Harvest Health: Chronic Disease Self-Management Program for Older African-Americans

No abstract available

Building an Institute to Translate Research into Practice: A Facilitation Model

No abstract available

An Innovative Interprofessional Course: Cultural Humility and Competence

As we tackle the disproportionate burden of chronic illness and access to quality health care of an increasingly diverse population, it is critical to infuse cultural and linguistic competence in all sectors of health care training. To reach the Healthy People 2020 goal of eliminating health disparities, health and human services education must provide the knowledge and experience to understand the root causes of health disparities, as well as strategies to advance ongoing cultural and linguistic competence

Teaching Cultural Humility and Competence: A Multi-disciplinary Course for Public Health and Health Services Students

Poster on the interdisciplinary Cultural Humility and Competence course taught at the Jefferson School of Population Health for the past several years. Overall Course Aim: Why a multi-disciplinary cultural humility competence course? An in-depth and advanced understanding of cultural diversity, health inequities and cultural competence in inter-professional health and human service delivery and administration. Facilitate development of cultural competence and humility in one\u27s self, colleagues and the work environment and its application to practice

Pediatric emergency medical care in Yerevan, Armenia: a knowledge and attitudes survey of out-of-hospital emergency physicians.

BACKGROUND: Out-of-hospital emergency care is at an early stage of development in Armenia, with the current emergency medical services (EMS) system having emergency physicians (EPs) work on ambulances along with nurses. While efforts are underway by the Ministry of Health and other organizations to reform the EMS system, little data exists on the status of pediatric emergency care (PEC) in the country. We designed this study to evaluate the knowledge and attitudes of out-of-hospital emergency physicians in pediatric rapid assessment and resuscitation, and identify areas for PEC improvement. METHODS: We distributed an anonymous, self-administered Knowledge and Attitudes survey to a convenience sample of out-of-hospital EPs in the capital, Yerevan, from August to September 2012. RESULTS: With a response rate of 80%, the majority (89.7%) of respondents failed a 10-question knowledge test (with a pre-defined passing score of ≥7) with a mean score of 4.17 ± 1.99 SD. Answers regarding the relationship between pediatric cardiac arrest and respiratory issues, compression-to-ventilation ratio in neonates, definition of hypotension, and recognition of shock were most frequently incorrect. None of the participants had attended pediatric-specific continuing medical education (CME) activities within the preceding 5 years. χ2 analysis demonstrated no statistically significant association between physician age, length of EMS experience, type of ambulance (general vs. resuscitation/critical care), or CME attendance and pass/fail status. The majority of participants agreed that PEC education in Armenia needs improvement (98%), that there is a need for pediatric-specific CME (98%), and that national out-of-hospital PEC guidelines would increase PEC safety, efficiency, and effectiveness (96%). CONCLUSIONS: Out-of-hospital emergency physicians in Yerevan, Armenia are deficient in pediatric-specific emergency assessment and resuscitation knowledge and training, but express a clear desire for improvement. There is a need to support additional PEC training and CME within the EMS system in Armenia

College Within A College (CwiC) – Population Health

Seminar presentation (55 PowerPoint Slides) The development of programmatic tracks providing students with academic opportunities outside of the traditional medical curriculum represents a national trend in medical education. With HRSA Interdisciplinary and Interprofessional Joint Graduate Degree five-year funding, the Department of Family and Community Medicine at ThomasJeffersonUniversitycreated an Inter-professional Primary Care Dual Degree Program (IPCDDP), which builds on JeffersonMedicalCollege’s College within a College (CwiC) Scholarly Concentrations Program in Population Health. The mission of the IPCDDP is to provide outstanding training in primary care and innovative education in chronic care management and population and public health in order to prepare primary care leaders to serve as future change agents working to improve the health of Americans, especially its most vulnerable and underserved populations. Key CwiC-PH components include: Year 1 – enhanced population health components of Introduction to Clinical Medicine (ICM) I, participation in community health initiatives, journal club, and twice monthly seminars Summer – population health related programs Year 2 – case studies in Fundamentals of Clinical Medicine, twice monthly seminars emphasizing application of the social and behavioral foundations of Public Health Year 3 – On going advising, enhanced clerkship experiences, Capstone planning Year 4 – Two community electives and completion of a Capstone Project Benefits to students include a certificate upon completion of the program, and 15 credits applied to the MPH program at Jefferson. The development, institutional collaboration, and a detailed description of the CwiC – PH program will be presented along with implementation, evaluation, and sustainability plans. Learning Objectives: Participants attending this session will be able to: 1. Organize an approach to integrating population health into health professional’s curriculum 2. Apply a methodology to recruit students into an area of concentration in population health 3. Identify the challenges in curricular reform and innovatio

A community-integrated home based depression intervention for older African Americans: descripton of the Beat the Blues randomized trial and intervention costs

