Impact of managed MediCal on California family practice programs.
Zweifler, J A
2001-05-01
An important source of patients for California's family practice program is MediCal. During the past 5 years, MediCal has established a variety of capitated managed care plans. To assess the impact of California's managed MediCal program on the state's 38 family practice training programs. A cross-sectional, retrospective descriptive survey. A 3-page, 11-question survey was developed by family practice residency directors and staff from the California Academy of Family Physicians, San Francisco. The 38 family practice programs in existence in California in September 1997 were stratified by type of managed MediCal in their county and by type of sponsoring institution--university, county, community based, staff-model health maintenance organization, or managed care system. Of the 38 family practice programs, 27 responded; 19 of 27 programs participated in managed MediCal. The total number of family health center patients, and the percentage of MediCal patients (48%-60%) at family practice programs was similar when stratified by programs with and without managed MediCal and by type of sponsorship. Most programs reported that they were able to compete effectively, although most also reported increased administrative, nursing, and front office costs. Managed MediCal patients were directly assigned to residents in only 3 of 19 programs. The introduction of managed MediCal has not adversely affected the number of patients cared for in California's family practice programs. Continued vigilance regarding California family practice programs' involvement in managed MediCal, including collection of accurate data on the number of MediCal patients and the financial and educational implications for California's family practice programs, is warranted.
Financing graduate medical education in family medicine.
Colwill, J M
1989-03-01
Family practice residency programs differ fiscally from residency programs in most other specialties because they have limited income-generating potential. The present review demonstrates that the typical family practice residency program has been fiscally solvent as a result of receiving approximately one-third of its income from state and federal appropriations. The level of such support plateaued in the 1980s and programs have not continued to expand despite an ongoing shortage of family physicians. Today, declining Medicare payments to hospitals threaten hospitals' contributions to family practice residency programs. The ability of family practice residency programs to meet the continuing need for family physicians will depend upon the development of specific state and federal policies that provide fiscal incentives to maintain and expand family practice residencies.
The increase in international medical graduates in family practice residency programs.
Koehn, Nerissa N; Fryer, George E; Phillips, Robert L; Miller, John B; Green, Larry A
2002-06-01
The number of filled positions in family practice residency programs decreased by 18.6% from 1997-2001. This study sought to determine the degree of reliance on international medical graduates (IMGs) to fill family practice residency positions and the relative proportion of US citizen IMGs. We analyzed the 1992-2001 National Resident Matching Program results, the 2000 American Medical Association Masterfile, and the 1992-2001 American Academy of Family Physicians Annual Survey of Family Practice Residency Programs. The percentage of IMGs matching in family practice remained stable between the years of 1992-1996 (10.0%-11.8%) but since 1997 has increased to a high of 21.4% in 2001. This rise in IMGs corresponds with a drop in the total percentage of family practice residency positions filled in the Match from 90.5% in 1996 to 76.3% in 2001. Despite the drop in Match numbers, the percentage of first-year family practice positions filled in July has remained in the range of 95.5%-97.8% since 1996. IMGs account for an increasing percentage of post-Match fills from 16.7% in 1996 to 47.9% in 2001. In 1999, a majority of family practice programs (279 [55.6%]), had at least one IMG. Of these, 48 programs (9.6%) had at least 50% of residents who were IMGs, and eight programs (1.6%) were entirely composed of IMGs. In five states (Connecticut, Illinois, Michigan, New Jersey, and New York), more than 25% of family practice residents were IMGs. Family practice is becoming increasingly reliant on IMGs to fill residency positions.
A survey of marketing practices by family practice residency programs.
Buckley, R L; Presley, R; Barrigar, R
1995-06-01
The purpose of the study reported in this article was to identify marketing practices that are being utilized by family practice residencies in the United States and to differentiate which strategies were felt to be most useful. A survey questionnaire on marketing strategies was mailed to 361 civilian family practice residencies listed in the 1992 Director of Family Practice Residency Programs. A total of 151 questionnaires were returned for a total response rate of 42.1 percent. The results were summarized using descriptive statistics and Chi-square analysis. Family practice residency programs use a number of different strategies to attract patients. The effectiveness of a given program is dependent on local factors, program strengths and the target population desired. The three most useful marketing strategies reported in the survey were HMO listings, emergency department referrals, and patient referrals. The three least effective strategies were health fairs, sports physicals, and school presentations.
ERIC Educational Resources Information Center
Singh, Sunita; Sylvia, Monica R.; Ridzi, Frank
2015-01-01
This ethnographic study presents findings of the literacy practices of Burmese refugee families and their interaction with a book distribution program paired with an intergenerational family literacy program. The project was organized at the level of Bronfenbrenner's exosystem (in "Ecology of human development". Cambridge, Harvard…
ERIC Educational Resources Information Center
Larner, Mary
The "Guidelines for Effective Practice" series was begun in 1991 to meet the need for better definition and articulation of what constitutes best practice in family support programs. This guide, the first issue of the series, focuses on the importance and necessity of linkages between family support and early childhood programs. Chapter…
ERIC Educational Resources Information Center
Bishop, Kathleen Kirk, Ed.; Taylor, Mary Skidmore, Ed.; Arango, Polly, Ed.
Designed to celebrate family/interprofessional collaborative partnerships, this publication describes high-quality examples of how families and professionals at the family, community, state, and national levels have worked together to create programs and practices that are family-friendly and responsive to what families have said they want and…
Supportive Housing for Homeless Families: Foster Care Outcomes and Best Practices. Summary
ERIC Educational Resources Information Center
Lenz-Rashid, Sonja
2013-01-01
The "Supportive Housing for Homeless Families: Foster Care Outcomes and Best Practices" report describes the outcome evaluation of Cottage Housing Incorporated's Serna Village program in Sacramento, California. Serna Village is a supportive housing program serving homeless families. Outcomes from the program illustrate that it is…
Family medicine research capacity building: five-weekend programs in Ontario.
Rosser, Walter; Godwin, Marshall; Seguin, Rachelle
2010-03-01
Research is not perceived as an integral part of family practice by most family physicians working in community practices. OBJECTIVE OF THE PROGRAM To assist community-based practitioners in answering research questions that emerge from their practices in order for them to gain a better understanding of research and its value. The Ontario College of Family Physicians developed a program consisting of 5 sets of weekend workshops, each 2 months apart. Two pilots of the 5-weekend program occurred between 2000 and 2003. After the pilots, thirteen 5-weekend programs were held in 2 waves by 20 facilitators, who were trained in one of two 1-day seminars. This 5-weekend program, developed and tested in Ontario, stimulates community practitioners to learn how to answer research questions emerging from their practices. A 1-day seminar is adequate to train facilitators to successfully run these programs. Evaluations by both facilitators and program participants were very positive, with many participants stating that their clinical practices were improved as a result of the program. The program has been adapted for residency training, and it has already been used internationally.
Teaching interpersonal skills in family practice: results of a national survey.
Kahn, G; Cohen, B; Jason, H
1979-02-01
The increasing recognition of the importance of a well-developed set of interpersonal skills to the competent family physician has resulted in a rapid growth in the formal teaching of interpersonal skills within family practice residencies. Of the 168 programs responding to a national survey of family practice residencies, 88 percent indicated that they have formal programs in interpersonal skills. It is estimated that there are well over 500 family practice faculty members who have special responsibilities in teaching interpersonal skills. While most programs address the component skills of the interpersonal process (eg, demonstrating empathy, information gathering, information giving, and psychological intervention), it is of concern that only about half offer explicit training in patient education (53 percent), specific types of counseling (eg, family counseling, 55 percent), or some of the specific interpersonal skills important in team practice and practice management (eg, supervisory skills). One of the most striking findings was that 88 percent of the reporting programs use videotechnology, with 77 percent of these planning to increase their use. Although most programs evaluate their interpersonal skills training using both indirect and direct assessment methods, only 25 percent attempt to use patient outcome as a measure of teaching effectiveness.
Putting the "family" back into family therapy.
Breunlin, Douglas C; Jacobsen, Elizabeth
2014-09-01
In this article, we examine the field of family therapy by drawing a distinction between two forms of practice: Whole Family Therapy (WFT), defined as treating the whole family, and Relational Family Therapy (RFT), defined as working with a subsystem of the family or an individual while retaining a systemic lens. Our thesis is that the practice of WFT has been in decline for some time and steps must be taken to keep it from becoming a defunct practice. We consider the trajectory of WFT and RFT throughout the development of family therapy through reference to the people, the literature, training, and practice patterns associated with family therapy. We remind the reader of the many benefits of WFT and suggest that today WFT is likely to be practiced in conjunction with RFT and individual therapy. Since training of family therapists today is largely located in degree-granting programs, we identify constraints to including WFT in such programs. We conclude by offering suggestions that can enhance a program's ability to train students in WFT. © 2014 FPI, Inc.
Emergency Room Practice among Family Physicians.
ERIC Educational Resources Information Center
Hansel, Nancy K.; And Others
1985-01-01
A self-report questionnaire of graduates of a family practice residency program obtained information on their practices, professional and emergency medicine experiences, and attitudes toward the practice of emergency medicine by family practioners. (Author/MLW)
ERIC Educational Resources Information Center
Kilburn, M. Rebecca, Ed.
2014-01-01
The Promising Practices Network (PPN) on Children, Families and Communities (www.promisingpractices.net) began as a partnership between four state-level organizations that help public and private organizations improve the well-being of children and families. The PPN website, archived in June 2014, featured summaries of programs and practices that…
Barr, Wendy B; Tong, Sebastian T; LeFevre, Nicholas M
2017-03-01
Group prenatal care has been shown to improve both maternal and neonatal outcomes. With increasing adaption of group prenatal care by family medicine residencies, this model may serve as a potential method to increase exposure to and interest in maternity care among trainees. This study aims to describe the penetration, regional and program variations, and potential impacts on future maternity care practice of group prenatal care in US family medicine residencies. The CAFM Educational Research Alliance (CERA) conducted a survey of all US family medicine residency program directors in 2013 containing questions about maternity care training. A secondary data analysis was completed to examine relevant data on group prenatal care in US family medicine residencies and maternity care practice patterns. 23.1% of family medicine residency programs report provision of group prenatal care. Programs with group prenatal care reported increased number of vaginal deliveries per resident. Controlling for average number of vaginal deliveries per resident, programs with group prenatal care had a 2.35 higher odds of having more than 10% of graduates practice obstetrics and a 2.93 higher odds of having at least one graduate in the past 5 years enter an obstetrics fellowship. Residency programs with group prenatal care models report more graduates entering OB fellowships and practicing maternity care. Implementing group prenatal care in residency training can be one method in a multifaceted approach to increasing maternity care practice among US family physicians.
DOE Office of Scientific and Technical Information (OSTI.GOV)
Not Available
The Institute of Medicine and the Pew Health Profession Commission have advocated that physicians broaden their participation in the envirorunental aspects of medical care. Accordingly, both organizations recommend training of future primary care physicians for greater competencies and appreciation of this area of medicine. The extent to which family practice educators are receptive to incorporating this topic into the residency curriculum is not known. A national survey of directors of family practice programs was conducted to assess their attitudes about environmental health education in family practice residency training. The ultimate goal of this study was to provide information that willmore » guide the development of an environmental health curriculum for family practice residency programs. Videotapes supporting this program have been indexed individually.« less
Psychosocial Training in U.S. Internal Medicine and Family Practice Residency Programs.
ERIC Educational Resources Information Center
Gaufberg, Elizabeth H.; Joseph, Robert C.; Pels, Richard J.; Wyshak, Grace; Wieman, Dow; Nadelson, Carol C.
2001-01-01
Surveyed directors of internal medicine (IM) and family practice (FP) residency programs regarding the format, content, and quantity of psychosocial training in their programs, their opinions on topics related to such training, and program demographics. Found considerable variation in content and time devoted to psychosocial training within and…
Training in interprofessional collaboration: pedagogic innovation in family medicine units.
Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien
2012-04-01
A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Based on adult learning theories, the program was divided into 3 phases--preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program's pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training.
Transforming family practice in British Columbia: the General Practice Services Committee.
Cavers, William J R; Tregillus, Valerie H F; Micco, Angela; Hollander, Marcus J
2010-12-01
To describe a new approach to primary care reform developed in British Columbia (BC) under the leadership of the General Practice Services Committee (GPSC). COMPOSITION OF THE COMMITTEE: The GPSC is a joint committee of the BC Ministry of Health Services, the BC Medical Association, and the Society of General Practitioners of BC. Representatives of BC's health authorities also attend as guests. This paper is based on the 2008-2009 annual report of the GPSC. It summarizes the history and main activities of the GPSC. The GPSC is currently supporting a number of key activities to transform primary care in BC. These activities include the Full Service Family Practice Incentive Program, which provides incentive payments to promote enhanced primary care; the Practice Support Program, which provides family physicians and their medical office assistants with various practical evidence-based strategies and tools for managing practice enhancement; the Family Physicians for BC Program to develop family practices in areas of identified need; the Shared Care Committee, which supports and enables the determination of appropriate scopes of practice among GPs, specialists, and other health care professionals; the Divisions of Family Practice, which are designed to facilitate interactions among family doctors and between doctors and their respective health authorities; and the Community Healthcare and Resource Directory, a Web-based resource to help health care providers find appropriate mental health resources. Early results indicate that the GPSC's initiatives are enhancing the delivery of primary care services in BC.
Developing Quality Indicators for Family Support Services in Community Team-Based Mental Health Care
Olin, S. Serene; Kutash, Krista; Pollock, Michele; Burns, Barbara J.; Kuppinger, Anne; Craig, Nancy; Purdy, Frances; Armusewicz, Kelsey; Wisdom, Jennifer; Hoagwood, Kimberly E.
2013-01-01
Quality indicators for programs integrating parent-delivered family support services for children’s mental health have not been systematically developed. Increasing emphasis on accountability under the Affordable Care Act highlights the importance of quality-benchmarking efforts. Using a modified Delphi approach, quality indicators were developed for both program level and family support specialist level practices. These indicators were pilot tested with 21 community-based mental health programs. Psychometric properties of these indicators are reported; variations in program and family support specialist performance suggest the utility of these indicators as tools to guide policies and practices in organizations that integrate parent-delivered family support service components. PMID:23709287
Family Literacy Packs: Preservice Teachers' Experiences with Family-School Connections
ERIC Educational Resources Information Center
Wilson, D. Reece
2017-01-01
Programs that promote family literacy, as defined by Hannon (2003), are "programs to teach literacy that acknowledge and make use of learners' family relationships and engagement in family literacy practices." Why are such programs important for young learners? According to Livingston and Wirt (2003), children who have homes with books,…
Three Cs of Translating Evidence-Based Programs for Youth and Families to Practice Settings
ERIC Educational Resources Information Center
Freire, Kimberley E.; Perkinson, Leah; Morrel-Samuels, Susan; Zimmerman, Marc A.
2015-01-01
Despite the growing number of evidence-based programs (EBPs) for youth and families, few are well-integrated in service systems or widely adopted by communities. One set of challenges to widespread adoption of EBPs relates to the transfer of programs from research and development to practice settings. This is often because program developers have…
ERIC Educational Resources Information Center
Benke, Carrie J.; Bailey, Sandra J.; Martz, Jill; Paul, Lynn; Lynch, Wesley; Eldridge, Galen
2013-01-01
Planning youth and family programming in the 21st century is daunting given family members' busy schedules. This is even more challenging when planning programs in rural areas, where there are vast distances between communities. This article discusses a research and educational outreach project that uses best practices in program development…
Transforming family practice in British Columbia
Cavers, William J.R.; Tregillus, Valerie H.F.; Micco, Angela; Hollander, Marcus J.
