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Grant AR, Cockburn B, Ahmed F, Dumanian R, Garcia Y, Gould J, Martinez-Novoa F, McFarland M, Dawson-Hahn E. Caregiver Experience with Bicultural, Bilingual Family Navigators to Support Early Childhood Development. J Immigr Minor Health 2024:10.1007/s10903-024-01591-9. [PMID: 38587688 DOI: 10.1007/s10903-024-01591-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2024] [Indexed: 04/09/2024]
Abstract
Recognizing the inequities in developmental screening and services for children in immigrant families, a pediatric primary care clinic in partnership with a community-based early childhood program co-created a bicultural, bilingual early childhood developmental (ECD) family navigator program in Seattle, Washington. The primary aim of this study is to explore caregivers' perspectives about this program. Twenty-seven caregivers of young children participated in semi-structured interviews that were thematically analyzed. Three key themes were identified: 1) sharing language and culture, 2) facilitating accessibility, and 3) promoting development. Caregivers valued linguistic and cultural concordance between the navigator and the family, the navigator's approach to screening to improve accessibility and reduce barriers, and the focus on supporting early childhood development. Understanding caregivers' experience with the ECD family navigator development program and the aspects they value, informs clinic-based approaches to ensure families of diverse language and cultural backgrounds have accessible development screening and connection to services.
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Affiliation(s)
- Abigail R Grant
- Department of Pediatrics, University of Washington, 325 Ninth Ave, Seattle, WA, 98104, USA.
- Harborview Medical Center, Seattle, WA, USA.
| | - Brenna Cockburn
- School of Medicine, University of Washington, Seattle, WA, USA
| | | | | | | | | | | | | | - Elizabeth Dawson-Hahn
- Department of Pediatrics, University of Washington, 325 Ninth Ave, Seattle, WA, 98104, USA
- Harborview Medical Center, Seattle, WA, USA
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Pang EM, Saynina O, Schapira L, Wise PH, Boynton H, Smith M, Chamberlain LJ, Smith SM. Cancer center-based follow-up among pediatric and adolescent/young adult cancer survivors: the role of a community-based organization and the social determinants of health. J Cancer Surviv 2023:10.1007/s11764-023-01463-5. [PMID: 37792162 DOI: 10.1007/s11764-023-01463-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 09/08/2023] [Indexed: 10/05/2023]
Abstract
PURPOSE Adherence to survivorship care is suboptimal among pediatric and adolescent/young adult (AYA) cancer survivors. We evaluated predictors of cancer center-based follow-up among pediatric/AYA cancer survivors, with an emphasis on social determinants of health (SDOH). METHODS This retrospective cohort study used electronic health record data at an academic medical center to identify patients aged 0-29 years at last cancer treatment who completed treatment 2010-2019. Cancer center-based follow-up was defined by oncology or survivorship clinic visits through 12/31/2022. Multivariate logistic regression models (overall, ages 0-19 [pediatric], 20-29 [YA]) evaluated the association of demographics, clinical/treatment characteristics, and SDOH (insurance type, distance to cancer center, area deprivation index) with clinic attendance. Further modeling accounted for the service area of a community-based organization (CBO) that supports families of children with cancer. RESULTS A total of 2210 survivors were included (56% pediatric, 44% YA; 66% non-White). Cancer center-based follow-up decreased from 94% 1-year post-treatment to 35% at > 5-7 years. In adjusted analysis, AYAs had the lowest follow-up (5-7 years post-treatment: OR 0.25 [0.15-0.41] for age 25-29; OR 0.25 [0.16-0.41] for age 20-24; OR 0.32 [0.20-0.52] for age 15-19). Survivors residing within the CBO service area were twice as likely to follow-up (OR 2.10 [1.34-3.29]). CONCLUSIONS Among a diverse population, AYA survivors were vulnerable to loss to follow-up. Other SDOH were not consistently associated with follow-up. Support from a CBO may partly explain these findings. IMPLICATIONS FOR CANCER SURVIVORS CBOs may strengthen survivorship follow-up within medically underserved communities. More research is needed to understand community support in survivorship.
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Affiliation(s)
- Emily M Pang
- Stanford University School of Medicine, Stanford, CA, USA
| | - Olga Saynina
- Center for Policy, Outcomes, and Prevention, Stanford University School of Medicine, Stanford, CA, USA
| | - Lidia Schapira
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Palo Alto, CA, USA
- Stanford Cancer Institute, Stanford, CA, USA
| | - Paul H Wise
- Center for Policy, Outcomes, and Prevention, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Heidi Boynton
- Jacob's Heart Children's Cancer Support Services, Watsonville, CA, USA
| | - Mary Smith
- Jacob's Heart Children's Cancer Support Services, Watsonville, CA, USA
| | - Lisa J Chamberlain
- Center for Policy, Outcomes, and Prevention, Stanford University School of Medicine, Stanford, CA, USA
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA, USA
| | - Stephanie M Smith
- Department of Pediatrics, Division of Pediatric Hematology, Oncology, Stem Cell Transplantation & Regenerative Medicine, Stanford University School of Medicine, 750 Welch Rd, Suite 200, Palo Alto, CA, 94304, USA.
