Lisa M. Vaughn

Picturing health: a photovoice pilot of Latina girls' perceptions of health.

The purpose of this study was to conduct a pilot participatory needs assessment, using Photovoice to engage in a critical dialogue with preadolescent Latina girls about their perceptions of health and immediate health concerns. Seven Latina girls participated in the Photovoice study and held a photography exhibition for the community to display their photographs and quotes from their discussions. Eight themes about being healthy emerged. Conducting a needs assessment, which concentrates on the voices and needs of these girls, can be the first step to creating successful and cost-efficient programs and interventions specifically suited to this group.

A Review of Community-based Participatory Research in Child Health

Objective:To review published studies that use an authentic community-based participatory research (CBPR) approach in child health to highlight the benefits, barriers, and scope of this approach with pediatric populations. Method:Studies using CBPR in child health were identified using PubMed, Scopus, and Web of Science through MeSH heading and keyword searches. Keywords included “community-based participatory research” and “child,” “youth,” and “adolescent.” Literature reviews and community-placed articles were excluded. Results:A total of 34 CBPR studies focused on child health were identified and analyzed for this review. The most common child health issue in these studies was obesity/diabetes. Other child health topics included health needs assessments, reproductive health, female health, HIV treatment, physical activity, mental health, maternal/child health, substance abuse, asthma, and youth with disabilities/special healthcare needs. Implications/Conclusion:CBPR offers a unique approach for translating evidence-based models and research knowledge from child health into effective and sustainable interventions.

Psychological size and distance: emphasising the interpersonal relationship as a pathway to optimal teaching and learning conditions

Background  Positive interpersonal relationships between teachers and learners increase the quality of learning. The purpose of this study was to investigate psychological size (perceived status) and psychological distance (perceived emotional connectedness) in medical teaching interactions and their impact on the teaching and learning process.

Limiting the effects of the media on body image: does the length of a media literacy intervention make a difference?

This study examined whether or not the length of a media literacy intervention had an impact on awareness of sociocultural ideals, internalization of sociocultural ideals, and body dissatisfaction. Fifty-four traditional-aged undergraduate females were assigned to a control condition (25.9%), a video only condition (22.4%), a short-term single session intervention condition (22.4%), or a long-term multi-session intervention condition (29.3%). The long-term intervention did decrease body dissatisfaction and both the short- and long-term intervention conditions decreased internalization of sociocultural ideals. It appears that longer term media literacy interventions have more potential to reduce body dissatisfaction than shorter term media literacy interventions and both short- and long-term media literacy interventions reduce internalization of socio cultural ideals.

A Comprehensive View of Parental Satisfaction With Pediatric Emergency Department Visits

STUDY OBJECTIVE We develop a comprehensive view of aspects of care associated with parental satisfaction with pediatric emergency department (ED) visits, using both quantitative and qualitative data. METHODS This was a retrospective observational study using data from an institution-wide system to measure patient satisfaction. For this study, 2,442 parents who brought their child to the ED were interviewed with telephone survey methods. The survey included closed-ended (quantitative) and open-ended (qualitative data) questions, in addition to a cognitive interview-style question. RESULTS Overall parental satisfaction was best predicted by how well physicians and nurses work together, followed by wait time and pain management. Issues concerning timeliness of care, perceived quality of medical care, and communication were raised repeatedly by parents in response to open-ended questions. A cognitive interview-style question showed that physicians and nurses sharing information with each other, parents receiving consistent and detailed explanations of their childs diagnosis and treatments, and not having to answer the same question repeatedly informed parent perceptions of physicians and nurses working well together. Staff showing courtesy and respect through compassion and caring words and behaviors and paying attention to nonmedical needs are other potential satisfiers with emergency care. CONCLUSION Using qualitative data to augment and clarify quantitative data from patient experience of care surveys is essential to obtaining a complete picture of aspects of emergency care important to parents and can help inform quality improvement work aimed at improving satisfaction with care.

The Problem Learner.

Background: A problem learner is a learner whose academic performance is significantly below performance potential because of a specific affective, cognitive, structural, or interpersonal difficulty. Problem learners are difficult for the clinical preceptor to manage. Description: We propose a general problem-solving process, the S-T-P model, through which unique solutions for different problem learners can be developed. The S-T-P model is a process that incorporates feedback and problem solving; it consists of three steps: (a) specify the problem (S); (b) desired target state (T); and (c) procedure, plan, or path to get from S to T (P). Evaluation: We offer suggestions for the evaluation of the problem learner, including more emphasis on peer and self-evaluation and insights to teaching and implementing the S-T-P model, including the use of role play. Conclusions: Considerations of the problem learner may suggest evaluation, curricular, and organizational changes in residency programs and medical schools.

