Building physician wellness into the culture: evaluating a family physician well-being programme using the physician wellness inventory.

PURPOSE: Family physicians have a higher incidence of burnout, dissatisfaction, and disengagement compared to other medical specialties. Addressing burnout on the individual and systemic level is important to promoting wellness and preventing deleterious effects on physicians and patients. We used the Physician Wellness Inventory (PWI) to assess the effects of a wellness programme designed to equip family physicians with skills to address burnout. METHODS: The PWI is a fourteen-item 5-point Likert scale broken down into 3 scores; (i) career purpose, (ii) cognitive flexibility, and (iii) distress. The PWI was distributed to a cohort of n = 111 family physician scholars at 3 time points: January 2021, May-June 2021, and October 2021. The response rate was 96.4% at baseline, and 72.1% overall. Demographic information was collected to assess differences. The survey was distributed online through Qualtrics (Provo, UT). RESULTS: Cognitive Flexibility scores at the endpoint were higher for POC scholars than white scholars (P = 0.024). Distress scores for all groups decreased over time. Female scholars were more nervous, and anxious at the start than male scholars (P = 0.012), which decreased over time (P = 0.022). New career scholars were more likely than later career scholars to be distressed (P = 0.007), but both groups' distress decreased over time (P = 0.003). Later career scholars' feelings of being bothered by little interest or pleasure in doing things decreased more than new career scholars (endpoint: P = 0.022; overall: P = 0.023). CONCLUSIONS: The wellness programme shows improvement in PWI scores, indicating the programme content should be evaluated further for system level improvements.

Research interests of family physicians applying for research training.

BACKGROUND: There is an ongoing need for research to support the practice of high quality family medicine. The Family Medicine Discovers Rapid Cycle Scientific Discovery and Innovation (FMD RapSDI) program is designed to build capacity for family medicine scientific discovery and innovation in the United States. Our objective was to describe the applicants and research questions submitted to the RapSDI program in 2019 and 2020. METHODS: Descriptive analysis for applicant characteristics and rapid qualitative analysis using principles of grounded theory and content analysis to examine the research questions and associated themes. We examined differences by year of application submission and the applicant's career stage. RESULTS: Sixty-five family physicians submitted 70 applications to the RapSDI program; 45 in 2019 and 25 in 2020. 41% of applicants were in practice for five years or less (n = 27), 18% (n = 12) were in in practice 6-10 years, and 40% (n = 26) were ≥ 11 years in practice. With significant diversity in questions, the most common themes were studies of new innovations (n = 20, 28%), interventions to reduce cost (n = 20, 28%), improving screening or diagnosis (n = 19, 27%), ways to address mental or behavioral health (n = 18, 26%), and improving care for vulnerable populations (n = 18, 26%). CONCLUSION: Applicants proposed a range of research questions and described why family medicine is optimally suited to address the questions. Applicants had a desire to develop knowledge to help other family physicians, their patients, and their communities. Findings from this study can help inform other family medicine research capacity building initiatives.

"Friendly reminder: hi! It is that time again ☺": understanding PMTCT care text message design preferences amongst pre- and post-partum women and their male partners.

BACKGROUND: Prevention of mother-to-child HIV transmission (PMTCT) services in Kenya can be strengthened through the delivery of relevant and culturally appropriate SMS messages. METHODS: This study reports on the results of focus groups conducted with pre and postnatal women living with HIV (5 groups, n = 40) and their male partners (3 groups, n = 33) to elicit feedback and develop messages to support HIV+ women's adherence to ART medication, ANC appointments and a facility-based birth. The principles of message design informed message development. RESULTS: Respondents wanted ART adherence messages that were low in verbal immediacy (ambiguous), came from an anonymous source, and were customized in timing and frequency. Unlike other studies, low message immediacy was prioritized over customization of message content. For retention, participants preferred messages with high verbal immediacy-direct appointment reminders and references to the baby-sent infrequently from a clinical source. CONCLUSION: Overall, participants favored content that was brief, cheerful, and emotionally appealing.

Patient vs. Community Engagement: Emerging Issues.