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Allen J. Successful development and implementation of a clinical practice site with community partners to engage family nurse practitioner students in health equity. J Prof Nurs 2023; 48:147-151. [PMID: 37775228 DOI: 10.1016/j.profnurs.2023.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 07/12/2023] [Accepted: 07/16/2023] [Indexed: 10/01/2023]
Abstract
BACKGROUND Family nurse practitioner (FNP) student clinical practice site availability is limited. Concurrently, many populations lack healthcare access, a common health inequity. Collaboration with community partners to develop clinical practice sites offer students active learning opportunities to increase their engagement and understanding of health equity. PURPOSE Using community collaboration, develop and implement an FNP student clinical practice site that can provide learning opportunities in addressing health equity. METHODS Local health data was reviewed, and health gaps were associated with social determinant of health inequities. A community partner was identified with the goal of facilitating students to provide proactive health care to homeless women. Health promotion and disease identification has been the focus of care provided by FNP students and faculty during an early-program clinical course, increasing access to care for an underserved population. CONCLUSION A community-academic partnership has developed where FNP students provide health promotion and safety net health care to homeless women since 2017. Student reflections have shown a positive impact on their understanding of health equity. The community partner has identified positive impacts to client health. This partnership has impacted health equity by increasing healthcare access for an underserved population while facilitating FNP student learning.
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Yeboah D, Tieder A, Durkin A, Walker-Harding LR. Health Care Anchors' Responsibilities and Approaches to Achieving Child Health Equity. Pediatr Clin North Am 2023; 70:761-774. [PMID: 37422313 DOI: 10.1016/j.pcl.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/10/2023]
Abstract
This article provides an overview of the anchor institution concept, recommended strategies for embracing an anchor mission, and the challenges that can arise in the process. An anchor mission centers on advocacy, social justice, and health equity. Hospitals and health systems are anchor institutions that are uniquely positioned to utilize their economic and intellectual resources in partnership with communities to mutually benefit the long-term well-being of both. Anchor institutions have a responsibility to invest in the education and development of their leaders, staff, and clinicians in health equity, diversity, inclusion, and anti-racism.
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Affiliation(s)
- Desiree Yeboah
- University of Washington/Seattle Children's Hospital, 4800 Sand Point Way Northeast, M/S OC.7830 PO Box 5371, Seattle, WA 98145-5005, USA.
| | - Alicia Tieder
- Seattle Children's Center for Diversity and Health Equity, 4800 Sand Point Way Northeast, M/S RB.2.419, Seattle, WA 98105, USA
| | - Ashley Durkin
- Seattle Children's Center for Diversity and Health Equity, 4800 Sand Point Way Northeast, M/S RB.2.419, Seattle, WA 98105, USA
| | - Leslie R Walker-Harding
- University of Washington/Seattle Children's Hospital, 4800 Sand Point Way Northeast, Seattle, WA 98105, USA
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Thelly ASS, Rose MJ, Rana S. Epilogue: Reflections from Stakeholders of a Facilitated Community Partnership Developed to Provide Palliative Care to a Vulnerable Population in Kerala. Indian J Palliat Care 2023; 29:94-99. [PMID: 36846278 PMCID: PMC9944653 DOI: 10.25259/ijpc_81_2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Accepted: 08/15/2022] [Indexed: 11/04/2022] Open
Abstract
Introduction In mid-March 2020, the Kerala government implemented additional preventive measures to the steps already taken to reduce the transmission of COVID-19. Strategies were taken by a non-governmental palliative care organisation (Pallium India) with Coastal Students Cultural Forum - a coastal area-based collective of young educated people in the coastal region to address the medical needs of people living in this community. The facilitated partnership lasted 6 months (July-December 2020) and addressed the palliative care needs of the community in the selected coastal regions during the first wave of the pandemic. Volunteers sensitised by the NGO identified more than 209 patients. The current article highlights the reflective narratives of key players in this facilitated community partnership. Materials and Method The current article is dedicated to highlighting the reflective narratives of key players in this facilitate community partnership to the readers of this journal. The palliative care team's overall experience was collected from selected key participants to understand the program's impact, identify areas of improvement, and discuss possible solutions if there were any challenges. The contents below are their statements on the experience of the entire program. Conclusion Palliative care delivery programmes must be configured to respond to local needs and customs, be community-based and integrated with local health and social care and have accessible referral pathways between and across services. They must also be responsive to changing individual and population needs and shifts in local and national health structures.
