Benita Walton-Moss

Measuring the Effectiveness of Faculty Mentoring Relationships

“Mentor” is a term widely used in academic medicine but for which there is no consensus on an operational definition. Further, criteria are rarely reported for evaluating the effectiveness of mentoring. This article presents the work of an Ad Hoc Faculty Mentoring Committee whose tasks were to define “mentorship,” specify concrete characteristics and responsibilities of mentors that are measurable, and develop new tools to evaluate the effectiveness of the mentoring relationship. The committee developed two tools: the Mentorship Profile Questionnaire, which describes the characteristics and outcome measures of the mentoring relationship from the perspective of the mentee, and the Mentorship Effectiveness Scale, a 12-item six-point agree–disagree-format Likert-type rating scale, which evaluates 12 behavioral characteristics of the mentor. These instruments are explained and copies are provided. Psychometric issues, including the importance of content-related validity evidence, response bias due to acquiescence and halo effects, and limitations on collecting reliability evidence, are examined in the context of the mentor–mentee relationship. Directions for future research are suggested.

A grounded theory of families responding to mental illness.

Despite decades of research documenting family burden related to mental illness of a relative, little is known about families’ responses over time. A grounded theory study was designed to describe families’ responses to these severe mental illnesses. Twenty-nine participants representing 17 families were interviewed 3 times over 2 years. Interviews were analyzed using constant comparison. Living with ambiguity of mental illness was the central concern. The basic social process was pursuing normalcy and included confronting the ambiguity of mental illness, seeking to control impact of the illness, and seeing possibilities for the future. Goals were managing crises, containing and controlling symptoms, and crafting a notion of “normal.” Strategies were being vigilant, setting limits on patients, invoking logic, dealing with sense of loss, seeing patients’ strengths, and taking on roles. The study revealed that families were profoundly affected by the social contexts of mental illnesses.

The Distribution of and Factors Associated With Intimate Terrorism and Situational Couple Violence Among a Population-Based Sample of Urban Women in the United States

It has been proposed that two distinct forms of intimate partner violence exist: intimate terrorism and situational couple violence. This article describes the distribution of factors that characterize intimate terrorism and situational couple violence, including controlling behaviors, violence escalation, and injury, among a representative sample of 331 physically assaulted women living in 11 North American cities. In addition, respondent, partner, and relationship characteristics associated with each form of violence are identified. Most women who experienced physical assault also experienced controlling behavior by their male partner. In multivariate analyses, respondents young age, violence escalation in the relationship, partners access to guns, previous arrests for domestic violence offenses, poor mental health, and previous suicide attempts or threats were associated with intimate terrorism, defined as experiencing one or more controlling behaviors. These results suggest that situational couple violence is rare and that moderate and high levels of controlling behaviors are associated primarily with partner factors.

Parenting style, parenting stress, and children's health-related behaviors.

Objective: Parental guidance is critical to the development of childrens health-related behaviors. The purpose of this study was to look at the relationship between parenting factors, including parenting style and parenting stress, and childrens health-related behaviors. Methods: In this descriptive, correlational study, 284 parents of preschool children were interviewed using the Child Rearing Questionnaire and the Korean Parenting Stress Index-Short Form. Results: Parent distress, authoritative and permissive parenting styles, family income, and mothers education were significantly associated with childrens health-related behaviors. Conclusions: These findings suggest that higher levels of warmth, characteristics of both parenting styles, may be a critical factor in the development of health-related behaviors.

EFFECTS OF MENTAL ILLNESS ON FAMILY QUALITY OF LIFE

Worldwide, at least 25% of persons and their families are affected by mental illness resulting in significant stress and burden; yet little is known about how the illness affects quality of family life. In this paper, we report a secondary analysis of a grounded theory study that identified the process by which 17 families managed mental illness over time. Families were characterized as Hanging On, Being Stable, or Doing Well based on their responses to caring for relatives with mental illness. Most of the families perceived themselves as Being Stable or Doing Well and four families perceived themselves as Hanging On. In this paper, these descriptors of family quality of life, interpreted within the context of family development and illness trajectories, are presented as a focus of professional support and intervention.

Detecting and addressing alcohol abuse in women

In the primary care setting, 20% to 25% of patients experience alcohol-related problems; however, clinicians often treat the symptoms of alcoholism and fail to identify the disease itself. Unlike men, women commonly seek help for alcoholism from primary care clinicians. Further, the development and progression of alcoholism is different in women than in men. Women with alcohol problems have higher rates of dual diagnoses, childhood sexual abuse, panic and phobia disorders, eating disorders, posttraumatic stress disorder, and victimization. Early diagnosis, brief interventions, and referral are critical to the treatment of alcoholism in women.

