Identifying Family Resource and Youth Services Employees Preparedness for Job Responsibilities and Service Offerings in Kentucky

Family Resource and Youth Services Center (FRYSC) coordinators help at-risk students and their families obtain access to the necessary resources to overcome obstacles that affect their ability to learn. Although mandated to provide certain services, each FRYSC coordinator is also able to identify the unique needs of their student population and tailor some services specifically to the children and families in their school community. The current study looks at the educational levels, experience on the job and feelings of preparedness for their positions. Additionally, FRYSC coordinators were asked to provide insight as to which factors influence their job success

The Need for Certified Diabetes Educators and Community Health Workers in Community-Based Diabetes Self-Management Education for High Risk Groups

The number of Americans with diabetes is projected to double, or triple by 2050 according to the Center for Disease Control (CDC). The CDC reports that as many as 1 in 3 U.S. adults could have diabetes by 2050, currently 1 in 10 U.S. adults has diabetes. Longer lifespans and an older, more diverse population are consider contributing factors for the current trend. Research shows that in spite of prevention efforts and medical advances, the prevalence of diabetes will increase by 54% between 2015 and 2030; annual deaths attributed to diabetes will climb by 38%; and total annual medical and societal costs related to diabetes will increase 53% by 2030. CDC scientists have identified a diabetes belt located mostly in the southern portion of the United States. This diabetes belt consists of 644 counties in 15 states. Sixty-eight (68) of Kentucky’s 120 counties are in this diabetes belt, which requires that ≥11% of adults aged ≥20 have been diagnosed as having type 2 diabetes

2018 Kentucky Dental Workforce Update

The perception that oral health is in some way less important than and separate from general health has been deeply ingrained in the American consciousness. Many Americans are unaware of ways to preserve oral health and may not recognize signs indicating they are in trouble. Poor oral health can contribute to various diseases including endocarditis, cardiovascular disease, diabetes, HIV/AIDS, osteoporosis, and Alzheimer’s disease. Kentuckians often fair worse on a multitude of health measures, especially rural Kentuckians. According to the 2019 County Health Rankings data, when compared to US averages, Kentuckians are more likely to smoke (18% vs 23%), be obese (32% vs 36%), be physically inactive (26% vs 31%), have diabetes (12% vs 14%), and report higher instances of poor or fair health (17% vs 22%). Rural Kentuckians experience these conditions at an even higher rate: physical inactivity (32%), diabetes (15%), and 23% report having poor or fair health. Life expectancy also decreases from the US average (77.4 years) to Kentucky’s average (74.4 years) to rural Kentucky’s average (73.8). In fact, the bottom ten counties with the lowest life expectancy are in rural Kentucky: (Owsley (67.8), Perry (69.0), Powell (69.8), Whitley (70.2), Breathitt (70.4), Floyd (70.6), Harlan (70.7), Lee (70.8), Gallatin (70.8), and Leslie (71.0)). Furthermore, Owsley County ranks eleventh in lowest life expectancy among all counties in the US. Social factors can contribute to a patient’s interest in or ability to seek oral health services which include: geography, socioeconomic conditions, oral health literacy, oral health preventive behaviors, and cultural preferences. Health behaviors including diet, smoking, and daily hygiene impact overall oral health. In addition, use of medications, abuse of substances, and genetic factors increase the likelihood of dental disease. Compounding health disparity problems is the lack of adequate reimbursement for oral care services in both public and private programs

Kentucky’s Primary Care Workforce: Current Status and Output of New Trainees January 2020 Update

Primary care is the backbone of American healthcare. Primary care (PC) physicians are especially cost-effective in preventing and managing illness and disability, and prolonging years of quality life. They also contribute significantly to the economy of their communities. Primary care shortages across the Commonwealth are severe. Kentucky ranks 43rd in the USA for its number of PC physicians per 100,000 people. The Commonwealth would have to add 246 primary care physicians annually to reach the US median by the end of 2029. Kentucky produces and retains only about 55 new PC physicians per year, recruiting 55 to 60 more from out of state. This total of 110 – 115 new physicians falls short of the 124 PC physicians that must be added annually to avoid worsening our shortage, and far below the 246 PC physicians that Kentucky would need to add each year to reach the US median in the coming decade

Kentucky’s Primary Care Workforce Shortages 2016 - 2025 and Recommendations for Increasing the Production of Primary Care Physicians for Kentucky

An excerpt from the executive summary: Kentucky and the nation face severe shortages of primary care (PC) physicians. PC physicians are essential to cost-effective healthcare. Kentucky ranks 40th among the United States in its PC physician workforce per 100,000 people, with 2,696 practicing PC physicians statewide. The purposes of this white paper are to: Present up-to-date data and information about the primary care workforce in Kentucky Describe current trainee pipelines that supply new primary care physicians to Kentucky Recommend strategies and tactics for improving the primary care physician workforc

Aboriginal-mainstream partnerships: Exploring the challenges and enhancers of a collaborative service arrangement for Aboriginal clients with substance use issues

Background: Partnerships between different health services are integral to addressing the complex health needs of vulnerable populations. In Australia, partnerships between Aboriginal community controlled and mainstream services can extend health care options and improve the cultural safety of services. However, although government funding supports such collaborations, many factors can cause these arrangements to be tenuous, impacting the quality of health care received. Research was undertaken to explore the challenges and enhancers of a government initiated service partnership between an Aboriginal Community Controlled alcohol and drug service and three mainstream alcohol rehabilitation and support services. Methods. Sixteen staff including senior managers (n=5), clinical team leaders (n=5) and counsellors (n=6) from the four services were purposively recruited and interviewed. Interviews were semi-structured and explored staff experience of the partnership including the client intake and referral process, shared client care, inter-service communication and ways of working. Results & discussion. Communication issues, partner unfamiliarity, 'mainstreaming' of Aboriginal funding, divergent views regarding staff competencies, client referral issues, staff turnover and different ways of working emerged as issues, emphasizing the challenges of working with a population with complex issues in a persistent climate of limited resourcing. Factors enhancing the partnership included adding a richness and diversity to treatment possibilities and opportunities to explore different, more culturally appropriate ways of working. Conclusion: While the literature strongly advises partnerships be suitably mature before commencing service delivery, the reality of funding cycles may require partnerships become operational before relationships are adequately consolidated. Allowing sufficient time and funding for both the operation and relational aspects of a partnership is critical, with support for partners to regularly meet and workshop arrangements. Documentation that makes clear and embeds working arrangements between partners is important to ameliorate many of the issues that can arise. Given the historical undercurrents, flexible approaches are required to focus on strengths that contribute to progress, even if incremental, rather than on weaknesses which can undermine efforts. This research offers important lessons to assist other services collaborating in post-colonial settings to offer treatment pathways for vulnerable populations. © 2013 Taylor et al.; licensee BioMed Central Ltd

Early and Late Direct Costs in a Southern African Antiretroviral Treatment Programme: A Retrospective Cohort Analysis

Gary Maartens and colleagues describe the direct heath care costs and identify the drivers of cost over time in an HIV managed care program in Southern Africa