2010-01-01
ABSTRACT OBJECTIVE To describe a new approach to primary care reform developed in British Columbia (BC) under the leadership of the General Practice Services Committee (GPSC). COMPOSITION OF THE COMMITTEE The GPSC is a joint committee of the BC Ministry of Health Services, the BC Medical Association, and the Society of General Practitioners of BC. Representatives of BC’s health authorities also attend as guests. METHOD This paper is based on the 2008–2009 annual report of the GPSC. It summarizes the history and main activities of the GPSC. REPORT The GPSC is currently supporting a number of key activities to transform primary care in BC. These activities include the Full Service Family Practice Incentive Program, which provides incentive payments to promote enhanced primary care; the Practice Support Program, which provides family physicians and their medical office assistants with various practical evidence-based strategies and tools for managing practice enhancement; the Family Physicians for BC Program to develop family practices in areas of identified need; the Shared Care Committee, which supports and enables the determination of appropriate scopes of practice among GPs, specialists, and other health care professionals; the Divisions of Family Practice, which are designed to facilitate interactions among family doctors and between doctors and their respective health authorities; and the Community Healthcare and Resource Directory, a Web-based resource to help health care providers find appropriate mental health resources. CONCLUSION Early results indicate that the GPSC’s initiatives are enhancing the delivery of primary care services in BC. PMID:21156899
Handheld Computer Use in U.S. Family Practice Residency Programs
Criswell, Dan F.; Parchman, Michael L.
2002-01-01
Objective: The purpose of the study was to evaluate the uses of handheld computers (also called personal digital assistants, or PDAs) in family practice residency programs in the United States. Study Design: In November 2000, the authors mailed a questionnaire to the program directors of all American Academy of Family Physicians (AAFP) and American College of Osteopathic Family Practice (ACOFP) residency programs in the United States. Measurements: Data and patterns of the use and non-use of handheld computers were identified. Results: Approximately 50 percent (306 of 610) of the programs responded to the survey. Two thirds of the programs reported that handheld computers were used in their residencies, and an additional 14 percent had plans for implementation within 24 months. Both the Palm and the Windows CE operating systems were used, with the Palm operating system the most common. Military programs had the highest rate of use (8 of 10 programs, 80 percent), and osteopathic programs had the lowest (23 of 55 programs, 42 percent). Of programs that reported handheld computer use, 45 percent had required handheld computer applications that are used uniformly by all users. Funding for handheld computers and related applications was non-budgeted in 76percent of the programs in which handheld computers were used. In programs providing a budget for handheld computers, the average annual budget per user was $461.58. Interested faculty or residents, rather than computer information services personnel, performed upkeep and maintenance of handheld computers in 72 percent of the programs in which the computers are used. In addition to the installed calendar, memo pad, and address book, the most common clinical uses of handheld computers in the programs were as medication reference tools, electronic textbooks, and clinical computational or calculator-type programs. Conclusions: Handheld computers are widely used in family practice residency programs in the United States. Although handheld computers were designed as electronic organizers, in family practice residencies they are used as medication reference tools, electronic textbooks, and clinical computational programs and to track activities that were previously associated with desktop database applications. PMID:11751806
Handheld computer use in U.S. family practice residency programs.
Criswell, Dan F; Parchman, Michael L
2002-01-01
The purpose of the study was to evaluate the uses of handheld computers (also called personal digital assistants, or PDAs) in family practice residency programs in the United States. In November 2000, the authors mailed a questionnaire to the program directors of all American Academy of Family Physicians (AAFP) and American College of Osteopathic Family Practice (ACOFP) residency programs in the United States. Data and patterns of the use and non-use of handheld computers were identified. Approximately 50 percent (306 of 610) of the programs responded to the survey. Two thirds of the programs reported that handheld computers were used in their residencies, and an additional 14 percent had plans for implementation within 24 months. Both the Palm and the Windows CE operating systems were used, with the Palm operating system the most common. Military programs had the highest rate of use (8 of 10 programs, 80 percent), and osteopathic programs had the lowest (23 of 55 programs, 42 percent). Of programs that reported handheld computer use, 45 percent had required handheld computer applications that are used uniformly by all users. Funding for handheld computers and related applications was non-budgeted in 76percent of the programs in which handheld computers were used. In programs providing a budget for handheld computers, the average annual budget per user was 461.58 dollars. Interested faculty or residents, rather than computer information services personnel, performed upkeep and maintenance of handheld computers in 72 percent of the programs in which the computers are used. In addition to the installed calendar, memo pad, and address book, the most common clinical uses of handheld computers in the programs were as medication reference tools, electronic textbooks, and clinical computational or calculator-type programs. Handheld computers are widely used in family practice residency programs in the United States. Although handheld computers were designed as electronic organizers, in family practice residencies they are used as medication reference tools, electronic textbooks, and clinical computational programs and to track activities that were previously associated with desktop database applications.
ERIC Educational Resources Information Center
Billings, Elsa S.
2009-01-01
This study investigated literacy values and practices among Latino families with preschool-age children. Results are part of a larger study that looked at the efficacy of a pediatric-based early literacy promotion program called Reach Out and Read (ROR). Participants included families participating in a ROR program in which…
ERIC Educational Resources Information Center
Kister, Joanna; And Others
This Resource Management Resource Guide is intended to help teachers implement Ohio's Work and Family Life Program. Course content focuses on the practical problems related to managing human and material resources, making consumer decisions, and feeding, clothing, and housing the family. These practical problems are posed through case studies and…
Environmental health training: a survey of family practice residency program directors.
Musham, C; Bellack, J P; Graber, D R; Holmes, D
1996-01-01
The Institute of Medicine and the American College of Physicians have advocated that physicians broaden their participation in the environmental aspects of medical care. Accordingly, both organizations recommend training of future primary care physicians for greater competency in and appreciation of this area of medicine. This study assessed the present emphasis on environmental health in family practice residency programs by examining the extent program directors expect graduates to have specific competencies in environmental medicine. A written survey was mailed to directors of all 393 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs. Respondents were asked to indicate the extent to which each of eight environmental health competencies was expected of their graduates. The list of environmental health competencies was based on the literature and on interviews with family practice educators. Perceptions about the "present" and "ideal" environmental health emphasis in their programs were also measured. A total of 262 completed surveys were returned for a response rate of 67%. Respondents reported that they expected their graduates to have general knowledge of and competence in environmental health areas that pertain to patient care. Competencies with social and political implications were least likely to be expected. Two thirds of respondents indicated that "minimal emphasis" is presently placed on environmental health. Seventy percent indicated that the "ideal" amount of emphasis placed on this topic is "moderate." This survey's results suggest that family practice residency program directors expect their graduates to know basic environmental health concepts and be skilled in related aspects of patient care. The development of environmental health training programs must take into account that environmental health may be viewed as a topic of secondary importance and that in most residencies, faculty expertise in this area is limited. For this reason, a self-tutoring strategy, aimed toward the educational needs of both faculty and residents, is recommended.
Toward Building a Typology for the Evaluation of Services in Family Support Programs.
ERIC Educational Resources Information Center
Manalo, Victor; Meezan, William
2000-01-01
Articulates how the family support movement emerged in the last 20 years, and describes the philosophical premises, principles, and practices that currently guide it. Considers the inability of current family support program typologies to guide outcome evaluations, and introduces a typology that deconstructs family support programs into their…
Toward building a typology for the evaluation of services in family support programs.
Manalo, V; Meezan, W
2000-01-01
This article briefly reviews the history, philosophy, practice principles, and foci of family support programs, examines the typologies currently in use to classify these programs, and discusses the difficulties these classifications pose for program evaluators. The authors introduce a new typology that deconstructs family support programs into their component services and discuss the potential of this typology for evaluation of family support services.
Defense Threat Reduction Agency > Careers > Onboarding > Special Programs
, programs, and practices to help our employees and Service members balance work and family responsibilities . We have put in place family-friendly Work/Life programs and policies designed to create a more Children and Family Leave Programs Work/Life Resources Onboarding Home Onboarding Overview Before You
Methodology and outcomes of a family medicine research fellowship.
Cronholm, Peter F; Straton, Joseph B; Bowman, Marjorie A
2009-08-01
There has not been a strong tradition of training researchers to provide the great amount of new evidence needed for the practice of family medicine. Few models for creating successful family medicine researchers have been presented in the literature. The authors report on the methodology and outcomes of a faculty development research fellowship in the University of Pennsylvania's Department of Family Medicine and Community Health. The fellowship focuses on the two domains-intensive research training and academic career development-and frames them with coursework in a content-appropriate master's degree program and clinical practice in an underserved community. Fifteen fellows have completed the program, which began in 1997. Most fellows' research work has been related to primary care and health disparities. Program completers have been the principal investigators on 39 funded studies and coinvestigators on 24 funded studies. They have, at the time this article was written, described their work in 236 publications, 114 of them peer reviewed. All but one program completer hold academic faculty positions, and 12 practice in underserved areas. In a research-intense institution, the fellowship program successfully trained family physicians to be independent clinical researchers and leaders who have substantially contributed to the national effort to mitigate health disparities through practice and research. The authors suggest that the outcomes strongly support the development of similar training opportunities in family medicine departments in other resource- and research-rich institutions.
Reducing Teachers' Work-Family Conflict: From Theory to Practice
ERIC Educational Resources Information Center
Cinamon, Rachel Gali; Rich, Yisrael
2005-01-01
Work-family conflict is a vocational psychology variable whose antecedents and outcomes have been extensively investigated. In contrast, less effort has been invested in creating practical programs to prevent and reduce it. This article provides the rationale and describes the framework for a comprehensive organizational program designed to ease…
Report on Marketing Practices in the Federal Family Education Loan Program
ERIC Educational Resources Information Center
US Senate, 2007
2007-01-01
This report was prepared by the Chairman's Staff of the Senate Health, Education, Labor and Pensions Committee setting forth the findings of an investigation into marketing practices in the Federal Family Education Loan program ("FFEL"). Evidence uncovered by the Chairman's investigation demonstrates that many FFEL lenders routinely…
The future of family practice training in California.
Midtling, J. E.; Barnett, P. G.; Blossom, H. J.; Burnett, W. H.
1990-01-01
Although the number of physicians in California has doubled since 1963, the number of family and general practice physicians has declined. The ratio of office-based primary care physicians to population has also decreased. Graduate medical education is funded largely from patient care revenues, but the low rate of reimbursement for ambulatory care makes training in primary care specialties especially dependent on public support. Medicare, the Veterans Administration, and the University of California provide more than $325 million a year in support of graduate medical education in California. Federal and state grant programs provide $5 million a year for family physician training in the state, but appropriations to these programs have been reduced in real terms. California family practice residencies are disproportionately located at county hospitals, where funding shortfalls make them especially vulnerable to cuts in grant programs. Additional resources will be needed if more family physicians are to be trained. Images PMID:2333709
Family practice residents aren't getting enough training in reproductive health care.
1997-10-17
Most doctors who graduate from family practice programs in the US receive little or no clinical training in reproductive health care, according to a study published in the September/October issue of Family Planning Perspectives. Researchers report that the majority of respondents to a 1995 survey of program directors and chief residents at 244 family medicine residency programs in the US reported they had no clinical experience in cervical cap fitting, diaphragm fitting, or IUD insertion and removal. What's more, only 15% of chief residents had gained clinical experience providing first-trimester abortions before graduating, despite the fact that 29% of programs included the training as either optional or routine. Only 5% of residents surveyed answered "yes" when asked whether they would "certainly" or "probably" provide abortions in their future practices. 65% responded that they "certainly would not" provide abortions. The study also found that residents who attended a program in which abortion training was offered were more likely to have a favorable attitude toward abortion training and services. full text
Resident partnerships: an effective strategy for training in primary care.
Adam, P; Williamson, H A; Zweig, S C; Delzell, J E
1997-06-01
To facilitate resident training in the ambulatory setting, a few family practice residency programs use a partnership system to train residents. Partnerships are pairs of residents from the same year that rotate together on inpatient services. We identified and characterized the advantages and disadvantages of partnership programs in family practice residencies. We conducted a national survey of family practice residencies, followed by phone interviews with residency directors of programs with partnerships. A total of 305 of 407 (75%) residencies responded; 10 programs fit our definition of partnership. Program directors were positive about resident partnerships. Benefits included improved outpatient continuity, enhanced medical communication skills, and emotional and intellectual support. Disadvantages were decreased inpatient exposure and difficulty coordinating residents' schedules. Directors were favorable about partnerships, which seem to be an underutilized technique to improve residency training.
Follow-up on family practice residents' perspectives on length and content of training.
Duane, Marguerite; Dovey, Susan M; Klein, Lisa S; Green, Larry A
2004-01-01
The structure of family practice residency programs remains essentially unchanged from the model first proposed more than 35 years ago. Advances in medical technology and knowledge combined with increasing restrictions on resident work hours and decreasing medical student interest invite reconsideration of how family physicians are trained. We resurveyed 442 third-year family practice residents who had participated in a prior study in 2000 to determine whether their opinions about the length and content of residency had changed and whether they would still choose to be a physician and a family physician. Thirty-seven percent of responding third-year residents favored extending family practice residency to 4 years. Compared as groups, there was relatively little change in opinion between first- and third-year residents. However, residents' individual responses about the settings and content areas for which they would be willing to consider extending training varied considerably between years 1 and 3. Personal characteristics did not seem to influence residents' opinions about length and content of training. Reasons for favoring a 4-year program and barriers to change were similar to those reported previously. Residents' commitment to medicine and family medicine was still strong and was not associated with their opinions about length of training. Although most surveyed residents favored a 3-year residency program, a substantial minority still supported extending training to 4 years, and the majority would still choose to enter family medicine programs if they were extended. Given a lack of consensus about specific content areas, family medicine should consider a period of experimentation to determine how to best prepare future family physicians.
Strengthening Refugee Families: Designing Programs for Refugee and Other Families in Need.
ERIC Educational Resources Information Center
Scheinfeld, Daniel; Wallach, Lorraine B.; Langendorf, Trudi
This manual details the principles and practices of the Refugee Families Program (RFP) in Chicago and the issues that have arisen in connecting these families to the educational, medical, welfare, and other institutions that can provide the family-strengthening support they need. The approach of RFP is to work with families through their…
The central city site: an urban underserved family medicine training track.
Bade, Elizabeth; Baumgardner, Dennis; Brill, John
2009-01-01
We describe the development of an urban track in family medicine residency designed to recruit a high percentage of minority students and promote their future practice in urban, underserved areas of Milwaukee. We report here on the residents and their first practice location and compared this information to what occurred in our original "main" residency program. Information about the program's development was obtained through testimonials from faculty and residency graduates and review of the original accreditation application to the Residency Review Committee. Information about the residents and their practice locations was obtained from the National Resident Matching Program and graduate placement data. The goal of training more minority doctors in Milwaukee was met, with eight of 16 (50%) residents at our urban-track site from minority groups. This compared to only 12% at our main program. Thirty-eight percent of graduates stayed to practice in an underserved area, compared to only 21% in our main program. Development of an urban track for our family medicine residency increased the number of minority physicians trained and the number of physicians practicing in underserved areas after graduation.
Infusing Family-Centered Practices into Agency Administration. Project Ta-kos.
ERIC Educational Resources Information Center
Parham, Patricia; McMahon, Patricia
This self-study manual for program administrators serving young special needs children and their families gives an overview of agency administration from the perspective of a family-centered approach. The areas of agency administration include: (1) family-centered philosophy and sound management practices; (2) governance; (3) mission; (4)…
ERIC Educational Resources Information Center
Illinois Literacy Resource Development Center, Rantoul.
Seven model family literacy programs in Illinois were monitored for one year to determine successful program components and characteristics and to assist local programs in developing and implementing practical evaluation systems. Six were networking programs each of which involved several agencies, and one program was designed on a center-based…
Capitalizing on Parent and Family Partnerships through Programming
ERIC Educational Resources Information Center
Ward-Roof, Jeanine A.; Heaton, Patrick M.; Coburn, Mary B.
2008-01-01
Interaction with parents and family members continues to increase college campuses across the nation. This article describes best practices for communicating with and programming for parents and family members of enrolled students. These include orientation, electronic outreach and communication, parent-family weekends, younger siblings events,…
Pathways to rural family practice at Memorial University of Newfoundland.