Pediatric Emergency Health Care Providers’ Knowledge, Attitudes, and Experiences Regarding Emergency Contraception

OBJECTIVES The objective was to describe knowledge, attitudes, and experiences regarding emergency contraception (EC) among pediatric emergency health care providers (HCPs). METHODS This multicenter, focus group study elicited thoughts and experiences from pediatric emergency HCPs about EC. Participants were physicians, nurse practitioners (NPs), and nurses in one of three urban, geographically distinct, pediatric emergency departments (EDs). A professional moderator used a semistructured format for sessions, which were audiotaped, transcribed, and analyzed for recurrent themes. Participants provided demographic information and completed a written survey evaluating EC knowledge. RESULTS Eighty-five HCPs (41 physicians, eight NPs, and 36 nurses) participated in 12 focus groups. Overall knowledge about EC was poor. Participants identified barriers including cost, privacy, knowledge, and provider refusal. Provision of EC for adolescents was supported by the majority of physicians and NPs; however, many nurses were not supportive, especially following consensual intercourse. The authors identified use of social judgment by nurses as a novel barrier to EC provision. The majority of HCPs did not support screening for potential EC need. The majority of physicians and NPs felt obligated to provide adolescents with all contraceptive options, while more nurses supported provider refusal to provide EC. CONCLUSIONS This study identified important HCP perceptions and barriers about EC provision in the pediatric ED. These findings may inform future efforts to improve EC provision for adolescents. Specifically, future studies to evaluate the differences in attitudes between nurses, physicians, and NPs, and the use of social judgment in EC provision, are warranted.

The Use of Concept Mapping to Identify Community-Driven Intervention Strategies for Physical and Mental Health:

Research that partners with youth and community stakeholders increases contextual relevance and community buy-in and therefore maximizes the chance for intervention success. Concept mapping is a mixed-method participatory research process that accesses the input of the community in a collaborative manner. After a school-wide health needs assessment at a low-income, minority/immigrant K–8 school identified bullying and obesity as the most important health issues, concept mapping was used to identify and prioritize specific strategies to address these two areas. Stakeholders including 160 K–8 students, 33 college students working in the school, 35 parents, 20 academic partners, and 22 teachers/staff brainstormed strategies to reduce and prevent obesity and bullying. A smaller group of stakeholders worked individually to complete an unstructured sorting of these strategies into groups of similar ideas, once for obesity and again for bullying. Multidimensional scaling and cluster analysis was applied to the sorting data to produce a series of maps that illustrated the stakeholders’ conceptual thinking about obesity and bullying prevention strategies. The maps for both obesity and bullying organized specific strategies into themes that included education, parental role, teacher/school supervision, youth role, expert/professional role, and school structure/support.

Teaching social determinants of child health in a pediatric advocacy rotation: Small intervention, big impact

Background: Traditionally, medical education does not specifically address the social determinants of health or how to advocate for families’ cultural, social or economic needs in spite of our increasingly diverse society. Aim: This article describes a new social–legal curriculum added to a Pediatric Residents Advocacy course. Methods: Pediatric interns completed ‘Memos To Myself’ after the Advocacy rotation. Results: The curriculum impacted residents’ (1) realization regarding family circumstances; (2) reflections regarding self and personal practice; and (3) knowledge about advocacy issues and community partnerships for solutions. Conclusions: This curriculum raised awareness about topics that are traditionally not covered in medical education.

Parental Expectations Regarding Discussions on Psychosocial Topics During Pediatric Office Visits

Parents from urban (n=67) and suburban (n=76) primary care settings responded to a survey determining the extent to which 9 common psychosocial concerns have affected their children. Parents also reported their expectations of their pediatrician to discuss such topics during a health care visit. Within both settings, discipline was the most frequently experienced (41%), commonly discussed (34.3%), and frequently expected (75.4%) topic to be discussed. The frequency of discussions on psychosocial topics was less than half that of the actual reported occurrence of the psychosocial concern. When discussions on psychosocial topics did occur, however, most parents (87.3%) perceived pediatricians as helpful.