Background African American women have disproportionately higher rates of breast cancer (BC) mortality than all other ethnic groups, thus highlighting the importance of promoting early detection. Methods African American women (N = 984) from San Diego, California participated in a randomized controlled trial testing the efficacy of BC education sessions offered in beauty salons. Cosmetologists received ongoing support, training, and additional culturally aligned educational materials to help them engage their clients in dialogues about the importance of BC early detection. Posters and literature about BC early detection were displayed throughout the salons and cosmetologists used synthetic breast models to show their clients how BC lumps might feel. Participants in the control group received a comparable diabetes education program. Baseline and six month follow-up surveys were administered to evaluate changes in women’s BC knowledge, attitudes and screening behaviors. Results This intervention was well received by the participants and their cosmetologists and did not interfere with, or prolong, the client’s salon visit. Women in the intervention group reported significantly higher rates of mammography compared to women in the control group. Training a single educator proved sufficient to permeate the entire salon with the health message and salon clients agreed that cosmetologists could become effective health educators. Conclusions Cosmetologists are in an ideal position to increase African American women’s BC knowledge and adherence to BC screening guidelines.

Pain is an important issue in quality of care and is increasingly cited as an outcome used to evaluate effectiveness of nursing care. Research indicates that nurses are not well prepared to care for patients with pain. Thus many patients are inadequately assessed and treated and consequently receive less than optimal pain management. The article describes the development, implementation, and evaluation of a pain education program designed to provide clinical nurses with the knowledge necessary to use appropriate pain management techniques. Program content stresses the use of a performance improvement framework for changing clinical practice in individual clinical settings.

This paper discusses issues to be considered by nurse researchers when groups should be used as a unit of randomization. Advantages and disadvantages are presented, with statistical calculations needed to determine effective sample size. Examples of these concepts are presented using data from the Black Cosmetologists Promoting Health Program. Different hypothetical scenarios and their impact on sample size are presented. Given the complexity of calculating sample size when using groups as a unit of randomization, it's advantageous for researchers to work closely with statisticians when designing and implementing studies that anticipate the use of groups as the unit of randomization.