Rourke, James; O'Keefe, Danielle; Ravalia, Mohamed; Moffatt, Scott; Parsons, Wanda; Duggan, Norah; Stringer, Katherine; Jong, Michael; Walsh, Kristin Harris; Hippe, Janelle
2018-03-01
To assess Memorial University of Newfoundland's (MUN's) commitment to a comprehensive pathways approach to rural family practice, and to determine the national and provincial effects of applying this approach. Analysis of anonymized secondary data. Canada. Memorial's medical degree (MD) graduates practising family medicine in Newfoundland and Labrador as of January 2015 (N = 305), MUN's 2011 and 2012 MD graduates (N = 120), and physicians who completed family medicine training programs in Canada between 2004 and 2013 and who were practising in Canada 2 years after completion of their postgraduate training (N = 8091). National effect was measured by the proportion of MUN's family medicine program graduates practising in rural Canada compared with those from other Canadian family medicine training programs. Provincial effect was measured by the location of MUN's MD graduates practising family medicine in Newfoundland and Labrador as of January 2015. Commitment to a comprehensive pathways approach to rural family practice was measured by anonymized geographic data on admissions, educational placements, and practice locations of MUN's 2011 and 2012 MD graduates, including those who completed family medicine residencies at MUN. Memorial's comprehensive pathways approach to training physicians for rural practice was successful on both national and provincial levels: 26.9% of MUN family medicine program graduates were in a rural practice location 2 years after exiting their post-MD training from 2004 to 2013 compared with the national rate of 13.3% (national effect); 305 of MUN's MD graduates were practising family medicine in Newfoundland and Labrador as of 2015, with 36% practising in rural areas (provincial effect). Of 114 MD students with known background who graduated in 2011 and 2012, 32% had rural backgrounds. Memorial's 2011 and 2012 MD graduates spent 20% of all clinical placement weeks in rural areas; of note, 90% of all first-year placements and 95% of third-year family medicine clerkship placements were rural. For the 25 MUN 2011 and 2012 MD graduates who also completed family medicine residencies at MUN, 38% of family medicine placement weeks were spent in rural communities or rural towns. Of the 30 MUN 2011 and 2012 MD graduates practising family medicine in Canada as of January 2015, 42% were practising in rural communities or rural towns; 73% were practising in Newfoundland and Labrador and half of those were in rural communities and rural towns. A comprehensive rural pathways approach that includes recruiting rural students and exposing all medical students to extensive rural placements and all family medicine residents to rural family practice training has resulted in more rural generalist physicians in family practice in Newfoundland and Labrador and across Canada. Copyright© the College of Family Physicians of Canada.
Beyond Parenting Practices: Family Context and the Treatment of Pediatric Obesity
ERIC Educational Resources Information Center
Kitzmann, Katherine M.; Dalton, William T., III; Buscemi, Joanna
2008-01-01
Many family-based treatments for pediatric obesity teach specific parenting practices related to weight management. Although youth in these programs show increases in positive health behaviors and reductions in the extent to which they are overweight, most remain overweight after treatment. A recent trend is to create tailored programs for…
Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve
2014-09-01
To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Interviews and focus groups were conducted. Nanaimo, BC. A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients' perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. Copyright© the College of Family Physicians of Canada.
Pathways to rural family practice at Memorial University of Newfoundland
Rourke, James; O’Keefe, Danielle; Ravalia, Mohamed; Moffatt, Scott; Parsons, Wanda; Duggan, Norah; Stringer, Katherine; Jong, Michael; Walsh, Kristin Harris; Hippe, Janelle
2018-01-01
Abstract Objective To assess Memorial University of Newfoundland’s (MUN’s) commitment to a comprehensive pathways approach to rural family practice, and to determine the national and provincial effects of applying this approach. Design Analysis of anonymized secondary data. Setting Canada. Participants Memorial’s medical degree (MD) graduates practising family medicine in Newfoundland and Labrador as of January 2015 (N = 305), MUN’s 2011 and 2012 MD graduates (N = 120), and physicians who completed family medicine training programs in Canada between 2004 and 2013 and who were practising in Canada 2 years after completion of their postgraduate training (N = 8091). Main outcome measures National effect was measured by the proportion of MUN’s family medicine program graduates practising in rural Canada compared with those from other Canadian family medicine training programs. Provincial effect was measured by the location of MUN’s MD graduates practising family medicine in Newfoundland and Labrador as of January 2015. Commitment to a comprehensive pathways approach to rural family practice was measured by anonymized geographic data on admissions, educational placements, and practice locations of MUN’s 2011 and 2012 MD graduates, including those who completed family medicine residencies at MUN. Results Memorial’s comprehensive pathways approach to training physicians for rural practice was successful on both national and provincial levels: 26.9% of MUN family medicine program graduates were in a rural practice location 2 years after exiting their post-MD training from 2004 to 2013 compared with the national rate of 13.3% (national effect); 305 of MUN’s MD graduates were practising family medicine in Newfoundland and Labrador as of 2015, with 36% practising in rural areas (provincial effect). Of 114 MD students with known background who graduated in 2011 and 2012, 32% had rural backgrounds. Memorial’s 2011 and 2012 MD graduates spent 20% of all clinical placement weeks in rural areas; of note, 90% of all first-year placements and 95% of third-year family medicine clerkship placements were rural. For the 25 MUN 2011 and 2012 MD graduates who also completed family medicine residencies at MUN, 38% of family medicine placement weeks were spent in rural communities or rural towns. Of the 30 MUN 2011 and 2012 MD graduates practising family medicine in Canada as of January 2015, 42% were practising in rural communities or rural towns; 73% were practising in Newfoundland and Labrador and half of those were in rural communities and rural towns. Conclusion A comprehensive rural pathways approach that includes recruiting rural students and exposing all medical students to extensive rural placements and all family medicine residents to rural family practice training has resulted in more rural generalist physicians in family practice in Newfoundland and Labrador and across Canada. PMID:29540400
Training in interprofessional collaboration
Paré, Line; Maziade, Jean; Pelletier, Francine; Houle, Nathalie; Iloko-Fundi, Maximilien
2012-01-01
Abstract Problem addressed A number of agencies that accredit university health sciences programs recently added standards for the acquisition of knowledge and skills with respect to interprofessional collaboration. Within primary care settings there are no practical training programs that allow students from different disciplines to develop competencies in this area. Objective of the program The training program was developed within family medicine units affiliated with Université Laval in Quebec for family medicine residents and trainees from various disciplines to develop competencies in patient-centred, interprofessional collaborative practice in primary care. Program description Based on adult learning theories, the program was divided into 3 phases—preparing family medicine unit professionals, training preceptors, and training the residents and trainees. The program’s pedagogic strategies allowed participants to learn with, from, and about one another while preparing them to engage in contemporary primary care practices. A combination of quantitative and qualitative methods was used to evaluate the implementation process and the immediate results of the training program. Conclusion The training program had a positive effect on both the clinical settings and the students. Preparation of clinical settings is an important issue that must be considered when planning practical interprofessional training. PMID:22611607
A Decade of Family Literacy: Programs, Outcomes, and Future Prospects. Information Series.
ERIC Educational Resources Information Center
Padak, Nancy; Sapin, Connie; Baycich, Dianna
This paper reviews and synthesizes reports about family literacy programs and practices, focusing on outcomes for adult learners. Emphasis is on resources available in the ERIC database beginning in 1990. Section 1 on programs reviews sometimes conflicting definitions of family literacy and finds that a common thread is strengthening…
Empowering Family Caregivers: The Powerful Tools for Caregiving Program
ERIC Educational Resources Information Center
Boise, Linda; Congleton, Leslie; Shannon, Kathy
2005-01-01
"Powerful Tools for Caregiving" is an education program for family caregivers of older adults. Based on a self-efficacy model, the program empowers family caregivers to reduce negative effects of caregiving and to practice self-care. Through a train-the-trainer approach, professional and community volunteers were trained as class leaders and…
Doebbeling, C C; Pitkin, A K; Malis, R; Yates, W R
2001-12-01
Despite tremendous growth in the number of combined-training residency programs, little is known about their directorships, financing, recruitment, curricula, and attrition rates, and the practice patterns of graduates. The authors surveyed residency program directors from combined internal medicine-psychiatry (IM/PSY) and family medicine-psychiatry (FP/PSY) programs to provide initial descriptive information. Programs' directors were determined from the American Medical Association's Graduate Medical Education Directory and FREIDA online database. Three mailings of a pretested questionnaire were sent to the 40 identified combined IM/PSY and FP/PSY residency programs. A total of 32 directors from 29 programs responded. Most programs were under the dual directorship of representatives from both the psychiatry department and either the internal medicine or the family medicine program. Although most directors responded that the residency program was based in psychiatry, both departments shared in administrative, recruiting, and financial responsibilities. Curricula varied widely, with limited focus on combined training experiences. Graduates (n = 41) tended to practice in academic settings (37%), where both aspects of training could be used. Others practiced in either community mental health centers or traditional private practice settings. The estimated attrition rate from combined residencies was 11%. Combined-training programs are directed by a diverse group of individuals, including dual-boarded physicians. Curricula vary widely, but most programs are within recommended guidelines. Further prospective studies are warranted to determine predictors of attrition and future practice plans.
The accelerated residency program: the Marshall University family practice 9-year experience.
Petrany, Stephen M; Crespo, Richard
2002-10-01
In 1989, the American Board of Family Practice (ABFP) approved the first of 12 accelerated residency programs in family practice. These experimental programs provide a 1-year experience for select medical students that combines the requirements of the fourth year of medical school with those of the first year of residency, reducing the total training time by 1 year. This paper reports on the achievements and limitations of the Marshall University accelerated residency program over a 9-year period that began in 1992. Several parameters have been monitored since the inception of the accelerated program and provide the basis for comparison of accelerated and traditional residents. These include initial resident characteristics, performance outcomes, and practice choices. A total of 16 students were accepted into the accelerated track from 1992 through 1998. During the same time period, 44 residents entered the traditional residency program. Accelerated resident tended to be older and had more career experience than their traditional counterparts. As a group, the accelerated residents scored an average of 30 points higher on the final in-training exams provided by the ABFP. All residents in both groups remained at Marshall to complete the full residency training experience, and all those who have taken the ABFP certifying exam have passed. Accelerated residents were more likely to practice in West Virginia, consistent with one of the initial goals for the program. In addition, accelerated residents were more likely to be elected chief resident and choose an academic career than those in the traditional group. Both groups opted for small town or rural practice equally. The Marshall University family practice 9-year experience with the accelerated residency track demonstrates that for carefully selected candidates, the program can provide an overall shortened path to board certification and attract students who excel academically and have high leadership potential. Reports from other accelerated programs are needed to fully assess the outcomes of this experiment in postgraduate medical education.
Identifying the need for curriculum change. When a rural training program needs reform.
Whiteside, C; Pope, A; Mathias, R
1997-08-01
To identify what changes should be made in the University of British Columbia's rural family practice training program curriculum to help graduates be better prepared to practice. Two cross-sectional surveys via mailed questionnaires: one designed to measure physicians' self-reported preparedness for practice and the other to measure the importance of various rural family medicine components. Rural training program graduates and preceptors representing rural communities in British Columbia. Thirty-nine graduates of the rural training program between 1982 and 1991 and 14 community-based rural training program preceptors representing eight communities throughout the province participated in this study. Percentage of graduates of the rural program who reported themselves to be underprepared on each family practice item and preceptors' mean scores for the attributed importance to rural practice of each item on this questionnaire. A list of curriculum areas most in need of reform was created. This list included trauma, counseling skills, radiology, vacuum extraction, fracture care, exercising community leadership, cost-effective use of diagnostic tests, using community health resources, obtaining hospital privileges, ophthalmology, dermatology, otolaryngology, personal and professional growth, relationships with other physicians, and personnel issues. Using both the level of graduates' self-reported underpreparedness and the attributed importance of elements of rural practice, as indicated by the preceptor survey, we developed a list of the areas of the rural training program curriculum most in need of reform.
ERIC Educational Resources Information Center
Al-Hadad, Nawal Khalil
2010-01-01
Family-professional partnership has been considered a recommended practice in Early Intervention/Early Childhood Special Education (EI/ECSE) programs for young children with disabilities and their families for the past two decades. The importance of establishing successful partnerships between families and professionals in educational planning has…
ERIC Educational Resources Information Center
Tao, Fumiyo; Ricciuti, Anne; St.Pierre, Robert
2003-01-01
The Even Start Family Literacy Program addresses the basic educational needs of parents and children from birth through age seven from low-income families. The program provides unified, multi-component services consisting of (1) interactive literacy activities between parents and their children; (2) training for parents to be the primary teachers…
Family practice residencies in community health centers--an approach to cost and access concerns.
Zweifler, J
1995-01-01
An inadequate number of trained primary care clinicians limits access to care at Community Health Centers. If family practice residents working in these centers can provide care to patients at a cost that is comparable to the center's hiring its own physicians, then expansion of Family Practice Residency Programs into community centers can address both cost and access concerns. A cost-benefit analysis of the Family Practice Residency Program at the Fresno, CA, community center was performed; the community center is affiliated with the University of California at San Francisco. Costs included (a) residents' salaries, (b) supervision of the family practice residents, (c) family practice program costs for educational activities apart from supervision at the community center, and (d) administrative costs attributable to family practice residents in the community center. Benefits were based on the number of patients that residents saw in the community center. Using this approach, a cost of $7,700 per resident per year was calculated. This cost is modest compared with the cost of training residents in inpatient settings. The added costs attributable to training residents in community health centers can be shared with agencies that are concerned with medical education, providing physicians to underserved communities, and increasing the supply of primary care physicians. Redirecting graduate medical education funding from hospitals to selected ambulatory care training centers of excellence would facilitate placing residents in community centers. This change would have the dual advantage of addressing the current imbalance between training in ambulatory care and hospital sites and increasing the capacity of community health centers to meet the health care needs of underserved populations. PMID:7610223
Ting, T Y
1984-09-01
This paper uses map analysis to study the transition of family limitation practice in Taiwan between 1961-80. The innovation-diffusion perspective emphasizes that birth control, particularly contraception, is a recent innovation and is essentially new in human culture. The innovation-diffusion theory assumes that the decline of fertility began in a setting where there was no, or at most very limited, previous practice of birth control. The theory emphasizes the importance of the spread of information. It also assumes that innovation starts in metropolitan centers, diffuses to other urban places with some delay, and penetrates to rural areas still later. Innovation behavior also diffuses from 1 area to another which is culturally and linguistically similar. Although there was some urban to rural diffusion from the Taiwan family planning program, the government supported program provided services more evenly between urban and rural areas, thus somewhat limiting the diffusion effect from the program. For the diffusion of family practice in Taiwan, it is expected that the availability of of information about and means of family limitation practice may effect the rate of the increase of small m values -- an index of family limitation -- in an area. The case study of Pingtung county shows that the demand-side diffusion from urban to rural areas was important in the earlier decade of the transition of family plimitation practice, but distance from urban center was less important as practice became more uniform through diffusion. Ethnicity, whether or not the township was dominated by Hakka or Fukienese, also seems to have played an important role in determining the pace at which the local residents adopted family practice limitation. Hakka townships seem to have adopted family limitation practice more slowly than Fukienese townships about the same distance from the urban center. The map analysis of Pingtung county provides descriptive evidence to support the diffusion of family limitation from urban centers to distant areas, while ethnic variables like Hakka population tend to delay the adoption of family limitation practice. In general, the urban center had higher m values than the surrounding rural areas in Pingtung county and for areas other than the urban center the the level of m values is a negative function of the distance to the urban center.
