Evaluating Interprofessional Competencies and Knowledge of and Confidence in Addressing Social Determinants of Health

Promoting health requires coordinated, team-based interventions responsive to multiple determinants of health. This study aimed to determine if interprofessional competencies and knowledge of and confidence in addressing the social determinants of health improved following an interprofessional learning event. A two-group randomized controlled trial was used to determine study outcomes among 408 health science students from 14 health profession programs in the Midwest. Formed groups were randomly assigned to the customary medical-based (control) or social determinants of health focused (experimental) case study. In small groups students engaged in a case study simulation and offered recommendations for intervention. Small improvements in knowledge of the social determinants of health were found among participants in both groups. Interprofessional competencies largely showed no significant differences between using the case study which emphasized social determinants of health compared to a medically based case study. The suggestions for interventions resulted in more frequent recommendations related to socioeconomic status and access to health care among students in the experimental group versus the recommendation of medically based health services among students in the control group. Additional qualitative research is recommended to learn more about how groups collaborated to form these recommendations

Development of Learning Materials to Address Social and Medical Factors Impacting a Minoritized Population

Health outcomes are multi-factorial. Health professionals must weigh all factors when making recommendations and providing intervention, however, limited learning materials which describe the health of minoritized populations exist for students in health science educational programs, necessitating the development of content for interprofessional learning that address the health factors experienced by underserved populations. This study used a descriptive design. Eleven expert content reviewers from eight health science and medical professions were recruited and provided feedback on the quality and content of a developed case study that described the lifestyle and health status of an individual from an ethnic minoritized population. Participants strongly agreed that the content strengthened the case study’s usefulness as a tool for interdisciplinary education. Most reviewers strongly agreed that social factors were a key component of the case and that it was suitable for use in interdisciplinary education. Incorporating social determinants into a case was viewed favorably by case reviewers who indicated that the components of the case were high quality and important as a tool for interprofessional education

Examining the Parent-Young Adult Relationship During the Transition to College: The Impact of Mismatched Expectations About Autonomy on College Student Adjustment

The present study examined individuation and expectations for autonomous behavior (EAB) with incoming college freshmen and their parents. To test the theory that greater mismatch between young adults and their parents about EAB would be associated with more negative adjustment to college, Collins' (1990) Expectancy-Violation Model was applied. Data were initially collected with online questionnaires from incoming college freshmen and one of their parents before the transition to college. Follow-up data (W2) were collected three months later to assess adjustment to college. Individuation was measured with the Late Adolescence Individuation Questionnaire; EAB and reports of actual autonomous behavior were assessed with a measure based on the Psychological Separation Inventory. College student adjustment was measured with indicators of psychological well-being (i.e., psychosomatic symptoms, depressive symptoms, positive affect) and adaptation to college (i.e., college self-efficacy, satisfaction with college, and anticipated fall college grades). Open-ended data were collected from young adults and their parents describing topics of autonomy behavior where they perceived disagreement. A MANOVA indicated that there were significant differences between the four individuation groups (a) individuated (high connectedness and high separateness), (b) pseudoautonomous (low connectedness and high separateness), (c) dependent (high connectedness and low separateness), and (d) ambiguous (low connectedness and low separateness) on the young adults' adjustment to college. Post-hoc planned comparisons revealed that college students in the "individuated" group were consistently better off than those in the "ambiguous" group. Some support was found for the hypothesis that a higher discrepancy (a) between parent and young adult EAB and (b) between young adults' reports of expected versus actual autonomous behaviors was associated with lower W2 young adult well-being. Quality of parent-young adult communication was found to moderate some of these associations. Qualitative data somewhat supported the quantitative results, as well as illustrated unique areas for disagreement on EAB. Jointly, these quantitative and qualitative findings suggest that young adults' level of individuation from parents and a mismatch between parents' and young adults' perceptions of future autonomous behavior may impact college students' psychological well-being during the transition to college

Family Financial Management -- Planning for the Future

3 pp.Promoting the health and well-being of families during difficult times

Family Financial Management -- Interventions Following a Disaster

3 pp.Promoting the health and well-being of families during difficult times

Sociocontextual Circumstances in Daily Stress Reactivity Among Caregivers for Elder Relatives

