Needs Assessment of Integrative Health Services at School-Based Health Centers.

Objective: The purpose of this needs assessment was to hear about adolescents' experience with and interest in accessing integrative health services (IHS) at their school-based health centers (SBHCs) so that future education and service offerings could be better informed. Subjects: We surveyed 373 9th to 12th graders, of mostly low-income and minority status, who were enrolled as patients at 6 SBHCs in New York City, New York. Verbal consent was obtained prior to their completing a survey on provided mobile devices. Design: The 35-item anonymous survey asked about adolescents' health goals, familiarity and experience with 14 different integrative health modalities and interest in learning about and accessing these modalities. Results: Among all patients, the most common health goal was improving sleep (65%). Before completing the needs assessment survey, almost all patients (98%) had heard of at least 1 integrative health modality and 69% had ever used any modality. On average, patients were interested in learning more about 7.6 of the modalities and were significantly more interested in learning about each modality from trained professionals than from trained peers or by themselves. Conclusions: Improving sleep was a central health goal for SBHC patients. The majority expressed interest in receiving information on massage, meditation and yoga from trained health professionals, and they wanted access to these modalities at their SBHCs. SBHCs are in a unique position of power in which they can bring desired, cost-effective integrative health modalities to marginalized students. Future efforts should expand provider training to support education on and delivery of these modalities and evaluation of their effectiveness at SBHCs.

Perspectives on Workforce Development Needs for Community Health Workers (CHWs): Results from a Statewide Survey of CHW Employers.

We conducted a survey of community health worker (CHW) employers in Texas to understand the employment context and workforce development needs of Texas CHWs. An electronic, mixed-methods survey was emailed to 841 CHW employers across Texas in Spring 2020. The survey consisted of 51 questions. The response rate was 22% (n = 182). Responses were analyzed using SPSS, Microsoft Excel, and N.Vivo. We found that most CHW employers directly employ their CHWs, and CHWs are typically part of a multidisciplinary healthcare team. Most respondents required their CHWs be certified by the state's health department and have at least a high school diploma or GED. The most common services that CHWs provide are health education/promotion and information referral. The main health issues that CHWs address are diabetes, hypertension, and mental/behavioral health. Current CHW workforce development needs include continued training on topics including chronic disease self-management and health promotion. CHW employers differ in their capacity to implement workforce development activities. There is significant variety in the employment context and workforce development needs of CHWs across Texas. Results reinforce previous findings on the need for specialized, continuing training for CHWs and the development of pathways, resources, and opportunities that could advance the CHW profession even more. These results can inform those interested in employing CHWs in their CHW program development. Findings from this study can be used to guide development of tailored curriculum for continuing education units, specialized certifications, or other professional development resources for CHWs.

Motivations and Experiences in a Physical Activity Program for Cancer Survivors: Findings from Key Informant Interviews.

PURPOSE: LIVESTRONG at the YMCA is an evidence-based 12-week physical activity (PA) program for cancer survivors. The purpose of our study was to understand the factors that motivated cancer survivors to begin the program, how the program impacted their habits, and how their experience influenced their motivation to continue with the program. APPROACH OR DESIGN: Key informant interviews. SETTING: Phone interviews conducted between April 15 and June 1, 2020. PARTICIPANTS: 27 cancer survivors in Texas who previously participated in the LS program. METHOD: Participants completed a 30- to 60-minute interview with one of four interviewers. All interviews were recorded, transcribed, and analyzed for themes. RESULTS: Most interviewees were motivated to begin the program because of a desire to feel better after treatment. The most cited motivator to continue in the program was the community of cancer survivors. During the program, interviewees enjoyed learning different exercises, the community of cancer survivors, and the supportive teachers. Nearly all interviewees adopted or changed a healthy habit as a result of the program. CONCLUSION: These results could be used by healthcare professionals to better understand what motivates cancer survivors to participate in a PA program. Results could also be used to plan or modify other PA programs for cancer survivors.

A Community-Academic Partnership for School-Based Nonviolence Education: The Healthy Power Program.

BACKGROUND: Youth violence is a significant problem affecting community health. Community-academic partnerships can advance youth nonviolence education by synergizing the strengths of collaborators while working toward a common goal. We describe a collaboration between an urban public middle school, community nonprofit, and university-based graduate school of nursing in implementing and evaluating the Healthy Power program, a school-based youth nonviolence program for middle-school boys. METHODS: A participatory program evaluation approach was used to plan and implement evaluation of the Healthy Power program with a cohort of 8 students. Collaborative planning allowed for the selection of measures that reflected program objectives and were of value to community partners while also scientifically sound. A mixed-methods approach included a focus group and a pretest-posttest with quantitative items and open-ended questions. RESULTS: While the quantitative pre-posttest did not show any significant change, the open-ended questions and focus group suggested that students had advanced their understanding and application of conflict resolution skills. CONCLUSIONS: The findings support the usefulness of community-academic partnerships for peace/conflict resolution education and program evaluation. Such programs may benefit from mixed methods of evaluation.

Primary carcinoma of the fallopian tube and epithelial ovarian carcinoma: a case-control analysis.

OBJECTIVE: To determine whether differences exist in clinicopathologic variables or survival between women with primary carcinoma of the fallopian tube (PCFT) and with epithelial ovarian carcinoma (EOC). STUDY DESIGN: University of Iowa Hospitals and Clinics (UIHC) tumor board records were analyzed from January 1, 1991, to April 30, 2001. No cases were knowingly excluded. Each case of PCFT was matched with 2 cases of EOC. Controls were the next 2 cases of EOC diagnosed at UIHC after each case of PFTC, with priority given to stage of disease, then histologic grade, followed by histology, with 1 year the limit for obtaining the closest match. RESULTS: Twenty-eight cases of PCFT were found. These were matched with 56 cases of EOC. The mean age at diagnosis was significantly older for women with PCFT (67 years) vs. women with EOC (60 years) (p = 0.005). The was no difference in prediagnosis hormonal contraceptive use (p=0.38), body mass index (p = 0.5) or rate of positive nodes (p = 0.19). Kaplan-Meier analysis revealed no difference in survival between PCFT and EOC (p = 0.5). CONCLUSION: There is no significant difference in clinical parameters or survival between patients with PCFT or EOC when matched for stage, grade and histology.

Treatment of exercise incontinence with a urethral insert: a pilot study in women.

OBJECTIVE: This study sought to evaluate the short- and medium-term effectiveness of an intraurethral device (FemSoft Insert, Rochester Medical Corporation, Stewartville, Minnesota) in the treatment of exercise-induced incontinence in women. DESIGN: An unblinded, controlled trial of device efficacy during supervised exercise sessions (phase 1) was followed by a 3-month uncontrolled trial of device effectiveness (phase 2). The setting was a tertiary care center, and female participants were 6 community adults with symptoms of significant stress incontinence during exercise. Phase 1 consisted of four standardized exercise sessions, two with and two without the insert in place. In phase 2, patients performed unsupervised exercise using the insert during a 3-month period. The main outcome measure was change in urine loss during exercise sessions performed with and without the device, as measured by change in pad weight. Secondary outcome measures were results of satisfaction surveys and occurrence of adverse events. RESULTS: Median urine loss during standardized exercise sessions decreased from 20 g (range, 4.9 to 80.2 g) without the device to 2.6 g (range, 1.3 to 6.8 g) with the device (P=0.03). Five women used the device at home during unsupervised exercise; one subject had a urinary tract infection. At the end of 3 months, satisfaction and comfort were rated high on a 5-point scale. CONCLUSION: The FemSoft urethral device is an effective, safe, and comfortable treatment for exercise incontinence in women.