Value of a regional family practice residency training program site
Fletcher, Sarah; Mullett, Jennifer; Beerman, Steve
2014-01-01
Abstract Objective To examine the perceptions of residents, nurses, and physicians about the effect of a regional family practice residency site on the delivery of health services in the community, as well as on the community health care providers. Design Interviews and focus groups were conducted. Setting Nanaimo, BC. Participants A total of 16 residents, 15 nurses, and 20 physicians involved with the family practice residency training program at the Nanaimo site. Methods A series of semistructured interviews and focus groups was conducted. Transcripts of interviews and focus groups were analyzed thematically by the research team. Main findings Overall, participants agreed that having a family practice residency training site in the community contributed to community life and to the delivery of health services in the following ways: increased community capacity and social capital; motivated positive relationships and attitudes in the hospital and community settings; improved communication and teamwork, as well as accessibility and understanding of the health care system; increased the standard of care; and facilitated the recruitment and retention of family physicians. Conclusion This family practice residency training site was beneficial for the community it served. Future planning for distributed medical education sites should take into account the effects of these sites on the health care community and ensure that they continue to be positive influences. Further research in this area could focus on patients’ perceptions of how residency programs affect their care, as well as on the effect of residency programs on wait times and workload for physicians and nurses. PMID:25217693
The Social Welfare Practice and Research Center at the Chinese University of Hong Kong
ERIC Educational Resources Information Center
Shek, Daniel T. L.
2009-01-01
The organization and research programs of the Social Welfare Practice and Research Centre (SWPRC) at the Chinese University of Hong Kong are outlined. There are five regular research programs (Family and Group Practice Research Centre, Human Behavior and the Social Environment Research Program, Mutual Aid and Social Capital Research Program,…
ERIC Educational Resources Information Center
Kister, Joanna; And Others
This Personal Development Resource Guide is intended to help teachers implement Ohio's Work and Family Life Program. Course content focuses on the practical problems faced by adolescents at the critical stage of their development. These practical problems are posed through case studies and shared experiences and examined using critical questions…
Berkel, Cady; Mauricio, Anne M; Sandler, Irwin N; Wolchik, Sharlene A; Gallo, Carlos G; Brown, C Hendricks
2017-12-14
This study tests a theoretical cascade model in which multiple dimensions of facilitator delivery predict indicators of participant responsiveness, which in turn lead to improvements in targeted program outcomes. An effectiveness trial of the 10-session New Beginnings Program for divorcing families was implemented in partnership with four county-level family courts. This study included 366 families assigned to the intervention condition who attended at least one session. Independent observers provided ratings of program delivery (i.e., fidelity to the curriculum and process quality). Facilitators reported on parent attendance and parents' competence in home practice of program skills. At pretest and posttest, children reported on parenting and parents reported child mental health. We hypothesized effects of quality on attendance, fidelity and attendance on home practice, and home practice on improvements in parenting and child mental health. Structural Equation Modeling with mediation and moderation analyses were used to test these associations. Results indicated quality was significantly associated with attendance, and attendance moderated the effect of fidelity on home practice. Home practice was a significant mediator of the links between fidelity and improvements in parent-child relationship quality and child externalizing and internalizing problems. Findings provide support for fidelity to the curriculum, process quality, attendance, and home practice as valid predictors of program outcomes for mothers and fathers. Future directions for assessing implementation in community settings are discussed.
Obstetrical Practice and Training in Canadian Family Medicine: Conserving an Endangered Species
Klein, Michael; Reynolds, J. L.; Boucher, Francois; Malus, Michael; Rosenberg, Ellen
1984-01-01
Family practice obstetricians are an endangered species. Our practices and teaching sites must provide the correct attitudinal as well as technical messages to result in a practitioner who will be able to meet the psychosocial and medical needs of the pregnant couple. Family practice obstetrics can be as safe as care given by obstetricians provided that the family practice group functions well, that obstetrical consultants are available and supportive, and assuming that technical approaches are reserved for those truly in need. In rural areas, obstetrical ability is essential, whilst in the urban setting it helps the family physician maintain a practice involving young families. Those trainees who fail to learn basic obstetrical skills (including family centered attitudes and approaches) may in any setting come to feel, belatedly, that their training programs failed in this respect. PMID:21279123
ERIC Educational Resources Information Center
Hagan, Melissa J.; Tein, Jenn-Yun; Sandler, Irwin N.; Wolchik, Sharlene A.; Ayers, Tim S.; Luecken, Linda J.
2012-01-01
This study tested the effect of the Family Bereavement Program (FBP), a preventive intervention for bereaved families, on effective parenting (e.g., caregiver warmth, consistent discipline) 6 years after program completion. Families (n = 101; 69% female caregivers; 77% Caucasian, 11% Hispanic) with children between ages 8 and 16 who had…
[Residency in family medicine: problems and solutions].
Boulé, Richard; Girard, Gilles
2003-04-01
To identify the problems encountered by residents during training and the solutions they proposed. Qualitative study. Family practice program at Sherbrooke University. Sixty-eight residents in the Family practice program between 1999 and 2000. We used the nominal group technique with four groups of participants. Then we held five 3-hour discussion groups to explore difficulties and solutions in depth. Finally, data were validated with a written questionnaire. At least 20% of respondents confirmed 65 difficulties and 61 solutions. Three major themes emerged: the many demands of the residence program, residents' personal experience of the program, and the lack of time for personal life. Publication of these results could help residents develop proactive adaptive strategies to deal with the stress of their training programs. Certain adjustments will be made by the program administration to make it easier for residents to manage their stress.
Family, School, and Community Partnerships: Practical Strategies for Afterschool Programs
ERIC Educational Resources Information Center
Finn-Stevenson, Matia
2014-01-01
Much attention is given today to the importance of forging family, school, and community partnerships. Growing numbers of schools, many of them with afterschool programs, are dedicating resources to support and sustain relationships with families and community-based organizations. And, among government agencies and the philanthropic sector, there…
ERIC Educational Resources Information Center
Longhurst, Mark F.
1994-01-01
Dialogue with Canadian family practice faculty and teachers indicates that the mentorship experience is one that cannot be assigned to a learner. Examines aspects of a mentorship that can be ascribed and explored in a family practice residency training program. (LZ)
Translating learning into practice
Armson, Heather; Kinzie, Sarah; Hawes, Dawnelle; Roder, Stefanie; Wakefield, Jacqueline; Elmslie, Tom
2007-01-01
PROBLEM ADDRESSED The need for effective and accessible educational approaches by which family physicians can maintain practice competence in the face of an overwhelming amount of medical information. OBJECTIVE OF PROGRAM The practice-based small group (PBSG) learning program encourages practice changes through a process of small-group peer discussion—identifying practice gaps and reviewing clinical approaches in light of evidence. PROGRAM DESCRIPTION The PBSG uses an interactive educational approach to continuing professional development. In small, self-formed groups within their local communities, family physicians discuss clinical topics using prepared modules that provide sample patient cases and accompanying information that distils the best evidence. Participants are guided by peer facilitators to reflect on the discussion and commit to appropriate practice changes. CONCLUSION The PBSG has evolved over the past 15 years in response to feedback from members and reflections of the developers. The success of the program is evidenced in effect on clinical practice, a large and increasing number of members, and the growth of interest internationally. PMID:17872876
Lacasse, Miriam; Ratnapalan, Savithiri
2009-09-01
To review the literature on teaching-skills training programs for family medicine residents and to identify formats and content of these programs and their effects. Ovid MEDLINE (1950 to mid-July 2008) and the Education Resources Information Center database (pre-1966 to mid-July 2008) were searched using and combining the MeSH terms teaching, internship and residency, and family practice; and teaching, graduate medical education, and family practice. The initial MEDLINE and Education Resources Information Center database searches identified 362 and 33 references, respectively. Titles and abstracts were reviewed and studies were included if they described the format or content of a teaching-skills program or if they were primary studies of the effects of a teaching-skills program for family medicine residents or family medicine and other specialty trainees. The bibliographies of those articles were reviewed for unidentified studies. A total of 8 articles were identified for systematic review. Selection was limited to articles published in English. Teaching-skills training programs for family medicine residents vary from half-day curricula to a few months of training. Their content includes leadership skills, effective clinical teaching skills, technical teaching skills, as well as feedback and evaluation skills. Evaluations mainly assessed the programs' effects on teaching behaviour, which was generally found to improve following participation in the programs. Evaluations of learner reactions and learning outcomes also suggested that the programs have positive effects. Family medicine residency training programs differ from all other residency training programs in their shorter duration, usually 2 years, and the broader scope of learning within those 2 years. Few studies on teaching-skills training, however, were designed specifically for family medicine residents. Further studies assessing the effects of teaching-skills training in family medicine residents are needed to stimulate development of adapted programs for the discipline. Future research should also assess how residents' teaching-skills training can affect their learners' clinical training and eventually patient care.
Family-Directed Child Evaluation and Assessment under IDEA: Lessons from Families and Programs.
ERIC Educational Resources Information Center
Berman, Carol; Shaw, Evelyn
This report discusses policies and practices for family-directed child evaluation and assessment under the Individuals with Disabilities Education Act (IDEA). The scope of the report includes practices across the early childhood spectrum, from birth through 5 years. Commonly used terminology is defined. Issues discussed include: the primacy of…
Family and Consumer Sciences Education. Vocational Education Program Courses Standards.
ERIC Educational Resources Information Center
Florida State Dept. of Education, Tallahassee. Div. of Applied Tech., Adult, and Community Education.
This document contains vocational education program course standards (curriculum frameworks and student performance standards) for exploratory courses, practical arts courses, and job preparatory programs offered at the secondary and postsecondary level as part of the family and consumer sciences component of Florida's comprehensive vocational…
Code of Federal Regulations, 2011 CFR
2011-10-01
... sponsorship includes approved residencies in family practice, internal medicine, pediatrics, or a categorical first-year program in family practice, internal medicine, or pediatrics; (2) a rotating internship in...
Impact of rural training on physician work force: the role of postresidency education.
Acosta, D A
2000-01-01
Many innovative strategies have been developed over the years to improve the recruitment and retention of physicians in the shortage areas of rural America. These strategies have met with varying success. Postresidency education, or fellowship training, for family physicians is yet another strategy that has been developed for the same purpose. Most applicants have been interested in obstetrical and rural health fellowship programs as a means for preparing for rural practice. This paper describes these programs (demographics, funding, applicant pool, curriculum) and reviews their graduate outcomes (practice location after matriculation, clinical privileges). Twenty-nine obstetrical and nine rural health fellowships are currently operational in the United States. Fellows who complete a rural health fellowship have a higher tendency to locate in rural settings. Almost all graduates from obstetrical and rural health programs attain general hospital privileges in family practice, including low-risk obstetrics. A significant number of graduates from both types of programs attain privileges in high-risk and operative obstetrics as well. Fellowship training can play an integral role in the preparation of family physicians for rural practice.
ERIC Educational Resources Information Center
Rahimi, Mohd Khairul Anuar
2017-01-01
This phenomenological study explored the experiences of international students in CACREP-accredited marriage, couple, and family counseling programs. Seven former international students from the program who have practiced counseling in their home country were interviewed to understand their learning experiences, adaptation process and counseling…
Facilitating Family Group Inquiry at Science Museum Exhibits
ERIC Educational Resources Information Center
Gutwill, Joshua P.; Allen, Sue
2010-01-01
We describe a study of programs to deepen families' scientific inquiry practices in a science museum setting. The programs incorporated research-based learning principles from formal and informal educational environments. In a randomized experimental design, two versions of the programs, called "inquiry games," were compared to two control…
Nelson, Gregory C; Gruca, Thomas S
2017-06-01
States are seeking ways to retain primary care physicians trained within their borders. We analyzed the 5-year retention and rural Iowa location decisions for 1,645 graduates of the Iowa Family Medicine Training Network (IFMTN)-eight residency programs (in seven different cities) that are affiliated with the Carver College of Medicine (University of Iowa). Data from 1977-2014 includes 98.5% of active graduates. Location in Iowa 5 years after graduation was the dependent variable in a binary logistic regression. A second model used rural location in Iowa as the dependent variable. Independent variables included graduation year cohort, IMG status, sex, undergraduate medical training in Iowa, medical degree, and residency location. Undergraduate medical training in Iowa was strongly related to retention. Compared to graduates of the AMC residency, graduates of six of the seven community-based programs were significantly more likely to be practicing in Iowa. While the overall proportion of graduates practicing in rural Iowa was high (47.3%), women and IMGs were significantly less likely to practice in rural areas. Graduates of the Mason City program were significantly more likely to practice in a rural area after graduation. The experience of the IFMTN suggests that educating family physicians in community-based programs contributes significantly to in-state retention even 5 years after graduation. While all programs contribute to the rural FM workforce in Iowa, the residency program located in a rural community (Mason City) has a disproportionately positive impact.
Teaching-skills training programs for family medicine residents
Lacasse, Miriam; Ratnapalan, Savithiri
2009-01-01
ABSTRACT OBJECTIVE To review the literature on teaching-skills training programs for family medicine residents and to identify formats and content of these programs and their effects. DATA SOURCES Ovid MEDLINE (1950 to mid-July 2008) and the Education Resources Information Center database (pre-1966 to mid-July 2008) were searched using and combining the MeSH terms teaching, internship and residency, and family practice; and teaching, graduate medical education, and family practice. STUDY SELECTION The initial MEDLINE and Education Resources Information Center database searches identified 362 and 33 references, respectively. Titles and abstracts were reviewed and studies were included if they described the format or content of a teaching-skills program or if they were primary studies of the effects of a teaching-skills program for family medicine residents or family medicine and other specialty trainees. The bibliographies of those articles were reviewed for unidentified studies. A total of 8 articles were identified for systematic review. Selection was limited to articles published in English. SYNTHESIS Teaching-skills training programs for family medicine residents vary from half-day curricula to a few months of training. Their content includes leadership skills, effective clinical teaching skills, technical teaching skills, as well as feedback and evaluation skills. Evaluations mainly assessed the programs’ effects on teaching behaviour, which was generally found to improve following participation in the programs. Evaluations of learner reactions and learning outcomes also suggested that the programs have positive effects. CONCLUSION Family medicine residency training programs differ from all other residency training programs in their shorter duration, usually 2 years, and the broader scope of learning within those 2 years. Few studies on teaching-skills training, however, were designed specifically for family medicine residents. Further studies assessing the effects of teaching-skills training in family medicine residents are needed to stimulate development of adapted programs for the discipline. Future research should also assess how residents’ teaching-skills training can affect their learners’ clinical training and eventually patient care. PMID:19752261
Teen Pregnancy Prevention Programs: Linking Research and Practice.
ERIC Educational Resources Information Center
Johns, Marilyn J.; Moncloa, Fe; Gong, Elizabeth J.
2000-01-01
Assessments of schools and community agencies with teen pregnancy prevention programs (n=23) in three California counties were conducted using surveys, interviews, and site visits. Best practices identified included youth development programs, Involvement of family and other caring adults, and culturally appropriate and locally relevant…
Peer support and peer-led family support for persons living with schizophrenia.
Duckworth, Kenneth; Halpern, Lisa
2014-05-01
Peer support and peer-led family psychoeducation represent two distinct and complementary recovery-oriented models to support individuals who live with schizophrenia and their families, respectively. The goals of these models focus on improving knowledge, coping, self-care, social support, and self-management strategies. These models represent important capacity-building strategies for people who live with the illness and the people who love them. This brief article is intended to provide the practicing clinician, person living with schizophrenia, and policy maker with a working knowledge of the current state of the literature in these two related fields. Practitioners should consider these resources and integrate them into their care. A person living with schizophrenia could use this review to advocate for appropriate resources and to identify career opportunities. Policy makers could benefit from an understanding of the literature to mitigate financial and cultural barriers to adopting these practices. The last 5 years have seen a dramatic expansion of the application of randomized controlled trials (RCTs) to give evidence to match the experience of people in these programs. The field has seen Wellness Recovery Action Plan (WRAP) named as evidence-based practice by the National Registry of Evidence-Based Practices. A RCT was also conducted for another peer-developed and led program called Building Recovery of Individual Dreams & Goals through Education & Support. Family to Family, the largest peer-led family psychoeducation course, was also found to have significant impact after the study and also 6 months later in RCT. Family to Family has also been named as an evidence-based practice. The field of people who are living well with schizophrenia working as resources and supports to others living with the illness is an idea that is growing momentum. This momentum has been matched by the RCT evidence. Peer support as a professional role has an emerging literature that needs to be grown. WRAP and National Alliance on Mental Illness's Family to Family program are evidence-based practices and widely available. Peer support and peer-led family support for persons living with schizophrenia is a nascent field with much potential.
