Rethinking Health Partnerships: Florida International University Herbert Wertheim College of Medicine’s Medical-Legal Partnership

Medical-legal partnership is a healthcare innovation aimed at addressing social determinants of health by adding lawyers to the healthcare team. Florida International University’s Herbert Wertheim College of Medicine (HWCOM) is leading innovation in teaching social determinants of health, interprofessional education, and medical-legal collaboration by way of its flagship service-learning program, Green Family Foundation Neighborhood Health Education Learning Program. This poster will demonstrate how the medical-legal partnership approach to addressing social determinants of health is applied at HWCOM, and present data on how exposure to medical-legal partnership is impacting the thinking of HWCOM students. The poster will feature data from ongoing research, and presenters will engage with the interdisciplinary audience to discuss the research, answer questions, and gain insight from audience reflections

Development of Learning Objectives to Guide Enhancement of Chronic Disease Prevention and Management Curricula in Undergraduate Medical Education

Phenomenon: Chronic disease is a leading cause of death and disability in the United States. With an increase in the demand for healthcare and rising costs related to chronic care, physicians need to be better trained to address chronic disease at various stages of illness in a collaborative and cost-effective manner. Specific and measurable learning objectives are key to the design and evaluation of effective training, but there has been no consensus on chronic disease learning objectives appropriate to medical student education. Approach: Wagner’sChronic Care Model (CCM) was selected as a theoretical framework to guide development of an enhanced chronic dis-ease prevention and management (CDPM) curriculum. Findings of a literature review of CDPM competencies, objectives, and topical statements were mapped to each of the six domains of the CCM to understand the breadth of existing learning topics within each domain. At an in-person meeting, medical educators prepared a survey for the modified Delphi approach. Attendees iden-tified 51 possible learning objectives from the literature review mapping, rephrased the CCM domains as competencies, constructed possible CDPM learning objectives for each competency with the goal of reaching multi-institutional consensus on a limited number of CDPM learning objectives that would be feasible for institutions to use to guide enhancement of medical student curricula related to CDPM. After the meeting, the group developed a survey which included 39 learning objectives. In the study phase of the modified Delphi approach, 32 physician CDPM experts and educators completed an online survey to prioritize the top 20 objectives. The next step occurred at a CDPM interest group in-person meeting with the goal of identifying the top 10 objectives. Findings: The CCM domains were reframed as the following competencies for medical student education: patient self-care management, decision support, clinical information systems, community resources, delivery systems and teams, and health system practice and improvement. Eleven CDPM learning objectives were identified within the six competencies that were most important in developing curriculum for medical students. Insights: These learning objectives cut across education on the prevention and management of individual chronic diseases and frame chronic disease care as requiring the health system science competencies identified in the CCM. They are intended to be used in combination with traditional disease-specific pathophysiology and treatment objectives. Additional efforts are needed to identify specific curricular strategies and assessment tools for each learning objective

Imbalanced Incentives: A Content Analysis of research Participant Incentive Structures in Clinical and Translational Science

In conducting research with underserved and vulnerable populations, incentives for research participants can improve recruitment efforts. However, incentives lose influence if researchers treat them as merely transactional. This study seeks to identify how researchers describe research participant incentives and incentive structures, with a focus on populations that experience health disparities. This study is a content analysis of research publications from peer-reviewed clinical journals. Although researchers share information about procedures through conference proceedings and grey literature, the most common mechanism for disseminating details about research studies is peer-reviewed literature. Sampling included research manuscripts from four journals (Annals of Family Medicine, Annals of Internal Medicine, American Journal of Emergency Medicine, American Journal of Obstetrics and Gynecology) within 2017-19. Within each issue, coders coded all manuscripts that the journal categorized as research. Using a deductive coding scheme, four authors sorted papers by research that enrolled participants versus other methods and then coded papers for variables of interest. Of 519 articles reviewed, 204 reported results to studies that enrolled human participants. Nine of these targeted populations that were vulnerable or experience disparities. Of 204 studies, 12 (5.9%) described an incentive for research participation. Participant type was significantly associated with offering a participant incentive, p \u3c .001. Healthcare workers and online participants were more likely to receive an incentive than clinical research participants. Funding was also significantly associated with offering a participant incentive, p \u3c .001, regardless of funding source. Of the 12 papers that disclosed incentive information, two focused on vulnerable populations. Findings here show few publications describe incentive structures, which indicates that either 1) incentives are underutilized in recruitment efforts or 2) studies are not publishing incentive information. Furthermore, incentives are more frequently used to recruit healthcare worker populations than community or clinical participants, which may indicate a transactional approach in contrast to a community or patient-oriented approach to research participation. A standardized approach to describing incentives could help researchers and clinicians contextualize a study’s findings

How Attributes of Place Threaten Community Trust in the American South: Opportunities for Improving Pandemic-Related Communication

Trust and mistrust influence the utilization of health services, the quality of overall healthcare, and the prevalence of health disparities. Trust has significant bearing on how communities, and the individuals within them, perceive health information and recommendations. The People and Places Framework is utilized to answer what attributes of place threaten community trust in public health and medical recommendations.Augusta-Richmond County is ranked among the least healthy counties in Georgia despite being home to the best healthcare-to-residence ratios and a vast array of healthcare services. Semi-structured interviews were conducted with 31 neighborhood residents. Data were analyzed using the Sort & Sift, Think & Shift method. Threats to community trust were identified within four local-level attributes of place: availability of products and services, social structures, physical structures, and cultural and media messages. We found a broader web of services, policies, and institutions, beyond interactions with health care, that influence the trust placed in health officials and institutions. Participants spoke to both a potential lack of trust (e.g. needs not being met, as through lack of access to services) and mistrust (e.g. negative motives, such as profit seeking or experimentation). Across the four attributes of place, residents expressed opportunities to build trust. Our findings highlight the importance of examining trust at the community level, providing insight into an array of factors that impact trust at a local level, and extend the work on trust and its related constructs (e.g. mistrust). Implications for improving pandemic-related communication through community relationship building are presented