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Affiliation(s)
- Anu Savio Savio Thelly
- Department of Palliative Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - M. Jima Rose
- Coastal Students Cultural Forum, Thiruvananthapuram, Kerala, India
| | - Smriti Rana
- Pallium India Trust, Aisha Memorial Hospital Building, Thiruvananthapuram, Kerala, India
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Im H, Swan LET. "We Learn and Teach Each Other": Interactive Training for Cross-Cultural Trauma-Informed Care in the Refugee Community. Community Ment Health J 2022; 58:917-929. [PMID: 34618270 DOI: 10.1007/s10597-021-00899-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 05/24/2021] [Indexed: 11/27/2022]
Abstract
This paper introduces culturally responsive and trauma-informed mental health training modules to build and enhance competences and partnerships among mental health professionals and refugee community leaders, while facilitating intercultural, mutual learning between participants from various cultural and professional backgrounds. Focus group interviews and participant self-reflections with the training participants (N = 54) were analyzed using thematic analysis. Findings revealed an enhanced understanding of culturally unique as well as universal trauma responses and coping in the refugee community, which led to the building and strengthening of a sense of community and an expansion of social networks and support systems. This study highlights the effectiveness of interactive learning and knowledge transference among participants with various cultural and professional backgrounds, showing that face-to-face interactions and mutual learning reportedly facilitated building relationships and trust among participants and especially those between refugee/immigrant community leaders and service providers.
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Affiliation(s)
- Hyojin Im
- School of Social Work, Virginia Commonwealth University, 1000 Floyd Ave, Richmond, VA, 23804, USA.
| | - Laura E T Swan
- Department of Population Health Sciences, University of Wisconsin-Madison, 610 Walnut St., Madison, WI, 53726, USA
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Arisukwu O, Akinfenwa S, Igbolekwu C. Primary healthcare services and maternal mortality in Ugep. Ann Med Surg (Lond) 2021; 68:102691. [PMID: 34401145 PMCID: PMC8358631 DOI: 10.1016/j.amsu.2021.102691] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/04/2021] [Accepted: 08/04/2021] [Indexed: 11/19/2022] Open
Abstract
This paper focusses on pregnancy related deaths which is a contemporary issue in modern day Nigeria. Maternal Mortality is more pronounced in Ugep, Cross River State with the maternal mortality ratio of l200/100,000 which is higher than the national figure of 1100/100,000 (Nigerian Partnership for Safe Motherhood, 2018). In Nigeria, about 75 % of women die as a result of these complications either during the course of giving birth or the week preceding delivery (Choudhry, 2012). Recent statistics shows that Maternal deaths account for 32% of all deaths among women age 15-49 in Nigeria. The maternal mortality rate for the seven-year period preceding NDHS 2013 survey was 1.05 maternal deaths per 1000 women. The maternal mortality ratio was 576 maternal deaths per 100,000 live births. The lifetime risk of maternal death indicates that out of every 30 women in Nigeria, one will have a death related to pregnancy or childbearing (NDHS, 2013). Statistics further revealed that pregnancy complications in 2012 led to the death of over 52,000 women in Nigeria (Dada, 2016). Maternal Mortality in the seven years preceding the National Demographic Health Survey in 2013 records the figure of live births to be 575 per 100,000, which implies that for one single pregnancy complications resulting to death, more than 20 others are confronted with disabilities which may last a life time, (NDHS, 2013). The theoretical application combines aspects of the Environmental Precedence Theory, Rational Choice Theory and the Health Belief Model (HBM) to explain core variables of the relationship between maternal health practices and pregnancy outcomes. Several conclusions were inferred from the application of sociological theories to the chosen contemporary issue.
