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Community Ment Health J ; 55(4): 561-568, 2019 05.
Artículo en Inglés | MEDLINE | ID: mdl-30094737


Schools of Public Health have a commitment to engage in practice-based research and be involved in collaborative partnerships. In 2016 the faculty, staff, and students from the University of Nebraska Medical Center College of Public Health and the Nebraska Department of Health and Human Services, Division of Behavioral Health collaborated to develop and administer a comprehensive assessment of the mental health and substance use disorder services provided by the Division of Behavioral Health. The purpose of this paper is to describe the process used to develop the trusting and mutually beneficial partnership and the data tools that were created and used to assess and determine the behavioral health needs. It is unrealistic to think that practitioners could undertake a project of this magnitude on their own. It is essential to have identified processes and systems in place for others to follow.

BMC Med Educ ; 18(1): 321, 2018 Dec 27.
Artículo en Inglés | MEDLINE | ID: mdl-30591050


BACKGROUND: Point-of-care-ultrasound (POCUS) training is expanding in undergraduate and graduate medical education, but lack of trained faculty is a major barrier. Two strategies that may help mitigate this obstacle are interprofessional education (IPE) and near-peer teaching. The objective of this study was to evaluate a POCUS course in which diagnostic medical sonography (DMS) students served as near-peer teachers for internal medicine residents (IMR) learning to perform abdominal sonography. METHODS: Prior to the IPE workshop, DMS students participated in a train-the-trainer session to practice teaching and communication skills via case-based simulation. DMS students then coached first-year IMR to perform POCUS examinations of the kidney, bladder, and gallbladder on live models. A mixed-methods evaluation of the interprofessional workshop included an objective structured clinical exam (OSCE), course evaluation, and qualitative analysis of focus group interviews. RESULTS: Twenty-four of 24 (100%) IMR completed the OSCE, averaging 97.7/107 points (91.3%) (SD 5.2). Course evaluations from IMR and DMS students were globally positive. Twenty three of 24 residents (96%) and 6/6 DMS students (100%) participated in focus group interviews. Qualitative analysis identified themes related to the learning environment, scanning technique, and suggestions for improvement. IMR felt the interprofessional training fostered a positive learning environment and that the experience complimented traditional faculty-led workshops. Both groups noted the importance of establishing mutual understanding of expectations and suggested future workshops have more dedicated time for DMS student demonstration of scanning technique. CONCLUSION: An interprofessional, near-peer workshop was an effective strategy for teaching POCUS to IMR. This approach may allow broader adoption of POCUS in medical education, especially when faculty expertise is limited.

Medicina Interna/educación , Sistemas de Atención de Punto , Enseñanza , Ultrasonografía , Abdomen/diagnóstico por imagen , Educación Médica/métodos , Humanos , Grupo Paritario , Estudiantes de Medicina
Breastfeed Med ; 13(5): 335-340, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29708765


BACKGROUND: Benefits of breastfeeding are well established. What is more, breastfeeding is associated with lower healthcare costs. More U.S. hospitals are adopting the World Health Organization's Ten Steps to Successful Breastfeeding; however, most hospitals fall short on key factors. OBJECTIVE: To our knowledge, this project is the first of its kind to use national-level data and a complex statistical modeling approach to identify a more complete picture of the variables related to breastfeeding duration within the postpartum period. METHODS: This secondary data analysis project used the Phase 7 Core PRAMS Research File (2012-2013) and the Standard Questions B1, B2, B3, and B4 variables in the statistical analysis. The outcome variable of interest was length of breastfeeding during the postpartum period. The postpartum period was defined as 8 weeks after delivery rather than the usual definition of 6 weeks to accommodate the way quit time is reported in the Pregnancy Risk Assessment Monitoring System (PRAMS) data. Univariate and multivariate analyses were conducted using PC SAS version 9.4. RESULTS: The multivariate analysis indicates that many of the modifiable factors associated with quitting breastfeeding within the postpartum period are hospital related. This pilot study reinforces the importance of 7 of the 10 Steps. CONCLUSIONS: These results underscore the importance of hospitals adopting evidence-based best practices for breastfeeding. The relationship found between Women, Infants, and Children receiving supplemental nutrition benefits and breastfeeding quit times requires further exploration. The study results also highlight the need to address modifiable factors that may be overlooked in traditional breastfeeding promotion efforts, such as depression and alcohol use.