1991-07-25
will cause a restructuring of the health care delivery system to nore closely reAmble civilian managed care models. •Manged Care There is no single ...health care system throxjh the PCP ( single arrow). The RCP decides if thre is need for care beyond the PCPs scope of practice and coordinates for the...availability, * 0 Family Practice 31 Arm MTFs must met the needs of the client, or patient, to ensure the sucess of any program. This is exaipllfied
Residency research requirements and the CanMEDS-FM scholar role
Koo, Jonathan; Bains, Jason; Collins, Marisa B.; Dharamsi, Shafik
2012-01-01
Abstract Objective To explore the perspectives of family medicine residents and recent family medicine graduates on the research requirements and other CanMEDS scholar competencies in family practice residency training. Design Semistructured focus groups and individual interviews. Setting Family practice residency program at the University of British Columbia in Vancouver. Participants Convenience sample of 6 second-year family medicine residents and 6 family physicians who had graduated from the University of British Columbia family practice residency program within the previous 5 years. Methods Two focus groups with residents and individual interviews with each of the 6 recently graduated physicians. All interviews were audiotaped, transcribed, and analyzed for thematic content. Main findings Three themes emerged that captured key issues around research requirements in family practice training: 1) relating the scholar role to family practice, 2) realizing that scholarship is more than simply the creation or discovery of new knowledge, and 3) addressing barriers to integrating research into a clinical career. Conclusion Creation of new medical knowledge is just one aspect of the CanMEDS scholar role, and more attention should be paid to the other competencies, including teaching, enhancing professional activities through ongoing learning, critical appraisal of information, and learning how to better contribute to the dissemination, application, and translation of knowledge. Research is valued as important, but opinions still vary as to whether a formal research study should be required in residency. Completion of residency research projects is viewed as somewhat rewarding, but with an equivocal effect on future research intentions. PMID:22859631
Transforming an MFT Program: A Model for Enhancing Diversity
ERIC Educational Resources Information Center
McDowell, Teresa; Fang, Shi-Ruei; Brownlee, Kenya; Young, Cecilia Gomez; Khanna, Anchal
2002-01-01
Marriage and family therapy programs need to go beyond the typical practices of recruiting and retaining students of color. Marriage and family therapy educators must assume positions of leadership by transforming graduate programs to reflect a deep, active, systemic commitment to both diversity and social justice. In this article, we argue that…
A School-Based Outreach Program in Adolescent Health
Malus, Michael
1986-01-01
Teenagers are often in a medical care vacuum. They avoid institutions and often see the family physician as part of the family setting of which they are striving to achieve independence. This article describes a school-based outreach program which has resulted in the creation of a Teenage Health Unit within a family-practice centre. PMID:21267228
Misyak, Sarah; Ledlie Johnson, Meredith; McFerren, Mary; Serrano, Elena
2014-01-01
To explore Family Nutrition Program assistants' perception of farmers' markets and alternative agricultural practices for themselves and their clients. Cross-section design, survey of Virginia Expanded Food and Nutrition Education Program (NEP) and Supplemental Nutrition Assistance Program-Education Family Nutrition Program assistants (n = 52) working with limited-resource populations. Twenty-one percent to 55% of FNP assistants valued alternative agricultural practices, and only 5% to 8% of FNP assistants perceived that their clients did so. Benefits to shopping at farmers' markets included supporting local economies, and food price, quality, and safety. Barriers included lack of transportation, location/convenience, hours, and food prices. Assistants rated the benefits to shopping at farmers' markets similarly for themselves and their clients, but rated many of the barriers to shopping at farmers' markets as significantly lower (P < .05) for themselves than for their clients. Future assistant trainings should address the connection between agriculture and health, and how to overcome barriers to shopping at farmers' markets for their clients. Copyright © 2014 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Barlow, Sarah E; Butte, Nancy F; Hoelscher, Deanna M; Salahuddin, Meliha; Pont, Stephen J
2017-12-21
Primary care practices can be used to engage children and families in weight management programs. The Texas Childhood Obesity Research Demonstration (TX CORD) study targeted patients at 12 primary care practices in diverse and low-income areas of Houston, Texas, and Austin, Texas for recruitment to a trial of weight management programs. This article describes recruitment strategies developed to benefit both families and health care practices and the modification of electronic health records (EHRs) to reflect recruitment outcomes. To facilitate family participation, materials and programs were provided in English and Spanish, and programs were conducted in convenient locations. To support health care practices, EHRs and print materials were provided to facilitate obesity recognition, screening, and study referral. We provided brief training for providers and their office staffs that covered screening patients for obesity, empathetic communication, obesity billing coding, and use of counseling materials. We collected EHR data from 2012 through 2014, including demographics, weight, and height, for all patients aged 2 to 12 years who were seen in the 12 provider practices during the study's recruitment phase. The data of patients with a body mass index (BMI) at or above the 85th percentile were compared with the same data for patients who were referred to the study and patients who enrolled in the study. We also examined reasons that patients referred to the study declined to participate. Overall, 26% of 7,845 patients with a BMI at or above the 85th percentile were referred to the study, and 27% of referred patients enrolled. Enrollment among patients with a BMI at or above the 85th percentile was associated with being Hispanic and with more severe obesity than with patients of other races/ethnicities or less severe obesity, respectively. Among families of children aged 2 to 5 years who were referred, 20% enrolled, compared with 30% of families of older children (>5 y to 12 y). Referral rates varied widely among the 12 primary care practices, and referral rates were not associated with EHR modifications. Engagement and recruitment strategies for enrolling families in primary care practice in weight management programs should be strengthened. Further study of factors associated with referral and enrollment, better systems for EHR tools, and data on provider and office adherence to study protocols should be examined. EHRs can track referral and enrollment to capture outcomes of recruitment efforts.
Butte, Nancy F.; Hoelscher, Deanna M.; Salahuddin, Meliha; Pont, Stephen J.
2017-01-01
Purpose and Objectives Primary care practices can be used to engage children and families in weight management programs. The Texas Childhood Obesity Research Demonstration (TX CORD) study targeted patients at 12 primary care practices in diverse and low-income areas of Houston, Texas, and Austin, Texas for recruitment to a trial of weight management programs. This article describes recruitment strategies developed to benefit both families and health care practices and the modification of electronic health records (EHRs) to reflect recruitment outcomes. Intervention Approach To facilitate family participation, materials and programs were provided in English and Spanish, and programs were conducted in convenient locations. To support health care practices, EHRs and print materials were provided to facilitate obesity recognition, screening, and study referral. We provided brief training for providers and their office staffs that covered screening patients for obesity, empathetic communication, obesity billing coding, and use of counseling materials. Evaluation Methods We collected EHR data from 2012 through 2014, including demographics, weight, and height, for all patients aged 2 to 12 years who were seen in the 12 provider practices during the study’s recruitment phase. The data of patients with a body mass index (BMI) at or above the 85th percentile were compared with the same data for patients who were referred to the study and patients who enrolled in the study. We also examined reasons that patients referred to the study declined to participate. Results Overall, 26% of 7,845 patients with a BMI at or above the 85th percentile were referred to the study, and 27% of referred patients enrolled. Enrollment among patients with a BMI at or above the 85th percentile was associated with being Hispanic and with more severe obesity than with patients of other races/ethnicities or less severe obesity, respectively. Among families of children aged 2 to 5 years who were referred, 20% enrolled, compared with 30% of families of older children (>5 y to 12 y). Referral rates varied widely among the 12 primary care practices, and referral rates were not associated with EHR modifications. Implications for Public Health Engagement and recruitment strategies for enrolling families in primary care practice in weight management programs should be strengthened. Further study of factors associated with referral and enrollment, better systems for EHR tools, and data on provider and office adherence to study protocols should be examined. EHRs can track referral and enrollment to capture outcomes of recruitment efforts. PMID:29267156
Michael A. Kilgore; John L. Greene; Michael G. Jacobson; Thomas J. Straka; Steven E. Daniels
2007-01-01
Financial incentive programs were evaluated to assess their contribution to promoting sustainable forestry practices on the nationâs family forests. The evaluation consisted of an extensive review of the literature on financial incentive programs, a mail survey of the lead administrator of financial incentive programs in each state forestry agency, and focus groups...
Michael A. Kilgore; John L. Greene; Michael G. Jacobson; Thomas J. Straka; Steven E. Daniels
2006-01-01
Financial incentive programs were evaluated to assess their contribution to promoting sustainable forestry practices on the nationâs family forests. The evaluation consisted of an extensive review of the literature on financial incentive programs, a mail survey of the lead administrator of financial incentive programs in each state forestry agency, and focus groups...
Geriatrics in family practice residency education: an unmet challenge.
Gazewood, John D; Vanderhoff, Bruce; Ackermann, Richard; Cefalu, Charles
2003-01-01
The aging of the US population poses one of the greatest future challenges for family practice residency graduates. At a time when our discipline should be strengthening geriatric education to address the needs of our aging population, the Group on Geriatric Education of the Society of Teachers of Family Medicine believes that recent guidelines from important family medicine organizations suggest that our discipline's interest in geriatric education may be waning. Barriers to improving geriatric education in family practice residencies include limited geriatric faculty, changes in geriatric fellowship training, competing curricular demands, and limited diversity of geriatric training sites. Improving geriatric education in family practice residencies will require greater emphasis on faculty development and integration of geriatric principles throughout family practice residency education. The Residency Review Committee for Family Practice should review the Program Requirements for Residency Education to ensure that geriatric training requirements are consistent with current educational needs. The leadership of family medicine organizations should collaboratively address the need for continued improvement in training our residents to care for older patients and the chronically ill.
Primary Care Physicians' Experience with Disease Management Programs
Fernandez, Alicia; Grumbach, Kevin; Vranizan, Karen; Osmond, Dennis H; Bindman, Andrew B
2001-01-01
OBJECTIVE To examine primary care physicians' perceptions of how disease management programs affect their practices, their relationships with their patients, and overall patient care. DESIGN Cross-sectional mailed survey. SETTING The 13 largest urban counties in California. PARTICIPANTS General internists, general pediatricians, and family physicians. MEASUREMENTS AND MAIN RESULTS Physicians' self-report of the effects of disease management programs on quality of patient care and their own practices. Respondents included 538 (76%) of 708 physicians: 183 (34%) internists, 199 (38%) family practitioners, and 156 (29%) pediatricians. Disease management programs were available 285 to (53%) physicians; 178 had direct experience with the programs. Three quarters of the 178 physicians believed that disease management programs increased the overall quality of patient care and the quality of care for the targeted disease. Eighty-seven percent continued to provide primary care for their patients in these programs, and 70% reported participating in major patient care decisions. Ninety-one percent reported that the programs had no effect on their income, decreased (38%) or had no effect (48%) on their workload, and increased (48%)) their practice satisfaction. CONCLUSIONS Practicing primary care physicians have generally favorable perceptions of the effect of voluntary, primary care-inclusive, disease management programs on their patients and on their own practice satisfaction. PMID:11318911
Family physician practice visits arising from the Alberta Physician Achievement Review
2013-01-01
Background Licensed physicians in Alberta are required to participate in the Physician Achievement Review (PAR) program every 5 years, comprising multi-source feedback questionnaires with confidential feedback, and practice visits for a minority of physicians. We wished to identify and classify issues requiring change or improvement from the family practice visits, and the responses to advice. Methods Retrospective analysis of narrative practice visit reports data using a mixed methods design to study records of visits to 51 family physicians and general practitioners who participated in PAR during the period 2010 to 2011, and whose ratings in one or more major assessment domains were significantly lower than their peer group. Results Reports from visits to the practices of family physicians and general practitioners confirmed opportunities for change and improvement, with two main groupings – practice environment and physician performance. For 40/51 physicians (78%) suggested actions were discussed with physicians and changes were confirmed. Areas of particular concern included problems arising from practice isolation and diagnostic conclusions being reached with incomplete clinical evidence. Conclusion This study provides additional evidence for the construct validity of a regulatory authority educational program in which multi-source performance feedback identifies areas for practice quality improvement, and change is encouraged by supplementary contact for selected physicians. PMID:24010980
ERIC Educational Resources Information Center
Chao, Xia; Mantero, Miguel
2014-01-01
This multi-sited ethnographic study examines the ways in which Latino and Asian immigrant parents' English learning through two church-based ESL programs in a Southeastern U.S. city affects their family literacy and home language practices. It demonstrates that the parents' participation in the programs is an empowering experience promoting ESL…
Integrated Behavioral Health Care in Family Medicine Residencies A CERA Survey.
Jacobs, Christine; Brieler, Jay A; Salas, Joanne; Betancourt, Renée M; Cronholm, Peter F
2018-05-01
Behavioral health integration (BHI) in primary care settings is critical to mental health care in the United States. Family medicine resident experience in BHI in family medicine residency (FMR) continuity clinics is essential preparation for practice. We surveyed FMR program directors to characterize the status of BHI in FMR training. Using the Council of Academic Family Medicine Educational Research Alliance (CERA) 2017 survey, FMR program directors (n=478, 261 respondents, 54.6% response rate) were queried regarding the stage of BHI within the residency family medicine center (FMC), integration activities at the FMC, and the professions of the BH faculty. BHI was characterized by Substance Abuse and Mental Health Services Agency (SAMHSA) designations within FMRs, and chi-square or ANOVA with Tukey honest significant difference (HSD) post hoc testing was used to assess differences in reported BHI attributes. Program directors reported a high level of BHI in their FMCs (44.1% full integration, 33.7% colocated). Higher levels of BHI were associated with increased use of warm handoffs, same day consultation, shared health records, and the use of behavioral health (BH) professionals for both mental health and medical issues. Family physicians, psychiatrists, and psychologists were most likely to be training residents in BHI. Almost half of FMR programs have colocated BH care or fully integrated BH as defined by SAMHSA. Highly integrated FMRs use a diversity of behavioral professionals and activities. Residencies currently at the collaboration stage could increase BH provider types and BHI practices to better prepare residents for practice. Residencies with full BHI may consider focusing on supporting BHI-trained residents transitioning into practice, or disseminating the model in the general primary care community.
Family Therapy for the Drug User: Conceptual and Practical Considerations
ERIC Educational Resources Information Center
Davis, Donald I.; And Others
1978-01-01
National surveys suggest that many drug treatment programs are utilizing family therapy. It is frequently the choice of treatment. Controlled studies of family therapy in drug abuse are sparce but encouraging. (MFD)
Strengthening Family Practices for Latino Families.
Chartier, Karen G; Negroni, Lirio K; Hesselbrock, Michie N
2010-01-01
The study examined the effectiveness of a culturally-adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9-12 year old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted with each family. Parental stress, parent-child dysfunctional relations, and child behavior problems were reduced in the families receiving the intervention; family hardiness and family attachment were improved. Findings contribute to the validation of the SFP with Latinos, and can be used to inform social work practice with Puerto Rican families.
ERIC Educational Resources Information Center
Quadros, Sabrina; Sarroub, Loukia K.
2016-01-01
The lack of research about the Karen, one of 135 ethnic groups from Myanmar limits literacy educators charged with educating this refugee population in public schools. In this case study the authors explore the literacy practices of Karen families when at school and in their homes and within an ESL family literacy program. The case of these…
[Paper on sterilization in the family planning programs of Colombia: a national debate].
