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2.
BMC Med Educ ; 24(1): 311, 2024 Mar 20.
Artigo em Inglês | MEDLINE | ID: mdl-38509537

RESUMO

BACKGROUND: Healthcare systems rely on well-trained family medicine physicians who can offer continuous quality services to their communities and beyond. The American Academy of Family Physicians and the World Organization of Family Doctors recommend that medical curricula should have adequately supervised education and training of the learners in family medicine during their preclinical and clinical placements. However, some medical schools don't have a comprehensive family medicine program to prepare graduates who can meet the community needs. This work aims to report the essential steps for the development, implementation, and evaluation of the family medicine program at the College of Medicine at the University of Sharjah in United Arab Emirates. METHODS: We used the Kern's 6-step model to describe the development, implementation, and evaluation of the family medicine program. This includes problem identification, needs assessment, goals setting, educational strategies, implementation, and evaluation. During 2014-2022, we longitudinally collected essential information about the family medicine program from different stakeholders including the feedback of clinical coordinators, adjunct clinical faculty, and medical students at the end-of-clerkship. All responses were analysed to determine the effective implementation and evaluation of the family medicine program. RESULTS: Over the course of 8 academic years, 804 medical students, 49 adjunct clinical faculty and three College of Medicine faculty participated in the evaluation of the family medicine program. The majority of respondents were satisfied with various aspects of the family medicine program, including the skills gained, the organisation of program, and the variety of clinical encounters. The medical students and adjunct clinical faculty suggested the inclusion of e-clinics, faculty development program, and the expansion of more clinical sites for the effectiveness of the family medicine program. CONCLUSIONS: We report a successful development, implementation, and evaluation of the family medicine program in United Arab Emirates with a positive and impactful learning experience. More attention should be paid towards a suitable representation of family medicine program in the medical curriculum with focused and targeted educational plans for medical students.


Assuntos
Educação de Graduação em Medicina , Estudantes de Medicina , Humanos , Estados Unidos , Medicina de Família e Comunidade/educação , Emirados Árabes Unidos , Currículo , Atenção à Saúde , Avaliação de Programas e Projetos de Saúde , Desenvolvimento de Programas
3.
GMS J Med Educ ; 41(1): Doc3, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38504863

RESUMO

Next to courses and seminars, tests and assessments represent the main parameters with which to describe an academic study program independent of its curricular content. Thus, the quality of education depends not only on the quality of the courses taught and how they are interconnected, but also on the quality of testing and the feedback given to students regarding their performance. Course quality should be ensured through course evaluation. The economic cost of courses is calculated based on the required teaching load. The concept of teaching load stems from the time when program planning was instructor-centered. The main variable in the rules and regulations governing university study was the number of hours per week per semester (or number of course hours). But even in today's student-centered planning, which uses ECTS credits per module as the variable, teaching loads are still used to determine the number of staff necessary to offer an academic study program. Some universities also include the assessments in the evaluation. Yet the economic costs of testing are de facto ignored almost everywhere, and this does not bode well for the quality of the assessments. Much progress would be made to improve higher education if assessments counted as part of the teaching loads and the curricular norm values. This paper identifies which requirements must be considered in order to include assessments in teaching loads.


Assuntos
Currículo , Estudantes , Humanos , Escolaridade , Desenvolvimento de Programas
4.
Can Med Educ J ; 15(1): 80-82, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38528905

RESUMO

Faculty development programs should offer transformative resources and prioritize the needs of the faculty. If faculty face difficulty in accessing such programs, the potential impact of the resources may be limited. To alleviate such issues, we designed a faculty development program that is available to anyone at any time in any configuration. By allowing faculty to choose from a diverse range of medical education topics based on their interests and needs, they may promptly apply crucial concepts in their teaching and education leadership roles. Faculty members can engage in personalized professional development, enhance their teaching practices, and ultimately foster their professional growth. Also, program coordinators and administrators can seamlessly integrate our resources into any existing faculty development program, serving as self-study materials, resources for existing programs, or a stand-alone curriculum with high accessibility, versatility, and ease of use.