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Affiliation(s)
- Ogadimma Arisukwu
- SDG 10, Nigeria
- Department of Sociology, Landmark University, Nigeria
| | - Stephen Akinfenwa
- SDG 10, Nigeria
- Department of Sociology, Landmark University, Nigeria
| | - Chisaa Igbolekwu
- SDG 10, Nigeria
- Department of Sociology, Landmark University, Nigeria
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Kyle RG, Atherton IM, Lasater K. Context, complexity and cross-pollination: Nursing leaders' views of the role of the voluntary and community sector in nurse education. Nurse Educ Today 2021; 99:104732. [PMID: 33592543 DOI: 10.1016/j.nedt.2020.104732] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/12/2020] [Revised: 12/03/2020] [Accepted: 12/16/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Placements in voluntary and community sector (VCS) organisations have long played an important part in student nurses' education in several countries. New standards for nurse education published by the Nursing and Midwifery Council in the United Kingdom include significant changes to practice supervision arrangements that enable students to spend more time in VCS organisations. OBJECTIVES To assess nursing leaders' views on the role of the VCS in nursing education and benefits of VCS placements for students and organisations. DESIGN Qualitative interview study. PARTICIPANTS Twenty-four nursing leaders from academic (n=15), practice (n=4) and regulatory (n=5) sectors. METHODS Semi-structured interviews were conducted face-to-face (n=21), by telephone (n=2) or Skype (n=1). Interviews were transcribed and analysed, using interview questions as structural themes, followed by inductive thematic analysis. RESULTS Nursing leaders identified three key roles for the VCS in nursing education: (1) determining knowledge needs; (2) developing curricula; (3) providing placements. Five key benefits of VCS placements for students were shared: (1) understanding the contribution of the VCS to care; (2) seeing the context and complexity of people's lives; (3) challenging attitudes and perceptions; (4) gaining confidence, knowledge and skills; and (5) supporting career decisions. Three benefits for VCS organisations were found: (1) cross-pollinating knowledge, skills and networks; (2) changing organisational cultures; (3) promoting careers in the VCS. CONCLUSIONS Changes to practice supervision models enabling closer relationships with the VCS were welcomed. Nursing leaders thought that VCS placements had potential to cross-pollinate ideas and harness the role of student nurses as knowledge brokers in increasingly integrated health and social care systems. Nurse educators should embrace opportunities offered through collaboration with the VCS for student learning and deeper partnerships across health and social care settings to enable students to gain deeper insight into the context and complexity of people's lives.
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Affiliation(s)
- Richard G Kyle
- Research & Evaluation, Public Health Wales, Cardiff, Wales, UK
| | | | - Kathie Lasater
- Edinburgh Napier University, Edinburgh, Scotland, UK; Oregon Health & Science University, Portland, OR, USA.
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Mendelson T, Sheridan SC, Clary LK. Research with youth of color in low-income communities: Strategies for recruiting and retaining participants. Res Social Adm Pharm 2020; 17:1110-1118. [PMID: 32912828 PMCID: PMC7445129 DOI: 10.1016/j.sapharm.2020.08.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Revised: 08/13/2020] [Accepted: 08/14/2020] [Indexed: 12/22/2022]
Abstract
Background Youth of color from low-income urban communities are crucial participants in research, as their involvement can shape effective, culturally responsive interventions and policy to promote youth health and well-being. These young people, however, are an often-neglected research population, due in part to perceived challenges associated with their inclusion as well as marginalized communities’ justifiable mistrust of research. Objectives Based on our experience conducting a school-based randomized intervention trial in Baltimore, Maryland, we present strategies for conducting research with low-income, urban youth of color. We discuss strategies in three domains: university-community partnership development, participant recruitment, and participant retention. Methods We reviewed partnership building and recruitment strategies employed by our team across four years of trial implementation and evaluated success of participant retention at our final survey timepoint. Results Partnership building was facilitated by selection of a study design that maximized benefits for all participants, promotion of capacity building at partner institutions, and attention to research staff hiring and training practices. Effective study recruitment strategies included personal contact with parents and close cooperation between school personnel and study staff. Providing incentives and collecting multiple types of participant contact information contributed to increased retention rates. On average, those who participated in the final survey timepoint were less likely to be male and Latinx and exhibited more favorable baseline mental health than those who did not, suggesting differential attrition based on youth characteristics. Conclusions Lessons learned from this school-based trial can be applied more broadly to research with low-income urban youth of color. Researchers should strive to maximize scientific rigor, minimize harm to vulnerable adolescents and their communities, promote positive research experiences for young people, and provide concrete benefits to those who participate.
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Affiliation(s)
- Tamar Mendelson
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, United States.
| | - Steven C Sheridan
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, United States
| | - Laura K Clary
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, United States
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Abstract
"As trends in immigration evolve across the United States, health care professionals must find a way to provide equal care to all patients, regardless of immigration status. This article addresses the special and unique health challenges faced by pediatric immigrant patients, and ways to address these challenges by leveraging community partnerships and a holistic approach to care. The article draws on the experience of Community Volunteers in Medicine, a nonprofit, philanthropy-funded health clinic that offers free medical, dental, and behavioral care to the uninsured of Chester County, Pennsylvania."
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Affiliation(s)
- Mary Brennan Wirshup
- Community Volunteers in Medicine, 300 Lawrence Drive, West Chester, PA 19380, USA
| | - Sarah Poutasse
- Community Volunteers in Medicine, 300 Lawrence Drive, West Chester, PA 19380, USA
| | - Adriana Deverlis
- Global Health Center, Children's Hospital of Philadelphia, 2716 South Street, 7th Floor, Station 7314, Philadelphia, PA 19146, USA.
