Teaching the Teachers: Development and Evaluation of a Racial Health Equity Curriculum for Faculty.

INTRODUCTION: Faculty are increasingly expected to teach about the impact of racism on health and to model the principles of health equity. However, they often feel ill-equipped to do so, and there is limited literature on faculty development on these topics. We developed a curriculum for faculty education on racism and actions to advance racial health equity. METHODS: The curriculum design was based on a literature review and needs assessments. Implementation consisted of four live virtual 1-hour sessions incorporating interactive didactics, cases, reflection, goal setting, and discussion offered to a multidisciplinary group of pediatric faculty at a children\u27s hospital. Topics included the history of racism, racism in health care, interacting with trainees and colleagues, and racial equity in policy. Evaluation consisted of pre- and postsurveys at the beginning and end of the curriculum and a survey after each session. RESULTS: A mean of 78 faculty members attended each session (range: 66-94). Participants reported high satisfaction and increased knowledge at the end of each session. Qualitative themes included self-reflection on personal biases, application of health equity frameworks and tools, becoming disruptors of racism, and the importance of systemic change and policy. DISCUSSION: This curriculum is an effective method for increasing faculty knowledge and comfort. The materials can be adapted for various audiences

Recent national trends in the use of adolescent inpatient bariatric surgery: 2000 through 2009

Objectives: To determine the current rate of inpatient bariatric surgical procedures among adolescents and to analyze national trends of use from 2000 to 2009. Design: Retrospective cross-sectional study. Setting: Discharge data obtained from the Healthcare Cost and Utilization Project Kids\u27 Inpatient Database, 2000 through 2009. Participants: Adolescents (defined herein as individuals aged 10-19 years) undergoing inpatient bariatric procedures. Intervention: Inpatient bariatric surgery. Main Outcome Measures: The primary outcome measure was the national population-based bariatric procedure rate. The secondary outcome measures were trends in procedure rates and type, demographics, complication rate, length of stay, and hospital charges from 2000 through 2009. Results: The inpatient bariatric procedure rate increased from 0.8 per 100 000 in 2000 to 2.3 per 100 000 in 2003 (328 vs 987 procedures) but did not change significantly in 2006 (2.2 per 100 000) or 2009 (2.4 per 100 000), with 925 vs 1009 procedures. The use of laparoscopic adjustable gastric banding approached one-third (32.1%) of all procedures by 2009. The cohort was predominantly female and older than 17 years. The prevalence of comorbidities increased from 2003 (49.3%) to 2009 (58.6%) (P=.002), while the complication rate remained low and the in-hospital length of stay decreased by approximately 1 day (P\u3c.001). Increasing numbers of patients had Medicaid as their primary payer source; however, most (68.3% in 2009) had private insurance. Conclusions: Despite the worsening childhood obesity epidemic, the rate of inpatient bariatric procedures among adolescents has plateaued since 2003. The predominant procedure type has changed to minimally invasive techniques, including laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass. Trends show low complication rates and decreasing length of stay, despite increasing comorbid conditions among patients. © 2013 American Medical Association