The Journal of Continuing Education in Nursing

Original Article 

Characteristics of E-Mail Solicitations From Predatory Nursing Journals and Publishers

Allison A. Lewinski, PhD, MPH, RN; Marilyn H. Oermann, PhD, RN, ANEF, FAAN

Abstract

Predatory publishers solicit manuscripts through e-mail invitations to potential authors, with the goal of enticing authors to submit a manuscript to the journal. This descriptive study examined the characteristics of 206 e-mail invitations from predatory journals and publishers sent to faculty and students in a school of nursing over a 10-week period. Characteristics of these e-mails included use of flattering language, due dates for submissions close to the date of the e-mail sent, requests for general topics, and awkward phrases. However, many e-mails did not have characteristics that clearly identified them as coming from a predatory journal or publisher. Education on predatory publishing is needed for all nurse authors, specifically how to identify and confirm whether a journal is predatory or legitimate.

J Contin Educ Nurs. 2018;49(4):171–177.

Abstract

Predatory publishers solicit manuscripts through e-mail invitations to potential authors, with the goal of enticing authors to submit a manuscript to the journal. This descriptive study examined the characteristics of 206 e-mail invitations from predatory journals and publishers sent to faculty and students in a school of nursing over a 10-week period. Characteristics of these e-mails included use of flattering language, due dates for submissions close to the date of the e-mail sent, requests for general topics, and awkward phrases. However, many e-mails did not have characteristics that clearly identified them as coming from a predatory journal or publisher. Education on predatory publishing is needed for all nurse authors, specifically how to identify and confirm whether a journal is predatory or legitimate.

J Contin Educ Nurs. 2018;49(4):171–177.

The Internet has had a significant influence on scholarly publishing. No longer are articles available in only print to subscribers; readers can now access articles electronically through their library or for a fee, without subscribing to a journal. Most print journals provide electronic versions of articles and other digital content for subscribers, and some nursing journals are published in electronic format only, with no print version available (Oermann et al., 2018). The landscape of scholarly publishing in nursing and health care has changed dramatically in the past few decades as a result of the Internet.

Accompanying these changes in scholarly publishing has been the growth of open access (OA) publications. In traditional subscription-based journals, authors transfer the copyright for the article to the publisher, and the subscription fees or fees paid per article for access cover the costs of publishing the article. In the OA model, authors may pay a fee, referred to as the article processing charge (APC), to retain the copyright and to cover the costs of publication. There are multiple models of OA, but in general, OA allows articles to be freely available on the Internet.

Predatory journals, a label coined by Beall (2017), have evolved from this OA model. These journals charge authors an APC to publish their manuscript and allow them to retain the copyright. However, predatory publishers are not reputable publishers of scholarly journals. Many authors (Beall, 2017; Frandsen, 2017; Moher et al., 2017; Oermann et al., 2016; Shamseer et al., 2017) note that predatory publishers:

  • Have questionable peer review processes, if any.
  • Are not indexed in bibliographic databases such as MEDLINE®, CINAHL®, and Scopus®.
  • Do not provide typical publishing services such as quality control and archiving (for preservation of the content).
  • Make claims on their journal websites that are not true.

In a study by Shamseer et al. (2017), the authors identified potential predatory journals from Beall's lists, OA journals that were presumed to be legitimate from PubMed Central®, and legitimate subscription journals from Index Medicus®. They randomly selected 100 journals from each of these groups for analysis. More than half (66%) of the predatory journal websites had spelling errors, compared with legitimate OA (6%) and subscription (3%) journals. A third of the predatory journals reported a bogus impact factor (Index Copernicus Value) versus three OA and no subscription-based journals. One other striking difference was that 73% of the predatory journals listed editors and editorial board members whose affiliation with the journal could not be verified (Shamseer et al., 2017).

Predatory journals are a global problem. Moher et al. (2017) found corresponding authors of articles published in predatory journals were from 103 countries. The most common countries were India (27%) and the United States (15%). Those findings are consistent with a study of predatory nursing journals, in which the predominant countries of authors were India, followed by the United States (Oermann et al., 2016). India also has a large number of predatory publishers (Shen & Bjork, 2015).