Rizo, A; Roper, L
1986-01-01
During 1984, family planning became the object of heated public debate in Colombia. In particular, considerable controversy surrounded the practice of sterilization. In Colombia in 1980, 49% of married women were practicing family planning. The main protagonist has been Profamilia, an IPPF affliate, which runs clinics and advisory services throughout Colombia. Sterilization is performed quite extensively on men of at least 28 years and women of 25 with 3 living children. Further activities of Profamilia include community distribution and social marketing programs. Many of the health facilities used are those of the Ministry of Public Health. The Minister of Health responded to criticism levelled by the Catholic church and others by instituting an investigation into alleged practices of mass sterilization. Profamilia declared publicy that sterilization was performed only under certain conditions, after waiting periods, and under no circumstances with coersion. Various groups including medical associations publicy supported Profamilia. Although recognizing the need for families to be limited in size, religious and other commentators suggested that sterilization was often presented as a solution to family ills, and that it represented foreign involvement in Colombian social policy. The opposing opinions were that church-supported natural family planning was not an effective enough strategy. The ministry has resolved to invoke more stringent screening of women desiring sterilization to include natural family planning in its programs, and to deal with international organizations only on the ministry level. The number of sterilizations has diminished. The controversy helped to expose political weaknesses of Profamilia's programs (e.g. the use of monetary incentives; lack of supervision).
USDA-ARS?s Scientific Manuscript database
Primary care practices can be used to engage children and families in weight management programs. The Texas Childhood Obesity Research Demonstration (TX CORD) study targeted patients at 12 primary care practices in diverse and low-income areas of Houston, Texas, and Austin, Texas for recruitment to ...
Family Supports in the USA: Current Trends in Policy and Practice.
ERIC Educational Resources Information Center
Traustadottir, Rannveig
Family support services are systematic efforts to support natural, adoptive, or foster families who have a family member with a disability. Programs vary in the types of services offered, goals, and number of families served. The most promising approaches to family support provide services that are flexible and individualized, build on informal…
Children of Color and Parental Incarceration: Implications for Research, Theory, and Practice
ERIC Educational Resources Information Center
Graham, James A.; Harris, Yvette R.
2013-01-01
Practical information about culturally appropriate interventions with children of incarcerated parents (CIPs) of color and their families is notably sparse. This study uses a cultural-ecological perspective to contextualize individual, family, and legal issues inherent in many intervention programs for CIPs of color. The authors highlight…
"The Refer Less Resolve More" Initiative: A Five-year Experience from CMC Vellore, India.
Velavan, Jachin
2012-01-01
India's one billion plus strong population presents huge health care needs. Presently, approximately 250,000 general practitioners and 30,000 Government doctors are a part of the Indian healthcare workforce, but 80% of them are based in urban India. Problems which plague healthcare delivery and attributed to physician practice may be enumerated as - physicians (1) lack competencies, (2) lack updating, (3) prescribe irrationally (pressures from pharmaceutical companies and patients), (4) practice unethically, (5) refer excessively to specialists and other clinical professionals, and (6) investigate for diseases without justification. A multi-competent Family Physician who could provide a single-window, ethical, and holistic healthcare to patients and families is the need of the hour. Therefore, training, equipping, and empowering these 250,000 doctors to become such physicians will reduce health costs considerably. Distance medical education using all the andragogic methods can be used to train large number of individuals without displacing them from their work-places. Distance learning provides a useful interface for rapidly developing a specialized pool of doctors practicing and advocating family medicine as most-needed discipline. This motivated CMC Vellore, a premier institution for medical education in India, to start a the "refer less resolve more initiative" by offering "two year family medicine diploma course" by distance mode. This is an innovatively-written program consisting of problem-based self-learning modules, video-lectures, video-conferencing, and face-to-face contact programs. Ten secondary level hospitals, across the country, under the supervision of national and international family medicine faculty form the pillars of this program. This distance learning program offered by CMC Vellore has become the platform for change as there is special focus is on ethics, rational prescribing, consultation skills, application of family medicine principles; and practical demonstration of compassionate, cost-effective and high-quality care. The change in attitude has resulted in transformation in three major aspects of practice: professional, ethical, and patient care. So far, 942 private practitioners and 177 government doctors have been enrolled.
Improving productivity levels: family planning services for factory workers.
Darmokusumo, H V
1989-10-01
In May 1984, the Minister of Manpower in Indonesia, the Chairman of the BKKBN, and representatives of the employers' and workers' organizations of Indonesia issued a joint decree pledging that they would work together to enhance the implementation of the family planning program among workers in the organized sector. 1 objective of the decree is to improve workers' productivity and the standard of living of workers and their families by implementing a family planning program. 1 baseline survey and a clinic-based survey in 5 provinces revealed that 90% of women workers are between 21-40, or are of reproductive age, and are sexually active. Only about 50% are practicing family planning; the other 50% are afraid to practice family planning due to potential side effects of various methods. This fear was most often caused by negative rumors spread by unsatisfied family planning clients. Placing materials for family planning promotion such as instructional posters and video programs advertising contraceptive services in the work setting may increase knowledge and help alleviate some of this fear. Other studies of family planning services show that employees prefer female medical doctors or midwives as service providers, employees are willing to pay for services (but can only afford a small fee), and family planning service points should be near employees' work sites.
Eck, Kaitlyn; Alleman, Gayle Povis; Quick, Virginia; Martin-Biggers, Jennifer; Hongu, Nobuko; Byrd-Bredbenner, Carol
2016-12-01
Community family educators have the opportunity to incorporate childhood obesity prevention concepts in their programming with families of young children, but often lack formal health and nutrition education. The purpose of this feasibility study was to create an online training certificate program for community family educators and assess the program's effectiveness at improving participant's knowledge, attitudes, and intended and actual behaviors related to healthy lifestyles. Community family educators (n = 68) completed an online pretest, viewed 13 brief videos (8-15 min) focused on childhood obesity related topics and took mini-knowledge self-checks after each video followed by an online posttest. At posttest, paired t tests showed participants' childhood obesity prevention related knowledge (i.e., nutrition, physical activity, screen time and sleep) improved significantly (p < 0.001). Participants' attitudes toward parenting behaviors related to feeding practices, family meals, physical activity, screen time control and parent modeling significantly (p < 0.05) improved. Improvements also were seen in participants' intentions to promote obesity prevention behaviors (i.e., age appropriate portions sizes, adequate physically active, and parental role modeling). Furthermore, changes in personal health behaviors at posttest revealed participants had significantly (p < 0.05) greater dietary restraint, improvements in sleep quality, and reductions of use of electronic devices during meals and snacks. Overall, participants were very satisfied with the training program, felt comfortable with skills acquired, and enjoyed the program. Findings suggest this online training program is a feasible and effective method for improving community family educators' knowledge, attitudes, and intentions for obesity-prevention related parenting practices.
Results of the peer assessment program of the College of Physicians and Surgeons of Ontario.
McAuley, R G; Henderson, H W
1984-01-01
This paper describes the experience of the College of Physicians and Surgeons of Ontario in developing and conducting a program for the peer assessment of physicians' office practices that would allow the standards of medical practice to be reviewed and assessed. Following two pilot projects in 1978 and 1979 that demonstrated the need, the feasibility and the acceptance of a peer assessment program the office practices of 391 randomly selected physicians were reviewed in 1981 and 1982. Included in the sample were 255 general/family practitioners and 136 specialists in seven fields. Serious deficiencies were found in the medical records of or in the care provided by 30 of the general/family practitioners and 3 of the specialists, accounting for 8% of the practices studied. The difference between the two groups of physicians was statistically significant (p less than 0.01). No predictors of significance were demonstrated in the general/family practitioner group. When follow-up assessments were done most of the physicians were found to have made the improvements that had been recommended. PMID:6478338
Klein, Doug; Staples, John; Pittman, Carmen; Stepanko, Cheryl
2012-01-01
The traditional needs assessment used in developing continuing medical education programs typically relies on surveying physicians and tends to only capture perceived learning needs. Instead, using tools available in electronic medical record systems to perform a clinical audit on a physician's practice highlights physician-specific practice patterns. The purpose of this study was to test the feasibility of implementing an electronic clinical audit needs assessment process for family physicians in Canada. A clinical audit of 10 preventative care interventions and 10 chronic disease interventions was performed on family physician practices in Alberta, Canada. The physicians used the results from the audit to produce personalized learning needs, which were then translated into educational programming. A total of 26 family practices and 4489 patient records were audited. Documented completion rates for interventions ranged from 13% for ensuring a patient's tetanus vaccine is current to 97% of pregnant patients receiving the recommended prenatal vitamins. Electronic medical record-based needs assessments may provide a better basis for developing continuing medical education than a more traditional survey-based needs assessment. This electronic needs assessment uses the physician's own patient outcome information to assist in determining learning objectives that reflect both perceived and unperceived needs.
Chaufan, Claudia; Yeh, Jarmin; Sigal, Byron
2015-04-01
Nutritional practices develop over the life course. Developing healthy habits at an early age can contribute to combating increasing child obesity rates. Through a range of activities that rely on the presence of an on-site food garden, North Bay Children's Center (NBCC), an early childhood education program, has enacted a "culture of health" into all aspects of the curriculum to promote healthy eating practices among children, families, teachers and staff. NBCC's garden program serves as a model in early childhood education and as a community-based intervention to improve family health and prevent child obesity.
Orlando, Lori A.; Buchanan, Adam H.; Hahn, Susan E.; Christianson, Carol A.; Powell, Karen P.; Skinner, Celette Sugg; Chesnut, Blair; Blach, Colette; Due, Barbara; Ginsburg, Geoffrey S.; Henrich, Vincent C.
2016-01-01
INTRODUCTION Family health history is a strong predictor of disease risk. To reduce the morbidity and mortality of many chronic diseases, risk-stratified evidence-based guidelines strongly encourage the collection and synthesis of family health history to guide selection of primary prevention strategies. However, the collection and synthesis of such information is not well integrated into clinical practice. To address barriers to collection and use of family health histories, the Genomedical Connection developed and validated MeTree, a Web-based, patient-facing family health history collection and clinical decision support tool. MeTree is designed for integration into primary care practices as part of the genomic medicine model for primary care. METHODS We describe the guiding principles, operational characteristics, algorithm development, and coding used to develop MeTree. Validation was performed through stakeholder cognitive interviewing, a genetic counseling pilot program, and clinical practice pilot programs in 2 community-based primary care clinics. RESULTS Stakeholder feedback resulted in changes to MeTree’s interface and changes to the phrasing of clinical decision support documents. The pilot studies resulted in the identification and correction of coding errors and the reformatting of clinical decision support documents. MeTree’s strengths in comparison with other tools are its seamless integration into clinical practice and its provision of action-oriented recommendations guided by providers’ needs. LIMITATIONS The tool was validated in a small cohort. CONCLUSION MeTree can be integrated into primary care practices to help providers collect and synthesize family health history information from patients with the goal of improving adherence to risk-stratified evidence-based guidelines. PMID:24044145
Developing a Family-Centered, Hospital-Based Perinatal Education Program
Westmoreland, Marcia Haskins; Zwelling, Elaine
2000-01-01
The development of a family-centered, comprehensive perinatal education program for a large, urban hospital system is described. This program was developed in conjunction with the building of a new women's center and, although the authors were fortunate that several opportunities for educational program development were linked to this project, many of the steps taken and the lessons learned can be helpful to anyone desiring to develop a similar program. This article relates perinatal education to the principles of family-centered maternity care, outlines the criteria for a quality educational program, gives rationale for this type of program development, and offers practical suggestions for starting or enhancing a perinatal education program within a hospital system. PMID:17273228
Biringer, Anne; Forte, Milena; Tobin, Anastasia; Shaw, Elizabeth; Tannenbaum, David
2018-05-01
To ascertain how program leaders in family medicine characterize success in family medicine maternity care education and determine which factors influence the success of training programs. Qualitative research using semistructured telephone interviews. Purposive sample of 6 family medicine programs from 5 Canadian provinces. Eighteen departmental leaders and program directors. Semistructured telephone interviews were conducted with program leaders in family medicine maternity care. Departmental leaders identified maternity care programs deemed to be "successful." Interviews were audiorecorded and transcribed verbatim. Team members conducted thematic analysis. Participants considered their education programs to be successful in family medicine maternity care if residents achieved competency in intrapartum care, if graduates planned to include intrapartum care in their practices, and if their education programs were able to recruit and retain family medicine maternity care faculty. Five key factors were deemed to be critical to a program's success in family medicine maternity care: adequate clinical exposure, the presence of strong family medicine role models, a family medicine-friendly hospital environment, support for the education program from multiple sources, and a dedicated and supportive community of family medicine maternity care providers. Training programs wishing to achieve greater success in family medicine maternity care education should employ a multifaceted strategy that considers all 5 of the interdependent factors uncovered in our research. By paying particular attention to the informal processes that connect these factors, program leaders can preserve the possibility that family medicine residents will graduate with the competence and confidence to practise full-scope maternity care. Copyright© the College of Family Physicians of Canada.
Hsiao, Chiu-Yueh; Tsai, Yun-Fang
2015-11-01
The aim of this study was to examine factors that influenced the perceptions of mental health nurses about involving families in their nursing practice. A sample of 175 Taiwanese mental health nurses who are employed in both inpatient and community settings completed structured questionnaires designed to measure empathy, attitudes about involving families in care, and perceptions of family nursing practice. Data were analyzed using descriptive statistics, Pearson's product-moment correlation, t test, one-way ANOVA, and a hierarchical multiple regression analysis. Positive perceptions of family nursing practice were correlated with more years of clinical experience in mental health, empathy, supportive attitudes toward the importance of family nursing care, and personal experiences with family members with serious illness in need of professional care. These findings may assist in the development of effective educational programs designed to help nurses integrate family nursing knowledge and skills in the care of patients and families experiencing mental illness. © The Author(s) 2015.
ERIC Educational Resources Information Center
Fujiwara, Takeo; Kato, Noriko; Sanders, Matthew R.
2011-01-01
The purpose of this study is to investigate the effectiveness of a group-based family intervention program known as the Group Positive Parenting Program (Triple P), with families in Japan. Reductions in children's behavioral problems, changes in dysfunctional parenting practices, and affects on parenting adjustment were examined. Participants of…
Martin, Shelly D; Bush, Anneke C; Lynch, Julia A
2006-09-01
Domestic terrorism is a real threat focusing on a need to engage in effective emergency preparedness planning and training. Front-line physicians are an important component of any emergency preparedness plan. Potential victims of an attack include children who have unique physiologic and psychological vulnerabilities in disasters. Front-line providers need to have adequate training to effectively participate in local planning initiatives and to recognize and treat casualties including children. The goal of the survey was to assess the current state of terrorism preparedness training, including child victims, by emergency medicine, family practice, and pediatric residency programs in the United States and to assess methods of training and barriers to establishing effective training. A survey was e-mailed to a comprehensive list of all US pediatric, family practice, and emergency medicine residency programs 3 times between September 2003 and January 2004. The survey measured the perceived risk of terrorist attack, level of training by type of attack, level of training regarding children, method of training, and barriers to training. Overall, 21% of programs responded (46 of 182 pediatric, 75 of 400 family practice, and 29 of 125 emergency medicine programs). Across all of the event types, emergency medicine programs were more likely to report adequate/comprehensive training. However, < 50% of emergency medicine programs report adequate training for children. Didactic classroom-based lectures were the most commonly used method of training. Emergency medicine programs were more likely to use scenario-based exercises. Among programs that use scenario exercises, 93% report that they never (40%) or only sometimes (53%) incorporate child victims into the scenarios. Time, funding, access to subject matter experts, and availability of training material are the most important barriers to effective training. Children are a precious national resource and a vulnerable population in disasters. Despite the availability of terrorism preparedness funding, these data suggest that we are failing to provide adequate training to front-line providers who may care for children in a catastrophic domestic terrorist event.
Clinicians' Perceptions of Screening for Food Insecurity in Suburban Pediatric Practice.
