Educational and health services innovation to improve care for rural Hispanic communities in the USA.
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BACKGROUND: Access to comprehensive and quality healthcare services is difficult for socioeonomically disadvantaged groups in rural regions. Barriers to health care for rural Latinos include lack of insurance, language barriers and cultural differences. For the Latino immigrant population in rural areas, barriers to access are compounded. HEALTH NEEDS OF RURAL AREAS: THE CASE OF WALHALLA, SC: The town of Walhalla, South Carolina, USA, is a rural community located in Oconee County, the northwest corner of the state. Disparities exist between rural and urban residents in several health categories, and these disparities illustrate the need to provide competent, appropriate and affordable healthcare to rural populations. The Hispanic population of Oconee has dramatically increased in the past decade, and the majority of these immigrants have no health insurance and have limited access to health services. DESIGNING A PROGRAM TO FIT THE COMMUNITY--THE "WALHALLA EXPERIENCE": The purpose of the Accessible and Culturally Competent Health Care Project (ACCHCP) is to provide care for underserved populations, in Oconee County, South Carolina while providing rural educational opportunities for health services students. Funded by the Health Resources and Services Administration of DHHS, the program is designed to offer culturally appropriate, sensitive, accessible, affordable and compassionate care in a mobile clinic setting. In this interdisplinary program, nurse practitioners, health educators, bilingual interpreters, medical residents and Clemson University students and professors all played key roles. Women in the community also serve as promotoras or lay health advisors. The program is unique in using educational initiatives and innovative strategies for bringing health care to this underserved community and offers important information for rural healthcare initiatives targeting minority groups. This article reports on the challenges and successes in the development and implementation of the ACCHCP program in Walhalla, South Carolina. (+info)
Student-developed problem-based learning cases: preparing for rural healthcare practice.
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INTRODUCTION: The need for health professionals is acute throughout rural communities worldwide. The Rural Health Interdisciplinary Program (RHIP) successfully trains health professional students for practice in rural USA. Student-developed problem-based learning (PBL) cases are a central feature of the RHIP and an important educational focus of learning. METHODS: This retrospective study was designed to describe 222 PBL cases developed by health professional students in the RHIP. The analysis focused on the extent to which student-developed cases reflect demographics and health conditions of rural New Mexico, as well as how successfully cases reflect rural interdisciplinary healthcare issues and practices. RESULTS: The PBL cases do reflect rural New Mexico in terms of population demographics, certain health problems and complexity of health issues. The cases appear address interdisciplinary, rural clinical concerns. However, the cases are less effective at raising issues related to public health, financial, legal and ethical issues, and other non-medical health topics. CONCLUSIONS: In order to strengthen attention to non-medical issues, PBL groups should have broad interdisciplinary membership, special case development training, and faculty encouragement to address a wide variety of health-related topics. Student-developed PBL cases appear to be an interesting way for health professional students to learn about rural healthcare issues and could be used in a variety different educational settings. (+info)
Who are the informaticians? What we know and should know.
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The beginning of the 21st century has seen a surge in interest and enthusiasm for health care information technology based on its ability to demonstrate improvements in the quality, safety, and cost-efficiency of health care. One question, however, for which we have fewer answers is "who will be the individuals that develop, implement, and evaluate these systems?" In particular, while most attention has been paid to the exemplar leaders in health information technology, less has been focused on the issue of the workforce necessary to sustain the systems to achieve their vision. The discipline of medical informatics must pay sufficient attention to the professional workforce that will deploy systems outside the informatics research setting so their benefits may more widely accrue. (+info)
First 3 years of the National AIDS Clearinghouse.
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The National AIDS Clearinghouse is an information service provided by the Centers for Disease Control. The Clearinghouse was established in 1987 to respond to increasing numbers of public and professional inquiries, to disseminate accurate information, and to make referrals to local sources of information and assistance. Four data bases--Resources and Services Database containing information about more than 16,000 organizations that provide counseling and testing for human immunodeficiency virus (HIV) and acquired immunodeficiency syndrome (AIDS) and other education and prevention services; Educational Materials Database containing more than 8,000 individual, hard-to-find educational materials; Funding Database; and the AIDS Clinical Trial Information Service (ACTIS) Database--are searched by information specialists to respond to more than 45,000 requests annually for information from a variety of health professionals, organizations, and the general public. Between 1987 and 1991, the Clearinghouse disseminated more than 60 million copies of publications related to HIV and AIDS. Information and education remain the most critical tools for the prevention of HIV infection, and the National AIDS Clearinghouse provides an essential element for the dissemination of education and prevention information. (+info)
Brief report: Influenza vaccination and health care workers in the United States.