Predatory publishers often solicit manuscripts through e-mail invitations to potential authors. The goal of these e-mails is to entice authors to submit a manuscript to the journal. These spam e-mails may advertise the journal's quick peer review and publication process. They often praise authors as the leading expert in an area and include other flattering phrases (Moher & Srivastava, 2015; Shamseer et al., 2017). Novice authors may not know about predatory journals nor how to differentiate a quality journal from a predatory journal. In other cases, authors may have had a manuscript rejected and view the predatory journal as an option to finally get the manuscript published (Nicoll & Chinn, 2015). The other issue is that some predatory journals have names similar to the reputable journal.

Moher and Srivastava (2015) analyzed the content of 311 e-mail invitations to submit a manuscript to a predatory journal. The majority of e-mails (78.5%) were from predatory journals on Beall's list. One third (n = 106) of the invitations began with a greeting that used words such as eminent and prominent. Although most of the invitations in their study indicated that the journal provided a peer review of the manuscript, other studies document the poor quality of peer review in predatory journals (Frandsen, 2017; Oermann et al., 2016; Shamseer et al., 2017).

Purpose

Limited studies have been done on predatory nursing journals. Oermann et al. (2016) identified 140 predatory nursing journals available from 75 publishers. Most of these journals were new and often published only one or two volumes. Although the journal websites claimed the journals were indexed, such as in PubMed or CINAHL, none were. In a follow up study, Oermann et al. (2018) documented the poor quality of the research being published in these journals. However, those studies did not examine the e-mails used to solicit manuscripts.

The number of e-mail invitations to submit manuscripts to predatory journals or an abstract to a predatory conference continues to increase, and many nurses are inundated with these e-mails. The purpose of this study was to examine the characteristics of these e-mail invitations sent to potential nurse authors.

Method

This was a descriptive study using data collected from a convenience sample of e-mails from predatory journals and publishers sent to faculty and doctoral students at a school of nursing in the United States. The university's institutional review board approved this study.

Setting and Sample

The data were collected from faculty and students in the PhD program in the school. The school has four degree programs: Bachelor of Science in Nursing, Master of Science in Nursing (clinical and nonclinical specialties, and advanced practice nursing programs), Doctor of Nursing Practice, and PhD.

Recruitment

We e-mailed faculty and students once, and then 3 weeks later, requesting them to forward to us any e-mails received from a potential predatory journal or publisher. In the recruitment e-mail, participants were informed that all identifying information would be removed during data cleaning, and no personal information (e.g., name, e-mail address, or any other identifying information within the e-mail) would be included in the analysis or publication of results. The first author e-mailed the PhD students via the PhD student listserv, and the other author e-mailed the faculty via the faculty listserv. All collected e-mails were forwarded to the first author, who then saved the e-mails in a secure folder on the school of nursing's shared drive. Data collection was stopped after 10 weeks.

Data Analysis Plan

The authors used Beall's criteria for determining predatory publishers, which had been applied in a prior study of 102 predatory nursing journals (Beall, 2015; Oermann et al., 2016). Examples of these criteria include a lack of indexing of the journal in bibliographic databases such as MEDLINE, CINAHL, Scopus, and others; questionable peer review processes; inaccurate information on the journal website; and a lack of publishing services, such as digital preservation, among others. The authors developed descriptive categories on which to examine the e-mails from these journals or publishers soliciting manuscripts or abstracts for presentation at conferences. The authors met and reviewed the collected e-mails, created categories, defined values for each category, and discussed the coded values until agreement was reached. All data were entered into a Microsoft® Excel® spreadsheet, and frequency counts were completed using SPSS software, version 24.

Results

The authors received 298 e-mails over 10 weeks. Duplicate e-mails (i.e., the same e-mail forwarded twice, based on the timestamp) were removed from the database (n = 78). Each e-mail was screened to confirm it was from a predatory journal or publisher. The authors removed e-mails from legitimate OA journals (n = 10). Legitimate journals were defined as those indexed in MEDLINE, CINAHL, or Scopus. We also removed short e-mails (i.e., those that included only an impact factor, a colorful headline requesting manuscripts, and an international address; n = 4). After review, we completed analysis on 206 e-mails. Table 1 describes the characteristics of the e-mails that were sent to faculty and students from predatory journals or publishers.

Characteristics of Collected E-Mails (N = 206)

Table 1:

Characteristics of Collected E-Mails (N = 206)

The majority of e-mails had some form of salutation; the most common salutations included “Dear Dr.” (n = 125, 60.7%), “Dear” (n = 39, 18.9%), “Dear Colleague” (n = 7, 3.4%), or “Dear Researcher” (n = 6, 2.9%). Of note, we received several salutations that were unique and appeared once in our sample: “Dear Eminent Researcher,” “Dear Professor, Doctor/Researcher,” “Dear Professors/Researchers/Authors/Students,” “Dr.,” and “Dear <<firstname>>.” Fourteen of the e-mails (6.8%) had a blank space where the salutation would commonly be located in an e-mail message.