Les programmes de développement du corps professoral doivent offrir des ressources transformatrices et donner la priorité aux besoins des enseignants. Si ces derniers ont des difficultés à accéder à ces programmes, l'impact potentiel des ressources peut être limité. Pour y remédier, nous avons conçu un programme de développement du corps professoral accessible à tous, à tout moment et dans n'importe quelle configuration. En permettant aux enseignants de choisir parmi une gamme variée de sujets relatifs à l'enseignement médical en fonction de leurs intérêts et de leurs besoins, ils peuvent rapidement mettre en pratique des concepts cruciaux dans leur rôle d'enseignant et de responsable de l'enseignement. Les membres du corps enseignant peuvent s'engager dans un développement professionnel personnalisé, améliorer leurs pratiques d'enseignement et, en fin de compte, favoriser leur croissance professionnelle. En outre, les coordonnateurs et administrateurs de programmes peuvent aisément intégrer nos ressources dans n'importe quel programme existant de formation du corps enseignant, en tant qu'outil d'auto-apprentissage, de ressources pour les programmes existants, ou de programme autonome avec une grande accessibilité, polyvalence et facilité d'utilisation.


Assuntos
Educação Médica , Docentes de Medicina , Humanos , Desenvolvimento de Programas , Desenvolvimento de Pessoal , Currículo
5.
Curr Oncol Rep ; 26(3): 200-211, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38358637

RESUMO

PURPOSE OF REVIEW: Over the last 2 decades, integrative oncology (IO) has seen exponential growth within cancer care. It aims to combine evidence-based complementary therapies with conventional treatments to improve the well-being and quality of life for individuals dealing with cancer. The proliferation of integrative medicine programs in major cancer centers globally reflects varying approaches shaped by cultural, demographic, and resource-based factors. RECENT FINDINGS: Drawing upon the expertise of leaders in IO from the Society for Integrative Oncology (SIO) Clinical Practice Committee, this manuscript serves as a practical guide for establishing an IO practice. Collating insights from diverse professionals, including oncologists, integrative oncologists, supportive care physicians, researchers, and clinicians, the paper aims to provide a comprehensive roadmap for initiating and advancing IO services. The primary objective is to bridge the gap between conventional cancer care and complementary therapies, fostering a patient-centric approach to address the multifaceted challenges encountered by individuals with cancer. This paper delineates several key sections elucidating different aspects of IO practice. It delves into the core components necessary for an IO service's foundation, outlines the initial medical consultation process, and presents crucial tools essential for successful consultations. By consolidating insights and expertise, this manuscript seeks to facilitate the integration of IO into mainstream cancer care, ultimately enhancing patient outcomes and experiences.


Assuntos
Terapias Complementares , Medicina Integrativa , Oncologia Integrativa , Neoplasias , Humanos , Qualidade de Vida , Desenvolvimento de Programas , Neoplasias/terapia
6.
BMC Health Serv Res ; 24(1): 175, 2024 Feb 07.
Artigo em Inglês | MEDLINE | ID: mdl-38326797

RESUMO

BACKGROUND: This study aimed to identify strategies for the implementation of a guided internet- and mobile-based intervention (IMI) for infant sleep problems ("Sleep Well, Little Sweetheart") in well-baby and community mental health clinics. STUDY DESIGN: We used group concept mapping, a two-phased mixed methods approach, conducted as a two-day workshop in each clinic. We recruited 20 participants from four clinics and collected sorting and rating data for implementation strategies based on the Expert Recommendations for Implementing Change taxonomy and brainstorming sessions. Data were analyzed using descriptive statistics, multidimensional scaling, and hierarchical cluster analysis to create cluster maps, laddergrams, and Go-Zone graphs. Participants were presented with the results and discussed and interpreted the findings at each of the clinics in spring 2022. RESULTS: Participants identified 10 clusters of strategies, of which Training, Embedding and Coherence, User Involvement and Participation, and Clinician Support and Implementation Counseling were rated as most important and feasible. Economy and Funding and Interactive and Interdisciplinary Collaboration were rated significantly lower on importance and feasibility compared to many of the clusters (all ps < 0.05). There was a correlation between the importance and feasibility ratings (r =.62, p =.004). CONCLUSIONS: The use of group concept mapping made it possible to efficiently examine well-baby and community clinics' perspectives on complex issues, and to acquire specific knowledge to allow for the planning and prioritization of strategies for implementation. These results suggest areas of priority for the implementation of IMIs related to infant sleep problems. TRIAL REGISTRATION: The study was pre-registered at Open Science Framework ( www.osf.io/emct8 ).