Lactancia Materna , Práctica Clínica Basada en la Evidencia , Promoción de la Salud/métodos , Adulto , Análisis Factorial , Femenino , Humanos , Modelos Logísticos , Análisis Multivariante , Proyectos Piloto , Periodo Posparto , Medición de Riesgo , Organización Mundial de la Salud , Adulto Joven
Breastfeed Med ; 12: 33-38, 2017.
Artículo en Inglés | MEDLINE | ID: mdl-27898210


INTRODUCTION: Support of others is a key factor for mothers who choose to breastfeed their infants, including those who balance work outside the home and breastfeeding. However, little research has been done to understand how maternal support during the postpartum period impacts mothers' ability to later balance work and breastfeeding, in particular full-time work and exclusive breastfeeding. The results of this qualitative study indicate that the timing of support plays a key role in mothers' ability to successfully overcome barriers during the early postpartum period, thus building maternal self-efficacy in addressing problems encountered when they return to work. METHODS: To understand the experience of low-income women who successfully balance full-time work and exclusive breastfeeding for the recommended 6 months, interviews were conducted with women who met study criteria for income level, work status, and exclusive breastfeeding. Breastfeeding peer counselors were also interviewed as key informants. Interviews were recorded, transcribed, and coded for themes. The results of both sets of interviews were triangulated with a focused literature review to assure the soundness of the qualitative analysis. RESULTS: Timing of support included acute support, such as help establishing a successful latch needed during the first 2 weeks after delivery, to deal with breastfeeding problems that mothers perceived as being mentally and emotionally overwhelming and longer-term support needed to overcome problems perceived as being less intense. CONCLUSIONS: The research invites further exploration into the relationship between breastfeeding support provided by mothers' support system, including healthcare professionals, during the postpartum period and rates of breastfeeding duration and exclusivity.

Lactancia Materna , Madres , Investigación Cualitativa , Apoyo Social , Mujeres Trabajadoras/psicología , Equilibrio entre Vida Personal y Laboral , Adulto , Lactancia Materna/psicología , Lactancia Materna/estadística & datos numéricos , Femenino , Promoción de la Salud , Humanos , Lactante , Recién Nacido , Masculino , Persona de Mediana Edad , Madres/psicología , Nebraska/epidemiología , Periodo Posparto/psicología , Pobreza , Embarazo , Reinserción al Trabajo/psicología , Factores Socioeconómicos , Encuestas y Cuestionarios , Mujeres Trabajadoras/estadística & datos numéricos , Adulto Joven
Health Mark Q ; 33(4): 321-326, 2016.
Artículo en Inglés | MEDLINE | ID: mdl-27767581


The Centers for Disease Control and Prevention, Association of Schools and Programs of Public Health, and the Council on Linkages Between Academia and Public Health Practice have emphasized the increasing need to train the public health workforce in social marketing. With only 21 U.S. academic institutions offering course work in social marketing and only four institutions offering degrees in social marketing there is a gap between what academic institutions are offering and these recommendations (Kelly, 2013 ). The successful application of social marketing in public health practice relies on academic institutions creating and promoting social marketing-related programs.

Mercadeo Social , Desarrollo de Personal , Humanos , Salud Pública
J Agromedicine ; 19(3): 316-24, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-24959763


This article describes the formal use of marketing concepts in a systematic approach to influence farmers to voluntarily increase respiratory protective device (RPD) use. The planning process for the project incorporated six key decision or action points, each informed by formative research or health behavior theory. The planning process included developing behavior change strategies based on a 4P model (product, price, place, and promotion). The resulting campaign elements included print and e-mail messages that leveraged motivators related to family and health in order to increase farmers' knowledge about the risks of exposure to dusty environments, four instructional videos related to the primary barriers identified in using RPDs, and a brightly colored storage bag to address barriers to using RPDs related to mask storage. Campaign implementation included a series of e-mails using a bulk e-mail subscription service, use of social media in the form of posting instructional videos on a YouTube channel, and in-person interactions with members of the target audience at farm shows throughout the Central States Center for Agricultural Safety and Health seven-state region. Evaluation of the e-mail campaigns indicated increased knowledge about RPD use and intent to use RPDs in dusty conditions. YouTube analytic data indicated continuing exposure of the instructional videos beyond the life of the campaign. The project demonstrates the efficacy of a planning process that incorporates formative research and clear decision points throughout. This process could be used to plan health behavior change interventions to address other agriculture-related health and safety issues.

Agricultura , Promoción de la Salud/métodos , Dispositivos de Protección Respiratoria/estadística & datos numéricos , Mercadeo Social , Enfermedades de los Trabajadores Agrícolas/prevención & control , Testimonio de Experto , Conductas Relacionadas con la Salud , Humanos , Internet , Comercialización de los Servicios de Salud , Nebraska , Plaguicidas/efectos adversos