Two Case Examples of Reaching the Hard-to-Reach: Low Income Minority and LGBT Individuals

‘Hard-to-reach’ is a term primarily used by researchers to describe groups of people who have been historically difficult to find or contact. It is important for the public interest to include hard-to-reach groups in research because excluding certain sub-populations diminishes the ability to identify groups that potentially have the highest burden of illness and to develop an understanding of why group differences exist. Thus, the purposes of this paper are to: 1) describe the challenges in recruiting hard-to-reach population in two separate research studies; 2) discuss the strategies that were used to overcome those challenges; and 3) provide recommendations for researchers. This paper followed a case study research strategy, with the authors using two of their own research studies involving hard-to-reach populations as case studies. The research studies used in these case studies involved two different hard-to-reach groups—low-income ethnic minorities who were un- or under-insured and lesbian or bisexual women and transgender men. Two overarching themes were identified as barriers to reaching the population of interest: (1) gaining interest and (2) building trust. These themes add to the literature regarding the multi-prong approach that is needed to recruit members of hard-to-reach populations. Despite the authors having buy-in from stakeholders and a multi-prong recruiting approach, barriers to gaining the interest of potential participants included language in recruitment flyers, competing demands for time, and transportation to the data collection site. Building trust with interested study participants was also a large issue noted between both studies, especially concerning sensitive questions or cultural barriers regardless of the reliability and validity of the tools used in the study

Building Early Confidence in a Practice-based Discipline

Front-loading coursework is an area that has little exploration and yet has many possibilities that may benefit beginning or entry-level students in academic practice-based programs. For the purposes of this proposal, front-loading is an educational approach to allow for a course to be reconstructed to focus first on skill attainment prior to entering the clinical setting. The premise of front-loading skills is to allow learners to engage in experiential learning, or learning by doing, which creates a frame of reference and context that can be drawn upon once the student moves to the clinical setting. Creating a frame of reference will help promote confidence and decrease anxiety allowing the student to exemplify skills in the clinical setting and begin to move from novice to expert within the students’ frame of reference. The confidence-building model can be applied to any practice-based program in preparing learners for their discipline.https://digitalscholarship.unlv.edu/btp_expo/1107/thumbnail.jp

Outcomes of Childbirth Education in PRAMS, Phase 8

Objective: To determine if childbirth education is associated with improved outcomes for national maternal child health goals in the United States. Methods: This was a secondary analysis of PRAMS data. The sample was limited to survey respondents who answered a question During your most recent pregnancy, did you take a class or classes to prepare for childbirth and learn what to expect during labor and delivery? The outcomes included nine national objectives from Title V and Healthy People. Logistic regression models were built with control for characteristics associated with attending childbirth education. Odds ratios were converted to adjusted risk ratios for interpretation. Stratification by maternal race/ethnicity and use of Medicaid identified opportunities for improvement in childbirth education. Results: Of the 2,256 eligible respondents, 936 (41.5%) attended childbirth education. Attending childbirth education was associated with reduced likelihood of primary cesarean (ARR 0.79), increased attendance at postpartum visit (ARR 1.06), use of birth control (ARR 1.07), safe infant sleep (Back to Sleep ARR 1.04; Sleep on Own 1.12), and breastfeeding (Ever breastfeed ARR 1.08; still breastfeeding ARR 1.15). No association was found for LARC use or postpartum depression. Not all benefits of childbirth education were apparent for all racial/ethnic groups, nor for those with Medicaid insurance. Conclusions for practice: Childbirth education is a community intervention that may help achieve population maternal and child health goals

Is There a Relationship Between Gestational Diabetes and Perinatal Depression?

Perinatal depression (PND) is one of the leading complications associated with childbirth. Early detection and treatment of depression, particularly during the perinatal period, is essential for the promotion of positive maternal-child outcomes. Gestational diabetes mellitus (GDM) has been suggested as a confounding factor associated with PND. Concerns associated with PND include interference with maternal-newborn bonding and long-term effects of neurobehavioral consequences. An exemplar case describing one woman\u27s experience with GDM and her subsequent complications associated with PND is presented to discuss maternal depression and its plausible association with GDM. Recommendations include universal screening with the validated Edinburgh Postnatal Depression Scale screening tool during the early perinatal period to reduce incidence of maternal-newborn complications associated with PND and promote underpinnings for best practice

Academic Outcome Measures of a Dedicated Education Unit Over Time: Help or Hinder?

Critical thinking, nursing process, quality and safety measures, and standardized RN exit examination scores were compared between students (n = 144) placed in a dedicated education unit (DEU) and those in a traditional clinical model. Standardized test scores showed that differences between the clinical groups were not statistically significant. This study shows that the DEU model is one approach to clinical education that can enhance students’ academic outcomes

Pulmonary emboli: an unusual presentation

The majority of deep vein thrombosis or pulmonary embolus occur in older adults with cardiovascular risk factors. The case study presented is significant because it involves a 23-year-old African male who presented at our federally qualified health center after he was discharged from the hospital with a second episode of pulmonary embolus and a non-occlusive thrombus in his right common femoral vein. His only risk factors were his ethnicity and inconclusive lupus anticoagulant test result

Rapid Fire Talk in Pediatric Physical Therapy Education

Entry level and post professional physical therapy education is enhanced when learners are actively engaging with material/patients through EPA’s and the essential core competencies. Active learning strategies are educational methods where students are actively involved in their learning. Entrustable Professional Activities (EPA) guide practice based assessment for students and professionals, carrying out trustful activities with multiple competencies. An agreement on the delivery of the essential competencies with active learning strategies to enhance EPA are still up for debate. First round of rapid fire will compare the delivery of content with focus on traditional, flipped and on-line classrooms. The second round of rapid fire will discuss active learning strategies creating or assessing impactful EPA with clear take home examples. Active learning strategies will include Team Based Learning (TBL), Experiential Learning, Reflection and Patient Simulation. This will conclude with a hearty discussion on classroom structure and strategies in pediatric physical therapy education leading to more effective, gratifying, and memorable learning outcomes