Assuntos
Saúde Mental , Transtornos do Sono-Vigília , Humanos , Análise por Conglomerados , Desenvolvimento de Programas , Aconselhamento
7.
Ann Glob Health ; 90(1): 10, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38344005

RESUMO

Background: Thirty-four million children globally have disabling hearing loss, with the highest prevalence in low- and middle-income countries (LMICs). Early identification and management is crucial, yet barriers to screening and treatment of hearing loss are extensive in LMICs. Unaddressed hearing loss negatively impacts individuals and communities. The WHO's 2021 World Report on Hearing urges the development of Ear and Hearing Care (EHC) programs to improve access to all aspects of care, including screening, diagnostics, management, and developmental support. A joint Nairobi- and Seattle-based group convened in 2021 to discuss strategies for program development in Kenya, as presented in this paper. Findings: Developing a national EHC program must include the necessary support services for a child with a diagnosed hearing loss, while simultaneously promoting engagement of family, community, and healthcare workers. Existing government and healthcare system policies and priorities can be leveraged for EHC programming. Strategies for success include strengthening connections between policymakers at national, county, and municipal levels and local champions for the EHC agenda, with a concurrent focus on policy, early detection and intervention, habilitation, and family-centered care. Updates to health policy and funding to support the accessibility of services and equipment should focus on leveraging national healthcare coverage for hearing technologies and services, strengthening referral pathways, training to bolster the workforce, and metrics for monitoring and evaluation. Additional strategies to support forward progress include strategic engagement of partners and leveraging local partners for phased scale-up. Conclusions and Recommendations: Recommendations to strengthen EHC within the Kenyan health system include concurrent leverage of existing health policies and priorities, partner engagement, and strengthening referral pathways, monitoring and evaluation, and training. These strategies may be generalized to other countries too.


Assuntos
Perda Auditiva , Criança , Humanos , Quênia , Perda Auditiva/diagnóstico , Perda Auditiva/terapia , Atenção à Saúde , Desenvolvimento de Programas , Benchmarking
8.
Infant Ment Health J ; 45(2): 185-200, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38230980

RESUMO

To address high rates of mental health and developmental concerns facing young children ages 0-6 in the United States and internationally, providers across professional sectors need Infant and early childhood mental health (IECMH) training and support. The training and teleconsultation program (TTP) is a state-funded program developed in one Mountain West state in the United States to provide free IECMH training and teleconsultation to any provider working with young children. The TTP included access to webinars and individual or group consultation with licensed mental health providers. Webinars focused on increasing awareness and knowledge related to attachment and child development, supporting parents and caregivers, trauma-informed practice, supporting emotional health of staff and providers, and culturally responsive practices with infants, young children, and caregivers. Teleconsultation included case consultation, reflective individual and group supervision, and collaboration supports/referrals. During the 18-month evaluation period, 1568 unique providers engaged in either training or teleconsultation services, an average of 9% growth in new providers each month, with representation from all professional sectors and all state counties. This program demonstrates the feasibility and need for statewide training and teleconsultation programs to help meet the needs of providers who interact with and support young children and caregivers.


