Marie Wolff

We’ve Had Training, Now What? Qualitative Analysis of Barriers to Domestic Violence Screening and Referral in a Health Care Setting

The present study assesses barriers to identification and referral of domestic violence (DV) victims by staff at a health care institution following a 3-hr DV training program in which 752 health care providers participated. Focus groups are conducted with staff in hospital departments that serve a high volume of women. Responses to focus group questions identify system-wide and individual hospital department barriers. These barriers have implications for health care organizations trying to implement DV screening protocols through training alone to change staff behavior in diverse clinical settings. Limitations of this study and future research recommendations are also discussed.

Building Effective Community—academic Partnerships to Improve Health: A Qualitative Study of Perspectives from Communities

Purpose To identify, through a qualitative study, community perspectives on the critical factors that facilitate the development, effectiveness, and sustainability of community—academic partnerships. Method Between June 1998 and April 1999, 25 semistructured interviews were conducted with community members who represented eight partnerships at five academic health centers. Content analysis and open coding were performed on the data, and patterns of ideas and concepts were categorized. Results After review of the data, responses from three partnerships were excluded. Nine major themes that community respondents thought strongly influenced the effectiveness of community—academic partnerships emerged from respondents from the remaining five partnerships: (1) creation and nurturing of trust; (2) respect for a communitys knowledge; (3) community-defined and prioritized needs and goals; (4) mutual division of roles and responsibilities; (5) continuous flexibility, compromise, and feedback; (6) strengthening of community capacity; (7) joint and equitable allocation of resources; (8) sustainability and community ownership; and (9) insufficient funding periods. Conclusion The themes that emerged from this study of the perceptions and experiences of the community partners in community—academic partnerships can be critical to further developing and evolving these partnerships.

Working with our communities: moving from service to scholarship in the health professions.

CONTEXT As faculty at health professionals schools have become increasingly engaged with their communities in partnerships to improve health, new questions have arisen about faculty rewards for such activities. To sustain the community work of their faculty, institutions need to reconceptualize faculty rewards, promotion, and tenure that are relevant to community activities. HISTORICAL PERSPECTIVE Scholarship has evolved since the 17th century from a focus on character-building to the practical needs of the nation to an emphasis on research. In 1990, Boyer proposed four interrelated dimensions of scholarship: (1) discovery; (2) integration;(3) application; and (4) teaching. The challenge became the development of criteria and innovative and creative ways to assess community scholarship. CURRENT MODELS FOR COMMUNITY SCHOLARSHIP This paper reviews four evidence-based models to document and evaluate scholarly activities that are applicable to community scholarship. PROPOSED MODEL FOR COMMUNITY SCHOLARSHIP We propose a new model for community scholarship that focuses on both processes and outcomes, crosses the boundaries of teaching, research, and service, and reshapes and integrates them through community partnership. We hope this model will generate national discussion about community scholarship and provide thought-provoking information that will move the idea of community scholarship to its next stage of development.

Leadership in a Public Housing Community

Community Health Advocate (CHA) programs train community members to assist and advocate for other members of the community regarding health and other community issues. These programs have been successful in improving the health and quality of life of communities. We developed a CHA program in a single public housing development. This program faced unique challenges since the advocates both worked and lived in the same setting. However, confronting and resolving these issues ultimately enhanced the quality of the program.

Development of a Church-Based Cancer Education Curriculum Using CBPR

ancer is the second leading cause of death (following heart disease) in the United States. An estimated 1.4 million cases of invasive cancer were diagnosed in the U.S. in 2005. 1 Racial and ethnic minorities constitute a disproportionate number of these cases. African Americans have both higher cancer incidence and higher rates of cancer mortality than Whites. For instance, African American men are 20% more likely than White males to be diagnosed with cancer and are 40% more likely to die, considering all cancers combined. The five year survival rate for African American women diagnosed with breast cancer is 75%, compared with 89% for White females. Differences in survival rates are due to various factors, including poverty, disparities in treatment, reduced access to medical care, and diagnosis at a later stage. 2 In general, African Americans have a decreased likelihood of surviving five years after diagnosis for all cancer types in comparison with Whites. Wisconsin cancer incidence and mortality rates mirror national patterns. From 1996 through 2000, Wisconsins average cancer mortality rate was 195.7 per 100,000 for the whole population and 271.6 per 100,000 for African Americans. The state average for cancer incidence was 454.3 per 100,000 compared with 523.5 per 100,000 for African Americans. Milwaukee County, located in southeastern Wisconsin, has the highest concentration of African Americans in the state (24.6%) and, not surprisingly, signifi - cantly higher cancer mortality and incidence rates than the state as a whole (488.7 per 100,000 compared with 218.9 per 100,000, respectively). 3

Community advocates in public housing.

