The incidence of perinatal opioid use and neonatal withdrawal continues to rise rapidly in the face of the growing opioid addiction epidemic in the United States, with rural areas more severely affected. Despite decades of research and development of practice guidelines, maternal and neonatal outcomes have not improved substantially. This focused ethnography sought to understand the experience of accessing care necessary for substance use disorder recovery, pregnancy, and parenting. Personal accounts of 13 rural women, supplemented by participant observation and media artifacts, uncovered three domains with underlying themes: challenges of getting treatment and care (service availability, distance/geographic location, transportation, provider collaboration/coordination, physical and emotional safety), opportunities to bond (proximity, information), and importance of relationships (respect, empathy, familiarity, inclusion, interactions with care providers). Findings highlight the need for providers and policy makers to reduce barriers to treatment and care related to logistics, stigma, judgment, and lack of understanding of perinatal addiction.

African food was a connection to family and the African community. Food choices and activities were strongly influenced by accessibility, social structures, and the environment. Dietary and activity-based interventions should include both American and African influences.

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Heart failure is a chronic condition affecting many with an emphasis on self-management to improve outcomes and decrease the cost of care. A potential strategy to improve the self-management of heart failure includes the use of a patient portal. The purpose of this integrative review is to synthesize what is known about patient portal use by adults with heart failure to identify contributing factors for use and areas for future research. Within the three zones of the Health Information Technology Acceptance Model, predominant themes contributing to patient portal use were identified. Within the health zone, the predominant themes were physical and mental health, quality of life, and social interaction. Within the information zone, the predominant themes included knowledge about heart failure and self-care, information sharing, and communication. Within the technology zone, the predominant themes include the barriers and facilitators of patient portal use and overall usability. Overall, the patient perceptions of the patient portal can lead to the acceptance and use of the technology that can enhance self-management. Healthcare providers should partner with adults with heart failure to maximize the features of the patient portal to support self-management.