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Michael L, Brady AK, Russell G, Rhodes SD, Namak S, Cody L, Vasquez A, Caldwell A, Foy J, Linton JM. Connecting Refugees to Medical Homes Through Multi-Sector Collaboration. J Immigr Minor Health 2019; 21:198-203. [PMID: 29767402 DOI: 10.1007/s10903-018-0757-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
As increasing numbers of refugees have resettled globally, an interdisciplinary group of stakeholders in Forsyth, North Carolina, recognized obstacles preventing coordinated medical care, which inspired the development of our Refugee Health Collaborative. This study assessed the Collaborative's impact on access to coordinated care within patient-centered medical homes (PCMH). A Collaborative-developed novel algorithm guided the process by which refugees establish care in PCMHs. All refugees who established medical care in the two primary health systems in our county (n = 285) were included. Logistic non-linear mixed models were used to estimate the differences between three time frames: pre-algorithm, algorithm implementation and refinement, and ongoing algorithm implementation. After algorithm implementation, there has been a significant decrease in the time required to establish care in PCMHs, increased provider acknowledgment of refugee status, and decreased emergency department (ED) visits. Multi-disciplinary, organized collaboration can facilitate enhanced access to care for refugee families at the population level.
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Affiliation(s)
| | | | - Greg Russell
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Shahla Namak
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Laura Cody
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Andrea Caldwell
- Forsyth County Department of Public Health, Winston-Salem, NC, USA
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Johnson SM, Trejo G, Beck KL, Worsley C, Tranberg H, Plax KL, Linton JM. Building Community Support Using a Modified World Café Method for Pregnant and Parenting Teenagers in Forsyth County, North Carolina. J Pediatr Adolesc Gynecol 2018; 31:614-619. [PMID: 29960076 DOI: 10.1016/j.jpag.2018.06.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Revised: 05/31/2018] [Accepted: 06/20/2018] [Indexed: 12/01/2022]
Abstract
STUDY OBJECTIVE To identify community priorities, foster awareness of existing supports, and recognize barriers and opportunities to enhance support services for pregnant and parenting teens (PPTs). DESIGN AND SETTING A modified World Café event incorporated parallel, rotating focus groups with semistructured, case-based discussions of salient issues. The event was organized and took place in Forsyth County, North Carolina. PARTICIPANTS Seventy-eight local health and social service professionals and 15 PPT representatives. INTERVENTIONS AND MAIN OUTCOME MEASURES Qualitative coding was used to thematically analyze transcript data. Quantitative data pre-/post-event comparisons were made using Fisher exact test. RESULTS Key community-based support services for PPTs were identified. Qualitative analysis yielded 10 key codes regarding barriers and opportunities to enhance community-based support services, resulting in 4 themes. Themes included maximizing access and efficient delivery of high-quality health care, engaging a 3-generation approach to meet the current and future needs of at-risk families, focusing efforts to meet the unique needs of each teen and his/her family, and emphasizing teen self-advocacy. Pre/post survey responses were overwhelmingly positive regarding use of the modified World Café format for discussion and network building. CONCLUSION The modified World Café Method offered a platform to collaboratively identify challenges and opportunities and to develop networks to improve health and well-being of PPTs. Engaging multiple stakeholders in meaningful dialogue might foster multidisciplinary, cross-sector collaboration that mitigates risk and enhances resilience among PPTs and their children.
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Affiliation(s)
- Soren M Johnson
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Grisel Trejo
- Clinical and Translational Science Institute Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Keli L Beck
- Department of Family and Community Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Carrie Worsley
- Forsyth County Department of Public Health, Winston-Salem, North Carolina
| | - Hope Tranberg
- Forsyth County Department of Public Health, Winston-Salem, North Carolina; Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Katie L Plax
- Division of Adolescent Medicine, Department of Pediatrics, Washington University School of Medicine in St Louis, St Louis, Missouri
| | - Julie M Linton
- Department of Pediatrics, Wake Forest School of Medicine, Winston-Salem, North Carolina; Clinical and Translational Science Institute Program in Community Engagement, Wake Forest School of Medicine, Winston-Salem, North Carolina.
