Report of Responses to the 2004, 2006, and 2008 Physician Assistant Re-Licensure Surveys

The Indiana State Department of Health and the Indiana Professional Licensing Agency developed a collaborative partnership to collect data through the licensing process to better understand the health professions workforce within the state. Beginning in 2004, physician assistants were asked to participate in voluntary surveys when renewing their licenses ever y two years. The purpose of this report is to summarize the participants’ responses to the survey items. The responses provide a detailed description of the physician assistant workforce in the state of Indiana to aid in the development of policies and programs to recruit and retain these health professionals where they are needed in Indiana

Listening through seeing: Using design methods to learn about the health perceptions of Garden on the Go® customers

The goal of this project is to apply an innovative approach to gathering beliefs and attitudes of an inner city population in a more valid and reliable way than traditional data collection methods. This community based research study will focus on dietary risk factors for obesity, diabetes type 2, and cardiovascular disease in underserved communities. Our study assesses what health means to the underserved Garden on the Go® clients and how they define a healthy diet. Garden on the Go®, a signature obesity prevention effort, is Indiana University Health’s year-round mobile produce delivery program providing fresh, affordable produce to Marion County neighborhoods in need. We build upon previous research conducted with Garden on the Go® to enhance the effectiveness of this intervention and provide valuable information that other groups may use to improve the impact of their efforts in meeting the health needs of similar communities

A Community Needs Assessment of the Physical Activity and Food Environment in a Predominantly Hispanic U.S. City

Introduction: Hispanics suffer disproportionately compared with non-Hispanic Whites from health conditions that are affected by physical inactivity and poor dietary habits. Method: A needs assessment was conducted in Hialeah, Florida, the largest enclave of Cubans in the United States, to assess the perspectives of community stakeholders and members regarding the roles of physical activity and nutrition environments. Interviews were performed with community stakeholders (n = 21), and responses were grouped into major themes. Surveys were conducted with community members (n = 85). Descriptive analyses were used to categorize responses and potential differences across responses were explored. Results: Both community members and stakeholders reported that the local park system was a major asset to healthy living in Hialeah and agreed that traffic issues and a lack of walkability were major barriers to being physically active; however, there was variability in the response to the quality of the food environment. Conclusion: The perspectives of the community members and stakeholders will be valuable in highlighting pathways to enhancing the health and wellness of the residents of Hialeah

THE FACTORS OF AN INDIANA BACKGROUND THAT INFLUENCE PRACTICE LOCATION CHOICE OF RESIDENCY AND FELLOWSHIP GRADUATES

poster abstractA shortage and unequal distribution of health care professionals in Indiana is increasingly restricting access to quality medical care for Indiana residents. There is a limited amount of research on the factors that predominate when residency and fellowship graduates choose their practice location. This pro-ject looks at the different factors affecting graduates’ choices of practice lo-cation, while specifically focusing on the connection of hometown, high school, college, and medical school locations to their decisions to practice in Indiana. Surveys were completed by 264 of the 383 graduating residents and fellows of the graduate medical education programs at Indiana Universi-ty School of Medicine during the exit interview process, yielding a response rate of 69%. The graduates responded to questions concerning demographic characteristics, assessment of their training, plans after graduation, intended practice location, and reasons for choosing their practice location. The larg-est contributor to choosing to practice in Indiana was graduating from a medical school in Indiana (80.6%). Having an Indiana hometown was the least contributing factor (76.1%), but the combination of hometown and medical school was the highest contributing factor (82.1%) to choosing to practice in Indiana. The top three reasons to stay in Indiana given by re-spondents who graduated from an Indiana medical school were “met my professional needs or preferences” (88.0%), “liked the people” (86.0%), and “met my personal needs or preferences” (76.0%). Also, factors concerning the needs of their spouse and family were only moderately important. This project’s data may assist admission committees when choosing graduates for their residency programs. By admitting more graduates who have deeper connections to Indiana, the number of health professionals in Indiana may increase, thus allowing more of Indiana’s residents to have access to quality health care

Dental Workforce Report of Indiana University School of Dentistry Graduates and Other Practicing Dentists in Indiana

All dentists who renewed their Indiana licenses on - line in 2010 or 2012 were asked to complete a voluntary survey instrument that ha d a 95.4% response rate 1 in 2010 and 80.7% response rate 2 in 2012. The purpose of this study was to describe the dental workforce in Indiana with a focus on comparing graduates from the Indiana University School of Dentistry (IUSD) to all other practicing ( n on - IUSD ) dentists in Indiana. Of primary interest is how well the graduates of IUSD are meeting the oral health needs of the population of the state, particularly in the rural and underserved areas. Using data from the Office of Alumni Relations at IUPUI, license numbers of IUSD alumni were matched to the license numbers of individuals in the 2010 or 2012 Indiana Dentist Licensure Survey datasets. Individuals whose license numbers matched with the alumni list were identified as “IUSD” graduates and those that did not match were identified as “non - IUSD” graduates. This report compares responses between 2,203 IUSD and 835 n on - IUSD graduates who renewed their licenses and completed the Indiana Dentist Licensure Surveys in 2010 or 2012, respectively. Lastly, most of the differences between groups were found to be statistically significant due to the large sample size of IUSD graduates compared to non - IUSD graduates. Thus, for the purposes of this report if the differences between groups were noted to be at least 10 percent they were considered remarkable and reported as such

Urinary phytoestrogens and cancer, cardiovascular, and all-cause mortality in the continuous National Health and Nutrition Examination Survey

