A Student-Led Health Education Initiative Addressing Health Disparities in a Chinatown Community

Together with community advocates, professional student organizations can help improve access to health care and sustain services to address the health disparities of a community in need. This paper examines the health concerns of an underserved Chinese community and introduces a student-led health education initiative that fosters service learning and student leadership. The initiative was recognized by the American Association of Colleges of Pharmacy (AACP) and received the 2012-2013 Student Community Engaged Service Award.     

AdvoCaring: A Cocurricular Program to Provide Advocacy and Caring to Underserved Populations in Baltimore

Objective. To incorporate direct patient care and service components throughout a 4-year pharmacy program to enable students to apply knowledge learned in the classroom and develop the human and caring dimensions of Fink’s Taxonomy of Significant Learning.Design. Groups of 10-12 students and a faculty advisor partnered with a local agency serving an underserved population of the greater Baltimore area to provide seven hours of service per student each semester. Activities were determined based on students’ skills and agency needs.Assessment. Over 10 000 hours of care were provided from fall 2009 through spring 2014 for clients at 12 partner agencies. Student feedback was favorable.Conclusion. Cocurricular learning enables students to use their skills to benefit local communities. Through an ongoing partnership, students are able to build on experiences and sustain meaningful care initiatives.     

社区健康教育实践与思考

社区健康教育是以健康为中心、以社区为范围、以全体居民为对象的健康教育活动。但是,随着人们对健康的重视及健康知识的迫切需求,对社区健康教育人员的综合能力提出了更高要求,为促进健康教育事业长远发展,建议一要加强社区医务人员的交流沟通技巧和健康教育传播技能培训,二要在个性化健康教育中注重了解服务对象的健康影响因素,三要结合家庭医生制度试点工作,在签约居民中培育一批志愿者,提高社区健康教育效率。     

Implementation and Evaluation of a 10-Week Health Equity Curriculum for Pharmacy Students

Objective. To describe a health equity curriculum created for pharmacy students and evaluate students’ perceptions and structural competency after completion of the curriculum.Methods. A health equity curriculum based on transformative learning and structural competency frameworks was implemented as a 10-week mandatory component of the pass-no pass neuropsychiatric theme for second year pharmacy students. Each week, students reviewed materials around a neuropsychiatric-related health equity topic and responded to discussion prompts through asynchronous forums or synchronous online video discussions. The effectiveness of the health equity curriculum was evaluated through assessment of structural competency through a validated instrument, an objective structured clinical examination (OSCE), and a questionnaire.Results. All enrolled second year pharmacy students (n=124) participated in the health equity curriculum. Of the 75 students who completed the structural competency instrument, 46 (61%) were able to identify structural determinants of health, explain how structures contribute to health disparities, or design structural interventions. Ninety-six of the 124 students (77%) were able to address their OSCE standardized patient’s mistrust in the health care system. Thematic analysis of student comments elucidated three themes: allyship, peer connection, and self-awareness. Students rated asynchronous discussion forums as significantly less effective than online video discussions and patient cases for achieving curricular objectives.Conclusion. A mandatory curriculum delivered remotely throughout the didactic pharmacy curriculum using a blended learning approach was an effective way to incorporate health equity content and conversations into existing courses. Implementation of this or similar curriculums could be an important step in training pharmacy students to be advocates for social justice.     

成都市社区卫生持续性服务调查研究

目的:揭示成都市社区卫生服务机构在持续性服务开展中存在的不足,提出完善持续性服务的建议,为卫生主管部门指导社区卫生服务工作、制定相关政策提供参考.方法:以问卷调查为主,并结合个人深入访谈.结果:成都市已基本建立起了比较完善的社区卫生服务网络,具有一定的规模,但持续性服务开展得不够完善.结论:本次调查研究较为全面地了解了我市社区卫生服务机构在持续性服务方面开展的情况,提出了完善持续性服务的建议,以期为卫生主管部门指导社区卫生服务工作、制定相关政策提供参考.     

