but may not be well educated about potential conflicts of interest in balancing cost-containment constraints with obtaining maximum q...

A community-based needs assessment was conducted to identify urban American Indian family caregivers' perceptions of the quality of care they received for their children with chronic conditions. Thirty family caregivers in a large midwestern city completed the What Do You Think? Survey. One third of the participants thought their child's providers...

To describe the sociocultural patterns that promote breastfeeding or weaning in the Ojibwe community, which has very low breastfeeding rates compared to the general population. A focused ethnographic approach with an ecological framework provided community level data. Semi-structured interviews (N = 52) were conducted in an urban Ojibwe community a...

This study aims to identify the relationship between the degree of uncertainty in the preadolescent’s chronic condition and family distress. In-home interviews were conducted with 99 mothers and 86 fathers of 99 preadolescents with chronic physical health impairments. Preadolescents were divided into separate groups, first based on the predictabili...

This qualitative study investigated the wishes and expectations that parents had for their children with chronic physical health conditions. Participants included parents of 21 African American, 20 Hispanic, and 22 European American children. Results indicated that many parents' wishes were specifically related to the child's chronic condition, inc...

The University of Minnesota School of Nursing aims to fully incorporate comple mentary and alternative health philosophy and healing practices into its baccalau reate, master's and doctoral programs. A planning process (1998-99) included School of Nursing faculty, administrators, and representatives of the university's Center for Spirituality and H...

The objective of this study was to identify the relationship between the degree of uncertainty in the child’s chronic condition and family distress. Data were collected from parents (173 mothers, 150 fathers) of young children (12 to 30 months old) who had been diagnosed with a chronic physical health impairment within the past 12 months. Children...

Little is known about physicians' perceptions of the influence of culture on the health care of children with chronic and disabling conditions. To identify physicians' perceptions of the impact of the family's ethnocultural background on the health care of school-aged children with chronic conditions and recommendations for improving care. Qualitat...

Background Little is known about physicians' perceptions of the influence of culture on the health care of children with chronic and disabling conditions.Objective To identify physicians' perceptions of the impact of the family's ethnocultural background on the health care of school-aged children with chronic conditions and recommendations for im...

This document reports on a 1998 conference of some 30 parents, educators, social workers, advocates, physicians, nurses, and social scientists who met to develop an action plan for improving the quality of services and cultural competence of providers of services to children with special health care needs from diverse cultural backgrounds. The conf...

To identify parents' perceptions of helpful vs unhelpful types of social support received in managing the care of preadolescents with chronic conditions. Multimethod cohort study with 1-year follow-up. General community. Volunteer, consecutive sample of parents of 124 preadolescents with a variety of chronic conditions. In-depth, in-home interviews...

Little research has been done on services and programs for children with chronic conditions and their families from the perspective of family caregivers from diverse cultural backgrounds. To identify recommendations that urban caregiving families from 3 major ethnocultural backgrounds have for improving the care of children with chronic conditions...

We questioned parents of 182 young children with a variety of chronic health conditions concerning the amount of emotional, informational, and tangible social support they received from the family, community, and service providers. We also asked parents to describe nonsupportive or hurtful behaviors received from family or community members. Both m...

To compare body dissatisfaction and unhealthy weight-loss practices among adolescents with and without chronic illness. Survey. The sample consisted of 2149 adolescent boys and girls with diabetes, asthma, attention deficit disorder, physical disabilities, or seizure disorders; and a comparison group of 1381 adolescents without chronic illness. Bod...

Data about health and educational services were collected from 187 families with young children (under two years) who have chronic illnesses and disabilities. The purpose was to assess parents' satisfaction with services their families received and to identify families' unmet service needs as well as the reasons for these unmet needs. Although fami...

To develop recommendations for effectively informing families about their child's chronic illness or disability. The sample included 43 families of infants with Down syndrome and/or congenital heart disease who were participating in Project Resilience, which is a multisite longitudinal research project. Family interviews were transcribed verbatim a...

Objective: To develop recommendations for effectively informing families about their child's chronic illness or disability.Methods: The sample included 43 families of infants with Down syndrome and/or congenital heart disease who were participating in Project Resilience, which is a multisite longitudinal research project. Family interviews were t...

The purpose of this study was to identify the major themes that 38 multigenerational families emphasized in their conversations about living with Alzheimer's disease. Interviews were conducted with families that were providing home care in the early stages of the disease. Family perceptions were analyzed with the aid of a computer content analysis...

Major stressful life events, particularly those that have chronic hardships, create a crisis for families that often leads to reorganization in the family's style of functioning. A major factor in this reorganization is the meaning the family gives to the stressful event. Often the meaning extends beyond the event itself and leads to a changed view...

In this article, a family systems theoretical framework is described for understanding the reciprocal relationships between chronic illness in a family member and the structure and functioning of the family system. The reciprocal impacts between the illness, individual development, and family functioning continue dynamically in a circular pattern o...

Investigated how Hispanic, African-American, and European-American caregiving families explain the cause of childhood chronic illness or disability and the extent to which indicators of resilience are evident in these explanations. The data for this study were drawn from the Cross-Cultural Meanings of Chronic Disability project and were collected t...