Palakshappa, Deepak; Vasan, Aditi; Khan, Saba; Seifu, Leah; Feudtner, Chris; Fiks, Alexander G
2017-07-01
National organizations recommend pediatricians screen for food insecurity (FI). Although there has been growing research in urban practices, little research has addressed FI screening in suburban practices. We evaluated the feasibility, acceptability, and impact of screening in suburban practices. We conducted a mixed methods study that implemented FI screening in 6 suburban pediatric primary care practices. We included all children presenting for either a 2-, 15-, or 36-month well-child visit ( N = 5645). Families who screened positive were eligible to be referred to our community partner that worked to connect families to the Supplemental Nutrition Assistance Program. We conducted focus groups with clinicians to determine their perceptions of screening and suggestions for improvement. Of the 5645 children eligible, 4371 (77.4%) were screened, of which 122 (2.8%) screened positive for FI (range: 0.9%-5.9% across practices). Of the 122 food-insecure families, only 1 received new Supplemental Nutrition Assistance Program benefits. In focus groups, 3 themes emerged: (1) Time and workflow were not barriers to screening, but concerns about embarrassing families and being unable to provide adequate resources were; (2) Clinicians reported that parents felt the screening showed caring, which reinforced clinicians' continued screening; (3) Clinicians suggested implementing screening before the visit. We found it is feasible and acceptable for clinicians to screen for FI in suburban practices, but the referral method used in this study was ineffective in assisting families in obtaining benefits. Better approaches to connect families to local resources may be needed to maximize the effectiveness of screening in suburban settings. Copyright © 2017 by the American Academy of Pediatrics.
Integrating self-help materials into mental health practice.
Church, Elizabeth; Cornish, Peter; Callanan, Terrence; Bethune, Cheri
2008-10-01
Patients' mental health issues have become an increasing focus of Canadian family physicians' practices. A self-help approach can help meet this demand, but there are few guidelines for professionals about how to use mental health self-help resources effectively. To aid health professionals in integrating self-help materials into their mental health practices. A resource library of print, audiotape, and videotape self-help materials about common mental health issues was developed for a rural community. The materials were prescreened in order to ensure high quality, and health professionals were given training on how to integrate self-help into their practices. The library was actively used by both health professionals and community members, and most resources were borrowed, particularly the nonprint materials. Health professionals viewed the resources as a way to supplement their mental health practice and reduce demands on their time, as patients generally worked through the resources independently. Some improvements are planned for future implementations of the program, such as providing health professionals with a "prescription pad" of resources and implementing Stages of Change and stepped-care models to maximize the program's effectiveness. Although more evidence is needed regarding the effectiveness of self-help within a family practice context, this program offers a promising way for family physicians to address mild to moderate mental health problems.
School, Family, and Community Partnerships: Your Handbook for Action. Second Edition.
ERIC Educational Resources Information Center
Epstein, Joyce L.; Sanders, Mavis G.; Simon, Beth S.; Salinas, Karen Clark; Jansorn, Natalie Rodriguez; Van Voorhis, Frances L.
Despite strong agreement on the importance of parent involvement, most schools, districts, and states still need help in developing comprehensive programs of school, family, and community partnerships. This revised handbook translates lessons learned over 20 years of research and fieldwork into practical solutions for program development. The book…
Lodge Programs Serving Family Functions for People with Psychiatric Disabilities.
ERIC Educational Resources Information Center
Onaga, Esther E.; McKinney, Kathleen G.; Pfaff, Judy
2000-01-01
Interviews were conducted with people affiliated with lodges, a community program for people with psychiatric disabilities, about their perceptions of promising practices. Responses validated the notion that the lodge serves many of the functions of a family. Provides excerpts from interviews to supplement this theme. Discusses implications for…
Compromise in Collaborating with Families: Perspectives of Beginning Special Education Teachers
ERIC Educational Resources Information Center
Hansuvadha, Nat
2009-01-01
This qualitative study evaluated the belief systems and professional practice of program graduates of an early childhood special education teacher preparation program regarding collaboration with families of children with disabilities. Eleven graduates were interviewed over the course of a school year to identify perceived challenges to their…
Vaccines provided by family physicians.
Campos-Outcalt, Doug; Jeffcott-Pera, Michelle; Carter-Smith, Pamela; Schoof, Bellinda K; Young, Herbert F
2010-01-01
This study was conducted to document current immunization practices by family physicians. In 2008 the American Academy of Family Physicians (AAFP) conducted a survey among a random sample of 2,000 of its members who reported spending 80% or more of their time in direct patient care. The survey consisted of questions regarding the demographics of the practice, vaccines that are provided at the physicians' clinical site, whether the practice refers patients elsewhere for vaccines, and participation in the Vaccines for Children (VFC) program. The response rate was 38.5%, 31.8% after non-office-based respondents were deleted. A high proportion of respondents (80% or more) reported providing most routinely recommended child, adolescent, and adult vaccines at their practice sites. The exceptions were rotavirus vaccine for children and herpes zoster vaccine for adults., A significant proportion, however, reported referring elsewhere for some vaccines (44.1% for children and adolescent vaccines and 53.5% for adult vaccines), with the most frequent referral location being a public health department. A higher proportion of solo and 2-physician practices than larger practices reported referring patients. A lack of adequate payment was listed as the reason for referring patients elsewhere for vaccines by one-half of those who refer patients. One-half of responders do not participate in the VFC program. Provision of recommended vaccines by most family physicians remains an important service. Smaller practices have more difficulty offering a full array of vaccine products, and lack of adequate payment contributes to referring patients outside the medical home. The reasons behind the lack of participation in the VFC program deserve further study.
Family practice residents' maternity leave experiences and benefits.
Gjerdingen, D K; Chaloner, K M; Vanderscoff, J A
1995-09-01
A growing number of residents are having babies during residency training. While many businesses are working to improve maternity conditions and benefits for their employees, residency programs are often not prepared to accommodate pregnant residents. This study was conducted to examine the maternity leave experiences of women who delivered infants during their family practice residency training. Program directors from each of the 394 family practice residency programs listed in the 1993 Directory of Family Practice Residency Programs were asked to distribute surveys to female residents who gave birth during their residency training and had returned to work by the time of the study. Of 199 known eligible residents, 171 (86%) completed surveys; these women represented 127 programs located in 36 states and Puerto Rico. Only 56.8% of women were aware of their program having a written maternity leave policy. The average length of maternity leave was 8 weeks; 76% had leaves of 10 weeks or less. For many, the maternity leave was derived from more than one source, including vacation, sick time, or a mother-child elective. Nearly all (88.3%) the women breast-fed, and the mean duration of breast-feeding was more than 19 weeks. In general, participants believed that having a baby during residency was somewhat difficult. Problems frequently encountered by women after their return to work included sleep deprivation and tiredness, difficulty arranging for child care, guilt about child care, and breast-feeding. Factors that detracted most from the childbirth experience were too little sleep, problems arranging for child care, and lack of support from the partner, residency faculty, and other residents. Having a baby during residency is somewhat difficult for the average female resident. Factors that may ease this difficulty include getting adequate sleep and receiving support from one's partner, faculty, and other residents.
The Family Impact Lens: A Family-Focused, Evidence-Informed Approach to Policy and Practice
ERIC Educational Resources Information Center
Bogenschneider, Karen; Little, Olivia M.; Ooms, Theodora; Benning, Sara; Cadigan, Karen; Corbett, Thomas
2012-01-01
Families have long been recognized for the contributions they make to their members and to society. Yet families are seldom substantively incorporated into the normal course of policy and program development, implementation, and evaluation. We propose the family impact lens as one way to shift the rhetoric from appreciating families to…
Psychiatry training in canadian family medicine residency programs.
Kates, N; Toews, J; Leichner, P
1985-01-01
Family physicians may spend up to 50% of their time diagnosing and managing mental disorders and emotional problems, but this is not always reflected in the training they receive. This study of the teaching of psychiatry in the 16 family medicine residency programs in Canada showed that although the majority of program directors are reasonably satisfied with the current training, they see room for improvement-particularly in finding psychiatrists with a better understanding of family practice, in integrating the teaching to a greater degree with clinical work, thereby increasing its relevance, and in utilizing more suitable clinical settings.
Smith, Katherine; Firth, Kimberly; Smeeding, Sandra; Wolever, Ruth; Kaufman, Joanna; Delgado, Roxana; Bellanti, Dawn; Xenakis, Lea
2016-01-01
Research suggests that the development of mind-body skills can improve individual and family resilience, particularly related to the stresses of illness, trauma, and caregiving. To operationalize the research evidence that mind-body skills help with health and recovery, Samueli Institute, in partnership with experts in mind-body programming, created a set of guidelines for developing and evaluating mind-body programs for service members, veterans, and their families. The Guidelines for Creating, Implementing, and Evaluating Mind-Body Programs in a Military Healthcare Setting outline key strategies and issues to consider when developing, implementing, and evaluating a mind-body focused family empowerment approach in a military healthcare setting. Although these guidelines were developed specifically for a military setting, most of the same principles can be applied to the development of programs in the civilian setting as well. The guidelines particularly address issues unique to mind-body programs, such as choosing evidence-based modalities, licensure and credentialing, safety and contraindications, and choosing evaluation measures that capture the holistic nature of these types of programs. The guidelines are practical, practice-based guidelines, developed by experts in the fields of program development and evaluation, mind-body therapies, patient- and family-centered care, as well as, experts in military and veteran's health systems. They provide a flexible framework to create mind-body family empowerment programs and describe important issues that program developers and evaluators are encouraged to address to ensure the development of the most impactful, successful, evidence-supported programs possible. Copyright © 2016 Elsevier Inc. All rights reserved.
Effectively Addressing Mental Health Issues in Child Welfare Practice: The Family Connection
ERIC Educational Resources Information Center
Pufahl, Elisabeth
2007-01-01
Nonprofit family-run organizations, such as Tennessee Voices for Children (TVC), are providing leadership in advocating for and delivering services to children and families in need. Utilizing a family-driven approach and a staff partially comprised of parent-professionals, TVC's Nashville Connection and Family Connection programs have strengthened…
Family medicine residents' practice intentions: Theory of planned behaviour evaluation.
Grierson, Lawrence E M; Fowler, Nancy; Kwan, Matthew Y W
2015-11-01
To assess residents' practice intentions since the introduction of the College of Family Physicians of Canada's Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. A survey based on Ajzen's theory of planned behaviour was administered on 2 occasions. McMaster University in Hamilton, Ont. Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. The survey was modeled so as to measure the respondents' intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents' intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University.
Family medicine residents’ practice intentions
Grierson, Lawrence E.M.; Fowler, Nancy; Kwan, Matthew Y.W.
2015-01-01
Abstract Objective To assess residents’ practice intentions since the introduction of the College of Family Physicians of Canada’s Triple C curriculum, which focuses on graduating family physicians who will provide comprehensive care within traditional and newer models of family practice. Design A survey based on Ajzen’s theory of planned behaviour was administered on 2 occasions. Setting McMaster University in Hamilton, Ont. Participants Residents (n = 135) who were enrolled in the Department of Family Medicine Postgraduate Residency Program at McMaster University in July 2012 and July 2013; 54 of the 60 first-year residents who completed the survey in 2012 completed it again in 2013. Main outcome measures The survey was modeled so as to measure the respondents’ intentions to practise with a comprehensive scope; determine the degree to which their attitudes, subjective norms, and perceptions of control about comprehensive practice influence those intentions; and investigate how these relationships change as residents progress through the curriculum. The survey also queried the respondents about their intentions with respect to particular medical services that underpin comprehensive practice. Results The responses indicate that the factors modeled by the theory of planned behaviour survey account for 60% of the variance in the residents’ intentions to adopt a comprehensive scope of practice upon graduation, that there is room for curricular improvement with respect to encouraging residents to practise comprehensive care, and that targeting subjective norms about comprehensive practice might have the greatest influence on improving resident intentions. Conclusion The theory of planned behaviour presents an effective approach to assessing curricular effects on resident practice intentions while also providing meaningful information for guiding further program evaluation efforts in the Department of Family Medicine at McMaster University. PMID:26889508
Sex Role Stress and Job Burnout among Family Practice Physicians.
ERIC Educational Resources Information Center
Lemkau, Jeanne P.; And Others
1987-01-01
Explored relationships among sex role stress, gender, and job burnout in family practice physicians (N=67) in four residency programs. Results showed sexes agreed in describing ideal physician. Men saw themselves falling short on expressiveness; women saw themselves short on instrumentality and sensitivity. Sex role measures were most related to…
ERIC Educational Resources Information Center
Rodriguez, Rachel; And Others
1993-01-01
This newsletter supplement is devoted to the theme of domestic violence affecting migrant women. It contains four articles describing programs providing violence prevention education to migrant women and children. "Family Violence and Migrant Women: Implications for Practice" (Rachel Rodriguez) discusses the social isolation of migrant women;…
Facilitating Attuned Interactions: Using the FAN Approach to Family Engagement
ERIC Educational Resources Information Center
Gilkerson, Linda
2015-01-01
Erikson Institute's Fussy Baby Network® (FBN) is a national model prevention program known for its approach to family engagement called the FAN (Gilkerson & Gray, 2014; Gilkerson et al., 2012). The FAN is both a conceptual framework and a practical tool to facilitate attunement in helping relationships and promote reflective practice. This…
Giving curriculum planners an edge
Oandasan, Ivy F.; Archibald, Douglas; Authier, Louise; Lawrence, Kathrine; McEwen, Laura April; Palacios, Maria; Parkkari, Marie; Plant, Heidi; Slade, Steve; Ross, Shelley
2015-01-01
Abstract Objective To pilot a survey of family medicine residents entering residency, describing their exposure to family medicine and their perspectives related to their future intentions to practise family medicine, in order to inform curriculum planners; and to test the methodology, feasibility, and utility of delivering a longitudinal survey to multiple residency programs. Design Pilot study using surveys. Setting Five Canadian residency programs. Participants A total of 454 first-year family medicine residents were surveyed. Main outcome measures Residents’ previous exposure to family medicine, perspectives on family medicine, and future practice intentions. Results Overall, 70% of first-year residents surveyed responded (n = 317). Although only 5 residency programs participated, respondents included graduates from each of the medical schools in Canada, as well as international medical graduates. Among respondents, 92% felt positive or strongly positive about their choice to be family physicians. Most (73%) indicated they had strong or very strong exposure to family medicine in medical school, yet more than 40% had no or minimal exposure to key clinical domains of family medicine like palliative care, home care, and care of underserved groups. Similar responses were found about residents’ lack of intention to practise in these domains. Conclusion Exposure to clinical domains in family medicine could influence future practice intentions. Surveys at entrance to residency can help medical school and family medicine residency planners consider important learning experiences to include in training. PMID:26052601
Family physicians in Switzerland: transition from residency to family practice.
Buddeberg-Fischer, Barbara; Klaghofer, Richard; Stamm, Martina
2011-01-01
The study is concerned with family physicians in the transition phase from residency to practice. Factors relating to the decision to take up a career in family medicine rather than a different medical career are investigated. Further, incentives and disincentives for starting a family practice as well as factors influencing the decision about practice location and practice model are addressed. In a prospective cohort study on physicians' career development, 88 family physicians and 437 physicians aspiring to a different medical career participated in a questionnaire survey on the reasons for their choice of specialty and career, their mentoring support, and their work-life balance aspirations. Quantitative and qualitative data were analyzed using hierarchical logistic regression and content analysis, respectively. Family physician tutors should actively approach trainees in medical school and residency, pointing out the advantages of family medicine in terms of continuity of patient contact and the wide range of illnesses and patients, as well as the prospect of a work-life balance tailored to personal needs. Unlike other countries, Switzerland started its structured residency-training programs only recently.
What influences success in family medicine maternity care education programs?