A Quality Improvement Activity to Promote Interprofessional Collaboration Among Health Professions Students

Objectives

To develop and evaluate a classroom-based curriculum designed to promote interprofessional competencies by having undergraduate students from various health professions work together on system-based problems using quality improvement (QI) methods and tools to improve patient-centered care.

Design

Students from 4 health care programs (nursing, nutrition, pharmacy, and physical therapy) participated in an interprofessional QI activity. In groups of 6 or 7, students completed pre-intervention and post-intervention reflection tools on attitudes relating to interprofessio nal teams, and a tool designed to evaluate group process.

Assessment

One hundred thirty-four students (76.6%) completed both self-reflection instruments, and 132 (74.2%) completed the post-course group evaluation instrument. Although already high prior to the activity, students'' mean post-intervention reflection scores increased for 12 of 16 items. Post-intervention group evaluation scores reflected a high level of satisfaction with the experience.

Conclusion

Use of a quality-based case study and QI methodology were an effective approach to enhancing interprofessional experiences among students.     

社区健康教育对高血压患者服药依从性的影响

目的探讨社区健康教育对高血压患者服药依从性的影响。方法选择2013年第四季度10¹2月我社区诊治的200例高血压患者进行服药依从性研究,比较分析社区健康教育前后的服药依从性差异。结果 200例高血压患者,经社区健康教育后服药依从性良好率为88.0%,血压控制率为79.0%,明显高于健康教育前,经比较,P<0.05,差异具有统计学意义。结论社区健康教育可以明显提高高血压患者的服药依从性,值得临床推广应用。     

张江社区卫生服务中心10年住院病种变化分析

目的：分析10年间住院病种的变化及影响因素。方法：选择2003年、2008年和2012年患者住院病史及登记资料,统计和观察住院患者的病种构成比。结果：10年间外科患者大幅度减少,慢性阻塞性肺疾病逐年下降,脑梗死上升到第一位,脑出血患者明显增加,上消化道出血和胆囊炎的急症患者逐年减少,老年性痴呆患者增多。住院人数减少,床位周转率下降。结论：卫生体制的改革、城市化进程的推进和乡镇卫生院转为社区卫生服务中心,影响了住院病种的变化。     

社区卫生服务机构门诊抗菌药物应用情况分析

目的回顾性分析2010年我市社区卫生服务机构门诊处方抗菌药物应用情况,为合理使用抗菌药物提供参考。方法随机抽取我市5个社区卫生服务机构2010年1~10月6000张使用抗菌药物的处方。分析抗菌药物使用情况。结果被调查的社区卫生服务机构门诊患者抗菌药物使用不合格率为48.5%。结论应加强干预和管理,促进安全合理使用抗菌药物。     

社区卫生服务体系药品不良反应病例报告分析

目的阐述抚顺市社区卫生服务体系药品不良反应病例报告分析情况，探索在我国社区卫生服务体系中药品不良反应监测规律。方法收集2006年全市社区卫生服务体系上报的药品不良反应病例报告，从性别和年龄分布、用药情况等进行分析。结果40岁以上的中老年人药品不良反应构成比较高，占60％；抗微生物药物和中药制刹药品不良反应构成比较高；新的、严重的不良反应占30%.结论通过对社区卫生服务体系上报的药品不良反应病例报告进行有益的探讨，可为社毒区卫生服务系统开展药品不良反应监测提供借鉴，也为基层社区医务人员的合理用药提供指导。     

广州市某区慢性病患者社区卫生服务利用影响因素研究

目的:了解广州市某区慢性病患者中社区卫生服务(CHS)利用情况及其影响因素。方法:采用多阶段分层抽样方法,利用固定效应和多水平logistic回归模型分析影响因素。结果:慢性病患者对CHS的利用率为63.05%,主要为看病和开药,慢性病随访仅为9.89%。慢性病患者的CHS利用率在一定程度上具有家庭聚集性或相关性,其影响因素主要有贫困户与否、文化程度、调查前一年住院、听社区讲座、健康知识得分。结论:多水平模型适用于层次结构数据。CHS机构应该针对不同人群的不同行为特点开展宣教活动,从而提高居民对CHS机构的利用率。     

谈大学生心理健康教育

结合实际 ,以人为本 ,从时代的要求出发 ,论述对大学生进行心理健康教育的重要性 ,提出针对性和建设性的建议     

A Cultural Competency Course for Pharmacy Students

Objective

To design, implement, and evaluate a course on health promotion and literacy.

