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Calabrese SK, Krakower DS, Rao S, Hansen NB, Mayer KH, Magnus M, Bunting SR, Marcus JL, Dovidio JF. Acceptability and Effectiveness of a One-Hour Healthcare Provider Intervention Integrating HIV Pre-Exposure Prophylaxis and Cultural Competence Training. AIDS Behav 2023; 27:3932-3940. [PMID: 37401992 PMCID: PMC10906281 DOI: 10.1007/s10461-023-04108-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/02/2023] [Indexed: 07/05/2023]
Abstract
Enhanced provider training could improve PrEP access and equity. We conducted a pilot randomized controlled trial comparing (a) a one-hour, group-based provider intervention integrating PrEP and Cultural Competence (PCC) training with (b) a standard HIV continuing medical education session (n = 56). PCC participants favorably rated the intervention and reported increased PrEP knowledge. The PCC intervention increased their confidence performing PrEP-related clinical activities and intention to prescribe PrEP. The percentage of participants discussing PrEP with patients increased marginally in both study conditions. The percentage of participants who prescribed PrEP and self-rated cultural competence did not change in either study condition.
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Affiliation(s)
- Sarah K Calabrese
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA.
- Department of Prevention and Community Health, George Washington University, Washington, DC, USA.
| | - Douglas S Krakower
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - Sharanya Rao
- Department of Psychological and Brain Sciences, George Washington University, Washington, DC, USA
| | - Nathan B Hansen
- Department of Health Promotion and Behavior, University of Georgia, Athens, GA, USA
| | - Kenneth H Mayer
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Beth Israel Deaconess Medical Center, Harvard University, Boston, MA, USA
| | - Manya Magnus
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, DC, USA
| | - Samuel R Bunting
- Chicago Medical School, Rosalind Franklin University, Chicago, IL, USA
| | - Julia L Marcus
- The Fenway Institute, Fenway Health, Boston, MA, USA
- Department of Population Medicine, Harvard Medical School and Harvard Pilgrim Health Care Institute, Boston, MA, USA
| | - John F Dovidio
- Department of Psychology, Yale University, New Haven, CT, USA
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Cheng C, Papadakos J, Umakanthan B, Fazelzad R, Martimianakis MA(T, Ugas M, Giuliani ME. On the advantages and disadvantages of virtual continuing medical education: a scoping review. CANADIAN MEDICAL EDUCATION JOURNAL 2023; 14:41-74. [PMID: 37465741 PMCID: PMC10351643 DOI: 10.36834/cmej.75681] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Introduction With the COVID-19 pandemic, most continuing medical education activities became virtual (VCME). The authors conducted a scoping review to synthesize the advantages and disadvantages of VCME to establish the impact of this approach on inequities that physicians face along the intersections of gender, race, and location of practice. Methods Guided by the methodological framework of Arksey and O'Malley, the search included six databases and was limited to studies published between January 1991 to April 2021. Eligible studies included those related to accredited/non-accredited post-certification medical education, conferences, or meetings in a virtual setting focused on physicians. Numeric and inductive thematic analyses were performed. Results 282 studies were included in the review. Salient advantages identified were convenience, favourable learning formats, collaboration opportunities, effectiveness at improving knowledge and clinical practices, and cost-effectiveness. Prominent disadvantages included technological barriers, poor design, cost, lack of sufficient technological skill, and time. Analysis of the studies showed that VCME was most common in the general/family practice specialty, in suburban settings, and held by countries in the Global North. A minority of studies reported on gender (35%) and race (4%). Discussion Most studies report advantages of VCME, but disadvantages and barriers exist that are contextual to the location of practice and medical subspecialty. VCME events are largely organized by Global North countries with suboptimized accessibility for Global South attendees. A lack of reported data on gender and race reveals a limited understanding of how VCME affects vulnerable populations, prompting potential future considerations as it evolves.
