Geriatric Interdisciplinary Team Training 2.0: A collaborative team-based approach to delivering care.

Interprofessional collaborative education and practice has become a cornerstone of optimal person-centered management in the current complex health care climate. This is especially important when working with older adults, many with multiple chronic conditions and challenging health care needs. This paper describes a feasibility study of the Geriatric Interdisciplinary Team Training 2.0 (GITT 2.0) program focused on providing interprofessional care to complex and frail older adults with multiple chronic conditions. A concurrent triangulation mixed-methods design facilitated program implementation and evaluation. Over three years (2013-2016), 65 graduate students from nursing, midwifery, social work, and pharmacy participated along with 25 preceptors. Participants were surveyed on their attitudes toward interprofessional collaboration pre and post-intervention and participated in focus groups. While attitudes toward interprofessional collaboration did not change quantitatively, focus groups revealed changes in language and enhanced perspectives of participants. Based on the evaluation data, the GITT 2.0 Toolkit was refined for use in interprofessional education and practice activities related to quality initiatives.

Priority Needs for Conducting Pandemic-relevant Clinical Research With Children in Europe: A Consensus Study With Pediatric Clinician-researchers.

BACKGROUND: Infectious disease (ID) pandemics pose a considerable global threat and can disproportionately affect vulnerable populations including children. Pediatric clinical research in pandemics is essential to improve children's healthcare and minimize risks of harm by interventions that lack an adequate evidence base for this population. The unique features of ID pandemics require consideration of special processes to facilitate clinical research. We aimed to obtain consensus on pediatric clinician-researchers' perceptions of the priorities to feasibly conduct clinical pediatric pandemic research in Europe. METHODS: Mixed method study in 2 stages, recruiting pediatric clinician-researchers with experience of conducting pediatric ID research in clinical settings in Europe. Stage 1 was an expert stakeholder workshop and interviews. Discussions focused on participant's experience of conducting pediatric ID research and processes to facilitate pandemic research. Information informed stage 2, an online consensus survey to identify pediatric inician-researchers priorities to enable ID pandemic research. RESULTS: Twenty-three pediatric clinician-researchers attended the workshop and 39 completed the survey. Priorities were primarily focused on structural and operational requirements of research design and regulation: (1) clarity within the European Clinical Trials Directive for pediatric pandemic research; (2) simplified regulatory processes for research involving clinical samples and data; and (3) improved relationships between regulatory bodies and researchers. CONCLUSIONS: Results suggest that changes need to be made to the current regulatory environment to facilitate and improve pediatric research in the pandemic context. These findings can provide expert evidence to research policy decision-makers and regulators and to develop a strategy to lobby for change.

Validating the Health Literacy Promotion Practices Assessment Instrument.

BACKGROUND: How health care professionals address health literacy as part of the provider-client relationship is important for prevention and promoting self-management and symptom management. Research usually focuses on patients' health literacy and fails to examine provider practices, thus leaving a gap in the literature and patient outcomes analyses. OBJECTIVE: The study tested the reliability and validity of a series of questions developed to evaluate health care provider health literacy promotion practices on an interprofessional sample. METHODS: This exploratory cross-sectional study took place between 2013 and 2015. Participants included graduate level health professions students from nursing, midwifery, medicine, pharmacy, and social work. Exploratory factor analyses with varimax rotation examined the reliability and validity of the instrument as a measure of health literacy promotion practices. KEY RESULTS: Of the participants in the programs, 198 completed the health literacy questions in the online survey. Exploratory factor analysis showed that questions loaded on two factors connected with either individual or organizational characteristics that facilitated health literacy promotion practices. The Cronbach's alpha for the instrument was 0.95. CONCLUSIONS: This study helped determine the reliability and validity of the items as measures of providers' health literacy practices. Future research will help to further establish the stability of the instrument as a measure and increase its potential reliability when linking provider practices to health literacy sensitive client outcomes. Testing the instrument separately and concurrently with each health profession is recommended until instrument stability across professional roles has been established. [Health Literacy Research and Practice. 2017;1(4):e239-e246.]. PLAIN LANGUAGE SUMMARY: We sought to develop a survey instrument people could use to assess how health care providers help patients understand their health better. After getting responses from 198 health care providers, we ran statistical tests to check the quality of the questions for measuring provider practices. We found the questions were good at evaluating provider practices around promoting patient understanding of health issues.