Design

Course objectives such as the development of cultural competency skills, awareness of personal biases, and appreciation of differences in health beliefs among sociocultural groups were addressed using a team-based learning instructional strategy. Student learning outcomes were enhanced using readiness assessment tests (RATs), group presentations, portfolio reflections, and panel discussions.

Assessment

Comparing precourse and postcourse Inventory for Assessing the Process of Cultural Competence among Healthcare Professionals (IAPCC-R) scores and portfolio responses indicated enhanced progress toward cultural competency. The Student Evaluation of Teaching (SET) provided suggestions for course enhancements.

Conclusions

Evidence supporting enhanced cultural competency after completing the course affirms its value as we prepare pharmacy students to provide patient-centered care in a culturally diverse world.     

程序化健康教育对妊娠合并梅毒患者的作用

目的探讨程序化健康教育对妊娠合并梅毒患者的作用。方法对42例患者进行程序化的健康教育,分别在教育前后进行相关知识测试以及了解对治疗及护理的依从性。结果经过系统、全面的教育后,患者对梅毒相关知识的了解及对治疗护理的依从性明显提高。结论程序化健康教育是一种系统的、全面的教育方法,提高了患者对治疗的依从性,对病情康复有明显促进作用,值得在临床护理中推广应用。     

High-Intensity Drug Use and Health Service Access Among Street-Involved Youth in a Canadian Setting

Background/Objectives: Addiction severity has been associated with numerous social- and health-related harms. This study sought to examine the prevalence and correlates of high-intensity drug use among street-involved youth in a Canadian setting with a focus on high-risk drug use practices and health service access.

Methods: Data were derived from the At-Risk Youth Study, a Vancouver-based prospective cohort of street-involved youth aged 14–26. We used generalized estimating equations to examine variables associated with high-intensity drug use, defined as daily use of crack cocaine, cocaine, heroin, or crystal methamphetamine. Results: From September 2005 to November 2012, of 1017 youth included in the analyses, 529 (52%) reported high-intensity drug use as defined above at least once during the study period. In a multivariate analysis, older age (Adjusted Odds Ratio [AOR] = 1.47); residing in the Downtown Eastside of Vancouver (AOR = 1.46); homelessness (AOR = 1.30); recent incarceration (AOR = 1.25); inability to access addiction treatment (AOR = 1.42); and crack pipe sharing and/or used syringe injecting (AOR = 2.64), were all positively and independently associated with high-intensity drug use (p < 0.05). The most common barrier to accessing addiction treatment reported by these youth was long waiting lists. Conclusions: High-intensity drug use among street-involved youth was prevalent and associated with structural and geographical disadvantages in addition to high-risk drug administration practices. Youth reporting more frequent drug use also reported barriers to accessing addiction treatment, highlighting the need to expand addiction services tailored to youth at greatest risk of harm from illicit drug use and street-involvement.     

成都市城乡基层医疗卫生机构孕产妇健康管理调查

目的:了解成都市社区卫生服务中心和乡镇卫生院开展孕产妇健康管理情况,并分析其影响因素。方法:采用多阶段分层抽样方式。分层采用市政府按照经济发展状况划分的3个圈层,在每个圈层分别选取2个区县(共6个),在第1圈层的2个区中分别抽取2个社区卫生服务中心作为调查对象,第2、第3圈层的4个区县各抽取1所社区卫生服务中心和2所乡镇卫生院作为调查对象。调查采取查阅资料的方式进行,资料来源于成都市2010年城乡基本公共卫生均等化调研资料之孕产妇健康管理部分。结果:社区卫生服务中心的妇保人员数量(专职、折算)明显多于乡镇卫生院,差异有统计学意义(P<0.05);开展孕情收集、督促产检、产前检查、产后访视、助产工作的社区卫生服务中心比例要低于乡镇卫生院的比例,但差异没有统计学意义(P>0.05)。社区卫生服务中心及乡镇卫生院的登记本产后访视率及产前随访率都显著高于2家机构的实际电话复核数据,差异有统计学意义(P<0.05)。结论:社区卫生服务中心及乡镇卫生院妇保人员应转变观念,做好产前随访及产后访视,促进孕产妇健康管理工作。     

