Integration of health into the school curriculum in Botucatu, São Paulo

This study focuses on the drafting and development of a public health program aimed at strategies to integrate health activities and the school curriculum. The program is based on three main lines of activity: full health care for schoolchildren, with special emphasis on the public school system; training of personnel in the fields of health and education by means of internships allowing participants to experience, work, and reflect critically on the activities with an interdisciplinary team; and work with teachers from the public elementary school system to implement and develop innovative measures in the fields of health and education to respond to the demand by schools and the community.     

Providing Comprehensive Sexual Health Care in Spinal Cord Injury Rehabilitation: Implementation and Evaluation of a New Curriculum for Health Care Professionals

A grant from the Paralyzed Veterans of America funded the development, implementation, and evaluation of a three-day interdisciplinary continuing education and training program in comprehensive sexual health care. The program was targeted toward health care professionals working in spinal cord injury (SCI) rehabilitation. The major goal of the program was to offer participants an opportunity to increase the knowledge, comfort, and skills necessary to understand and manage the sexual health care needs of people with SCI. The curriculum included clearly stated goals, behavioral objectives in operational terms, and multiple quantitative and qualitative program evaluations. In addition, the comprehensive curriculum incorporated extensive skills training including state-of-the-art standardized patient training techniques. Evaluation results indicated statistically significant and qualitatively important positive gains in knowledge, comfort, and skills. The five month follow-up study indicated that skills learned over the three-day workshop were successfully transferred to the work environment.     

A collaborative approach to program evaluation of community-based teen pregnancy prevention projects

The purpose of this article is to demonstrate a model for collaboration between program providers and program evaluators. The article describes how university-based evaluators, a state health department, and local program providers collaborated to evaluate 12 projects implementing commercially developed teenage pregnancy prevention (TPP) programs in school settings. Approximately 2,200 students participate annually in the programs. Program evaluation staff and local program providers worked together to construct logic models that helped guide the intervention and evaluation design. The local providers also participated in training sessions, conducted by the evaluation team, to increase their understanding and skills related to program evaluation methods. Student-level outcomes related to knowledge, attitudes, skills, behaviors, as well as an assessment of curricula fidelity were included in the evaluation. The result of this collaborative model has been a quality program evaluation for the projects while maintaining community input regarding program improvements that reflect local population needs.     

Safety makes sense: a program to prevent unintentional injuries in New York City public schools

Estimates suggesting that 10% to 25% of unintentional injuries to school-aged children occur in and around American schools are alarming. Information from the National Health Information Survey indicates as many as 3.7 million children are injured in schools annually. To address these concerns, The New York Academy of Medicine and the Board of Education of the City of New York in 1998 launched Safety Makes Sense, a multidimensional school-based, injury prevention initiative. The Safety Makes Sense program integrates unintentional injury prevention into comprehensive school health education in elementary and middle school classrooms and is implemented by interdisciplinary teams within a coordinated school health program. The multifaceted program also integrates safety and music education, and includes development of a handbook for teachers and staff, student booklets, staff development training workshops, and evaluation.     

Continuing education on teaching skills for health professionals. Evaluation of training the trainers

Effective Patient Teaching (EPT), a health professions continuing education course, improves educators' teaching skills when presented by its developers. This study aimed to determine whether others could teach EPT with similar effectiveness. Four nurse managers who provide staff training and supervision for multiple hospital diabetes care units presented EPT to health care professionals at seven such sites; another seven served as controls. The evaluation included observations of trainers conducting EPT programs in the field, teaching skills ratings of health professionals in both groups, and knowledge test administered to patients. Six months after training, teaching skills scores of health professional EPT participants were better (p < .05) than controls. The EPT program improves participants' teaching skills and maintains these effects in field settings, when presented by faculty not involved in its development.     