Purpose Experimental studies suggest that phytoestrogen intake alters cancer and cardiovascular risk. This study investigated the associations of urinary phytoestrogens with total cancer (n = 79), cardiovascular (n = 108), and all-cause (n = 290) mortality among 5179 participants in the continuous National Health and Nutrition Examination Survey (1999–2004). Methods Urinary phytoestrogens were measured using high-performance liquid chromatography with tandem mass spectrometric detection. Survival analysis was performed to evaluate hazard ratios (HRs) and 95 % confidence intervals (CIs) for each of the three outcomes in relation to urinary phytoestrogens. Results After adjustment for confounders, higher urinary concentrations of total enterolignans were associated with a reduced risk of death from cardiovascular disease (HR for tertile 3 vs. tertile 1 0.48; 95 % CI 0.24, 0.97), whereas higher urinary concentrations of total isoflavones (HR for tertile 3 vs. tertile 1 2.14; 95 % CI 1.03, 4.47) and daidzein (HR for tertile 3 vs. tertile 1 2.05; 95 % CI 1.02, 4.11) were associated with an increased risk. A reduction in all-cause mortality was observed for elevated urinary concentrations of total enterolignans (HR for tertile 3 vs. tertile 1 0.65; 95 % CI 0.43, 0.96) and enterolactone (HR for tertile 3 vs. tertile 1 0.65; 95 % CI 0.44, 0.97). Conclusions Some urinary phytoestrogens were associated with cardiovascular and all-cause mortality in a representative sample of the US population. This is one of the first studies that used urinary phytoestrogens as biomarkers of their dietary intake to evaluate the effect of these bioactive compounds on the risk of death from cancer and cardiovascular disease

Association between Urinary Phytoestrogens and C-reactive Protein in the Continuous National Health and Nutrition Examination Survey

Objective: A reduced risk of some cancers and cardiovascular disease associated with phytoestrogen intake may be mediated through its effect on serum C-reactive protein (CRP; an inflammation biomarker). Therefore, this study examined the associations between urinary phytoestrogens and serum CRP. Methods: Urinary phytoestrogen and serum CRP data obtained from 6009 participants aged ≥ 40 years in the continuous National Health and Nutrition Examination Survey during 1999–2010 were analyzed. Results: After adjustment for confounders, urinary concentrations of total and all individual phytoestrogens were inversely associated with serum concentrations of CRP (all p < 0.004). The largest reductions in serum CRP (mg/L) per interquartile range increase in urinary phytoestrogens (ng/mL) were observed for total phytoestrogens (β = −0.18; 95% confidence interval [CI], −0.22, −0.15), total lignan (β = −0.15; 95% CI, −0.18, −0.12), and enterolactone (β = −0.15; 95% CI, −0.19, −0.12). A decreased risk of having high CRP concentrations (≥3.0 mg/L) for quartile 4 vs quartile 1 was also found for total phytoestrogens (OR = 0.63; 95% CI, 0.53, 0.73), total lignan (OR = 0.64; 95% CI, 0.54, 0.75), and enterolactone (OR = 0.59; 95% CI, 0.51, 0.69). Conclusion: Urinary total and individual phytoestrogens were significantly inversely associated with serum CRP in a nationally representative sample of the U.S. population

Dietary intake of isoflavones and coumestrol and the risk of prostate cancer in the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial

Experimental studies have revealed that phytoestrogens may modulate the risk of certain sites of cancer due to their structural similarity to 17β‐estradiol. The present study investigates whether intake of these compounds may influence prostate cancer risk in human populations. During a median follow up of 11.5 years, 2,598 cases of prostate cancer (including 287 advanced cases) have been identified among 27,004 men in the intervention arm of the Prostate, Lung, Colorectal and Ovarian Cancer Screening Trial. Dietary intake of phytoestrogens (excluding lignans) was assessed with a food frequency questionnaire. Cox proportional hazards regression analysis was performed to estimate hazard ratios (HRs) and 95% confidence intervals (CI) for dietary isoflavones and coumestrol in relation to prostate cancer risk. After adjustment for confounders, an increased risk of advanced prostate cancer [HR (95% CI) for quintile (Q) 5 vs. Q1] was found for the dietary intake of total isoflavones [1.91 (1.25–2.92)], genistein [1.51 (1.02–2.22), daidzein [1.80 (1.18–2.75) and glycitein [1.67 (1.15–2.43)] (p‐trend for all associations ≤0.05). For example, HR (95% CI) for comparing the Q2, Q3, Q4 and Q5 with Q1 of daidzein intake was 1.45 (0.93–2.25), 1.65 (1.07–2.54), 1.73 (1.13–2.66) and 1.80 (1.18–2.75), respectively (p‐trend: 0.013). No statistically significant associations were observed between the intake of total isoflavones and individual phytoestrogens and non‐advanced and total prostate cancer after adjustment for confounders. This study revealed that dietary intake of isoflavones was associated with an elevated risk of advanced prostate cancer

Report of Responses to the 2003, 2005 and 2007 Indiana Physician Surveys

A variety of survey methods have been used since the 1970’s to learn more about the physician supply and distribution in the state of Indiana. Since 1997, a voluntary survey instrument has been attached to the physician license renewal form, which physicians complete every 2 years. Those renewing their licenses online in 2003, 2005 and 2007 were invited to complete the survey. Those renewing their license through the mail were not given the opportunity to complete the survey. The physician survey was implemented through a collaboration of the Indiana State Department of Health (ISDH) and the Indiana Professional Licensing Agency (IPLA). This report summarizes the responses to the 2003, 2005 and 2007 Indiana Physician Surveys and compares these results to the results of the prior physician surveys reported in the Indiana Physician Survey Databook, 1997 and the Indiana Physician Survey Databook, 2001

Data Brief: Indiana Physician Assistants 2012

The physician assistant (PA) workforce in Indiana is growing quickly. Since 2004, the estimated number of non‐government − employed PAs actively working in Indiana has more than doubled, from less than 400 in 2004 to nearly 900 in 2012