社区卫生服务机构药学服务模式研究

目的对社区卫生服务机构药学服务模式进行研究,为我国社区药学服务的发展提出参考建议,使药学服务更好地发挥在城市医疗卫生体系中的作用。方法对社区卫生服务中心实行随机抽样问卷调查,具体对象为社区卫生服务中心的药学人员和社区居民,将收集到的相关信息录入Excel2003软件,经核对无误后转入SPSS13．0进行统计分析。结果在社区居民的意识里,还没有形成正式的药学服务概念,医师对药学服务的理解不够深入,药学服务在社区卫生机构中没有形成科学的模式。结论应通过加强政策支持和相应的培训,转变服务模式,建立适宜的考核评价体系等措施,积极发展社区药学服务工作。     

Impact of Providing a Living Learning Community for First-Year Pre-Pharmacy Students

Objective. To conduct a retrospective cohort pilot study to evaluate the impact of a living learning community (LLC) designed for undergraduate pre-pharmacy students interested in pursuing a Doctor of Pharmacy (PharmD) degree program.Methods. Persistence, retention, and progression within the pre-pharmacy program, as well as grade point average (GPA) were measured for LLC students and their pre-pharmacy peers who did not participate in the LLC. Information was obtained from the university’s data system and analyzed. Persistence was defined as the student continuing at the university from the fall to spring academic terms. Retention was defined as the student being enrolled at the university during a subsequent fall term. Progression was determined by whether the student had successfully completed the pre-pharmacy curriculum and began pharmacy school within two or three years of initial enrollment in the pre-pharmacy program.Results. Despite having admissions characteristics comparable to other pre-pharmacy students, students who participated in the LLC demonstrated significantly higher grade-point averages and retention than their peers who did not participate.Conclusion. Living learning community programs may be a valuable contributor to pre-pharmacy student success in terms of students’ persistence, retention, and progression in a pre-pharmacy program.     

药品零差价政策对北下关社区卫生服务中心药品处方的影响

目的研究药品零差价政策对北下关社区卫生服务中心药品处方的影响。方法采用医院计算机系统,对药品零差价政策实施前后,即2005—12—26至2006—12—25和2006—12—26至2007—12—25两个时间段的就诊人数、各项医疗收入、药品处方进行统计。结果药品零差价政策改变了医师的处方习惯,减少了患者的药费支出,改变了患者的治疗习惯。增加了就诊人数和处方数。但是同时也反映出一定的问题。结论药品零差价政策是一项成功的政策,可让利于民。     

Effects of a Community Prevention Intervention on Public Awareness,Knowledge, and Risk Perception of Club Drug Use by Youth in Taiwan

This study evaluated the effects of mobilizing community coalitions and implementing prevention intervention concerning public awareness, knowledge, and perception of the risks associated with club drug use by Taiwanese urban youth. A quasi-experimental design was used. Three communities in Taipei city were included in the present study. A total of 328 residents successfully participated in the baseline survey (April 2008), and 276 residents were successfully interviewed for the follow-up survey (September 2008). The generalized estimating equation (GEE) method was used. The percentage of the intervention respondents who reported having seen or heard antidrug messages increased significantly between the time of the baseline survey (63.7%) and the follow-up survey (77.4%), while the percentage of attendance at antidrug events increased from 23.1% to 38.7% during the same time interval. In addition, community knowledge and perception of the problem of club drug use by youth rose significantly between the baseline and the follow-up in the intervention communities. The study's limitations are noted.