Effects of a graduate-level interprofessional education program on adult nurse practitioner student and internal medicine resident physician attitudes towards interprofessional care

Abstract This article describes the development, implementation and evaluation of a longitudinal interprofessional education (IPE) experience for adult nurse practitioner students and internal medicine residents. This experience focused on providing care for complex community based patients during clinic and home visits, preceded by didactic learning that emphasized understanding one another’s professional roles and education, teamwork and conflict management. Evaluation demonstrated significant improvements in attitudes and beliefs associated with professional role, respect among health professions’ disciplines and conflict management. Results with regards to attitudes towards IPE and interprofessional practice, and valuing teamwork training were mixed. In particular, the curricular intervention did not change participants’self-reported skill in communication and did not affect attitudes and beliefs towards effects of interprofessional education on patient outcomes.

Prospective pilot study of living kidney donor decision-making and outcomes

Abstract:  In its recent report on organ donation, the Institute of Medicine has recommended rigorous studies of how living organ donors make the decision to donate. In this pilot study, 65 donor applicants were interviewed while being evaluated in the outpatient donor clinic and 20 were surveyed again three months after donation. Fifteen and six of these subjects were surveyed again in six and 12 months respectively. Several strategies for retaining donors in a prospective longitudinal study are discussed. Half of the donors indicated that the decision to donate was a shared family decision. Married donors were slightly more likely than non‐married donors to involve another family member in this decision. Several donors made practical recommendations for improved education of donors during what many perceived to be a very lengthy evaluation process. Some subjects recommended more discussion about post‐operative pain and the expected pace of recovery after discharge. Others spoke of the challenge of completing basic homemaking tasks when the donor and recipient were in the same nuclear family. We are continuing to explore these and other aspects of donor decision‐making and outcomes and have expanded our sample to include non‐donors in the post‐evaluation period.

Community Based Cardiovascular Health Interventions in Vulnerable Populations: A Systematic Review

Background:Although cardiovascular health has been improving for many Americans, this is not true of those in “vulnerable populations.” To address this growing disparity, communities and researchers have worked for decades, and as a result of their work, a growing body of literature supports the use of community engagement as a component of successful interventions. However, little literature synthesizes community-based interventions that address this disparity among a wide range of vulnerable populations. Objective:This article provides a critical review of community-based cardiovascular disease interventions to improve cardiovascular health behaviors and factors among vulnerable populations based on the American Heart Association’s 7 metrics of ideal cardiovascular health. Methods:In February 2011, 4 databases (PubMed, PsychInfo, CINAHL, and Scopus) were searched using the following keywords: vulnerable populations OR healthcare disparities AND cardiovascular disease AND clinical trials OR public health practice AND English. Results:This search strategy resulted in the retrieval of 7120 abstracts. Each abstract was reviewed by at least 2 authors, and eligibility for the systematic review was confirmed after reading the full article. Thirty-two studies met eligibility criteria. Education was the most common intervention (41%), followed by counseling or support (38%) and exercise classes (28%). Half of the interventions were multicomponent. Healthcare providers were the most frequent interventionists. Interventions aimed at decreasing blood pressure were the most promising, whereas behavior change interventions were the most challenging. Almost all of the interventions were at the individual level and were proof-of-concept or efficacy trials. Conclusions:This analysis provides a step toward understanding the current literature on cardiovascular interventions for vulnerable population. The next step should be integrating the identified successful interventions into larger health systems and/or social policies.

Health Status and Birth Outcomes Among Pregnant Women in Substance Abuse Treatment

PURPOSE We sought to examine the physical and mental health status and low birthweight and preterm birth among low-income pregnant women in substance abuse treatment. METHODS A prospective correlational design was used with 84 pregnant women enrolled in a university-affiliated, comprehensive, hospital-based substance abuse treatment program. The majority of the sample reported heroin as their primary substance of abuse. RESULTS Approximately 39% of the infants were born preterm and 27.5% were low birthweight. Poorer perception of current health, cocaine as the primary substance of abuse, and number of prior substance abuse treatment admissions were independently associated with preterm birth. Being African American and a poorer perception of current health were independently associated with low birthweight. CONCLUSION Asking about perceptions of their current health is a useful addition to comprehensive assessment for pregnant women with substance abuse problems in any setting. Further knowledge of womens physical and mental health status will improve identification of those who are at even greater risk in a group at high risk overall.