Improving Health through Action on Economic Stability: Results of the Finances First Randomized Controlled Trial of Financial Education and Coaching in Single Mothers of Low-Income.

OBJECTIVES: Evaluate the health impact of a novel financial education and coaching program in single mothers of low-income in Omaha, Nebraska. METHODS: Employed, single mothers earning no more than 200% of the 2017 Federal Poverty Level (n = 345) enrolled in the study between April 2017 and August 2020 and were randomized to receive a novel financial education and coaching program, the Financial Success Program (FSP) or no intervention control. Demographics, biometrics, financial strain, health behaviors and healthcare utilization were assessed at baseline and the 12-month study visits. RESULTS: Participants who completed the FSP demonstrated significantly reduced financial strain, an increased rate of smoking cessation, and a reduction in avoidance of medical care due to cost compared to participants in the control group. CONCLUSIONS: The FSP represents an effective model in promoting economic stability in vulnerable individuals through a reduction in financial strain. Health behavior changes including an increased rate of smoking cessation were demonstrated within the first 12 months of intervention.

Impact of Interprofessional Telehealth Case Activities on Students' Perceptions of Their Collaborative Care Abilities.

Objective. To describe the development, implementation, and assessment of simulated interprofessional education (IPE) telehealth case activities. Methods. Faculty from pharmacy and physician assistant schools developed interprofessional cases covering topics addressed in both curricula and designed for specific levels of learners. Using a telehealth format, pharmacy students were paired with physician assistant students and met at specified times in a virtual room. Faculty representing both professions assessed students as they discussed a patient case, determined a diagnosis, and collaborated to develop appropriate treatment options. Pre-experience and post-experience data and student reflections were collected. Results. Pharmacy students' responses to items on the Team Skills Scale (TSS) completed after participating in four IPE telehealth case activities indicated positive changes. Mean total TSS scores significantly improved from pre-experience 62.3 (SD 8.4) to post-experience 72.6 (SD 5.7). Quantitative evaluation of student teams' participation in an interprofessional activity was assessed using the Creighton Interprofessional Collaborative Evaluation (C-ICE) instrument and the average score was 90%. Theme analysis was performed on student reflections and the most prominent themes identified were satisfaction from interacting with other health care professionals, increased confidence in clinical decision-making ability, and affirmation that IPE telehealth cases should be included in each year of the curriculum. Conclusion. Implementation of interprofessional cases using telehealth technology is an effective way for pharmacy schools to incorporate IPE into their curriculum. Students reported improved self-perception of interprofessional competence and attitudes toward interprofessional collaboration after participating in IPE telehealth cases.

A health education program for underserved community youth led by health professions students.

OBJECTIVES: To develop and implement a health fair and educational sessions for elementary school children led by health professions students. DESIGN: The structure and process were developed with elementary school administration to determine the health topics to be covered. Students and faculty members created a "hands-on," youth-oriented health fair and interactive health educational sessions. Quantitative and qualitative data were collected on learning outcomes from the underserved child population and health professions students. ASSESSMENT: The health fair and educational sessions increased awareness of underserved youth in the areas of critical health behaviors, purposeful education on health issues facing their community, and exposure to careers in various health professions. The activities provided meaningful learning experiences for the health professions students. CONCLUSION: The health education program model is an excellent way to teach health education, communication and critical thinking skills, and service learning to health professions students.

Use of a multidisciplinary tool to achieve target outcomes in Native American patients with diabetes: Treat-to-target.

PURPOSE: Our purpose was to test a communication tool used in a multidisciplinary setting to more effectively achieve the recommended goals for glucose, blood pressure, lipids, and prophylactic aspirin use in a Native American population with type 2 diabetes. METHODS: One hundred randomly selected patients were included in this observational, pre-intervention, post-intervention study design. The team began with a chart audit documenting hemoglobin A(1c) (Hgb A(1c)), blood pressure, cholesterol levels, and aspirin use. The intervention included the development of a one page form used to prompt providers to intensify therapy when the patient was not meeting evidence-based goals. The audit was repeated one year later. RESULTS: Analysis of 74 patients completing the study showed a decrease in Hgb A1C from 8.812% pre-intervention to a mean 8.214% post-intervention (p < 0.007). At the time of pre-intervention audit, patients were already at target for blood pressure and no significant further decrease was found. Measures of total cholesterol, triglycerides, and aspirin use showed improvement, but statistical significance was not met. CONCLUSION: The one-page multidisciplinary tool used to intensify therapy significantly improved glucose control. More consistent interaction of the multidisciplinary team is necessary to reach other desired goals.

A pharmacist's introduction to the effects of aging on patients with cerebral palsy.

OBJECTIVE: To review the development of comorbidities in patients living with cerebral palsy (CP) and explore potential areas for intervention by consultant pharmacists. DATA SOURCES: A MEDLINE search (1993 to present) was conducted to identify literature in the English language focusing on CP and aging. Based on the initial literature evaluation, an additional search was conducted to locate literature focusing on comorbidities in CP including, but not limited to, nutritional deficiencies, medication misadventures, osteoporosis, gastroesophageal reflux disease, and pain. STUDY SELECTION AND DATA EXTRACTION: All studies evaluating coexisting medical conditions associated with CP as they relate to aging. DATA SYNTHESIS: CP affects nearly 500,000 adults in the United States. Spastic CP is the most common form. Chronic medical conditions typically seen in the general older adult population may occur earlier in life for patients with CP. CONCLUSION: Health care maintenance issues are often overlooked in adult patients with CP. Consultant pharmacists can be helpful resources and advocates for appropriate medication therapy, monitoring, and preventive services for these patients.