title: Evidence of Public Health Nursing Effectiveness: A Realist Review.
abstract: The purpose of this realist review was to examine PHN interventions and their outcomes during the period preceding the Affordable Care Act (1990-2010), to determine what types of interventions demonstrated effectiveness, and whether these were related to target population or setting.
  
  
  
  The review focused on PHN interventions with data support documented over 20 years. A search of the published literature using CINHAL, PubMed, and ancestry methods resulted in 64 articles meeting the search criteria. The researchers reviewed each article for the relevant variables; achieved consensus for each variable; and summarized results using descriptive statistics.
  
  
  
  Documented PHN interventions targeted vulnerable populations. Interventions included health education, behavior change, and screening. There was evidence of effectiveness of PHN interventions in a number of studies; however, the study limitations and variety of intervention types make overall conclusions about PHN effectiveness challenging.
  
  
  
  Despite the long history of PHN working in communities to promote and maintain the health of vulnerable populations, practice outcomes have not been well documented. Further work is needed to: strengthen the methods for documenting effectiveness of PHN practice; focus on promising PHN interventions via multisite studies; and translate evidence-based PHN interventions to practice settings.
authors.affiliation: Community, Systems and Mental Health Nursing, College of Nursing, Rush University, Chicago, Illinois.
authors.forename: Susan M
authors.identifier: 0000-0002-9236-3911
authors.initials: SM
authors.lastname: Swider
authors.affiliation: Community, Systems and Mental Health Nursing, College of Nursing, Rush University, Chicago, Illinois.
authors.forename: Pamela F
authors.initials: PF
authors.lastname: Levin
authors.affiliation: Community, Systems and Mental Health Nursing, College of Nursing, Rush University, Chicago, Illinois.
authors.forename: Virginia
authors.initials: V
authors.lastname: Reising
mesh_terms: D006801:Humans; D015403:Nursing Evaluation Research; D017063:Outcome Assessment, Health Care; D058991:Patient Protection and Affordable Care Act; D011637:Public Health Nursing; D016032:Randomized Controlled Trials as Topic; D014481:United States
keywords: Public Health Nursing effectiveness; Public Health Nursing interventions; Public Health Nursing practice; community health nursing