Closing the Gap: Raising Medical Professionals\u27 Transgender Awareness and Medical Proficiency through Pharmacist-led Education

Introduction: Patients who are transgender have unique population-specific needs and risk factors. Nationwide surveys of health profession school administrators indicate a gap in coverage of lesbian, gay, bisexual, and transgender health content in their curricula. To address this gap, a pharmacist-developed transgender–health care focused seminar was presented to medical professionals, trainees, and students accompanied by a novel education assessment scale. Methods: The seminar was presented by a psychiatric pharmacy resident to health care professionals and trainees in various settings. Subjects covered during the seminar included terminology, diagnostic criteria and prevalence of gender dysphoria, nonhormonal treatment, gender-affirming hormone therapy, and other considerations. The Trans* Health Education Evaluation Scale (THEES) was developed to assess participants’ self-perceived proficiency regarding care of patients who are transgender immediately before and after attending a seminar. Total scale scores were compared preseminar and postseminar using a repeated- measures t-test, and sign tests with Bonferroni correction were used for individual scale items. Psychometric properties of this scale were examined. Results: Five seminars were given, and a total of 100 scales were completed by health care–associated workers and students. The majority of participants were in the pharmacy or medical professions. Attending 1 seminar significantly improved THEES total and individual item scores (P,.001). Additionally, 90% of participants felt the seminar was directly applicable to their practice, and 84% felt more confident in providing care to patients who are transgender. Discussion: A single, pharmacist-led, trans health–focused education session significantly improved the confidence level and self-perceived proficiency of health care–associated personnel as measured by THEES

Closing the gap: Raising medical professionals' transgender awareness and medical proficiency through pharmacist-led education

Introduction: Patients who are transgender have unique population-specific needs and risk factors. Nationwide surveys of health profession school administrators indicate a gap in coverage of lesbian, gay, bisexual, and transgender health content in their curricula. To address this gap, a pharmacist-developed transgender–health care focused seminar was presented to medical professionals, trainees, and students accompanied by a novel education assessment scale. Methods: The seminar was presented by a psychiatric pharmacy resident to health care professionals and trainees in various settings. Subjects covered during the seminar included terminology, diagnostic criteria and prevalence of gender dysphoria, nonhormonal treatment, gender-affirming hormone therapy, and other considerations. The Trans* Health Education Evaluation Scale (THEES) was developed to assess participants' self-perceived proficiency regarding care of patients who are transgender immediately before and after attending a seminar. Total scale scores were compared preseminar and postseminar using a repeated-measures t-test, and sign tests with Bonferroni correction were used for individual scale items. Psychometric properties of this scale were examined. Results: Five seminars were given, and a total of 100 scales were completed by health care–associated workers and students. The majority of participants were in the pharmacy or medical professions. Attending 1 seminar significantly improved THEES total and individual item scores (P<.001). Additionally, 90% of participants felt the seminar was directly applicable to their practice, and 84% felt more confident in providing care to patients who are transgender. Discussion: A single, pharmacist-led, trans health-focused education session significantly improved the confidence level and self-perceived proficiency of health care-associated personnel as measured by THEES

Guide to Measuring Household Food Security, Revised 2000

Excerpts: Food insecurity is a complex, multidimensional phenomenon which varies through a continuum of successive stages as the condition becomes more severe. Each stage consists of characteristic conditions and experiences of food insufficiency to fully meet the basic needs of household members, and of the behavioral responses of household members to these conditions. A variety of indicators is needed to capture the various combinations of food conditions, experiences, and behaviors that, as a group, characterize each such stage. This is what the 18-item "core module" set of indicators provides. The chapters below describe some of the characteristic aspects of the continuum of food insecurity and hunger, and Exhibit 3-2 (p.32) illustrates graphically the relationship of the food security measure to this continuum. An even larger, more detailed indicator set than the 18-item standard U.S. food security scale might do an even better job of measuring the severity of food insecurity/hunger--e.g., it could distinguish more fully among the various time paths of the experience (cyclical, episodic, prolonged, brief but intense, etc.) and among the alternative behavioral paths that reveal the various coping strategies that households employ in attempting to deal with food-resource inadequacy. However, for the main purpose of assessing the prevalence of food insecurity/hunger at each of its several measurable levels of severity among U.S. households, the 18-item core module has been shown to be a stable, robust, and reliable measurement tool. The Core Module has been designed, not only for use in national surveys, but also for local groups wanting to determine the extent and severity of food insecurity and hunger within their own communities, using a technically well grounded and tested method to produce local prevalence estimates comparable with national and state-level standard benchmark figures. Local studies using either the Core Module or the standard 6-item subset can play a key role in documenting the presence of hunger in the community as measured under standard national practice, in providing a sound base for broader community needs assessment, and in helping focus attention on unmet food-security needs within the community

A cluster randomized intervention trial to promote shoe use by children at high risk for podoconiosis

Abstract The aim was to evaluate whether an intervention including education about the role of inherited susceptibility in development of a tropical lymphedema increased shoe-wearing among high risk children without increasing community stigma. A cluster randomized intervention trial was conducted with caregivers in affected and unaffected households. Six communities in Ethiopia were randomly assigned to: (1) usual care health education (UC), (2) household-based skills training and community awareness campaign (HB), or (3) HB plus a genetics education module (GE). Recruitment for the six month intervention began in February 2012 and study activities were completed May 2013. Primary outcomes 3 and 12 months were direct observation of shoe use by an index child (age 3-6), experienced stigma among affected participants (n=585), and unaffected participants’ (n=1,124) reports of enacted stigma. Among affected households, neither intervention arm increased shoe wearing or reduced stigma relative to the usual care condition at 3 or 12 months (shoe wearing 3-month difference (95% CI): HB-UC 0.15 (-0.09, 0.40); GE-UC 0.07 (-0.18, 0.32); 12- month: HB-UC -0.24 (-0.34, -0.14); GE-UC -0.18 (-0.28, -0.08); stigma 3-month: HB-UC 0.42 ( -0.63, 1.47); GE-UC 0.62 (-0.43, 1.66); 12-month: HB-UC 0.49 (-0.02, 0.99) ; GE-UC 0.12 ( -0.38, 0.62)). Among unaffected households, differences by intervention arms were marginally significant (p<0.09) with the GE and HB arms showing the largest baseline to 12 month decreases in enacted stigma: HB-UC -0.25 (-0.64, 0.15) ; GE-UC -0.45 (-0.84, -0.05). Improved understanding of disease heritability showed greatest benefit for unaffected households. Key words: intervention, genetics, shoe wearing, neglected tropical disease