Student scientific inquiry in the core curriculum.

OBJECTIVE: To design and implement a required student-driven research program as a capstone experience in the doctor of pharmacy (PharmD) curriculum. DESIGN: A research proposal in the form of a competitive grant application was required for each of 65 fourth-year students in an inaugural PharmD class at Touro College of Pharmacy in New York. The focus of the proposals was on hypothesis-driven research in basic science, clinical research, health outcomes, and public health. ASSESSMENT: Students' research proposals were graded using a standardized grading instrument. On a post-experience survey, most students rated the overall experience positively, indicating increased confidence in their research skills. About two-thirds of faculty members were satisfied with their students' performance, and the great majority thought the experience would be useful in the students' careers. CONCLUSION: The capstone research project was a positive experience for fourth-year students.

Cardiovascular disease and risk factors in an indigenous minority population. The All-Ireland Traveller Health Study.

BACKGROUND: The Traveller community are an indigenous minority group in Great Britain and Ireland who experience premature mortality. While minority populations worldwide are known to have high rates of risk factors for cardiovascular disease (CVD), Traveller CVD risk has not previously been defined. DESIGN: All-Ireland cross-sectional census survey of the Traveller minority population (n = 10,615 families). METHODS: A subsample of adult respondents completed a health survey (n = 2023). CVD was defined as self-report of doctor-diagnosed heart attack, angina, or stroke. CVD risk factors and measures of social position were examined in the Traveller group using age-adjusted prevalence and prevalence ratios (PR). Comparisons were made with a general population sample of low socioeconomic status. RESULTS: Age-adjusted prevalence of CVD in the Traveller population was 5.6% (95% CI 4.6-6.8), similar to that in the comparator population. Compared to those without CVD, Travellers with CVD had a higher prevalence of self-report of diabetes, hypertension, hypercholesterolaemia, current smoking, and a measure of distrust. Compared with the general population sample, Travellers had a higher prevalence of diabetes (adjusted PR 2.8, 95% CI 2.1-3.8) and lifestyle-related risk factors such as smoking (PR 1.3, 95% CI 1.2-1.4), fried food consumption (PR 2.8, 95% CI 2.4-3.2), and physical inactivity (PR 1.3, 95% CI 1.2-1.4). CONCLUSIONS: This comprehensive census survey confirms CVD as an important health risk in the economically disadvantaged Irish Traveller community. Our findings add to the international knowledge base on minority populations and CVD risk.

The health care experiences of Travellers compared to the general population: the All-Ireland Traveller Health Study.

OBJECTIVES: Travellers are a minority population in Ireland and Great Britain, who have poorer health status than the general population. This study aims to investigate Traveller health service utilization and experiences of health service quality. METHODS: Community-based census survey of all Traveller households on the island of Ireland in 2008 and 2009. Comparisons were made with survey data from a nationally representative sample of the Irish general public entitled to means-tested general medical services from the INSIGHT '07 survey. RESULTS: Valid responses were provided by 1,947 Traveller respondents (32.5% males). Travellers reported significantly higher use of hospital services including Emergency Room services (sex- and age-adjusted relative risk (RR) 2.37, 95% CI 1.99-2.82) and mental health services (adjusted RR 2.89, 95% CI 2.02-4.14). They described significantly poorer quality health care experiences than did the comparator population, with fewer Travellers expressing trust in caregivers (adjusted RR 0.51, 95% CI 0.47-0.55) and rating the quality of health service they received as being very good or excellent (adjusted RR 0.59, 95% CI 0.55-0.64). After multivariable adjustment for the dimensions of service quality, population (Traveller or INSIGHT '07) was not associated with an overall rating of health service quality. CONCLUSIONS: Travellers report greater use of and adequate access to health services, but describe a consistently poorer quality health care experience. This quality gap has implications for Traveller engagement with health care professionals.