Innovations in Maternal and Child Health: Pairing Undergraduate and Graduate Maternal and Child Health Students in Summer Practica in State Title V Agencies.

Objective As part of the National MCH Workforce Development Center, an innovative internship program placed MCH undergraduate and graduate students in summer practica in state Title V agencies. Graduate student mentoring of undergraduates and leadership and professional development training and support are key features of the program. The objective of this paper is to report on the results of the evaluation of the MCH Paired Practica Program in its pilot years, 2014-2016. Methods Students completed pre and post internship questionnaires which included closed as well as open-ended questions. In addition, the Title V state health agency preceptors completed a questionnaire at the end of each summer. Results Over the 3-year pilot project, a total of 17 teams participated. Students were from 6 of the 13 graduate Centers of Excellence in MCH programs in Schools of Public Health and two undergraduate MCH Pipeline Programs. There were 11 participating states. After the practicum experience, there was a significant increase in students' confidence in a number of measures related to working in complex, dynamic environments and in their ability to contribute to improvements in MCH population health. Students reported having more confidence in their ability to function effectively as an informal/formal MCH leader (p = 0.02), more confidence in their ability to contribute to improvements in MCH population health (p = 0.04), and being more prepared to enter the workforce after the practicum experience (p = 0.07), although there was no significant change in students' (n = 22) interest in seeking a job in a Title V agency or a community based organization with a MCH focus. Nearly 60% of the students did state at the posttest that they would likely seek additional education in MCH. Overall, the Title V preceptors (n = 14) were very positive about the program although in some instances there was less confidence in the knowledge and skills of the undergraduate students. Conclusion The MCH Paired Practica Program is a unique effort to go beyond the academic training of undergraduate and graduate MCH students to provide them with direct exposure to the field, as well as leadership, mentorship, and professional development training. While some challenges emerged related to differences in skills between undergraduates and graduate MCH students, participating students demonstrated clear improvements in their leadership skills including increased confidence in their ability to take initiative, provide opinions and feedback, to function informally or formally as leaders, and to contribute to improvements in MCH population health.

The UNC-CH MCH Leadership Training Consortium: building the capacity to develop interdisciplinary MCH leaders.

This article describes the UNC-CH MCH Leadership Consortium, a collaboration among five MCHB-funded training programs, and delineates the evolution of the leadership curriculum developed by the Consortium to cultivate interdisciplinary MCH leaders. In response to a suggestion by the MCHB, five MCHB-funded training programs--nutrition, pediatric dentistry, social work, LEND, and public health--created a consortium with four goals shared by these diverse MCH disciplines: (1) train MCH professionals for field leadership; (2) address the special health and social needs of women, infants, children and adolescents, with emphasis on a public health population-based approach; (3) foster interdisciplinary practice; and (4) assure competencies, such as family-centered and culturally competent practice, needed to serve effectively the MCH population. The consortium meets monthly. Its primary task to date has been to create a leadership curriculum for 20-30 master's, doctoral, and post-doctoral trainees to understand how to leverage personal leadership styles to make groups more effective, develop conflict/facilitation skills, and identify and enhance family-centered and culturally competent organizations. What began as an effort merely to understand shared interests around leadership development has evolved into an elaborate curriculum to address many MCH leadership competencies. The collaboration has also stimulated creative interdisciplinary research and practice opportunities for MCH trainees and faculty. MCHB-funded training programs should make a commitment to collaborate around developing leadership competencies that are shared across disciplines in order to enhance interdisciplinary leadership.

Medical homes for children with special healthcare needs in North Carolina.

BACKGROUND: The American Academy of Pediatrics defines a medical home as medical care for children that is accessible, continuous, comprehensive, family-centered, coordinated, and compassionate. North Carolina uses the medical home concept as a model for providing high quality care to children with special healthcare needs (CSHCN). However, until recently, information on medical homes for CSHCN in North Carolina has not been available. METHODS: Using North Carolina data from the National Survey of Children with Special Health Care Needs (2000-2002), we describe the characteristics of children having a special healthcare need. We conducted bivariate analysis of socio-demographic factors with medical home and its five components (family-centered care, effective care coordination, personal doctor or nurse, usual source of care, and referrals for specialty care) and multivariate analysis to identify the predictors of having a medical home. RESULTS: Fifty-six percent of CSHCN in North Carolina have a medical home. White CSHCN are 1.7 times more likely to have a medical home compared to non-white CSHCN. CSHCN with no functional limitations are 1.6 times more likely to have a medical home compared to children with some or severe limitations of their functional status. CONCLUSIONS: Current, population-based information about CSHCN and their families is essential for assessing needs and evaluating pediatric initiatives at the state level. Disparities among CSHCN due to race and functional status should be considered in organizing services for CSHCN in North Carolina.

Health disparities among adults with developmental disabilities, adults with other disabilities, and adults not reporting disability in North Carolina.

OBJECTIVES: The purposes of this study were (1) to identify disparities between adults with developmental disabilities and non-disabled adults in health and medical care, and (2) to compare this pattern of disparities to the pattern of disparities between adults with other disabilities and adults without disabilities. METHODS: The authors compared data on health status, health risk behaviors, chronic health conditions, and utilization of medical care across three groups of adults: No Disability, Disability, and Developmental Disability. Data sources were the 2001 North Carolina Behavioral Risk Factor Surveillance System and the North Carolina National Core Indicators survey. RESULTS: Adults with developmental disabilities were more likely to lead sedentary lifestyles and seven times as likely to report inadequate emotional support, compared with adults without disabilities. Adults with disabilities and developmental disabilities were significantly more likely to report being in fair or poor health than adults without disabilities. Similar rates of tobacco use and overweight/obesity were reported. Adults with developmental disabilities had a similar or greater risk of having four of five chronic health conditions compared with non-disabled adults. Significant medical care utilization disparities were found for breast and cervical cancer screening as well as for oral health care. Adults with developmental disabilities presented a unique risk for inadequate emotional support and low utilization of breast and cervical cancer screenings. CONCLUSIONS: Significant disparities in health and medical care utilization were found for adults with developmental disabilities relative to non-disabled adults. The National Core Indicators protocol offers a sound methodology to gather much-needed surveillance information on the health status, health risk behaviors, and medical care utilization of adults with developmental disabilities. Health promotion efforts must be specifically designed for this population.