Understanding influenza immunization uptake rates among the Hispanic LGBTQIA community.

OBJECTIVES: Most national-level data regarding lesbian, gay, bisexual, transgender, queer/questioning, intersex, and allies (LGBTQIA) immunizations are limited. The primary objective of this study was to identify factors that influence behaviors, attitudes, and perceptions toward the uptake of the influenza vaccine within the Hispanic LGBTQIA community. METHODS: This was a prospective survey that assessed vaccine acceptability and practices regarding the influenza vaccine within the LGBTQIA community. Collection of data occurred through the use of social media platforms from July 2016 to May 2018. A total of 126 participants (mean age 32.03 ± 11.68 years) completed a 15-minute, 26-item, English/Spanish survey. A number of outcome measures assessed perceptions of vaccine effectiveness and safety. In addition, perceived severity of influenza symptoms and perceived susceptibility to contract influenza was assessed. RESULTS: A logistic regression model assessed the impact of several factors on influenza vaccine uptake. Perceived susceptibility of contracting influenza from the vaccine (P = 0.015) and perceived ease of receiving the influenza vaccine (P = 0.005) were the strongest predictors of vaccine uptake. Results showed no association between disclosure of sexual orientation and influenza immunization uptake (χ2= 3.55; P = 0.17). Exploratory analyses revealed that non-Hispanic patients were more likely to perceive that their health care providers were aware of their sexual orientation compared with Hispanic patients (χ2= 8.66; P = 0.013). CONCLUSION: Several factors emerged as predictors of influenza vaccine uptake in the LGBTQIA population. Further studies are needed to explore additional factors such as disclosure of sexual orientation and variation of uptake based on vaccine type (STD vs. non-STD vaccines).

Project DIS-IMPACT: Drug information in English and Spanish to improve patient preparation before colonoscopy.

OBJECTIVE: To create culturally appropriate colonoscopy education services and handouts for the Hispanic population undergoing a colonoscopy procedure to ensure correct bowel preparation. SETTING: Project DIS-IMPACT was conducted at a federally qualified, nonprofit community health center along the United States-Mexico border. PRACTICE DESCRIPTION: Patients identified in the study included those who were at least 50 years of age and had not received a colonoscopy between July 1, 2012, and February 28, 2013. Participants included uninsured Hispanics, able to speak English or Spanish, registered with the clinic, and referred by a provider working at the health center. PRACTICE INNOVATION: The process of evaluating and developing colonoscopy screening education included creating a standing order, developing medication education handouts in both English and Spanish, and documenting areas of improvement at monthly pharmacy staff meetings. MAIN OUTCOME MEASURES: Outcomes of the program included a descriptive statistics analysis of the served population and culturally appropriate counseling recommendations used in the medication (polyethylene glycol electrolyte solution) education handouts. RESULTS: A total of 143 participants received colonoscopy, including 49 men and 94 women. As the classes were conducted, the patient information handouts were adapted accordingly based on culturally appropriate recommendations from participants and providers. CONCLUSION: Pharmacists played a unique role in providing culturally appropriate precolonoscopy education material to assist in successful colonoscopy preparation.

Development of a community pharmacy human papillomavirus vaccine program for underinsured university students along the United States/Mexico border.

OBJECTIVE: To describe the development and implementation of a human papillomavirus (HPV) vaccine patient assistance program (PAP) for university students, and to acquire information on the number who accessed the program and completed the series. SETTING: University of Texas at El Paso University Student Health Clinic Pharmacy, Fall 2011-Spring 2014. PRACTICE DESCRIPTION: A community pharmacy located within the university student health clinic providing services to an underinsured student population. PRACTICE INNOVATION: Existing evidence shows the benefit of using PAP in community pharmacies but is nonspecific regarding the use of PAP for vaccines in an uninsured and underinsured Hispanic student population. The implementation of this unique HPV vaccine program in a community setting aims to increase awareness, access, and rates. MAIN OUTCOME MEASURES: Primary measures included results from a needs-assessment questionnaire that were used to implement the HPV vaccine program. After implementation, utilization data were collected on the number of students who qualified and enrolled in the HPV PAP and the number of students who completed the HPV series. RESULTS: The preliminary data from a needs assessment indicated that a majority (72.1%, n = 80) of students did not understand how HPV is transmitted. A total of 89 students qualified for PAP. The majority were women (81%). A total of 71 students (79.8%) received their second dose and 43 (48.3%) completed the series. CONCLUSIONS: Although pharmacists continue to provide vaccine services, minorities such as the Hispanic population continue to be underimmunized. Students may not be taking the proper precautions to prevent the acquisition of HPV. For these reasons services such as this HPV vaccine program are warranted. Pharmacists need to continue to educate and advocate on the importance of vaccines and how they prevent disease.

