As the editor, I am occasionally asked "Why did this group of authors get published in JAANP?" This is always in response to a writing team that is not led by, or perhaps does not include, a nurse practitioner (NP) author. Similarly, questions arise about whether certain subject matter is appropriate for an NP population. I can understand these questions, because a primary purpose of our organization, AANP, is to promote the NP role, and at times, the connection to that role may not seem as direct. Recall that our journal aim is "to be the leading research-based scientific journal providing cutting edge information in practice, education, advocacy, research, and leadership for all nurse practitioners (NPs) and others with an interest in the nurse practitioner role (emphasis added)."

Although our focus is always on topics that concern NPs in their multiple roles, we also want to acknowledge that NPs can and should be leaders of interdisciplinary teams in every setting. In considering how to support NPs in leadership roles, we all recognize that we will not get there by taking an insular approach to manuscript consideration. A broad variety of writers express an interest in publishing in JAANP, and the more we learn about these writers and their work relating to NPs, the better equipped we are to understand and to lead.

In addition, although the task of the journal is to publish those topics that relate directly to the NP role and scope, we also recognize that our scope rightly continues to expand. I rely on our outstanding editorial board and our team of expert peer reviewers to keep me abreast of new areas to include, over and above my constant effort to stay in touch with issues and trends. This effort is a primary reason for my ongoing clinical practice and frequent attendance at local, state, and national NP meetings. Our field is growing rapidly, and the journal will continue to reflect that.

Our readers also provide valuable feedback on potential future content for the journal. Last month, we received a reader perspective on a recently published article that provides some further implications for NP education:

Dear Editor,

In response to the article titled, "Improving lesbian, gay, bisexual, transgender, and queer/questioning health: Using a standardized patient experience to educate advanced practice nursing students" (Kuzma et al, 2019) that appeared in JAANP Online Now, I'd like to highlight the importance of this topic. As a queer-identified graduate nursing student and LGBTQ activist fighting for greater education about LGBTQ health, I was so pleased to come across this study in JAANP. It is a well-devised and timely pilot project, demonstrating encouraging results.

The study cites that LGBTQ individuals make up a reported 3.5% of Americans-that was the 2012 Gallup poll result. The number has risen steadily each year, up to 4.5% in 2018 (Newport, 2018). Despite the increase, these numbers are assumed to be artificially low due to the nature of self-reporting and the societal prejudice that still exists regarding LGBTQ identities (Morin, 2013). Additionally, members of the LGBTQ population, especially transgender and queer/nonbinary people, suffer a range of health disparities. LGBTQ patients have unique care needs not realized by health care providers (WPATH, 2012). The reported median 2.13 hours of formal content regarding LGBTQ individuals covered in graduate nursing programs is woefully inadequate and rarely taught in a way that provides meaningful context for practice. That's where this pilot project comes in. Every graduate nursing program should pay attention.

Considerable thought and planning have been put into this pilot project. Other graduate programs will reap the benefits if they adopt this model. As the study points out, this format can be adapted to undergraduate nursing education and transferred into other disciplines such as medicine, dentistry, and pharmacy. More research and curriculum development are needed; however, this is a very promising step in the right direction. If we want to educate our graduate-prepared nurses to the best of our ability and keep nursing programs on the cutting edge of patient care, it is imperative that we include this type of multimodal LGBTQ care education in graduate nursing programs throughout the country. Nurses at all levels are known patient advocates, so we must provide them the tools they need.

Sincerely,

We welcome other feedback from our readers on this or other topics, and we actively seek articles that reflect your interests as NPs and health care team leaders.

This month, Mboineki and Chen presents an additional study on the development of the NP role in Tanzania. The authors previously published a study in JAANP in 2017 concerning health care providers' perceptions of the role. In this latest study, needs for health system changes to support the role are highlighted. This study provides further perspective into the development of the NP role internationally.

Erica Kierce and team present a unique and interesting study on the use of the PHQ-9 questionnaire repeatedly in depressed patients, along with pharmacogenomic testing, to guide medication selection. The authors note that, as usual, there is no substitute for provider judgment.

Roula Balani and colleagues studied nutrition knowledge, attitudes, and eating self-regulation in adult patients and found that several factors related to self-regulation problems were much more prevalent in obese individuals, potentially giving providers a new pathway to address in assisting these patients.

Patricia Hollen and team studied medically at-risk adolescents to find predictors of poor-quality decision-making related to substance abuse. The authors found that teens overestimate their ability to make good decisions and recommended multiple strategies such as fact sheets to help patients understand their risks.

Crystal Dodson and colleagues conducted a qualitative thematic analysis of NP use of mobile apps for prescribing and found that problems with the perception of affordability and reliability were limiting the adoption of these tools. This study provides a good foundation for follow-up studies on this topic.

Sharon Keating and Mary McCurry examined the effects of a text messaging intervention for weight loss. Although this intervention occurred over a brief period, the authors provide a framework for longer term use of this promising technique.

This issue also includes a sponsored article by Davida Kruger and Lucia Novak on ultrafast-acting insulin analogs. I hope you enjoy these new contributions to our science.

References