Most of the e-mails did not contain any topic or information about the manuscript they were requesting or about the mission of the journal. For example, these e-mail messages typically listed the journal's name and asked recipients to submit a manuscript to the journal without specifying any topic areas. Approximately one third of the e-mails (n = 66) were requests for manuscripts or abstracts on very general topics such as “all aspects of pediatrics,” “all aspects in endocrinology and diabetes,” or “all the aspects of nursing and women's health.” The other e-mails requested manuscripts on topics that closely resembled the journal's name, such as a journal on family studies requesting manuscripts on marital or family studies.

Most of the e-mails did not include information about the peer review process or a time line for peer review. Four journals requested submissions within 1 week, and an additional 15 asked recipients to submit their manuscripts within 1 to 3 weeks. More than half of the requests (n = 116, 56.3%) included a due date for the manuscript or abstract. Frequently, the due dates were close to the date of the e-mail. Examples include:

  • E-mail sent on the 5th of a month, with the manuscript due the 10th of that same month.
  • E-mail sent on the 15th of the month, with the manuscript due on the 20th of the next month.
  • E-mail sent on the 16th of the month, with the manuscript due on the 30th of the same month. In addition, most e-mails did not list the length of time to publication.

Few e-mails (n = 11, 5.3%) stated that there was a fee (APC) for publishing in the journal. Ten of the e-mails included the “impact factor” of the journal; however, none of these were actual impact factors from Journal Citation Reports®. Most e-mails did not indicate the journal was indexed, but the 17 that did listed websites that were not bibliographic databases, such as Academic Keys (a higher education job website). Almost all e-mails included a formal signature at the end of the e-mail that had some combination of “Regards,” “Sincerely,” or “Thanks.”

Nearly half of the e-mails contained a flattering greeting or statement about the prestige of the individual to whom the e-mail was sent. For example, e-mails began with:

  • Blissful greetings of the day!
  • Hope you are doing well!
  • Hope this mail finds you jovial mood and good health.
  • Apologize for bother in your busy schedule.

Several e-mails contained language that mimicked an e-mail from a colleague, such as “We have sent you an e-mail earlier, but haven't heard from you. So we wanted to follow up today to see if you are interested in our invitation,” or “We have gone through your quality research and contribution in the field.” Further, several e-mails contained the title of an author's recently published manuscript, such as, “It's a great honor for me to consider you as a potential author based on your previous article entitled, [title of article].” Other greetings included superfluous language such as:

  • We greatly acknowledge your research and contribution to the field….
  • With references to your eminent contributions in the field of….
  • We have chosen selective scientists who have made their contributions to the scientific community.
  • Greetings!! Congratulations for being the best!! It gives us immense pleasure to invite you to write.
  • Your published papers have added value to the existing literature and really helped other researchers to frame their future projects accordingly.

Of note, most of the e-mails from predatory publishers (n = 119, 57.8%) merely welcomed the author to submit a manuscript. These e-mails are more of an issue for nurse authors because it is not as obvious that the journal or conference is predatory.

In addition, several e-mails contained awkward phrases or used words incorrectly. For example, e-mails included phrases such as:

  • We might want to request your essence as speaker/keynote speaker at the upcoming Annual Nursing Conference…is a two days conference comprising of complete talks, unique sessions, oral and blurb introductions of associate explored papers and most recent research items for presentation.
  • Acceptance Notification: within 2–3 days after submission; Online Publication: within 24 hours after complete all formalities.
  • Hope this mail finds you jovial mood and good health.
  • Apologize for bother in your busy schedule.

However, many e-mails contained appropriate sentence structure and word usage.

Discussion

This study described the characteristics of e-mails received from predatory journals and publishers. The frequency of e-mails from these journals is increasing and alarming in nature, as many of the e-mails look similar to those that might be sent from legitimate nursing journals.