中小学饮食服务人员营养知识现状及需求调查

目的 了解中小学饮食服务人员的营养知识水平和需求。方法 对6省、市12个市、县22所中小学校的135名饮食服务人员进行问卷调查。结果 学校饮食服务人同的基础营养知识水平较低，对营养缺乏病知识的回顾正确率较低，对营养与疾病知识有一定的了解，具有一定的烹调知识。71.9%的人通过多种途径获得过健康和营养方面的知识。94.1%的人表示愿意多学习一些有关健康和营养的知识。结论 学校饮食服务人员的营养知识水平较低，不全面，建议通过多种途径对他们进行营养知识的培训。     

An interdisciplinary nutrition assessment and intervention protocol for children with disabilities

Because of the multifactorial nature of the nutrition problems associated with developmental disabilities, a well-organized, interdisciplinary effort is necessary to deal with such problems. A team composed of professional and support staff, the client, and the family needs to be involved in an integrated approach to service. The team members share their knowledge and expertise in developing an individual program plan to meet identified needs. This article describes the development and implementation of a prototype for interdisciplinary nutritional evaluation and intervention in an outpatient setting. In 1987, a Regional Nutrition and Feeding Diagnosis and Evaluation Clinic was established through a contractual agreement between the University of Georgia University Affiliated Program and St. Mary's Hospital in Athens, GA. The purposes of the clinic are twofold: to offer direct services to developmentally disabled infants and children who require outpatient services and to provide a unique community-based interdisciplinary training experience for graduate students in nutrition and other health disciplines. The interdisciplinary treatment protocol is based on current knowledge in the treatment of developmental disabilities.     

Challenges of preparing allied health professionals for interdisciplinary practice in rural areas

Meeting the health needs of individuals in rural communities involves addressing the challenges of complex multifaceted health problems, limited local health resources and services, isolation, and distance. Interdisciplinary collaboration can create solutions to health care problems that transcend conventional, discipline-specific methods, procedures, and techniques. This paper reports on the four-pronged approach of the Western Maryland Area Health Education Center used to prepare allied health students to be interdisciplinary team members in rural areas. It describes the development of four interdisciplinary instructional team member training venues (in-class instruction, Web-based modules, service-learning programs, and faculty development workshops) that integrate opportunities to develop and practice interdisciplinary health promotion skills in rural communities. Challenges to implementing the model are described, including developing faculty and student training participation, integrating training venues into existing programs at participating institutions, and designing a unified program evaluation.     

Extending Professional Education to Health Workers at Grass Root Level: An Experience from All India Institute of Medical Sciences,New Delhi

Background:

In India, the opportunities for professional education of the grass root level health workers are grossly inadequate. Capacity building of all categories of health workers is needed for enhancing health outcomes.

Objectives:

To plan and implement a professional development training program for all categories of allied health workers and to assess its outcomes in terms of knowledge and skills

Materials and Method:

We planned and organized a ‘one week’(15 h) training program for 10 categories of allied health workers (1260) working in our hospital. The program included nine generic skills/topics: the prestige of AIIMS, sterilization & infection control, universal precaution, biomedical waste management, public health, life style & healthy nutrition, fire safety, communication skills and office procedure besides subject specific skills. Trainers were drawn from 12 departments. Training methodology included interactive lectures, narratives, demonstrations, videos, PPT slides, and informal discussions with participants. The effectiveness of the program was judged on the basis of participants’ feedback, feedback from the supervisors, and our own observations post training.

Results:

Feedback from the participants and their supervisors after training was encouraging. The participants described training as a “life time experience”. The supervisors reported improvement in confidence, communication skills, and awareness of workers.

Conclusion:

The success of the program was due to the use of interactive methods, involvement of multidisciplinary team, and commitment from leadership. We recommend that professional education should be linked with career advancement. Academic institutions can play a key role in taking such initiatives.     

Interdisciplinary case management: a model for intervention

Interdisciplinary case management is required when clients present problems that do not fall within the purview of any one discipline. The interdisciplinary approach entails the participation of professional and support staff, along with the client and his/her family, in diagnosis, individual program planning, implementation, and evaluation. For example, interdisciplinary case management for a patient with Prader-Willi syndrome (PWS) results in cost-effective, efficacious treatment. Because of the diversity of symptoms, the treatment of Prader-Willi syndrome must incorporate knowledge and skills from a variety of areas. A model for the interdisciplinary case management of PWS is presented. The model is problem focused and emphasizes goals formulated and acted upon by the disciplines represented on the client's treatment team. Communication and coordination of efforts are central to the utility of the model. Additional benefits of interdisciplinary case management include the opportunity for ongoing education and role expansion of team members.     

