C. Michael Brooks

Assessing the use of metered dose inhalers by adults with asthma.

The development and analysis of an instrument to evaluate the use of metered dose inhalers by patients in the University of Alabama at Birmingham (UAB) Asthma Program is presented. A total of 238 adult asthma patients demonstrated use of the metered dose inhaler for this analysis. Patient skill in using the inhaler was recorded using the instrument, Inhaler-Use Checklist, developed at UAB. The study found that most patients use metered dose inhalers incorrectly, despite training received from their physicians on proper use of inhalers.

A Multi-Stage Asthma Screening Procedure for Elementary School Children

This paper describes an asthma screening procedure developed to identify children with asthma for an intervention study. Students were classified into three categories based on questionnaire responses (previous asthma, suspected asthma, and no evidence of asthma). Those classified as suspected asthma by questionnaire underwent further testing, including spirometry and exercise challenge. Using the questionnaire alone, the measured asthma prevalence was 32%; the addition of spirometry and step testing reduced this estimate to 9.89%. The diagnosis of asthma was confirmed in 96% of children who saw the study physician. This screening procedure can identify school children with suspected undiagnosed asthma.

Features of Asthma in Older Adults

A study compared clinical and functional features of elderly patients with asthma to younger patients at a university medical center. Older patients had a larger than predicted reduction in pulmonary function parameters even though physician-assessed severity, duration of diagnosed asthma, and smoking status were no different between groups. A significant increase in the comorbid diagnosis of chronic obstructive pulmonary disease was noted in older patients with asthma. These two points support the hypothesis that long-standing asthma may lead to irreversible airflow obstruction. Older patients reported better medication compliance and decreases in some respiratory symptoms and demonstrated lower health care utilization.

Approaches for Longitudinally Tracking Graduates of NCI-Funded Short-Term Cancer Research Training Programs

Short-term cancer research programs for health professions students typically state goals of encouraging and fostering interest in pursuing cancer research-based careers. Evaluating career choices and professional achievements of these trainees has been problematic. Well-designed program evaluation is a key element in determining successful training experiences, and program-specific outcome measures are typically used to assess the effectiveness of each short-term cancer research experience. We describe evaluation approaches for longitudinal tracking of participants of our National Cancer Institute-sponsored Cancer Research Experiences for Students program at the University of Alabama at Birmingham, emphasizing those approaches that demonstrated greatest effectiveness. We also evaluate the various methods we used in terms of cost, efficiency, and effectiveness. Recommendations are provided to assist comparable training programs facing the challenges of longitudinal tracking and program evaluation.

Achieving Consensus on Leadership Competencies and Outcome Measures The Pediatric Pulmonary Centers' Experience

Pediatric Pulmonary Centers (PPCs) are federally funded interdisciplinary leadership training programs aiming to improve the health of families and children. This article describes the process PPCs used to efficiently and effectively achieve consensus on leadership training competencies and outcome measures among a large and diverse group of health professionals. Phase 1 used a modified Delphi technique to develop an initial set of competencies and outcome measures. Phase 2 used the nominal group technique and modified focus group strategies to refine and prioritize the competencies and outcomes measures. Participants reported being highly satisfied with the process and outcomes. In Phase 3, a formal program evaluation instrument was implemented, designed to measure the competency and describe the career paths and leadership accomplishments of previous trainees. The consensus process adopted can serve as a model for academic and public health entities seeking to achieve consensus on program goals, strategies, methods, priorities, and outcomes.