Using a daily diary design, we examined whether emotional and physical reactivity in the face of care-related stressors is more intense for caregivers (CGs) living with lower levels of available socioemotional support and higher numbers of extrinsic stressors. Sixty-three CGs reported their experiences based on the past 24 hr (i.e., number of caregiving tasks, care recipient problem behaviors, family disagreements regarding care, depressive symptoms, feelings of burden, physical symptoms) on eight consecutive survey days; they also reported on extrinsic stressors and available socioemotional support. Multilevel analyses indicated significant moderator effects: within-person patterns of reactivity to care-related stressors were especially strong for CGs with lower levels of available socioemotional support and higher numbers of extrinsic stressors. For example, managing additional care recipient problem behaviors on a given day was more strongly associated with increased depressive and physical health symptoms as well as feelings of burden for CGs with relatively high numbers of extrinsic stressors. Implications for intervention are discussed. Copyright 2010, Oxford University Press.

<i>My Journey</i>: Development and Practice-Based Evidence of a Culturally Attuned Teen Pregnancy Prevention Program for Native Youth

A clear need exists for teen pregnancy prevention programs that are responsive to the specific needs and cultural contexts of Native American communities. Recent data indicates that the birth rate for Native teens is nearly two and a half times the rate for White teens (32.9 versus 13.2). To address this disparity, we conducted formative research with Northern Plains Native American community members, resulting in My Journey, a culturally attuned curriculum for 6&#8315;8th graders. My Journey is grounded in traditional values and teachings to promote self-efficacy in sexual health decision-making and engagement in prosocial behaviors. We conducted a pilot study with 6&#8315;8th grade students (n = 45), aged 11&#8315;14 years (22 females, 23 males). Pilot study findings confirm program feasibility and acceptability. The process evaluation revealed that teachers liked the curriculum, particularly its adaptability of cultural components and ease of student engagement. The outcome evaluation demonstrated that My Journey provided an avenue for NA youth to increase their sex refusal self-efficacy. Application of the culture cube framework revealed My Journey has made a meaningful practice-based evidence contribution as a community-defined, culturally integrated curriculum that is effective. Future directions include broader implementation of My Journey, including adaption for additional populations

Fostering Social Determinants of Health Transdisciplinary Research: The Collaborative Research Center for American Indian Health

The Collaborative Research Center for American Indian Health (CRCAIH) was established in September 2012 as a unifying structure to bring together tribal communities and health researchers across South Dakota, North Dakota and Minnesota to address American Indian/Alaska Native (AI/AN) health disparities. CRCAIH is based on the core values of transdisciplinary research, sustainability and tribal sovereignty. All CRCAIH resources and activities revolve around the central aim of assisting tribes with establishing and advancing their own research infrastructures and agendas, as well as increasing AI/AN health research. CRCAIH is comprised of three divisions (administrative; community engagement and innovation; research projects), three technical cores (culture, science and bioethics; regulatory knowledge; and methodology), six tribal partners and supports numerous multi-year and one-year pilot research projects. Under the ultimate goal of improving health for AI/AN, this paper describes the overarching vision and structure of CRCAIH, highlighting lessons learned in the first three years

Influences on HPV vaccination across levels of the social ecological model: perspectives from state level stakeholders

Nationally, human papillomavirus (HPV) vaccination rates fall short of the Healthy People 2020 goal of 80% completion. Although strategies to increase these rates exist, low rates persist. We used concept mapping with state-level stakeholders to better understand barriers and facilitators to HPV vaccination. Concept mapping is a participatory research process in which respondents brainstorm ideas to a prompt and then sort ideas into piles. We present results of the brainstorming phase. We recruited participants identified by researchers’ professional connections (n = 134) via e-mail invitations from five states (Iowa, South Dakota, Minnesota, Oregon, and Washington) working in adolescent health, sexual health, cancer prevention and control, or immunization. Using Concept Systems’ online software we solicited participants’ beliefs about what factors have the greatest influence on HPV vaccination rates in their states. From the original sample 58.2% (n = 78) of participants completed the brainstorming activity and generated 372 statements, our team removed duplicates and edited statements for clarity, which resulted in 172 statements. We coded statements using the Social Ecological Model (SEM) to understand at what level factors affecting HPV vaccination are occurring. There were 53 statements at the individual level, 22 at the interpersonal level, 21 in community, 51 in organizational, and 25 in policy. Our results suggest that a tiered approach, utilizing multi-level interventions instead of focusing on only one level may have the most benefit. Moreover, the policy-level influences identified by participants may be difficult to modify, thus efforts should focus on implementing evidence-based interventions to have the most meaningful impact