Para lidiar con las altas tasas de salud mental y preocupaciones sobre el desarrollo a las que se enfrentan los pequeños niños de edad 0-6 en los Estados Unidos e internacionalmente, quienes proveen el servicio dentro de la gama de todos los sectores profesionales necesitan entrenamiento y apoyo en el campo de la salud mental infantil y la temprana niñez (IECMH). El programa de entrenamiento y teleconsulta (TTP) es un programa con fondos estatales desarrollado en un estado del oeste montañoso en los Estados Unidos para ofrecer entrenamiento y teleconsulta gratis en IECMH a cualquier profesional que trabaja con niños pequeños. El TTP incluye acceso a seminarios web y consulta individual o en grupo con profesionales licenciados de la salud mental. Los seminarios web se enfocaron en incrementar la conciencia y el conocimiento relacionado con la afectividad y el desarrollo del niño, apoyar a progenitores y cuidadores, la práctica con atención informada sobre trauma, apoyar la salud emocional del personal y los proveedores, así como las prácticas culturalmente sensibles con los infantes, niños pequeños y quienes les cuidan. La teleconsulta incluyó consulta de casos, supervisión con reflexión tanto individual como de grupo, así como los apoyos/referencias colaborativas. Durante el período de evaluación de 18 meses, 1,568 proveedores con características particulares recibieron los servicios del entrenamiento o de la teleconsulta, un promedio de 9% de aumento de nuevos proveedores cada mes, con representación de todos los sectores profesionales y todos los condados del estado. Este programa demuestra la posibilidad y necesidad de programas de entrenamiento y teleconsulta a través de todo el estado para ayudar a satisfacer las necesidades de los proveedores que interactúan con y apoyan a los niños pequeños y quienes les cuidan.


Pour faire face aux taux élevés d'inquiétudes en matière de santé mentale et de comportement dont sont témoins les jeunes enfants âgés de 0-6 ans aux Etats-Unis et internationalement, les prestataires au travers des secteurs professionnels ont besoin de formation et de soutien en santé mentale du nourrisson et de la petite enfance (IECMH). Le programme de téléconsultation et de formation (TTP en anglais) est un programme financé au niveau de l'état développé dans un état des montagnes rocheuses aux Etats-Unis afin d'offrir une formation et une téléconsultation IECMH gratuite à tout prestataire travaillant avec de jeunes enfants. Le TTP a incorporé un accès à des webinaires et à une consultation individuelle ou de groupe avec des prestataires de santé mentale agréés. Les webinaires ont porté sur l'accroissement de la sensibilisation et des connaissances liées à l'attachement et au développement de l'enfant, au soutien des parents et des personnes prenant soin des enfants, à une pratique consciente des traumas, et au soutien de la santé émotionnelle des employés et des prestataires, et à des pratiques culturellement adaptées avec les nourrissons, les jeunes enfants et les personnes prenant soin d'eux. La téléconsultation a inclus une consultation de cas, une supervision de réflexion individuelle et de groupe, et des soutiens/références de collaboration. Durant la période d'évaluation de 18 mois, 1568 prestataires uniques se sont engagés soit dans une formation ou des services de téléconsultation, avec une moyenne de 9% de croissance chez les nouveaux prestataires chaque mois, avec une représentation de tous les secteurs professionnels et les comtés de l'état. Ce programme démontre la fiabilité et le besoin de programmes de formation et de téléconsultations au niveau de l'état afin d'aider à remplir les besoins des prestataires qui travaillent et soutiennent les jeunes enfants et les personnes prenant soin d'eux.


Assuntos
Consulta Remota , Lactente , Criança , Humanos , Pré-Escolar , Estados Unidos , Desenvolvimento de Programas , Estudos de Viabilidade , Saúde Mental , Pais/psicologia
9.
J Gen Intern Med ; 39(Suppl 1): 36-43, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38227169

RESUMO

BACKGROUND: In response to the aging population, the Department of Veterans Affairs (VA) seeks to expand access to evidence-based practices which support community-dwelling older persons such as the Geriatric Resources for Assessment and Care of Elders (GRACE) program. GRACE is a multidisciplinary care model which provides home-based geriatric evaluation and management for older Veterans residing within a 20-mile drive radius from the hospital. We sought to expand the geographic reach of VA-GRACE by developing a hybrid-virtual home visit (TeleGRACE). OBJECTIVES: The objectives were to: (1) describe challenges encountered and solutions implemented during the iterative, pre-implementation program development process; and (2) illustrate potential successes of the program with two case examples. DESIGN: Quality improvement project with longitudinal qualitative data collection. PROGRAM DESCRIPTION: The hybrid-virtual home visit involved a telehealth technician travelling to patients' homes and connecting virtually to VA-GRACE team members who participated remotely. APPROACH & PARTICIPANTS: We collected multiple data streams throughout program development: TeleGRACE staff periodic reflections, fieldnotes, and team meeting notes; and VA-GRACE team member interviews. KEY RESULTS: The five program domains that required attention and problem-solving were: telehealth connectivity and equipment, virtual physical examination, protocols and procedures, staff training, and team integration. For each domain, we describe several challenges and solutions. An example from the virtual physical examination domain: several iterations were required to identify the combination of telehealth stethoscope with dedicated headphones that allowed remote nurse practitioners to hear heart and lung sounds. The two cases illustrate how this hybrid-virtual home visit model provided care for patients who would not otherwise have received timely healthcare services. CONCLUSIONS: These results provide a blueprint to translate an in-person home-based geriatrics program into a hybrid-virtual model and support the feasibility of using hybrid-virtual home visits to expand access to comprehensive geriatric evaluation and ongoing care for high-risk, community-dwelling older persons who reside geographically distant from the primary VA facility.


