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Background The American Association of Colleges of Nursing (AACN) and the Future of Nursing 2030 report emphasize the need for nursing students' competence in disaster care. Academic service-learning is a practical pedagogical approach for developing these skills that bolsters population health and leadership competencies. Method The Red Cross developed nine Academic Service-Learning (AS-L) modules that integrate training and hands-on experiences in disaster preparedness, response and recovery, well-being, diverse blood donation, case management, and immunizations and global health. Self-scored pre- and postquestions were developed to assess students' knowledge and confidence in skill application. Results Ongoing evaluation shows promising preliminary results in student learning and community engagement. Active faculty participation significantly improved student learning outcomes. Conclusion The Red Cross AS-L initiative augments nursing students' disaster and community health competencies through practical training and immersive experiences that align with evolving health care needs and AACN competencies. [J Nurs Educ. 2025;64(4):265–268.]

Background Despite the importance of social determinants in health outcomes, little is known about the best practices for screening and referral during clinical encounters. This study aimed to implement universal social needs screening and community service referrals in an academic emergency department (ED), evaluating for feasibility, reach, and stakeholder perspectives. Methods Between January 2019 and February 2020, ED registration staff screened patients for social needs using a 10-item, low-literacy, English-Spanish screener on touchscreens that generated automatic referrals to community service outreach specialists and data linkages. The RE-AIM framework, specifically the constructs of reach and adoption, guided the evaluation. Reach was estimated through a number of approaches, completed screenings, and receipt of community service referrals. Adoption was addressed qualitatively via content analysis and qualitative coding techniques from (1) meetings, clinical interactions, and semi-structured interviews with ED staff and (2) an iterative “engagement studio” with an advisory group composed of ED patients representing diverse communities. Results Overall, 4608 participants were approached, and 61% completed the screener. The most common reason for non-completion was patient refusal (43%). Forty-seven percent of patients with completed screeners communicated one or more needs, 34% of whom agreed to follow-up by resource specialists. Of the 482 participants referred, 20% were reached by outreach specialists and referred to community agencies. Only 7% of patients completed the full process from screening to community service referral; older, male, non-White, and Hispanic patients were more likely to complete the referral process. Iterative staff ( n = 8) observations and interviews demonstrated that, despite instruction for universal screening, patient presentation (e.g., appearance, insurance status) drove screening decisions. The staff communicated discomfort with, and questioned the usefulness of, screening. Patients ( n = 10) communicated a desire for improved understanding of their unmet needs, but had concerns about stigmatization and privacy, and communicated how receptivity of screenings and outreach are influenced by the perceived sincerity of screening staff. Conclusions Despite the limited time and technical barriers, few patients with social needs ultimately received service referrals. Perspectives of staff and patients suggest that social needs screening during clinical encounters should incorporate structure for facilitating patient-staff relatedness and competence, and address patient vulnerability by ensuring universal, private screenings with clear intent. Trial registration ClinicalTrials.gov, NCT04630041 .

Abstract National pediatrics guidelines recommend screening all patients for unmet social needs to improve self-management of chronic conditions and health outcomes and to reduce costs. Practitioners involved in training pediatric clinicians need to understand how to prepare pediatric clinicians to effectively conduct social needs screening and where current training methods fall short. Our qualitative study investigated whether using “standardized” patients during trainee education improved trainees’ ability to assess and address adolescent patients’ social needs. Vulnerable adolescents should be prioritized in social determinants of health translational research because increased risk taking and emotionality may predispose this population to lower self-esteem and self-efficacy. We trained 23 adolescents (aged 16–18) recruited from an urban health-career education program to act as standardized patients (SPs). Two cohorts of nurse practitioner trainees (n = 36) enrolled in a simulation where the patient-actor presented with a minor chief complaint and related a fabricated complex social history. Pre-encounter, Cohort 1 (n = 18) reviewed psychosocial screeners; Cohort 2 (n = 18) were given in-depth information about social needs before meeting patients. SPs gave individualized feedback to trainees, and self-reflections were analyzed using thematic analysis. In Cohort 1, trainees identified some social needs, yet few intervened. Trainees expressed discomfort in: (a) asking socially sensitive questions and (b) triaging patient versus clinician priorities. Cohort 2 demonstrated improvements compared to Cohort 1 in identifying needs yet had similar difficulty with organization and questioning. Trainees were able to utilize a lower-stakes interaction with patient-actors to raise awareness regarding a patient’s sensitive needs and to organize care surrounding these patient-centered concerns. Simulations that use realistic adolescent standardized patients significantly help trainees improve their interpersonal communication with teens and their comfort with assessing social needs.

Emergency departments see a disproportionate share of low-income and uninsured patients. We developed and evaluated a process for identifying social needs among emergency department patients, for facilitating access to community-based resources, and for integrating clinical and community-based data. We leveraged an academic-community partnership to develop a social needs screening tool and referral process. In a 25-day feasibility trial incorporating rapid improvement cycles, emergency department staff screened 210 patients for social needs. Observational and interview notes were analyzed, and data were linked from patient screenings, the United Way of Salt Lake 2-1-1 consumer information system, and electronic health records. Domains uncovered during pilot testing included screening based on appearance or insurance; discomfort asking stigmatizing questions; and lack of clarity regarding the screening's purpose. During the trial, 61% (n = 129) of patients reported 1 or more need, 52% (n = 67) of whom wanted follow-up. Of the 65 patients with complete data who wanted referrals, 49% (n = 32) were ultimately reached by 2-1-1, which provided an average of 4 community referrals (eg, pharmacy programs, utility assistance). Service usage 3 months before versus 3 months after emergency department index dates demonstrated that patients with social needs experienced a significant increase in emergency department use compared with those without needs (1.07 vs 1.36, P = .03), while patients with no needs experienced increases in primary care visits compared with those patients with unmet needs (0.24 vs 0.56, P = .03). We demonstrated the ability to systematically screen and refer for emergency department patients' unmet social needs by using existing resources and to link screening results, service referral details, and health service data. However, our experiences demonstrate that widespread implementation efforts should thoughtfully address staff perceptions and patient communication challenges.

This exploratory secondary analysis study aims to identify factors associated with suicidal ideation in college students, and then explores and predicts how these contributors operate within a conceptual model using a national dataset from the 2018-2019 Healthy Minds Study (n=11,337). The testing data subset was overlaid on a conceptual model adapted from Integrated Motivational-Volitional Model that includes demographic, clinical, and contextual factors, and then analyzed using partial least squares structural equation modeling. The resulting model performed acceptably at identifying relevant phenomena and explained approximately 23% of the variance in suicidal ideation in the sample but lacked adequate predictive value. All pathways were significant and reflective of the current literature with good composite and internal reliability, as well as high convergent validity and discriminant validity. The model was validated on the second data subset and well-demonstrated by subsamples of select age-based cohorts. In conclusion, while we were able to apply an adapted IMV framework to evaluate risk factors for suicidal ideation among college students, the study was limited by secondary analysis and a priori model design. As such, we were unable to confirm or reject the IMV as a conceptual model but were able to lay a novel groundwork for future learning algorithms in suicidology by highlighting an innovative methodology, as well as significant pathways and relationships between indicators of risk.