Co-curricular assessment plan for developing pharmacy professionals (RxPro) after the first professional year.

INTRODUCTION: To measure changes in student professionalism from co-curricular activities. METHODS: A prospective cohort study followed first-year pharmacy students at The University of Texas at El Paso School of Pharmacy. Students completed one co-curricular activity each semester. Learning was assessed using the RxPro VALUE rubric and Professionalism Assessment Tool (PAT) at the beginning and end of the first professional year. The RxPro VALUE rubric included six domains (connections to experience, lifelong learning, diversity of communities and cultures, civic identity and commitment, empathy, and reflection and self-assessment) and was rated from 0 (not yet applied) to 4 (exemplary). The PAT contained 33-items in five domains (reliability, responsibility, and accountability; lifelong learning and adaptability; relationships with others; upholding principles of integrity and respect; and citizenship and professional engagement) and was rated from 1 (knows) to 5 (teaches) (maximum score = 165). RESULTS: Mean scores on the RxPro VALUE rubric increased (p < 0.05) from baseline to end of year in five domains: connections to experience (1.44 vs. 2.07), diversity of communities and cultures (1.75 vs. 2.3), civic identity and commitment (1.34 vs. 2.33), empathy (1.44 vs. 2.37), and reflection and self-assessment (1.53 vs 2.19). No significant changes were seen in PAT scores from baseline (M = 114.19, standard deviation = 32.832) to end of year (M = 119.56, standard deviation = 29.63, p = 0.35). CONCLUSIONS: The RxPro VALUE rubric detected growth in professional behaviors among first-year doctor of pharmacy students, while no significant change was observed in the PAT.

Influenza and Intentions to Vaccinate in an Underserved Hispanic Population: The Role of Theoretically Derived Constructs.

BACKGROUND: Past research has focused on understanding influenza vaccine acceptance in non-Hispanic white populations; however, research on the social causes of influenza vaccine acceptance rates in Hispanic populations is slowly developing. OBJECTIVE: The purpose of this study was to assess theoretically driven predictors (i.e. attitudes, perceptions, behaviors, etc.) on influenza and the intention to vaccinate. METHODS: A survey was administered to assess predictors of intentions to receive the influenza vaccine. The survey included items adapted from the National Flu Survey. RESULTS: Key constructs common in models of health behaviors emerged as predictors of behavioral intentions to receive the flu vaccine. Recent vaccination within the past year (P < 0.001), perceived effectiveness of the flu vaccine (P < 0.004), and perceived safety of the flu vaccine (P = 0.009) were predictors of intentions to vaccinate. Exploratory analyses revealed that government distrust was a statistically significant predictor of intentions to vaccinate (P = 0.044). CONCLUSION: The above results have important implications for health-care providers and public health educators. The better we understand the relationship between theoretically driven predictors and vaccine behaviors, the more educators and health-care providers can focus on meaningful, culturally sensitive, targeted-vaccine education.

Assessing the impact of faculty research profile videos on students' perceptions towards research at a school of pharmacy.

BACKGROUND AND PURPOSE: Innovative delivery of research education and training in pharmacy education improves student perception of, and involvement in, professional pharmacy research. The purpose of this project was to utilize a flipped-classroom video technology approach to introduce our Capstone research experience and to assess the impact of the video technology on student's perceptions of pharmacy research. EDUCATIONAL ACTIVITY AND SETTING: Faculty recorded one-min videos that provided an overview of current research. Each video included a research introduction, explanation of student incorporation into research, and impact of research on the field of expertise. Students were assigned to review faculty videos. To assess impact of the videos on students' perceptions of research, t-tests compared five variables before and after students watched the videos. These variables included research curiosity, research interest, research inspiration, research motivation, and pharmacy research interest. FINDINGS: Across all students, no differences were detected. A statistically significant interaction emerged that suggested prior pharmacy experience may impact research curiosity, interest, and inspiration. SUMMARY: Findings demonstrated that the impact of research videos on pharmacy students' attitudes and perceptions towards research may depend on students' past experiences in a pharmacy setting. Further research is needed to identify factors that impact students' perceptions of pharmacy research. The information from this study provided our faculty members with valuable insights that can be used to better prepare students in the laboratory, classroom, and beyond.