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Affiliation(s)
| | - Janet Papadakos
- Cancer Education Program, Princess Margaret Cancer Centre, Ontario, Canada
- The Institute for Education Research, University Health Network, Ontario, Canada
- Institute of Health Policy, Management & Evaluation, University of Toronto, Ontario, Canada
| | - Ben Umakanthan
- Cancer Education Program, Princess Margaret Cancer Centre, Ontario, Canada
| | - Rouhi Fazelzad
- Library and Information Sciences, Princess Margaret Cancer Centre, Ontario, Canada
| | | | - Mohamed Ugas
- Cancer Education Program, Princess Margaret Cancer Centre, Ontario, Canada
| | - Meredith Elana Giuliani
- Cancer Education Program, Princess Margaret Cancer Centre, Ontario, Canada
- The Institute for Education Research, University Health Network, Ontario, Canada
- Radiation Medicine Program, Princess Margaret Cancer Centre, Ontario, Canada
- Department of Radiation Oncology, University of Toronto, Ontario, Canada
- The Wilson Centre, University Health Network, Ontario, Canada
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McCaffrey E, Chang S, Farrelly G, Rahman A, Ritchie B, Goldade R, Cawthorpe D. The Economic Impact of Providing Evidence-Based Pediatric Mental Health Literacy Training to Primary Care Physicians. Psychiatry Investig 2021; 18:695-700. [PMID: 34340278 PMCID: PMC8328829 DOI: 10.30773/pi.2021.0014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Accepted: 05/09/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE This paper presents a review of the current state of child and adolescent mental health literacy and provides current evidence of the economic impact of a pediatric mental health literacy (MHL) training program. METHODS Employing a case-series-comparison design, physician referrals to urgent and specialized mental health services were linked with patient-specific information comparing referrals from MHL participants and non-participating physicians. The economic impact analysis was based on changes in the admitted referral frequency and lengths of stay for the MHL group, compared to themselves pretraining, and over the same time period compared to non-participating physicians. RESULTS Average scheduled ambulatory admission rates per physician remained constant for trained and untrained pre-post groups. Average scheduled ambulatory admission wait time and length of stay reduced significantly post-training for MHL-trained physicians compared to pre-training and untrained physicians. In addition to reductions in length of stay, the total bed costs saving for emergency/inpatients admission deferrals was $2,932,112 or about $20,000 per MHL-trained physician. CONCLUSION The estimated economic impact of the MHL training shows a substantial return on investment and supports wider implementation. The MHL training program should be a key feature of mental health reform strategies, as well as continuing and undergraduate medical education.
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Affiliation(s)
- Eden McCaffrey
- Alberta Health Services, Child and Adolescent Addiction and Mental Health and Psychiatry Program, Calgary, Canada
| | - Samuel Chang
- Alberta Health Services, Child and Adolescent Addiction and Mental Health and Psychiatry Program, Calgary, Canada.,Department of Psychiatry, The University of Calgary, Cumming School of Medicine, Calgary, Canada
| | - Geraldine Farrelly
- Alberta Health Services, Child and Adolescent Addiction and Mental Health and Psychiatry Program, Calgary, Canada.,Department of Psychiatry, The University of Calgary, Cumming School of Medicine, Calgary, Canada.,Department of Paediatrics, The University of Calgary, Cumming School of Medicine, Calgary, Canada
| | - Abdul Rahman
- Alberta Health Services, Child and Adolescent Addiction and Mental Health and Psychiatry Program, Calgary, Canada.,Department of Psychiatry, The University of Calgary, Cumming School of Medicine, Calgary, Canada
| | - Blair Ritchie
- Alberta Health Services, Child and Adolescent Addiction and Mental Health and Psychiatry Program, Calgary, Canada.,Department of Psychiatry, The University of Calgary, Cumming School of Medicine, Calgary, Canada
| | - Roxanne Goldade
- Alberta Health Services, Child and Adolescent Addiction and Mental Health and Psychiatry Program, Calgary, Canada.,Department of Psychiatry, The University of Calgary, Cumming School of Medicine, Calgary, Canada.,Department of Paediatrics, The University of Calgary, Cumming School of Medicine, Calgary, Canada
| | - David Cawthorpe
- Alberta Health Services, Child and Adolescent Addiction and Mental Health and Psychiatry Program, Calgary, Canada.,Department of Psychiatry, The University of Calgary, Cumming School of Medicine, Calgary, Canada.,Department of Community Health Sciences, The University of Calgary, Cumming School of Medicine, Calgary, Canada
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