ABSTRACT: BACKGROUND: Primary care is the principle setting for depression treatment; yet many older African Americans in the United States fail to report depressive symptoms or receive the recommended standard of care. Older African Americans are at high risk for depression due to elevated rates of chronic illness, disability and socioeconomic distress. There is an urgent need to develop and test new depression treatments that resonate with minority populations that are hard-to-reach and underserved and to evaluate their cost and cost-effectiveness. METHODS/DESIGN: Beat the Blues (BTB) is a single-blind parallel randomized trial to assess efficacy of a non-pharmacological intervention to reduce depressive symptoms and improve quality of life in 208 African Americans 55+ years old. It involves a collaboration with a senior center whose care management staff screen for depressive symptoms (telephone or in-person) using the Patient Health Questionnaire (PHQ-9). Individuals screened positive (PHQ-9 ≥ 5) on two separate occasions over 2 weeks are referred to local mental health resources and BTB. Interested and eligible participants who consent receive a baseline home interview and then are randomly assigned to receive BTB immediately or 4 months later (wait-list control). All participants are interviewed at 4 (main study endpoint) and 8 months at home by assessors masked to study assignment. Licensed senior center social workers trained in BTB meet with participants at home for up to 10 sessions over 4 months to assess care needs, make referrals/linkages, provide depression education, instruct in stress reduction techniques, and use behavioral activation to identify goals and steps to achieve them. Key outcomes include reduced depressive symptoms (primary), reduced anxiety and functional disability, improved quality of life, and enhanced depression knowledge and behavioral activation (secondary). Fidelity is enhanced through procedure manuals and staff training and monitored by face-to-face supervision and review of taped sessions. Cost and cost effectiveness is being evaluated. DISCUSSION: BTB is designed to bridge gaps in mental health service access and treatments for older African Americans. Treatment components are tailored to specific care needs, depression knowledge, preference for stress reduction techniques, and personal activity goals. Total costs are $584.64/4 months; or$146.16 per participant/per month. TRIAL REGISTRATION: ClinicalTrials.gov #NCT00511680

College Within A College (CwiC) – Population Health

The development of programmatic tracks providing students with academic opportunities outside of the traditional medical curriculum represents a national trend in medical education. With HRSA Interdisciplinary and Interprofessional Joint Graduate Degree five-year funding, the Department of Family and Community Medicine at ThomasJeffersonUniversitycreated an Inter-professional Primary Care Dual Degree Program (IPCDDP), which builds on JeffersonMedicalCollege’s College within a College (CwiC) Scholarly Concentrations Program in Population Health. The mission of the IPCDDP is to provide outstanding training in primary care and innovative education in chronic care management and population and public health in order to prepare primary care leaders to serve as future change agents working to improve the health of Americans, especially its most vulnerable and underserved populations. Key CwiC-PH components include: Year 1 – enhanced population health components of Introduction to Clinical Medicine (ICM) I, participation in community health initiatives, journal club, and twice monthly seminars Summer – population health related programs Year 2 – case studies in Fundamentals of Clinical Medicine, twice monthly seminars emphasizing application of the social and behavioral foundations of Public Health Year 3 – On going advising, enhanced clerkship experiences, Capstone planning Year 4 – Two community electives and completion of a Capstone Project Benefits to students include a certificate upon completion of the program, and 15 credits applied to the MPH program atJefferson. The development, institutional collaboration, and a detailed description of the CwiC – PH program will be presented along with implementation, evaluation, and sustainability plans. Learning Objectives: Participants attending this session will be able to: 1. Organize an approach to integrating population health into health professional’s curriculum 2. Apply a methodology to recruit students into an area of concentration in population health 3. Identify the challenges in curricular reform and innovatio

A community-integrated home based depression intervention for older African Americans: descripton of the Beat the Blues randomized trial and intervention costs

Abstract Background Primary care is the principle setting for depression treatment; yet many older African Americans in the United States fail to report depressive symptoms or receive the recommended standard of care. Older African Americans are at high risk for depression due to elevated rates of chronic illness, disability and socioeconomic distress. There is an urgent need to develop and test new depression treatments that resonate with minority populations that are hard-to-reach and underserved and to evaluate their cost and cost-effectiveness. Methods/Design Beat the Blues (BTB) is a single-blind parallel randomized trial to assess efficacy of a non-pharmacological intervention to reduce depressive symptoms and improve quality of life in 208 African Americans 55+ years old. It involves a collaboration with a senior center whose care management staff screen for depressive symptoms (telephone or in-person) using the Patient Health Questionnaire (PHQ-9). Individuals screened positive (PHQ-9 ≥ 5) on two separate occasions over 2 weeks are referred to local mental health resources and BTB. Interested and eligible participants who consent receive a baseline home interview and then are randomly assigned to receive BTB immediately or 4 months later (wait-list control). All participants are interviewed at 4 (main study endpoint) and 8 months at home by assessors masked to study assignment. Licensed senior center social workers trained in BTB meet with participants at home for up to 10 sessions over 4 months to assess care needs, make referrals/linkages, provide depression education, instruct in stress reduction techniques, and use behavioral activation to identify goals and steps to achieve them. Key outcomes include reduced depressive symptoms (primary), reduced anxiety and functional disability, improved quality of life, and enhanced depression knowledge and behavioral activation (secondary). Fidelity is enhanced through procedure manuals and staff training and monitored by face-to-face supervision and review of taped sessions. Cost and cost effectiveness is being evaluated. Discussion BTB is designed to bridge gaps in mental health service access and treatments for older African Americans. Treatment components are tailored to specific care needs, depression knowledge, preference for stress reduction techniques, and personal activity goals. Total costs are $584.64/4 months; or$146.16 per participant/per month. Trial Registration ClinicalTrials.gov #NCT00511680</p