Discerning among legitimate OA and predatory journals is a challenge for all authors, not only those in nursing (Eriksson & Helgesson, 2017; Hansoti, Langdorf, & Murphy, 2016; Moher & Srivastava, 2015). One of the issues with predatory journals is their lack of indexing in recognized bibliographic databases, such as MEDLINE and CINAHL, which hinders finding the articles in a search. In our sample, faculty and students received some e-mails they thought were from predatory journals; however, the e-mails actually originated from legitimate OA journals (n = 10). These journals were published by a reputable publisher, were indexed in bibliographic databases, and had an impact factor. These e-mail invitations asked for more specific manuscript topics than the e-mails from predatory journals. These were confirmed to be legitimate journals by a search of bibliographic databases to determine whether the journal was indexed in one of them, and the peer review guidelines at the journal website were also reviewed; these steps are similar to those suggested in the literature (Eriksson & Helgesson, 2017; Hansoti et al., 2016; Moher & Srivastava, 2015).

With Beall's (2015) list of predatory publishers and standalone journals no longer available on the Internet, we found the process to identify journals confusing and time consuming, despite the one author's extensive experience in publishing and our collective experience reading these study data. Consistent with an earlier study on predatory nursing journals, which revealed difficulty in locating the APC for a publication (Oermann et al., 2016), few e-mails in this study contained information about the APC. Beall (2015) suggested that one of the characteristics of predatory publishers is they provided limited information about the APC or hide this information on the journal website. Our struggle to correctly identify whether a journal was legitimate highlights the challenges nurses—many of whom may not have much experience in writing for publication—may have when they receive an e-mail requesting a manuscript or inviting them to present at a conference. Therefore, the frequency with which nurses receive e-mails from predatory journals and publishers, in combination with confusion about the various types of journal and publishing options, is a concern.

Overall, the e-mails sent from predatory journals and publishers requested manuscripts in a general range of subjects. Nurses whose area of research or clinical practice is different from the topics in an e-mail asking them to submit a manuscript would likely not consider that journal. Similarly, experts in a field might be skeptical about a request for manuscripts about an entire subject area (e.g., pediatrics) that did not specify a subfield (e.g., pediatric cardiology, pediatric nursing, pediatric rehabilitation). Of more concern are e-mails soliciting manuscripts in an area of research or clinical practice consistent with the recipient's own expertise. Some of the e-mail invitations sent from predatory journals included the title of a prior publication by the nurse and were in the same subject area.

By collecting these e-mails, the authors learned that the same e-mail invitation was sent to many individuals at the same time. On the basis of this pattern, the current study authors determined that most likely, predatory journal e-mails are sent in bulk to potential authors regardless of research topic or clinical specialty. Consistent with the findings of Moher and Srivastava (2015) and Kozak, Iefremova, and Hartley (2016), some e-mail messages included flattering language; a note that the sender had read the author's prior work; a short time frame for publication; and awkward phrases, missing words in a sentence, and grammatical and spelling errors. It is likely that a nurse who received an e-mail invitation with missing words or incorrect grammar would be skeptical about submitting a manuscript. However, the challenge is when e-mail invitations do not have incorrect statements or errors, which was the case with the majority of e-mails in this study.

Implications

The increase in e-mails from predatory journals and publishers is troubling for nurse scholars and clinicians who aim to disseminate research to a wide audience. However, of particular concern is a general lack of awareness of predatory journals among nurses in all settings. In the authors' school of nursing, despite routine e-mails sent to faculty and students about how to identify predatory journals and conferences, both authors still received questions about what these were and how to identify them. These questions are concerning because nurses may be lured into submitting manuscripts to these journals and abstracts to these conferences. Specifically, novice authors are at increased risk because of their inexperience in publishing, lack of awareness of predatory journals and conferences, and lack of knowledge of how to select an appropriate journal for submission of a manuscript.

Continuing education programs are one way to expose nurses to the problem of predatory journals and conferences. These programs can educate nurses about predatory publishing and teach them how to identify credible, legitimate journals. Nurses need to be aware of this issue and know to check that the journal they are considering for submission is indexed in a bibliographic database and is peer reviewed (Hansoti et al., 2016; Laine & Winker, 2017; Moher & Srivastava, 2015; Oermann et al., 2016). Nurses can consult with faculty, clinical educators, medical librarians, experienced authors, and journal editors when they have questions about a journal and to guide them in selecting a reputable journal. Guidelines for evaluating the integrity of a journal should be shared with nurses (Nicoll, 2014). Nurse researchers and administrators in clinical settings who have significant publishing expertise serve on editorial boards and as peer reviewers and are familiar with journals in an area of research and practice are other resources for clinicians in identifying potential journals for a manuscript and avoiding predatory journals.