Assuntos
Telemedicina , Veteranos , Humanos , Idoso , Idoso de 80 Anos ou mais , Visita Domiciliar , Avaliação de Programas e Projetos de Saúde , Desenvolvimento de Programas
10.
Eval Program Plann ; 103: 102404, 2024 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-38244416

RESUMO

Current understanding of what sustains public health programs is derived primarily from evaluations of programs delivered for only a few years. To improve program planning and knowledge on program sustainment, we examined real-world population programs that have been delivered for >2 years. Our focus was physical activity and nutrition programs for obesity prevention. We identified programs through published literature and searched through publicly available information on the theoretical factors determining sustainment. We reviewed 90 programs and explored intervention characteristics, provider, delivery and process level factors, and the outer environment influences. Programs were sustained on average 15 years and more frequently characterised as behavioural change skills programs targeting children, funded by non-government organisations and delivered by community organisations. Most programs had undergone some modification (n = 55). Differences between programs were observed across key factors: Programs sustained 15+ years were mainly behaviour skills programs (n = 21); and characterised by interactive designs (i.e., face-to-face or digital) over static innovations (i.e., print material) compared with those sustained <15 years (p = 0.024). While government funding supported many of the programs (n = 45;), those sustained 15+ years were more likely to have been commercially funded (p = 0.044); and were less likely to have current community involvement (p = 0.013). Differences in ownership and funding were also observed across countries. While multiple factors may influence program sustainment, longer delivered programs where distinguished by their program characteristics and outer contextual factors, suggesting such factors may have an important role in sustaining programs in the longer-term.


Assuntos
Participação da Comunidade , Obesidade , Criança , Humanos , Avaliação de Programas e Projetos de Saúde , Obesidade/prevenção & controle , Desenvolvimento de Programas , Exercício Físico
11.
PLoS One ; 19(1): e0296438, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38166130

RESUMO

INTRODUCTION: Older adults living alone in rural areas frequently experience health declines, social isolation, and limited access to services. To address these challenges, our medical academic university supported a quality improvement project for developing and evaluating the Visiting Neighbors program in two rural Appalachian counties. Our Visiting Neighbors program trained local volunteers to visit and guide rural older adults in healthy activities. These age-appropriate activities (Mingle, Manage, and Move- 3M's) were designed to improve the functional health of older adults. The program includes four in-home visits and four follow-up telephone calls across three months. PURPOSE: The purpose of this paper was to describe the 3M's Visiting Neighbors protocol steps guiding the quality improvement procedures relating to program development, implementation, and evaluation. METHODS AND MATERIALS: This Visiting Neighbors study used a single-group exploratory quality improvement design. This program was tested using quality improvement standards, including collecting participant questionnaires and visit observations. RESULTS: Older adults (> 65 years) living alone (N = 30) participants were female (79%) with a mean age of 82.96 (SD = 7.87) years. Volunteer visitor participants (N = 10) were older adult females. Two volunteer visitors implemented each visit, guided by the 3M's activities manual. All visits were verified as being consistently delivered (fidelity). Enrollment and retention data found the program was feasible to conduct. The older adult participants' total program helpfulness ratings (1 to 5) were high (M = 51.27, SD = 3.77). All volunteer visitor's program helpfulness ratings were also high (M = 51.78, SD = 3.73). DISCUSSION: The Visiting Neighbors program consistently engaged older Appalachian adults living alone in the 3M's activities. The feasibility and fidelity of the 3M's home visits were verified. The quality improvement processes included engaging the expert advisory committee and rural county stakeholders to ensure the quality of the program development, implementation, and evaluation.