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Pike JM, Yazel-Smith L, Haberlin KM, Hannon TS. Feasibility of Implementing Community Partnerships to Provide Diabetes Prevention Services to Youth. J Community Health 2018; 44:137-142. [PMID: 30094724 DOI: 10.1007/s10900-018-0563-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Type 2 diabetes (T2D) in youth has increased as a result of the obesity epidemic. Diabetes prevention programming is needed for youth, at risk for T2D, and their families. However, there is a lack of diabetes prevention services for this population. There is evidence for the benefit of lifestyle modification for decreasing diabetes risk, however there are barriers for youth to access these services in a traditional clinical setting. Our Youth Diabetes Prevention Clinic (YDPC) created partnerships within the community to increase access to diabetes prevention services for at risk youth. YDPC personnel approached community organizations who had the expertise and capacity to partner in needed areas. These partnerships allowed for the development and facilitation of a community-based diabetes prevention group. Youth and their families participated in a 12 week diabetes prevention group. We measured attendance and participant satisfaction with the program. Families attended an average of 5.1 sessions from January to October 2016. Participant satisfaction was collected five times. Physical activity was rated as "awesome" or "good" by 88% of the respondents. The nutrition activities were rated as "awesome" or "good" by 97% of respondents. Physicians and families express a desire for diabetes prevention services, however barriers make it difficult for families to fully participate. Creating partnerships within the community allows for increased access to diabetes prevention services for high-risk, underserved families.
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Affiliation(s)
- Julie M Pike
- Youth Diabetes Prevention Clinic, Indiana University Health, Indianapolis, IN, USA. .,Department of Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis, IN, USA.
| | - Lisa Yazel-Smith
- Department of Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Kathryn M Haberlin
- Youth Diabetes Prevention Clinic, Indiana University Health, Indianapolis, IN, USA.,Department of Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Tamara S Hannon
- Youth Diabetes Prevention Clinic, Indiana University Health, Indianapolis, IN, USA.,Department of Pediatric and Adolescent Comparative Effectiveness Research, Indiana University School of Medicine, Indianapolis, IN, USA
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Wallington S, Oppong B, Dash C, Coleman T, Greenwald H, Torres T, Iddirisu M, Adams-Campbell LL. A Community-Based Outreach Navigator Approach to Establishing Partnerships for a Safety Net Mammography Screening Center. J Cancer Educ 2018; 33:782-787. [PMID: 27995458 PMCID: PMC5940570 DOI: 10.1007/s13187-016-1152-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
Washington, DC, has one of the highest incidence and mortality rates for breast cancer in the USA. Patient navigation coupled with informational and community resources are important strategies that assist patients' access and help them understand the complex world of cancer care. The Georgetown Lombardi Comprehensive Cancer Center's Capital Breast Care Center (CBCC) is a safety net mammography screening center that utilizes a community-based navigation program. In addition to providing assistance with coordination of clinical services, navigators at CBCC are integral in establishing intra-community partnerships to educate members of the community about breast cancer screening. The aim of this study was to detail the role of patient navigation at the CBCC, with an emphasis on community engagement and community-based partnerships. We describe the process by which CBCC established partnerships with multiple community organizations between 2004 and 2015 and analyzed data of women screened in relationship to the evolution of the patient navigation services. Application of the CBCC navigation model that integrates individual patient outreach with community engagement has yielded viable and lasting community partnerships that have resulted in an increase in mammography uptake, especially among medically underserved minority women.
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Affiliation(s)
| | - Bridget Oppong
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Chiranjeev Dash
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Tesha Coleman
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Holly Greenwald
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Tanya Torres
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Marquita Iddirisu
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC, USA
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Lewis CC, Scott K, Marriott BR. A methodology for generating a tailored implementation blueprint: an exemplar from a youth residential setting. Implement Sci 2018; 13:68. [PMID: 29769096 PMCID: PMC5956960 DOI: 10.1186/s13012-018-0761-6] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 05/04/2018] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Tailored implementation approaches are touted as more likely to support the integration of evidence-based practices. However, to our knowledge, few methodologies for tailoring implementations exist. This manuscript will apply a model-driven, mixed methods approach to a needs assessment to identify the determinants of practice, and pilot a modified conjoint analysis method to generate an implementation blueprint using a case example of a cognitive behavioral therapy (CBT) implementation in a youth residential center. METHODS Our proposed methodology contains five steps to address two goals: (1) identify the determinants of practice and (2) select and match implementation strategies to address the identified determinants (focusing on barriers). Participants in the case example included mental health therapists and operations staff in two programs of Wolverine Human Services. For step 1, the needs assessment, they completed surveys (clinician N = 10; operations staff N = 58; other N = 7) and participated in focus groups (clinician N = 15; operations staff N = 38) guided by the domains of the Framework for Diffusion [1]. For step 2, the research team conducted mixed methods analyses following the QUAN + QUAL structure for the purpose of convergence and expansion in a connecting process, revealing 76 unique barriers. Step 3 consisted of a modified conjoint analysis. For step 3a, agency administrators prioritized the identified barriers according to feasibility and importance. For step 3b, strategies were selected from a published compilation and rated for feasibility and likelihood of impacting CBT fidelity. For step 4, sociometric surveys informed implementation team member selection and a meeting was held to identify officers and clarify goals and responsibilities. For step 5, blueprints for each of pre-implementation, implementation, and sustainment phases were generated. RESULTS Forty-five unique strategies were prioritized across the 5 years and three phases representing all nine categories. CONCLUSIONS Our novel methodology offers a relatively low burden collaborative approach to generating a plan for implementation that leverages advances in implementation science including measurement, models, strategy compilations, and methods from other fields.
