Evaluation of the pathways for students into health professions: the training of under-represented minority students to pursue maternal and child health professions.

The Pathways for Students into Health Professions program is one of four nationally funded programs by the Maternal and Child Health Bureau of the US Department of Health and Human Services to support the training of undergraduate students, particularly from under-represented minority groups to pursue maternal and child health professions. To assess the program's impact on student ratings, knowledge, and interest in maternal and child health professions. A baseline survey on student ratings and knowledge in maternal and child health topics and careers, public health topics, and career development topics was provided to 32 students at the beginning of their first year in the program and approximately 1 year after participation. Half of the students (16 students) in the program from 2009-2011 were from traditionally underrepresented minority groups. After participation, students reported significantly higher ratings of interest in maternal and child health topics and careers and in receiving adequate academic and career guidance. Students also reported significantly higher knowledge of public health, childhood and maternal morbidity and mortality, health care disparities, and life course health development. The program's didactic, experiential, and mentorship activities are changing student ratings and knowledge in a favorable direction toward maternal and child health careers and topics. Undergraduate training programs may be an important mechanism to strengthen the pipeline of a diverse healthcare workforce.

Creating an MCH Pipeline for Disadvantaged Undergraduate Students.

PURPOSE: To address minority health disparities in maternal and child health (MCH), increasing the diversity of the MCH workforce is an important strategy. DESCRIPTION: Guided by the MCH Leadership Competencies, we developed an undergraduate pipeline program for disadvantaged students. Our target population is minority undergraduates who are interested in entering health professions but have academic challenges. We identify these students early in their undergraduate careers and expose them to the field of MCH through a 4-unit course, summer field practicum at an MCH community-based organization or agency, and volunteer experience in a student-run organization focused on helping children and families. We also provide academic advising and personal counseling by a faculty mentor and leadership training opportunities. ASSESSMENT: Since 2006, 75 students have participated in our program, of which 36 are still enrolled and 39 have graduated. Among the graduates, three (8 %) have completed graduate school and are working in a health field; 11 (28 %) are enrolled in graduate school; and 13 (33 %) are currently applying to graduate school. Of the remaining graduates, seven (18 %) are employed in a health field, and five (13 %) are working in an unrelated field. CONCLUSION: Pipeline programs should attempt to reach students as early as possible in their undergraduate careers to more effectively influence their academic trajectories. Many minority students face academic and personal challenges; therefore, intensive academic advising and one-on-one faculty mentoring are important components of pipeline programs.

Adherence to treatment among economically disadvantaged patients with panic disorder.

OBJECTIVE: The purpose of this study was to examine the feelings of disadvantaged patients about and experiences of treatment for anxiety disorders in primary care settings. METHODS: The patients had participated in the Collaborative Care for Anxiety and Panic study, which tested the effectiveness of an intervention to help primary care providers treat panic disorder. The treatment comprised cognitive behavioral therapy (CBT) combined with pharmacotherapy administered by primary care physicians with the expert advice of a psychiatrist. Post hoc semistructured interviews were conducted with 21 intervention participants who were classified according to adherence or nonadherence to treatment. The interview focused on reactions to CBT; reactions to the different features of the intervention, such as therapy sessions, demonstration videotapes, exercises, and a workbook; and comfort with the therapist. Two members of the research team independently coded, analyzed, and interpreted the data. RESULTS: Three themes emerged: information was empowering and reduced the sense of isolation experienced by participants, participants engaged in a dynamic and iterative personalized assessment of the intervention, and barriers to adherence were predominantly logistical. CONCLUSIONS: Results indicate that the extent to which patients chose to remain in treatment and follow treatment recommendations was rarely an all-or-nothing phenomenon. In a disadvantaged population such decisions seem to be influenced by the beliefs of the patient about what will and will not be effective in his or her individual case, an ongoing self-assessment of well-being, and the logistical barriers that come into play.