Nurses also should be educated about resources on the Internet for journal selection. One strategy is to search for potential journals in directories, which assess journals before including them, such as The Directory of Nursing Journals at the International Academy of Nursing Editors (INANE) website ( https://nursingeditors.com/journals-directory/). Each of the nursing journals in this directory is carefully vetted to ensure it meets publishing standards, which are indicated on the INANE website. Nurses can be educated to review the journals in the directory for a potential journal for their manuscript. Another strategy is to search for potential journals from among those indexed in a bibliographic database. There also are Internet resources for making a decision about a journal. One such resource is “Think. Check. Submit,” which is a checklist to use for reviewing potential journals ( http://thinkchecksubmit.org/). Table 2 provides recommendations for identifying whether an e-mail invitation is from a predatory journal or publisher. This table can be shared with nurses as a resource to use when they receive e-mail invitations soliciting manuscripts or asking them to submit abstracts to a conference.

Eight Tips to Identify a Predatory Journal or Publisher

Table 2:

Eight Tips to Identify a Predatory Journal or Publisher

Limitations

Limitations of this study include the use of a convenience sample of faculty and students in a PhD nursing program from one school of nursing in the United States. The data collection was influenced by the university's spam filter and e-mail system. The spam filter system may have directly routed the e-mails to a person's “junk” folder; therefore, the recipients may not have known that they received an e-mail invitation to submit to a predatory journal or conference unless they actively looked in that folder or received the e-mail in their inbox. In addition, data were collected for a period of 10 weeks; thus, this short period of time may not have captured the wide variety of predatory journal e-mails being sent to potential nurse authors.

Conclusion

This study described characteristics of e-mail invitations to submit a manuscript to a predatory journal or an abstract to a conference. Publishers are innovative in their marketing techniques, including flattering language and a note that the sender had read the author's prior work. They may entice authors to submit their work by advertising their short time frame for peer review and publication. Sometimes predatory journal names are similar to the names of legitimate journals, making it difficult to recognize the e-mail is from a predatory publisher. Although some of the marketing techniques used by predatory publishers would alert the nurse to question the journal, e-mail invitations that lacked these characteristics are of most concern. Therefore, this article included tips to help determine whether a journal or publisher is predatory or legitimate.

References

  • Beall, J. (2015). Criteria for determining predatory open-access publishers. Retrieved from http://libguides.uwi.edu/ld.php?content_id=23397574
  • Beall, J. (2017). What I learned from predatory publishers. Biochemia Medica: Casopis Hrvatskoga Drustva Medicinskih Biokemicara, 27, 273–278. doi:10.11613/BM.2017.029 [CrossRef]
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  • Frandsen, T.F. (2017). Are predatory journals undermining the credibility of science? A bibliometric analysis of citers. Scientometrics, 113, 1513–1528. doi:10.1007/s11192-017-2520-x [CrossRef]
  • Hansoti, B., Langdorf, M.I. & Murphy, L.S. (2016). Discriminating between legitimate and predatory open access journals: Report from the International Federation for Emergency Medicine Research Committee. Western Journal of Emergency Medicine, 17, 497–507. doi:10.5811/westjem.2016.7.30328 [CrossRef]
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  • Moher, D. & Srivastava, A. (2015). You are invited to submit. BMC Medicine, 13, 180. doi:10.1186/s12916-015-0423-3 [CrossRef]
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  • Nicoll, L.M. & Chinn, P.L. (2015). Caught in the trap: The allure of deceptive publishers. Nurse Author & Editor, 25, 4.
  • Oermann, M.H., Conklin, J.L., Nicoll, L.H., Chinn, P.L., Ashton, K.S., Edie, A.H. & Budinger, S.C. (2016). Study of predatory open access nursing journals. Journal of Nursing Scholarship, 48, 624–632. doi:10.1111/jnu.12248 [CrossRef]
  • Oermann, M.H., Nicoll, L.H., Chinn, P.L., Ashton, K.S., Conklin, J.L., Edie, A.H. & Williams, B.L. (2018). Quality of articles published in predatory nursing journals. Nursing Outlook, 66, 4–10. doi:10.1016/j.outlook.2017.05.005 [CrossRef]
  • Shamseer, L., Moher, D., Maduekwe, O., Turner, L., Barbour, V., Burch, R. & Shea, B.J. (2017). Potential predatory and legitimate biomedical journals: Can you tell the difference? A cross-sectional comparison. BMC Medicine, 15, 28. doi:10.1186/s12916-017-0785-9 [CrossRef]
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Characteristics of Collected E-Mails (N = 206)