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Affiliation(s)
- Cara C. Lewis
- Kaiser Permanente Washington Health Research Institute, 1730 Minor Ave, Suite 1600, Seattle, WA 98101 USA
- Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th St, Bloomington, IN 47405 USA
- Department of Psychiatry and Behavioral Sciences, Harborview Medical Center, School of Medicine, University of Washington, Box 359911, 325 9th Ave, Seattle, WA 98104 USA
| | - Kelli Scott
- Department of Psychological and Brain Sciences, Indiana University, 1101 E. 10th St, Bloomington, IN 47405 USA
| | - Brigid R. Marriott
- Department of Psychological Sciences, University of Missouri, 315 Psychology Building, Columbia, MO 65211 USA
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16
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Uhm SY, Tsoh JY, Mackin RS, Gause M, Chan J, Franklin J, Eckfield M, Salazar M, Vigil O, Bain D, Stark S, Vega E, Delucchi KL, Mathews CA. Comparison of a peer facilitated support group to cognitive behavior therapy: Study protocol for a randomized controlled trial for hoarding disorder. Contemp Clin Trials 2016; 50:98-105. [PMID: 27444427 DOI: 10.1016/j.cct.2016.07.018] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Revised: 07/14/2016] [Accepted: 07/17/2016] [Indexed: 11/30/2022]
Abstract
Although individual and group cognitive-behavioral therapy (CBT) is the standard treatment approach for hoarding disorder (HD), it requires trained mental health professionals with specialization in HD. There is a need to offer additional options and services due to the limited number of professionals with advanced training, combined with the high prevalence rate of individuals with HD. A structured support group led by trained facilitators or lay professionals using a facilitator's manual and participant workbook (Buried in Treasures or BiT), addresses this need and increases accessibility. Prior studies of BiT groups have shown decreased hoarding symptoms. Only one retrospective study compared BiT and CBT outcomes in a naturalistic setting and showed no difference. Thus, a well-powered randomized controlled trial is needed to directly compare these forms of treatment. This paper presents a non-inferiority controlled trial protocol that compares group CBT to group BiT. Three hundred participants with HD, 18years or older, are being recruited for a 16-week treatment study. Participants are randomly assigned to either the CBT or BiT group. The primary outcome is reduction in hoarding symptom severity. Secondary outcomes include reduction in other indices of hoarding symptomology, including functional impairment, physical clutter, cognition, and changes in neuropsychological functioning.
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Affiliation(s)
- Soo Y Uhm
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Janice Y Tsoh
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - R Scott Mackin
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Michael Gause
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Joanne Chan
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - John Franklin
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Monika Eckfield
- Department of Nursing and Health Sciences, California State University, East Bay, California, USA
| | - Mark Salazar
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Ofilio Vigil
- University of California Davis Health System, California, USA
| | - David Bain
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Sandra Stark
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Eduardo Vega
- Mental Health Association of San Francisco, San Francisco, California, USA
| | - Kevin L Delucchi
- Department of Psychiatry, University of California, San Francisco, California, USA
| | - Carol A Mathews
- Department of Psychiatry, University of California, San Francisco, California, USA; College of Medicine, University of Florida, Florida, USA.
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17
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Kelley-Quon LI, Crowley MA, Applebaum H, Cummings K, Kang RJ, Tseng CH, Mangione CM, Shew SB. Academic- community partnerships improve outcomes in pediatric trauma care. J Pediatr Surg 2015; 50:1032-6. [PMID: 25812442 DOI: 10.1016/j.jpedsurg.2015.03.033] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2015] [Accepted: 03/10/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND To address the specialized needs of injured children, pediatric trauma centers (PTCs) were established at many large, academic hospitals. This study explores clinical outcomes observed for injured children treated at an academic-sponsored community facility. METHODS In partnership with an academic medical center in a major metropolitan area, a not-for-profit community hospital became a designated Level II PTC in October 2010. Data for injured children <15 years old treated prior to PTC designation from January 2000 to September 2010 were prospectively collected using the Trauma and Emergency Medicine Information System and compared to data collected after PTC designation from January 2011 to December 2013. RESULTS Overall, 681 injured children were treated at the community hospital from January 2011 to December 2013. Children treated after PTC designation were less likely to undergo computed tomography (CT) (50.9% vs. 81.3%, p<0.01), even when controlling for age, gender, injury type, injury severity, and year (OR 0.18, 95%CI 0.08-0.37). Specifically, fewer head (45.7% vs. 68.7%, p<0.01) and abdominal CTs (13.2% vs. 26.5%, p<0.01) were performed. Hospital length of stay was significantly shorter (2.8 ± 3.7 days vs. 3.7 ± 5.9 days, p<0.01). Mortality was low overall, but also decreased after PTC designation (0.4% vs. 2.0%, p=0.02). CONCLUSIONS These results indicate that academic-community partnerships in pediatric trauma care are a feasible alternative and may lead to improved outcomes for injured children.