Evaluating the Standardization of Transitions of Care in a Texas-Mexico Border Academic Family Medicine Practice.

PURPOSE: This quality improvement project aimed to assess the elements of the current workflow process that meets requirements for transitions of care from a family medicine inpatient to outpatient service following the Transitional Care Management (TCM) program developed by the Centers for Medicare & Medicaid Services. The purpose of the study was to assess the current family medicine workflow and determine whether the current process meets the criteria for billing and calculate the potential loss of reimbursement. METHODS: Interviews with key personnel, review of practice policies, and a retrospective chart review were performed for clinic patients discharged from the inpatient to outpatient family medicine service. RESULTS: A total of 37 patients met inclusion criteria for the chart review. Of these, 8% of patients seen at the outpatient clinic met all criteria for TCM. Potential reimbursement for those who met TCM criteria was $293.14 USD; the estimated potential TCM reimbursement for patients not meeting criteria was $1997.76 USD. CONCLUSION: Standardized, team-based TCM services have shown to decrease readmission rates for high-risk patient populations. Results from this project identified processes in place at the family medicine practice to facilitate the development of a standardized transitional care service which could meet both TCM and best practice models.

Identifying opportunities for PharmD curricular reform by surveying oncology pharmacists about career preparedness and exposure.

INTRODUCTION: The primary objective of the study was to assess factors that predict pursuit of an oncology post-graduate year 2 (PGY-2) residency. Additional objectives included identifying the role of and exploring opportunities for PharmD curricula to increase student interest in the oncology field. METHODS: An anonymous 15-minute survey was developed and administered to oncology pharmacists and residents. Study participants were included if they were actively practicing as clinical pharmacists in an oncology setting in the US, maintained an active pharmacist license, and >18 years of age. Responses were analyzed using descriptive and inferential statistics. All results are reported in aggregate, with the exception of quotes obtained from open-ended responses. RESULTS: Eighty participants were included in analyses. After controlling for variance due to age, sex, race, years of practice, the number of oncology advanced pharmacy practice experiences (APPEs) correlated with pursuit of a PGY-2 residency in oncology (p = 0.047). Additionally, participants' perceived level of preparedness from didactic oncology training predicted pursuit of an oncology PGY-2 residency (p = 0.002). Emerging themes in pursuing oncology from open-ended items revealed that inclusion of supportive care in the didactic curriculum and having a family member or friend diagnosed with cancer were important factors. Additionally, participants' responses regarding PharmD curricula included recommendations to inform didactic and experiential education. CONCLUSIONS: The results support the need for reevaluation of oncology education in PharmD curricula. Further studies could explore specific aspects of didactic curriculum that impact the level of student preparedness, and which elements encourage a student pharmacist to seek further training in the oncology field.

Evaluating the Types of Pharmacy Student Interventions Made During an Interprofessional 6-Week Adult Internal Medicine Rotation.

INTRODUCTION: The new standards for pharmacy education require that pharmacy students are involved in direct and interprofessional team-based care in multiple practice settings, which include "real-time" interactions with physician prescribers and medical students. METHODS: From April 2014 to December 2015, fourth-year Doctor of Pharmacy (PharmD) students at University Medical Center of El Paso, Texas were assigned to an interprofessional team that was comprised of physician prescribers, medical students, and a pharmacist faculty. They recorded their interventions that were analyzed for type, number, physician acceptance, clinical importance, and time requirements for intervention recommendation. Interventions were divided into 5 main types and further divided into specific categories. RESULTS: Twelve PharmD students contributed 531 interventions, resulting in an average of 44 interventions per student with a physician acceptance rate of 87%. The most common types of interventions performed by PharmD students were under the categories of Therapy Needed (29.8%), Too Low Dose/Frequency (21.1%), Too High Dose/Frequency (8.3%), Therapeutic Level Monitoring (6.8%), and IV to PO Conversion (4.9%). A majority of interventions were of moderate clinical importance (56.1%) and took approximately 15 minutes to complete (92.5%). CONCLUSION: PharmD students under the supervision of clinical faculty on an interprofessional internal medicine team are valuable collaborators and contributors in decreasing the number of drug-related problems that can negatively impact patient care.