Assuntos
Melhoria de Qualidade , Humanos , Feminino , Idoso , Idoso de 80 Anos ou mais , Masculino , Avaliação de Programas e Projetos de Saúde/métodos , Desenvolvimento de Programas , Região dos Apalaches , Inquéritos e Questionários
12.
Semin Pediatr Surg ; 33(1): 151389, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38245993

RESUMO

Pediatric robotic surgery has seen increasing implementation for its many benefits over the past two decades. As more pediatric surgeons gain exposure to robotic surgery, the interest in utilizing this technology is growing. However, there are no guidelines or existing framework for developing pediatric general surgery robotic programs. Programmatic development can be challenging, requiring institutional support, a minimum 12-month multistep process in partnership with the robot manufacturer, and organization of a local dedicated team. A cornerstone to all program building is collaboration and communication with key stakeholders who are committed to establishing a robotic surgery program. In this manuscript, we detail numerous best practices for implementation, followed by three variations of programmatic development, each drawing lessons from one of three practice settings: (i) A children's hospital in a large medical center associated with an adult hospital, (ii) a free-standing children's hospital, and (iii) a community-based practice. We aim for this article to provide a framework that can serve as a guide for those beginning this process, consolidating the key resources and strategies used to develop a robust pediatric robotic surgery program.


Assuntos
Procedimentos Cirúrgicos Robóticos , Robótica , Especialidades Cirúrgicas , Cirurgiões , Adulto , Humanos , Criança , Desenvolvimento de Programas
13.
Med Educ Online ; 29(1): 2308955, 2024 Dec 31.
Artigo em Inglês | MEDLINE | ID: mdl-38290044

RESUMO

The development of leadership skills has been the topic of several position statements over recent decades, and the need of medical leaders for a specific training was emphasized during the COVID-19 crisis, to enable them to adequately collaborate with governments, populations, civic society, organizations, and universities. However, differences persist as to the way such skills are taught, at which step of training, and to whom. From these observations and building on previous experience at the University of Ottawa, a team of medical professors from Lyon (France), Ottawa, and Montreal (Canada) universities decided to develop a specific medical leadership training program dedicated to faculty members taking on leadership responsibilities. This pilot training program was based on a holistic vision of a transformation model for leadership development, the underlying principle of which is that leaders are trained by leaders. All contributors were eminent French and Canadian stakeholders. The model was adapted to French faculty members, following an inner and outer analysis of their specific needs, both contextual and related to their time constraints. This pilot program, which included 10 faculty members from Lyon, was selected to favor interactivity and confidence in older to favor long-term collaborations between them and contribute to institutional changes from the inner; it combined several educational methods mixing interactive plenary sessions and simulation exercises during onescholar year. All the participants completed the program and expressed global satisfaction with it, validating its acceptability by the target. Future work will aim to develop the program, integrate evaluation criteria, and transform it into a graduating training.


Assuntos
Currículo , Liderança , Humanos , Idoso , Avaliação de Programas e Projetos de Saúde , Canadá , Docentes , Docentes de Medicina , Desenvolvimento de Programas
14.
Clin Obstet Gynecol ; 67(1): 169-185, 2024 03 01.
Artigo em Inglês | MEDLINE | ID: mdl-38281174

RESUMO

Perinatal mood and anxiety disorders and substance use disorders are the primary causes of maternal mortality in the postpartum period and represent major public health concerns. Despite this, these conditions remain undertreated. Behavioral health integration in outpatient obstetric settings is necessary but insufficient to meet the needs of all patients. Inpatient behavioral health integration represents a promising avenue for addressing gaps in care. Results from recent program development indicate that needs assessment, stakeholder backing, collaboration with existing programs, and adaptability are key factors in successful implementation.