Does Practice Make Perfect? A Randomized Control Trial of Behavioral Rehearsal on Suicide Prevention Gatekeeper Skills

Suicide is the third leading cause of death among 10-24-year-olds and the target of school-based prevention efforts. Gatekeeper training, a broadly disseminated prevention strategy, has been found to enhance participant knowledge and attitudes about intervening with distressed youth. Although the goal of training is the development of gatekeeper skills to intervene with at-risk youth, the impact on skills and use of training is less known. Brief gatekeeper training programs are largely educational and do not employ active learning strategies such as behavioral rehearsal through role play practice to assist skill development. In this study, we compare gatekeeper training as usual with training plus brief behavioral rehearsal (i.e., role play practice) on a variety of learning outcomes after training and at follow-up for 91 school staff and 56 parents in a school community. We found few differences between school staff and parent participants. Both training conditions resulted in enhanced knowledge and attitudes, and almost all participants spread gatekeeper training information to others in their network. Rigorous standardized patient and observational methods showed behavioral rehearsal with role play practice resulted in higher total gatekeeper skill scores immediately after training and at follow-up. Both conditions, however, showed decrements at follow-up. Strategies to strengthen and maintain gatekeeper skills over time are discussed.     

Community Fieldwork Collaboration Between Medical and Social Work Students

This article describes an educational demonstration in interdisciplinary community field experiences between social work and medical students at The University of Kentucky Medical Center at Lexington. The joint training effort involved collaboration between the medical school, the hospital social service department, the school of social work, and community social and health agencies. The pilot program in which students from different professions lived for 6 weeks in outlying rural communities served by the medical center, provided an opportunity: (a) to study the feasibility of combining a broad community health study experience with casework services in a hospital-based educational program and (b) to assess the benefits of early interdisciplinary community and clinical work between future doctors and social workers. Students saw the advantages of cooperative teamwork in studying community problems, and were able to apply classroom theory about community organization to real community situations. The organizational structure and staff resources required to carry out such a demonstration are described, and the implications of the training project are discussed.     

Comparing Traditional Versus Retrospective Pre-/Post-assessment in an Interdisciplinary Leadership Training Program

Objectives As the U.S. healthcare system shifts toward collaboration, demand for leaders with interdisciplinary skills increases. Leadership competencies guide interdisciplinary training programs; however, identifying cost-effective methods for evaluating leadership competencies is challenging, particularly when interdisciplinary trainees have different areas of expertise and professional goals. Traditional pre-/post-testing, a common method for evaluating leadership competencies, is subject to response-shift bias, which can occur when participants’ understanding of a construct changes between pre- and post-test. As a result, participants may rate their knowledge of the construct lower at post-test. Retrospective pre-tests are one method thought to reduce response-shift bias in pre-/post-tests. The current study explores the use of a retrospective pre-test to control for response-shift bias in an interdisciplinary training program. Methods Over three cohort years, thirty-four trainees from an interdisciplinary leadership program completed a self-assessment aligned with MCH leadership competencies. The traditional pre-test self-assessment was completed at the beginning of the training program. The retrospective pre-/post-test self-assessment was completed at the end of the training program. Results Retrospective pre/post-test scores indicate significant self-reported increases in all 24 leadership areas (p?≤?.001). Furthermore, participants’ self-ratings were significantly higher on the traditional pre-test for all 24 areas than on the retrospective pre-test (p?≤?.001). Conclusions for Practice Retrospective pre-tests appeared to control for response-shift bias and may be a cost-effective way to evaluate trainee change within an interdisciplinary leadership program. These findings suggest the methodology’s usefulness in interdisciplinary training and its potential use in the broader world of community-based MCH training initiatives.

     

Partnering with public health: a model for baccalaureate nursing education

This article discusses the implementation of a one-year project developed to increase and improve the quality of public health nursing experiences for baccalaureate nursing students at one state-assisted university. The partnership model involved collaboration with public health departments, the academic nursing programs, and community agencies and leaders. The project led to the development of increased student skills related to interdisciplinary team work, program development, and cultural competency skills. A needs assessment questionnaire of the public health department partner staff supported a need to develop public health work force skills. The project provided opportunities for nursing faculty development. The project results support the need for service-academic partnerships to develop the public health nursing workforce.     

