To protect children from the negative effects of ETS exposure, nurses should discuss not only if parents smoke but also if family members and friends are allowed to smoke in the home. It would be helpful to assess the priority that parents set on ETS and how they attempt to prevent it in their daily lives.

Although school-based health centers (SBHCs) deliver health care to vulnerable children, their effectiveness has not been well documented. This study compared the benefits of an SBHC with a School Health Survey and selected HEDIS measures in preschool children with and without access to an SBHC. Preschoolers with access to an SBHC (N = 130) and preschoolers without access (N = 131) were compared on (a) HEDIS measures including well-child care, immunizations, dental care, and smoke exposure; (b) measures of access and use of physical and mental health services; (c) satisfaction with health care; (d) barriers and facilitators to care; and (e) health insurance. Significant differences were found in parents' perceptions of children's physical and emotional health, self-esteem, incidence of behavioral problems, difficulty in obtaining care, number of hospitalizations, and satisfaction with care received. Findings suggest that holistic services provided by an SBHC positively impact the health of vulnerable preschool children.

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This project demonstrates the challenges of altering the nutritional status of children in a homeless shelter. Despite mothers showing better knowledge of nutritional requirements for children, the types of food served in the cafeteria were an obstacle to them in practicing what they had learned. The cafeteria staff's ability to demonstrate their learning was impeded by the constraints of food donations. Educational strategies may need to be augmented by policies to improve the nutritional status of children in homeless shelters.

Background: Educational strategies are needed to prepare nurses to become sophisticated consumers of information and to apply that information in practice. Expertise in problem solving and clinic decision making skills is necessary if nurses are to function effectively in an increasingly complex health care environment. RNs entering programs leading to bachelor degrees (RN-BSN) have basic skills but need opportunity to develop higher level creative problem solving and critical thinking skills. The purpose of this article is to investigate the use of the “unfolding case study” as an innovative strategy to increase clinical decision making and problem solving skills in participants in a public health course in an online nursing program.

Methods: Participants in a public health nursing course were assigned to develop a case study over time integrating concepts of chronic illness with public health nursing. This problem based learning method supported adult learning principles of motivation, autonomous learning, and application to practice, all elements of online learning. The unfolding case studies were evaluated using a rubric to insure that participants completed course objectives. A survey, administered at the end of the course, provided feedback on perceptions of learning using this strategy.

Results: All students successfully completed the unfolding case study over a four week period through which they demonstrated integration of knowledge and application in the clinical setting. Feedback provided by participants confirmed an increase in knowledge of public health nursing, creative problem solving, and the ability to apply concepts of chronic illness using a public health framework.