Assuntos
Pacientes Internados , Período Pós-Parto , Gravidez , Feminino , Humanos , Desenvolvimento de Programas , Afeto , Mortalidade Materna
15.
Support Care Cancer ; 32(1): 84, 2024 Jan 05.
Artigo em Inglês | MEDLINE | ID: mdl-38177609

RESUMO

PURPOSE: Despite recommendations for cancer survivors to participate in routine physical activity (PA), offering programs that fit both survivors' needs and sponsoring organizations' resources remains a challenge. The purpose of this study is to explore the perspectives of cancer survivors and organizational stakeholders with the intent of developing PA peer-led programs that organizations can implement into their programming. METHODS: This study explored cancer survivors' (n = 11) and cancer care organizational stakeholders' (n = 27) perspectives on the design and feasibility of PA programs targeted for cancer survivors. Semi-structured interview guides were developed for survivors and stakeholders; interviews lasted approximately 30 min. Two analysts used a thematic analysis approach and independently conducted a line-by-line coding of each transcript. With guidance from a senior analyst, the codes were collapsed into themes and subthemes. RESULTS: The qualitative analysis of the interview data resulted in seven major themes relating to PA program development and success. Survivor-related themes included the following: (1) developing PA programs based on cancer survivors' characteristics and experiences; (2) perceived value and importance of accessible, face-to-face instruction; (3) ensuring success based on physical abilities and limitations of the survivor; and (4) the value of physician recommendation for PA participation. Organization-related themes included the following: (1) incorporating participant and community input into program offerings; (2) program feasibility and sustainability; (3) incorporating organizational experience when adopting new program initiatives. CONCLUSION: These findings highlight the challenges of developing viable PA programs for cancer survivors and may guide organizations in future program development and implementation.


Assuntos
Sobreviventes de Câncer , Neoplasias , Humanos , Exercício Físico , Sobreviventes , Desenvolvimento de Programas , Pesquisa Qualitativa , Neoplasias/terapia
16.
Behav Modif ; 48(2): 111-127, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-37864323

RESUMO

Past research suggests behavioral treatments are effective for challenging behavior in children and young adults with neurodevelopmental disorders, such as autism spectrum disorder (ASD). However, access to these services can be limited and require substantial resources. To address this issue, the current study provides a programmatic description of an individualized parent-mediated service model targeting moderate challenging behavior. In the program, therapists coached parents to implement functional analyses and individualized function-based treatment packages. Forty-one families of children and young adults with neurodevelopmental disorders participated. Most clients (75.6%) met all admission treatment goals and parents reported significant decreases in frequency and severity of challenging behaviors at discharge. Parents also reported less stress at discharge. Outcomes of the study suggest this parent-mediated treatment model is a viable option to treating moderate challenging behavior in children and young adults with intellectual and developmental disorders.


Assuntos
Transtorno do Espectro Autista , Criança , Adulto Jovem , Humanos , Transtorno do Espectro Autista/terapia , Desenvolvimento de Programas , Pais
17.
Am J Trop Med Hyg ; 110(1): 188-193, 2024 01 03.
Artigo em Inglês | MEDLINE | ID: mdl-37983934

RESUMO

Mentorship is essential to health researchers in achieving their full potential and advancing public health. In most low-resource settings, there is a paucity of training on how to be a successful mentor. The Center for International Reproductive Health Training at the University of Michigan conducted and evaluated a workshop at two universities in Uganda for mentors of new reproductive health research grant awardees. The program aimed to strengthen mentors' mentorship skills and to identify ways to foster institutional support for mentoring. Mentors rated their post-training skills using a 5-point Likert scale (not skilled to extremely skilled) immediately and 3 months after the training. Ten of 19 mentors who participated in the training completed the evaluation. The majority were 41 to 50 years old, male, midcareer faculty. Immediately after the training, mentors rated themselves (mean ± SD) highest in knowledge of research ethics (4.4 ± 0.5), fostering independence in mentees (4.3 ± 0.9), and understanding the benefits of mentoring (3.9 ± 1.1). Mentors felt least confident in fostering institutional change to support mentorship (3.3 ± 0.8), communication (3.5 ± 0.5), and overcoming adversity (3.5 ± 0.8). The two most important things the mentors learned were how to appreciate and manage diversity and how they can benefit from mentorship. Barriers to mentoring that persisted after the program ended included lack of time and institutional resources. Enhancing mentorship training opportunities will foster a generation of scientists who are more supported, skilled, and productive in research, leading to better reproductive and public health outcomes in their communities.