Training health professionals: a multidisciplinary team approach in a university-based weight-loss program

In a university-based weight-loss program for preadolescent girls, a multidisciplinary team delivered the intervention. The team included a nurse/health educator, an exercise physiologist, a psychologist, five dietitians, and 17 dietetics, nursing, and medical students, The six-month program provided 12 educational sessions in nutrition, stress management, behavior modification, and exercise. Concurrent sessions for parents addressed comparable educational topics and parenting skills. Dietitians and student research assistants (n = 19) were surveyed regarding their participation on a multidisciplinary team and their acquisition of new knowledge/skills. The survey included both open-ended questions and Likert-type statements. Results indicate that participation enhanced knowledge of nutrition counseling/education (chi = 1.6) as well as appreciation for research (chi = 1.8) and for the multidisciplinary team approach (chi = 1.7). Qualitative data reinforce the benefits of the multidisciplinary experience and multiskill training. Exercise, stress management, parenting skills, and psychological techniques were perceived as important skills to develop for professional careers.     

Reducing unmet needs: a prevocational medical training program in public health medicine and primary health care in remote Australia

OBJECTIVES: To describe the development and implementation of a prevocational medical training program in public health medicine and primary health care in remote Australia and to evaluate the program's adherence to adult learning principles. METHODS: Reports, funding applications and other relevant material relating to the program were reviewed to document learning objectives, and teaching and program implementation strategies. RESULTS: The 24-week program employs two prevocational medical practitioners each year and comprises four weeks at Fremantle Hospital's sexual health clinic followed by 20 weeks in the Kimberley. Curriculum objectives include clinical and public health aspects of sexually transmitted infection management, immunisation, clinical audit and quality improvement, primary health care in remote Aboriginal communities, oral and written presentation skills and working as part of an interdisciplinary team. Teaching strategies used were in accordance with adult learning principles. CONCLUSIONS: Prevocational medical training in public health medicine and primary health care in remote Australia is achievable and reduces current gaps in prevocational medical education.     

Evaluation of a School-Based Train-the-Trainer Intervention Program to Teach First Aid and Risk Reduction Among High School Students

BACKGROUND: Farming is a hazardous occupation posing health risks from agricultural exposures for the farm owner and family members. First Aid for Rural Medical Emergencies (F.A.R.M.E.) was developed to support a train-the-trainer (TTT) program to prepare high school students to teach first aid skills and risk reduction through peer interaction. This study was designed to evaluate the educational effectiveness for first aid skill development and awareness of safety issues and injury prevention impacting agricultural communities. METHODS: Forty-three agricultural science students from a rural high school participated in the study. A quasi-experimental design was used to evaluate knowledge acquisition and anticipatory action among groups: those participating in training and a comparison group with no training. The intervention group included 27 participants trained as first aid peer instructors using the F.A.R.M.E. manual, return demonstration, case scenario facilitation training, and teaching evaluation sessions. The effectiveness of the program was evaluated using triangulated data. Independent t test analyses were conducted on post-test scores to evaluate the knowledge acquisition and anticipatory action scores between groups. Focus group sessions assessed attitudes, experiences, and values held following the intervention of teaching peers. RESULTS: Results indicate that the intervention group scored significantly higher on anticipatory action (t = 2.23, p = .03) but not knowledge acquisition (t = 1.37, p = .18). Focus group data suggest that the TTT format bolstered confidence in teaching, confirmed that teens enjoy learning from teens, and fostered pride in team work. CONCLUSIONS: The F.A.R.M.E. TTT resulted in a theory and evidence-based intervention that can be implemented in a school setting to promote knowledge and skill acquisition of first aid and injury prevention among rural high school students.     

SOCIAL WORK AND LIAISON PSYCHIATRY

The Liaison Team of the Department of Psychiatry at Cook County Hospital uses a generic, multidisciplinary, crisis intervention approach to mental health consultation to facilitate humane and comprehensive yet cost-effective care for the medically indigent. Social work functions on the team include diagnosis, short-term individual and group treatment, referral, follow-up, staff development, in-service training, program planning, and interdisciplinary clinical instruction.     

Social work and liaison psychiatry.

The Liaison Team of the Department of Psychiatry at Cook County Hospital uses a generic, multidisciplinary, crisis intervention approach to mental health consultation to facilitate humane and comprehensive yet cost-effective care for the medically indigent. Social work functions on the team include diagnosis, short-term individual and group treatment, referral, follow-up, staff development, in-service training, program planning, and interdisciplinary clinical instruction.