An Evaluation Methodology for Longitudinal Studies of Short-Term Cancer Research Training Programs

The need to familiarize medical students and graduate health professional students with research training opportunities that cultivate the appeal of research careers is vital to the future of research. Comprehensive evaluation of a cancer research training program can be achieved through longitudinal tracking of program alumni to assess the program’s impact on each participant’s career path and professional achievements. With advances in technology and smarter means of communication, effective ways to track alumni have changed. In order to collect data on the career outcomes and achievements of nearly 500 short-term cancer research training program alumni from 1999–2013, we sought to contact each alumnus to request completion of a survey instrument online, or by means of a telephone interview. The effectiveness of each contact method that we used was quantified according to ease of use and time required. The most reliable source of contact information for tracking alumni from the early years of the program was previous tracking results, and for alumni from the later years, the most important source of contact information was university alumni records that provided email addresses and telephone numbers. Personal contacts with former preceptors were sometimes helpful, as were generic search engines and people search engines. Social networking was of little value for most searches. Using information from two or more sources in combination was most effective in tracking alumni. These results provide insights and tools for other research training programs that wish to track their alumni for long-term program evaluation.

The Journal of Cancer Education: A Retrospective Review of Quality Indicators

The JCE publication history exceeds 600 peer reviewed cancer education articles. Two methodological approaches were used for a retrospective perspective of JCE quality: Journal Impact Factor (JIF) and Citation Analysis (CA). The Journal Impact Factor comparison included only medical or health journals with an educational focus. Citation Analysis was conducted to identify attributes of most cited JCE articles and their cancer education focus. Despite concerns in the literature about the merits of both methods, results provided useful insights about JCE quality. Results will guide quality improvement plans and assist authors interested in publishing their cancer education research results in the JCE.The JCE publication history exceeds 600 peer reviewed cancer education articles. Two methodological approaches were used for a retrospective perspective of JCE quality: Journal Impact Factor (JIF) and Citation Analysis (CA). The Journal Impact Factor comparison included only medical or health journals with an educational focus. Citation Analysis was conducted to identify attributes of most cited JCE articles and their cancer education focus. Despite concerns in the literature about the merits of both methods, results provided useful insights about JCE quality. Results will guide quality improvement plans and assist authors interested in publishing their cancer education research results in the JCE.

Evaluation Issues in the Development of Expert Systems in Medicine

Evaluation of medical decision support software (MDSS) -computer programs to assist health professionals with diagnostic and/or therapeutic decisions -has not kept pace with the development of such programs. This article describes the following formative evaluation issues that must be addressed by developers of MDSS to evaluate these programs properly: (1) How can systematic feedback be obtained about an evolving program? (2) How can enough data to evaluate the program be obtained? (3) How much instruction is necessary? (4) What are the most important aspects for users to evaluate? and (5) How can the appropriate use of a developing MDSS be assured? Data from an ongoing evaluation of an existing MDSS, Quick Medical Reference, are used to illustrate the issues and to suggest recommendations for addressing them.

HIPAA for Cancer Educators: Are You Correctly Using PHI?

Privacy and confidentiality policies and practices, including Health Insurance Portability and Accountability Act (HIPAA) policies, may vary from institution to institution because they are developed to be institution-specific. HIPAA privacy and security regulations represent the minimum standards, and the expectation is that institutions will develop policies and practices that are reasonable and appropriate for their institution. These privacy and information security safeguards impact the use of sensitive and protected data often used by cancer educators. Therefore, it is important for cancer educators to be familiar with the policies, rules, and guidelines their institution has developed to comply with HIPAA. However, despite institutional differences, certain principles related to the confidentiality, protection, and uses of a patient’s health information remain consistent. HIPAA provides two sets of regulations that directly impact the work of many cancer educators: privacy and information security. The HIPAA Privacy Rule includes some security requirements, and HIPAA Security Regulations were designed to ensure privacy of the patient’s protected health information (PHI). This paper focuses primarily on the privacy factors.

Validity of the Allied Health Aptitude Test in a Respiratory Therapy Education Program

Scores on the Allied Health Aptitude Test and previous GPAs for 102 students were correlated with a dichotomous measure of their persistence and their GPAs in the Respiratory Therapy program at the University of Alabama at Birmingham. The multiple correlation for predicting grades was .62, and for predicting persistence was .47. These results are comparable to those obtained in other academic prediction studies and support the validity of this test.