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Affiliation(s)
- Lorraine I Kelley-Quon
- Division of Pediatric Surgery, Department of Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS Bldg., MC 957098, Los Angeles, CA, USA, 90095-7098; Robert Wood Johnson Foundation Clinical Scholars, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 10940 Wilshire Blvd. Ste 710, Los Angeles, CA, USA, 90095-7394.
| | - Melanie A Crowley
- Trauma Department, Northridge Hospital Medical Center - Richie Pediatric Trauma Center, 18300 Roscoe Boulevard, Northridge, CA, USA, 91328.
| | - Harry Applebaum
- Division of Pediatric Surgery, Department of Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS Bldg., MC 957098, Los Angeles, CA, USA, 90095-7098; Trauma Department, Northridge Hospital Medical Center - Richie Pediatric Trauma Center, 18300 Roscoe Boulevard, Northridge, CA, USA, 91328.
| | - Katie Cummings
- Trauma Department, Northridge Hospital Medical Center - Richie Pediatric Trauma Center, 18300 Roscoe Boulevard, Northridge, CA, USA, 91328.
| | - Richard J Kang
- Pediatrics Department, Northridge Hospital Medical Center - Richie Pediatric Trauma Center, 18300 Roscoe Boulevard, Northridge, CA, USA, 91328.
| | - Chi-Hong Tseng
- Robert Wood Johnson Foundation Clinical Scholars, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 10940 Wilshire Blvd. Ste 710, Los Angeles, CA, USA, 90095-7394.
| | - Carol M Mangione
- Robert Wood Johnson Foundation Clinical Scholars, Division of General Internal Medicine and Health Services Research, David Geffen School of Medicine at UCLA, 10940 Wilshire Blvd. Ste 710, Los Angeles, CA, USA, 90095-7394; David Geffen School of Medicine, University of California, Los Angeles, Jonathan and Karin Fielding School of Public Health, 10940 Wilshire Blvd Ste 700, Los Angeles, CA, USA, 90095-7394.
| | - Stephen B Shew
- Division of Pediatric Surgery, Department of Surgery, Mattel Children's Hospital, David Geffen School of Medicine at UCLA, 10833 Le Conte Avenue, CHS Bldg., MC 957098, Los Angeles, CA, USA, 90095-7098; Trauma Department, Northridge Hospital Medical Center - Richie Pediatric Trauma Center, 18300 Roscoe Boulevard, Northridge, CA, USA, 91328.
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Foy CG, Vitolins MZ, Case LD, Harris SJ, Massa-Fanale C, Hopley RJ, Gardner L, Rudiger N, Yamamoto K, Swain B, Goff DC, Danhauer SC, Booth D, Gaspari J. Incorporating prosocial behavior to promote physical activity in older adults: rationale and design of the Program for Active Aging and Community Engagement (PACE). Contemp Clin Trials 2013; 36:284-97. [PMID: 23876672 PMCID: PMC4041385 DOI: 10.1016/j.cct.2013.07.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Revised: 07/10/2013] [Accepted: 07/11/2013] [Indexed: 11/23/2022]
Abstract
Despite the benefits of regular physical activity among older adults, physical activity rates are low in this population. The Program for Active Aging and Community Engagement (PACE) is an ongoing randomized controlled trial designed to compare the effects of two interventions on physical activity at 12 months among older adults. A total of 300 men and women aged 55 years or older will be randomized into either a healthy aging (HA) control intervention (n = 150), which is largely based upon educational sessions, or a prosocial behavior physical activity (PBPA) intervention (n = 150), which incorporates structured physical activity sessions, cognitive-behavioral counseling, and opportunities to earn food for donation to a regional food bank based on weekly physical activity and volunteering. The PBPA intervention is delivered at a local YMCA, and a regional grocery store chain donates the food to the food bank. Data will be collected at baseline, 3, 6, and 12 months. The primary outcome is physical activity as assessed by the Community Healthy Activities Model Program for Seniors (CHAMPS) Questionnaire at 12 months. Secondary outcomes include physical function and health-related quality of life. If successful, the PACE study will demonstrate that prosocial behavior and volunteerism may be efficaciously incorporated into interventions and will provide evidence for a novel motivating factor for physical activity.
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Affiliation(s)
- Capri G Foy
- Wake Forest School of Medicine, Division of Public Health Sciences, USA.
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