VariableFrequency, n (%)
Salutation (Dr., Professor)
  No salutation14 (6.8)
  Some form of salutation192 (93.2)
Topic (name of journal)
  Nonea120 (58.3)
  Focused20 (9.7)
  General66 (32)
Date manuscript is due to journal
  Nonea90 (43.7)
  Date listed116 (56.3)
Length of peer review process
  Nonea185 (89.8)
  ⩽ 1 week4 (1.9)
  > 1 week15 (7.3)
  Any date2 (1)
Length of time to publication
  Nonea183 (88.8)
  Date listed23 (11.2)
Publishing discount mentioned
  Nonea185 (89.8)
  Free or APC waived10 (4.9)
  APC price or discount mentioned11 (5.3)
Stated impact factor
  Nonea196 (95.1)
  Number listed10 (4.9)
Stated databases in which journal is indexed
  Nonea181 (87.9)
  Incorrect bibliographic database17 (8.2)
  Correct bibliographic information8 (3.9)
Signature at bottom of e-mail
  Nonea17 (8.3)
  Formal sign-off189 (91.7)
Publisher information is listed
  Nonea178 (86.4)
  Name listed28 (13.6)
Introduction (first sentence of first paragraph of e-mail)
  No flattering personal greeting119 (57.8)
  Flattering personal greeting87 (42.2)

Eight Tips to Identify a Predatory Journal or Publisher

Determine whether the salutation of the e-mail is correct. (e.g., Are you considered eminent or have great expertise in your field? Is your name spelled or written correctly? If a student, have you obtained your degree?) Determine whether the topics requested are a reasonable consideration in your field of research or expertise. (e.g., Is the e-mail requesting a broad array of topics? Are the topics within the same field of research or clinical practice?)Look for flattering and effusive language in the subject and text of the e-mail. (e.g., Are you referred to as eminent or a great researcher or clinician? Does the e-mail state that the journal or publisher is honored to include your impactful work or mention your work is a great contribution to the field?) Identify the turnaround time for peer review and time to publication. (e.g., Is the turnaround time realistic in relation to journals in your field or subfield?) Identify whether the e-mail contains typographical, grammatical, or sentence structure errors. (e.g., Does the e-mail make sense? Are there spelling errors? Missing words? Are the sentences clear and concise?) Determine whether the journal is indexed in bibliographic databases such as MEDLINE, CINAHL, Scopus, or others. (e.g., What databases are listed in the e-mail? If a database is mentioned, is the journal actually indexed in it? Are the databases listed bibliographic databases?) Determine whether the words in the e-mail are congruent with their dictionary definitions. (e.g., Do they “tolerate authors?” Do they request “blurb introductions of associate explored papers?” Does the e-mail ask you to present a “dynamic at the conceptual accommodation interface?” Does the e-mail ask you to “not hold your thoughts and be initiative in disseminating your work?”) Use available resources to confirm the journal is legitimate. (e.g., http://thinkchecksubmit.org/, Directory of Nursing Journals at https://nursingeditors.com/journals-directory/, search for journal in a bibliographic database)
Authors

Dr. Lewinski is Postdoctoral Fellow, Durham Center for Health Services Research in Primary Care, Durham Veterans Affairs Health Care System, and Dr. Oermann is Thelma M. Ingles Professor of Nursing, Director of Evaluation and Educational Research, Duke University School of Nursing, Durham, North Carolina.

The authors have disclosed no potential conflicts of interest, financial or otherwise.

Support for Allison A. Lewinski, PhD, MPH, RN, was provided by grant TPH 21-000 from the Department of Veterans Affairs Office of Academic Affiliations. Publication support was provided by the Durham VA Health Services Research Center of Innovation funding (CIN 13-410).

Address correspondence to Marilyn H. Oermann, PhD, RN, ANEF, FAAN, Thelma M. Ingles Professor of Nursing, Director of Evaluation and Educational Research, Duke University School of Nursing, DUMC 3322, 307 Trent Drive, Durham, NC 27710; e-mail: marilyn.oermann@duke.edu.

Received: October 27, 2017
Accepted: January 17, 2018

10.3928/00220124-20180320-07

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