BACKGROUND: The value proposition of including patients at each step of the research process is that patient perspectives and preferences can have a positive impact on both the science and the outcomes of comparative effectiveness research. How to accomplish engagement and the extent to which approaches to community engagement inform strategies for effective patient engagement need to be examined to address conducting and accelerating comparative effectiveness research. OBJECTIVES: To examine how various perspectives and diverse training lead investigators and patients to conflicting positions on how best to advance patient engagement. RESEARCH DESIGN: Qualitative methods were used to collect perspectives and models of engagement from a diverse group of patients, researchers and clinicians. The project culminated with a workshop involving these stakeholders. The workshop used a novel approach, combining World Café and Future Search techniques, to compare and contrast aspects of patient engagement and community engagement. SUBJECTS: Participants included patients, researchers, and clinicians. MEASURES: Group and workshop discussions provided the consensus on topics related to patient and community engagement. RESULTS: Participants developed and refined a framework that compares and contrasts features associated with patient and community engagement. CONCLUSIONS: Although patient and community engagement may share a similar approach to engagement based on trust and mutual benefit, there may be distinctive aspects that require a unique lexicon, strategies, tactics, and activities.

Using the Health Literacy Universal Precautions Toolkit to Improve the Quality of Patient Materials.

Patient materials are often written above the reading level of most adults. Tool 11 of the Health Literacy Universal Precautions Toolkit ("Design Easy-to-Read Material") provides guidance on ensuring that written patient materials are easy to understand. As part of a pragmatic demonstration of the Toolkit, we examined how four primary care practices implemented Tool 11 and whether written materials improved as a result. We conducted interviews to learn about practices' implementation activities and assessed the readability, understandability, and actionability of patient education materials collected during pre- and postimplementation site visits. Interview data indicated that practices followed many action steps recommended in Tool 11, including training staff, assessing readability, and developing or revising materials, typically focusing on brief documents such as patient letters and information sheets. Many of the revised and newly developed documents had reading levels appropriate for most patients and--in the case of revised documents--better readability than the original materials. In contrast, the readability, understandability, and actionability of lengthier patient education materials were poor and did not improve over the 6-month implementation period. Findings guided revisions to Tool 11 and highlighted the importance of engaging multiple stakeholders in improving the quality of patient materials.

Developing an Effective Campus Sexual Assault Prevention Task Force: Lessons Learned From Multiple Midwestern Universities.

Background/Aim. Developing a comprehensive prevention strategy requires a coordinated effort among campus stakeholders. Creating a campus sexual assault prevention task force consisting of key stakeholders is a way to ensure coordinated and sustainable prevention efforts. Understanding how to convene and maintain an effective campus prevention task force is important. However, there is little literature offering such guidance. In this article, we present the facilitators, barriers, and lessons learned from creating a campus sexual assault prevention task force in seven Midwestern postsecondary institutions. Method. Our data come from interviews with 25 key stakeholders, representing seven Midwestern postsecondary institutions. Questions focused on the perceived strengths and capacity to form a campus prevention task force, barriers, current campus knowledge, and attitudes toward sexual assault, current institutional support for prevention efforts, and current prevention programing. Results. Main barriers to developing a task force included (a) limited capacity, (b) lack of knowledge, (c) limited student engagement, and (d) bureaucratic structure. Facilitators included (a) strong interpersonal relationships, (b) a positive campus culture, and (c) preexisting programing.

Leveraging community-academic partnerships to improve healthy food access in an urban, Kansas City, Kansas, community.

BACKGROUND: Americans can combat overweight (OW) and obesity by eating unprocessed, fresh foods. However, all Americans do not have equal access to these recommended foods. Low-income, minority, urban neighborhoods in particular often have limited access to healthy resources, although they are vulnerable to higher levels of OW and obesity. OBJECTIVE: This project used community-based participatory research (CBPR) principles to investigate the food needs of residents and develop a business plan to improve access to healthy food options in an urban, Kansas City, Kansas, neighborhood. METHODS: Partner community organizations were mobilized to conduct a Community Food Assessment survey. The surveys were accompanied by flyers that were part of the communication engagement strategy. Statistical analysis of the surveys was conducted. We engaged low-income, minority population (40% Latino, 30% African American) urban communities at the household level. RESULTS: Survey results provided in-depth information about residents' food needs and thoughts on how to improve food access. Results were reported to community members at a town hall style meeting. LESSONS LEARNED: Developing a strategic plan to engage a community and develop trust is crucial to sustaining a partnership particularly when working with underserved communities. This project demonstrates that, if well managed, the benefits of academic and community partnerships outweigh the challenges thus such relationships should be encouraged and supported by communities, academic institutions, local and national government, and funders. CONCLUSION: A CBPR approach to understanding an urban community's food needs and opinions is important for comprehensive food access planning.