Tenant safety patrolDeveloped in response to safety concerns in the building.Patrol members received 10 hours of training.Advocates work in teams of 2 for regularly scheduled shifts.Program has had a significant impact on security in the building.General equivalency diploma preparation programProgram meets weekly and provides material and informal tutoring.Volunteer teacher from the community assists the advocates with the program.Health committeeAddresses residents’ health concerns as well as misconceptions and myths about disease.Organizes and sponsors an annual health fair.Conducted a health assessment survey.Organizes presentations on diabetes, cancer, smoking, healthy lifestyle habits, etc.Spirituality meetingsProgram meets 3 times a week for prayer, readings, and singing.Local minister participates in the program.Social activitiesStrengthen community cohesiveness and social networks.Activities include a monthly potluck dinner, morning coffee club, weekly discussion group, weekly movie time, special events such as Black history celebrations.

Empowerment, Leadership, and Sustainability in a Faith-Based Partnership to Improve Health

Community-based participatory research is a noted approach for improving community health and reducing health disparities. Community partnerships can serve as a catalyst for change in public health efforts. This article will apply empowerment theory and sustainability principles to an existing faith-based partnership. BRANCH Out is a partnership among 13 African American churches, the City of Milwaukee Health Department—Community Nutrition, and the Medical College of Wisconsin. The partnership goal was to change inaccurate perceptions, knowledge and negative attitudes, and behaviors about chronic disease and promote healthy youth leadership. Faith-based empowerment can occur at the individual, organizational, and community level. BRANCH Out demonstrates how partnerships can be sustained in multiple ways. The partnership also highlights the unique contributions of churches to community health outcomes.

Care of the Student With Special Healthcare Needs The Development of the WISHeS Unlicensed Assistive Personnel Training

Care of the Student With Special Healthcare Needs is a free resource that can assist school nurses in ensuring they are providing the most up-to-date, evidence-based care to children. Although the training module was developed to improve the care provided to Wisconsin children, the module can be accessed by school nurses and unlicensed assistive personnel (UAP) across the United States and internationally. School nurses in other states would need to review their state’s nurse practice act and school district policies to evaluate which procedures they are allowed to delegate.

Best Practice at Your Fingertips The WISHeS School Nurse Procedure Website

School nurses are responsible for providing and supervising school nursing services for children with complex health concerns. Given that school nurses frequently practice in isolation and may have limited access to clinical practice changes, they can benefit from up-to-date, evidence-based resources. Additionally, the resources must account for the fact that the nursing procedures will be performed in the unique setting of a school building and, in many cases, will be performed by school personnel who have limited formal education in health care. This article provides an overview of a newly developed, easy to use, online school nursing procedures website for school nurses and other school personnel.

Development, Implementation and Evaluation of an M3 Community Health Curriculum

Abstract: Objectives: This paper describes the development, implementation and evaluation of an M3 community health curriculum that responds to recent changes within the health care finance and delivery system. Methods: The new curriculum was developed based on AAMC recommendations, LCME requirements, a national review of undergraduate community health curricula, and an internal review of the integration of community health concepts in M3 clerkships. Results: The M3 curriculum teaches: 1) the importance of being a community responsive physician; 2) SES factors that influence health; 3) cultural competency; and 4) the role of physicians as health educators. Student evaluations for the first twelve months of implementation indicate that students are most satisfied with presentations and less satisfied with required readings and a patient interview project. Discussion: Most students agree that at the completion of the course they understand what it means to be a community-responsive physician, and they have developed skills to help them become more community responsive. Evaluation tools need to be developed to assess if students’ behavior has changed due to course participation.