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OBJECTIVE: To determine influenza vaccination rates among U.S. health care workers (HCWs) by demographic and occupational categories. DESIGN AND PARTICIPANTS: We analyzed data from the 2000 National Health Interview Survey (NHIS). Weighted multivariable analyses were used to evaluate the association between HCW occupation and other variables potentially related to receipt of influenza vaccination. HCWs were categorized based on standard occupational classifications as health-diagnosing professions, health-assessing professions, health aides, health technicians; or health administrators. MAIN INDEPENDENT VARIABLES: Demographic characteristics and occupation category. MAIN OUTCOME VARIABLES: Receipt of influenza vaccination within 12 months of survey. ANALYSIS: Descriptive statistics and weighted multivariable logistic regression. RESULTS: There were 1,651 HCWs in the final sample. The overall influenza vaccination rate for HCWs was 38%. After weighted multivariable analyses, HCWs who were under 50 (odds ratio [OR] 0.67%, 95% confidence interval [CI]: 0.50 to 0.89, compared with HCWs 50 to 64), black (OR 0.57 95% CI: 0.42, 0.78, compared with white HCWs), or were health aides (OR 0.73%, 95% CI: 0.51, 1.04, compared with health care administrators and administrative support staff) had lower odds of having been vaccinated against influenza. CONCLUSIONS: The overall influenza vaccination rate among HCWs in the United States is low. Workers who are under 50, black, or health aides have the lowest rates of vaccinations. Interventions seeking to improve HCW vaccination rates may need to target these specific subgroups. (+info)
Low back pain and occupation among Irish health service workers.
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BACKGROUND: The health services sector has been identified as a high-risk work sector for low back pain (LBP) and related absenteeism. AIMS: To establish levels and predictors of LBP prevalence and associated sick leave among health service workers. To identify if levels of LBP or related absenteeism differ between occupational groups. METHODS: A postal survey using a standardized questionnaire and disproportionate random sampling of occupational groups was conducted at a single Dublin hospital. Overall hospital LBP prevalence and sickness absence were calculated using weighted analysis methods. Univariate analysis included the use of Chi-square, Fisher's exact and Mann-Whitney tests. Multivariate logistic regression techniques were used to explore for independent predictors of lifetime LBP prevalence and LBP-related sickness absence. RESULTS: An overall response rate of 62% (n = 246) was achieved. Lifetime, annual and point prevalence rates for the hospital employees were calculated at 46, 30 and 15.5%, respectively. No significant difference in prevalence was found between occupational groups but sick leave did differ with the highest level among general support and nursing staff. Multivariate analysis confirmed that occupation was an independent predictor for LBP-related sick leave (P < 0.05). CONCLUSIONS: LBP prevalence rates did not differ significantly between occupational groups but occupation was found to be an independent predictor of LBP-related sick leave. Involvement in manual handling did not predict either LBP or related sick leave. (+info)
Wikis, blogs and podcasts: a new generation of Web-based tools for virtual collaborative clinical practice and education.
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BACKGROUND: We have witnessed a rapid increase in the use of Web-based 'collaborationware' in recent years. These Web 2.0 applications, particularly wikis, blogs and podcasts, have been increasingly adopted by many online health-related professional and educational services. Because of their ease of use and rapidity of deployment, they offer the opportunity for powerful information sharing and ease of collaboration. Wikis are Web sites that can be edited by anyone who has access to them. The word 'blog' is a contraction of 'Web Log' - an online Web journal that can offer a resource rich multimedia environment. Podcasts are repositories of audio and video materials that can be "pushed" to subscribers, even without user intervention. These audio and video files can be downloaded to portable media players that can be taken anywhere, providing the potential for "anytime, anywhere" learning experiences (mobile learning). DISCUSSION: Wikis, blogs and podcasts are all relatively easy to use, which partly accounts for their proliferation. The fact that there are many free and Open Source versions of these tools may also be responsible for their explosive growth. Thus it would be relatively easy to implement any or all within a Health Professions' Educational Environment. Paradoxically, some of their disadvantages also relate to their openness and ease of use. With virtually anybody able to alter, edit or otherwise contribute to the collaborative Web pages, it can be problematic to gauge the reliability and accuracy of such resources. While arguably, the very process of collaboration leads to a Darwinian type 'survival of the fittest' content within a Web page, the veracity of these resources can be assured through careful monitoring, moderation, and operation of the collaborationware in a closed and secure digital environment. Empirical research is still needed to build our pedagogic evidence base about the different aspects of these tools in the context of medical/health education. SUMMARY AND CONCLUSION: If effectively deployed, wikis, blogs and podcasts could offer a way to enhance students', clinicians' and patients' learning experiences, and deepen levels of learners' engagement and collaboration within digital learning environments. Therefore, research should be conducted to determine the best ways to integrate these tools into existing e-Learning programmes for students, health professionals and patients, taking into account the different, but also overlapping, needs of these three audience classes and the opportunities of virtual collaboration between them. Of particular importance is research into novel integrative applications, to serve as the "glue" to bind the different forms of Web-based collaborationware synergistically in order to provide a coherent wholesome learning experience. (+info)
Training the primary care team--a successful interprofessional education initiative.
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BACKGROUND: A multidisciplinary approach to the education of health professionals is being increasingly promoted as a means to cultivate collaborative practice between professions in the health care sector and to enhance patient care. METHOD: One hundred and two students from seven different University of Queensland Health Science disciplines completed between one and three interprofessional seminars involving small group work, case discussion, expert panel presentation, and interactive question and answers. RESULTS: Paired sample T testing indicated significant differences in pre- and post-responses related to knowledge of effective clinical management, multidisciplinary assessment, goal setting, roles and responsibilities, and referral networks across all disciplines. Similar testing also indicated significant shifts in attitude to increased job satisfaction, reduced fragmentation of care, and reduction in professional boundaries related to multidisciplinary care. Ninety-six percent of participants indicated that the benefit of a team approach was effectively modelled. DISCUSSION: Undergraduate interprofessional education can result in highly significant shifts in knowledge of, and attitudes to, multidisciplinary team care. (+info)