Assuntos
Tutoria , Mentores , Masculino , Humanos , Adulto , Pessoa de Meia-Idade , Desenvolvimento de Programas , Uganda , Saúde Reprodutiva , Avaliação de Programas e Projetos de Saúde
18.
Am J Infect Control ; 52(3): 365-367, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38036177

RESUMO

Although critical access hospitals are small, the expected infection prevention activities remain extensive. Program standards, aligned with the Association for Professionals in Infection Control and Epidemiology infection prevention competency model domains, were developed and implemented in a midwestern health care system. Time estimates for completion of each activity were assigned and then extrapolated to offer guidance on necessary full-time equivalents for adequate staffing.


Assuntos
Atenção à Saúde , Controle de Infecções , Humanos , Recursos Humanos , Estudantes , Hospitais , Desenvolvimento de Programas
19.
Laryngoscope ; 134(2): 637-644, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-37462294

RESUMO

OBJECTIVES: Many summer research programs (SRPs) for URiM students exist; however, only a few have been established by otolaryngology programs, who have a unique opportunity to provide a diverse experience. We sought to assess URiM undergraduate student perspectives on the most valuable program features that influence decision-making and how this might be useful to otolaryngology programs seeking to establish pathway programs. MATERIALS AND METHODS: An externally facing REDCap survey composed of 37 questions in scaled, multiple-choice, and open-ended form. The survey was delivered to applicants via email over two time periods in April 2021 and February 2022. All survey responses were analyzed using descriptive statistics and categorized according to demographic information, program features, and advertising mechanisms. RESULTS: Seventy-one percent of our applicants self-identified as URiM. Over 60% experienced financial hardship, and 31% experienced educational hardship. The single most important feature when selecting a summer research program (SRP) was access to mentorship followed by clinical shadowing and research opportunities. When program features were aggregated into groups, institutional features were the most important, followed closely by funding features. Finally, students prefer to learn about SRPs through their university, followed by social media, despite many students learning about our program through other means. CONCLUSIONS: Paid programs with effective advertising, research, mentoring, and clinical shadowing are highly valued by URiM undergraduate students. Understanding student perspectives is critical for programs aiming to address the "leaky pipeline" while being deliberate in their support of underrepresented students. LEVEL OF EVIDENCE: 5 Laryngoscope, 134:637-644, 2024.


Assuntos
Grupos Minoritários , Estudantes de Medicina , Humanos , Desenvolvimento de Programas , Grupos Minoritários/educação , Mentores , Universidades
20.
Telemed J E Health ; 30(1): 126-133, 2024 01.
Artigo em Inglês | MEDLINE | ID: mdl-37311170

RESUMO

Introduction: Caregivers of children with chronic illness, such as hematology-oncology conditions, face numerous stressors, and a subset experience persistent distress and poor psychological outcomes. Many logistical and ethical barriers complicate the provision of mental health care to caregivers in children's hospital settings. Telemental health (TMH) is one method to increase access and reduce barriers. Methods: A partnership was established with an outside TMH agency to provide mental health care to caregivers of children with hematology-oncology conditions. Development and implementation strategies are described, and feasibility was measured on four dimensions. Results: One hundred twenty-seven (n = 127) caregivers were referred for TMH services in the first 28 months of program implementation. Of the total, 63/127 (49%) received TMH services for at least one session. Most caregivers had a child in active medical treatment (89%). A small portion (11%) of caregivers were bereaved or had a child in hospice care. Program feasibility was enhanced by hospital leadership support and availability of staffing, financial, and technology resources. Available resources also contributed to the practicality of program development and swift implementation and integration within the defined hospital system. Discussion: Partnership with an outside TMH agency increased access to care and reduced barriers to treating caregivers in a children's hospital setting. Offering mental health interventions to caregivers aligns with evidence-based standards of care. Future research will elucidate caregiver satisfaction with this modality of treatment and whether use of TMH reduces disparities in caregiver receipt of mental health care in children's hospital settings.


Assuntos
Serviços de Saúde Mental , Telemedicina , Criança , Humanos , Cuidadores/psicologia , Telemedicina/métodos , Saúde Mental , Desenvolvimento de Programas
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