Biringer, Anne; Forte, Milena; Tobin, Anastasia; Shaw, Elizabeth; Tannenbaum, David
2018-01-01
Abstract Objective To ascertain how program leaders in family medicine characterize success in family medicine maternity care education and determine which factors influence the success of training programs. Design Qualitative research using semistructured telephone interviews. Setting Purposive sample of 6 family medicine programs from 5 Canadian provinces. Participants Eighteen departmental leaders and program directors. METHODS Semistructured telephone interviews were conducted with program leaders in family medicine maternity care. Departmental leaders identified maternity care programs deemed to be “successful.” Interviews were audiorecorded and transcribed verbatim. Team members conducted thematic analysis. Main findings Participants considered their education programs to be successful in family medicine maternity care if residents achieved competency in intrapartum care, if graduates planned to include intrapartum care in their practices, and if their education programs were able to recruit and retain family medicine maternity care faculty. Five key factors were deemed to be critical to a program’s success in family medicine maternity care: adequate clinical exposure, the presence of strong family medicine role models, a family medicine–friendly hospital environment, support for the education program from multiple sources, and a dedicated and supportive community of family medicine maternity care providers. Conclusion Training programs wishing to achieve greater success in family medicine maternity care education should employ a multifaceted strategy that considers all 5 of the interdependent factors uncovered in our research. By paying particular attention to the informal processes that connect these factors, program leaders can preserve the possibility that family medicine residents will graduate with the competence and confidence to practise full-scope maternity care. PMID:29760273
Family, school, and community partnerships: practical strategies for afterschool programs.
Finn-Stevenson, Matia
2014-12-01
Much attention is given today to the importance of forging family, school, and community partnerships. Growing numbers of schools, many of them with afterschool programs, are dedicating resources to support and sustain relationships with families and community-based organizations. And, among government agencies and the philanthropic sector, there is widespread recognition that schools cannot be successful if they function alone in their quest to educate our nation's children, but must work with families and in the context of the community. Although the field is enjoying unprecedented popularity and many more schools and afterschool programs are partnering with community agencies and organizations, the notion of engaging parents and the community has not yet become an integral part of school reform, and in the afterschool field, practitioners who work at the program level directly with students often struggle with how they can make partnerships a reality. This chapter draws upon lessons learned from the School of the 21st Century (21C) to provide practical strategies for reaching out to and working with families and the community. The School of the 21st Century includes an afterschool component and is one of several national initiatives that use a community school strategy. © 2014 WILEY PERIODICALS, INC.
Deradicalization or Disengagement : A Framework for Encouraging Jihad Abandonment
2016-06-10
resulted in entire group disengagement, while the German HAYAT Program and Saudi Counseling Program seek individual de-radicalization/disengagement... Counseling Y Optional N/A Y Y Family Counseling N Y N Y Y Practical Support Measures Y Y Y Y Y Disengage Guarantee – Type Y - Family N Y – Group N...disengagement. The U.S. could easily support religious counseling in de-radicalization programs in partner nations overseas. Group or Individual Programs
Promoting Family-Centered Teaching: Can One Course Make a Difference?
ERIC Educational Resources Information Center
Bingham, Ann; Abernathy, Tammy V.
2007-01-01
Historically, preservice teacher education programs have not adequately prepared teachers in parent involvement or family-centered practices. Because teachers do not routinely encourage family involvement, and parents do not always participate when they are encouraged to do so, the importance of preservice training to involve family members in…
Strengthening Adoption Practice, Listening to Adoptive Families
ERIC Educational Resources Information Center
Atkinson, Anne; Gonet, Patricia
2007-01-01
In-depth interviews with 500 adoptive families who received postadoption services through Virginia's Adoptive Family Preservation (AFP) program paint a richly detailed picture of the challenges adoptive families face and what they need to sustain adoption for many years after finalization. Findings document the need for support in a variety of…
Nature and nurture in the family physician's choice of practice location.
Orzanco, Maria Gabriela; Lovato, Chris; Bates, Joanna; Slade, Steve; Grand'Maison, Paul; Vanasse, Alain
2011-01-01
An understanding of the contextual, professional, and personal factors that affect choice of practice location for physicians is needed to support successful strategies in addressing geographic maldistribution of physicians. This study compared two categories of predictors of family practice location in non-metropolitan areas among undergraduate medical students: individual characteristics (nature), and the rural program component of their training program (nurture). The study aimed to identify factors that predict the location of practice 2 years post-residency training and determine the predictive value of combining nature and nurture variables using administrative data from two undergraduate medical education programs. Databases were developed from available administrative sources for a retrospective analysis of two undergraduate medical education programs in Canada: Université de Sherbrooke (UdeS) and University of British Columbia (UBC). Both schools have a strong mandate to evaluate the impact of their programs on physician distribution. The dependent variable was location of practice 2 years after completing postgraduate training in family medicine. Independent variables included individual and program characteristics. Separate analyses were conducted for each program using multiple logistic regression. The nature and nurture variables considered in the models explained only 21% to 27% of the variance in the eventual location of practice of family physician graduates. For UdeS, having an address in a rural/small-town environment at application to medical school (OR=2.61, 95% CI: 1.24-6.06) and for UBC, location of high school in a rural/small town (OR=4.03, 95% CI: 1.05-15.41), both increased the chances of practicing in a non-metropolitan area. For UdeS the nurture variable (ie length of clerkship in a non-metropolitan area) was the most significant predictor (OR=1.14, 95% CI: 1.067-1.22). For both medical schools, adding a single nurture variable to the model using only nature variables significantly increased the amount of variation accounted for in predicting location of practice in non-metropolitan areas. Aspects of graduates' rural background increase the chances of practicing in a non-metropolitan area. A third-year clerkship experience in a rural area may increase the chances of non-metropolitan practice. Although the total variation predicted by both nature and nurture variables in this study was small, adding a nurture variable significantly improves the prediction of individuals who will practice in a non-metropolitan area. The fact that total variation predicted was small is likely to be due to the limitations of the administrative databases used. Different strategies are being implemented in each university to improve the quality of existing administrative databases, as well as to collect relevant data about intent-to-practice, training characteristics, and the attitudes, beliefs and backgrounds of students.
Transportation Exploration. Practical Arts. Instructor's Manual. Competency-Based Education.
ERIC Educational Resources Information Center
Keeton, Martha; And Others
This manual provides curriculum materials for implementing a career exploration class in transportation occupations within a Practical Arts Education program for middle/junior high school students. Introductory materials include the program master sequence, a list of transportation occupations (land, water and aerospace transportation families),…
Family medicine education in Canada, 1983.
Hennen, B K
1983-12-01
We now have good information about family medicine in terms of content, principles, and practice load. Undergraduate, residency and continuing education are improving, but some family medicine programs still have limited support from their university's faculty and governments. Residency in-training assessment and the certification process are better developed than is evaluation of new family doctors' practice performance. Research in the family medicine base is expanding, and residents are increasingly involved in projects. Family medicine teachers are now on a par with other clinical faculty, because they must meet tougher criteria for appointment and promotion. The political leadership of family medicine education, shared by the College of Family Physicians of Canada and academic departments, requires strong consensus and persistent activity.
ERIC Educational Resources Information Center
Smithgall, Cheryl; Jarpe-Ratner, Elizabeth; Yang, Duck-Hye; DeCoursey, Jan; Brooks, LaShaun; Goerge, Robert
2009-01-01
Launched in 2005, the Illinois Integrated Assessment (IA) program partners child welfare caseworkers with licensed clinicians to provide better information about the functioning of children entering foster care and about child and family strengths, support systems, and service needs. The information-gathering activities and the collaborative…
ERIC Educational Resources Information Center
Association for Community Based Education, Washington, DC.
A field evaluation of 14 community-based family and intergenerational literacy programs identified the most effective strategies, structures, and approaches to reach and teach the "hardest to reach." Information was collected through 90-minute telephone surveys with program coordinators and/or executive directors. Although different in structural…
Literacy Engagement and Parental Development through Even Start Family Literacy Participation
ERIC Educational Resources Information Center
Robinson, Petra A.
2012-01-01
This study examined how parental participation in Even Start programs contributes to family literacy engagement and parental development. More specifically, its primary aim was to develop an understanding of how parental participation in the program influences their reading behaviors and other literacy practices as well as to highlight observed…
Addressing Cultural Variables in Parent Training Programs with Latino Families
ERIC Educational Resources Information Center
Barker, Chikira H.; Cook, Katrina L.; Borrego, Joaquin, Jr.
2010-01-01
There has recently been increased attention given to understanding how cultural variables may have an impact on the efficacy of treatments with Latino families seeking psychological services. Within parent training programs, understanding the extent to which culture can affect parenting practices is vital to providing quality care. The focus of…
Academic family medicine in Canada.
Hennen, B K
1993-01-01
Fifty years ago family practice in Canada had no academic presence. Stimulated by a number of general practitioners and with the support of the Canadian Medical Association, the College of General Practitioners of Canada (CGPC) was founded in 1954. In 1962, conferences on education for general practice attended by the Association of Canadian Medical Colleges and the CGPC led to pilot postgraduate residencies in family practice supported by Department of National Health and Welfare. The first certification examination was held in 1969 and, by 1974, all Canadian medical schools had a family medicine residency program. Today departments of family medicine contribute substantially to undergraduate education in all 16 schools. In Canada, the medical profession, governments and the medical schools have demonstrated the importance they place on appropriate education for family physicians. PMID:8477381
The Family Map: A Tool for Understanding the Risks for Children in Families with Substance Abuse
ERIC Educational Resources Information Center
Bokony, Patti A.; Conners-Burrow, Nicola A.; Whiteside-Mansell, Leanne; Johnson, Danya; McKelvey, Lorraine; Bradley, Robert H.
2010-01-01
This article reviews the findings from our assessments of children and their families in two Head Start programs using the Family Map. Specifically, we used the Family Map assessment tool to identify risks to children associated with alcohol and drug use in families with young children. Practical suggestions are offered to administrators about the…
Baril, J.; Théoret, J.
1997-01-01
PROBLEM BEING ADDRESSED: Family medicine residents have difficulty developing the complex skills needed to work with families. OBJECTIVE OF PROGRAM: To develop an educational program to teach family medicine residents at Laval University a new type of family intervention technique, based on the systems approach, using a practical and interactive method. MAIN COMPONENTS OF PROGRAM: Using Brien's systematic planning model, the authors developed and tested a series of six interactive workshops on three themes. The first theme aims to motivate residents by showing them why it is important to use a systems approach with their patients. The second theme explores a family situation in an individual interview. The third enables residents to conduct a family interview. The whole program has been tested and evaluated. All of the materials needed to teach these skills are contained in a trainer's guide and a video cassette. CONCLUSION: This educational program's originality lies in its combination of the systems approach and interactive training for residents. The program could easily be presented as a continuing medical education activity. PMID:9333406
ERIC Educational Resources Information Center
Vacca, John; Feinberg, Edward
2000-01-01
Discussion of problems faced by early interventionists in working with families offers practical guidelines for developing effective collaborations between early intervention programs and families. These include establishing family-centered services and rules for clinician/parent communication, encouraging the family to be a genuine coparticipant,…
Robohm, Jennifer S
2017-05-01
Family physicians are a critical part of the healthcare system in rural areas, but little is known about the training they need to more effectively address behavioral health disparities. Practicing family physicians in Montana were surveyed about the behavioral health needs of their patients, the behavioral resources at their disposal, their prioritization of a number of behavioral skills and interventions in the training of family physicians, factors that limit their own use of behavioral skills, and the extent of their behavioral science training. Respondents across the state reported high rates of mental/emotional health issues and high need for health behavior change in their patients. Surprisingly, although rural family physicians reported access to significantly fewer behavioral health resources, they did not rate any of the behavioral skills as higher training priorities than their urban counterparts and they were more likely to identify limitations (lack of patient interest, lack of confidence or competence, and inadequate knowledge or training) on their own use of such skills in practice. Family physicians, both rural and urban, whose residency programs had a higher emphasis on behavioral science felt better prepared to use behavioral skills in practice. Consequently, rural training programs are encouraged to emphasize behavioral science training for their family medicine residents, particularly training that focuses on mental health stigma reduction, emphasizes time savings and practicality, covers more severe psychiatric presentations, promotes cultural sensitivity to rural values of autonomy and self-sufficiency, and teaches skills to advocate for individual and community health with regard to behavioral health disparities.
Seven Research-Based Ways That Families Promote Early Literacy. Research-to-Practice Brief
ERIC Educational Resources Information Center
Caspe, Margaret; Lopez, M. Elena
2017-01-01
Positive early-literacy experiences--whether at home, in early-childhood programs, schools, or libraries--set children on a trajectory to become confident readers by the time they reach third grade, which is an important milestone on the pathway toward high school graduation. This review outlines seven practices that research shows families use to…
Patient and family psychoeducation: Service development and implementation in a center in Iran.
Mirsepassi, Zahra; Tabatabaee, Maryam; Sharifi, Vandad; Mottaghipour, Yasaman
2018-02-01
Family and patient psychoeducation have demonstrated significant improvement in clinical and social outcomes for patients suffering from severe mental disorders and their families. However, these evidence-based practices are not widely implemented at service delivery level and into routine clinical practice, especially in less developed countries. The aim of this article is to report the processes of development and implementation of a psychoeducational service for patients with severe mental illnesses and their families in Iran. The program was developed at Roozbeh Hospital in Tehran, Iran. A group of clinicians worked on the development phase of the program and drafting the manuals. Then, a series of workshops and supervision sessions were held to train group leaders for implementation of the group psychoeducation for patients and families. In the pilot phase, the services were delivered to two groups of patients and families, and then the manual was revised based on the feedback from group leaders and participants. The program consisted of eight 90-minute weekly patient group sessions and 6 weekly multiple family group sessions. Two manuals for patient education (schizophrenia and bipolar disorder) were developed. Several information sheets were developed and distributed during different sessions of family and patient psychoeducation related to the content of each session. Despite providing the hospital clinicians with the information regarding these new services, less than 10% of the admitted patients were referred by their clinicians. Feasibility and sustainability of the program are affected by a number of factors. Low referral rate of clinicians, limited resources of the hospital, issues related to stigma and logistic issues are barriers in implementation of these services. Administrators' and clinicians' understanding of the importance of patient and family psychoeducation seems to be crucial in sustainability of such programs in routine service delivery.
A new family programme in Zhejiang province.
Xu, B
1994-04-01
Zhejiang Province in China has promoted a new family planning program since April 1993. The program stresses delayed marriage and childbearing, fewer and healthier births, modernization of family life, and prosperity through hard work. The people are receptive to the new program out of a desire for an improved standard of living. The objective is to build small, modern families who 1) practice deferred marriage and childbearing; 2) voluntarily practice family planning and have no unplanned births; 3) practice avoidance of consanguineous marriage, become sterilized if a carrier of a hereditary disease of chromosomal abnormality, and use premarital education and counseling and proper prenatal care; 4) uphold the laws and maintain discipline in action to avoid criminal behavior; 5) establish families that respect the old, care for children, and help their neighbors; 6) complete 9 years of compulsory education; and 7) create well being through hard work. The program is compatible with the strategy of the "three stresses" and an integrated approach. IEC and service provision are important components in program implementation. The target population are the masses and grassroots cadres, particularly those in the childbearing ages. IEC will be directed in different ways to different groups. Those aged 18-35 years will receive education. Face to face interaction with family planning workers and lectures will be directed to grassroots cadres. The mass media will be employed to reach the masses. The messages will include information and persuasion to adopt new families, accept family planning regulations, and learn about contraceptive use, healthy births and childrearing, education, health care, sex education, and income generation skills. Classes will be conducted for groups, such as teenagers, unmarried youth, pregnant women, and lactating women. Priority will be given to couples that accept the certificates for one child; favoritism will be granted for allocation of housing; acceptance in kindergartens and schools, employment, and military positions; and receipt of business licenses and poverty aide. Sterilization will be rewarded with longer paid leave and subsidies. Services will include contraceptive provision and follow-up, infertility treatment, gynecological check-ups, sex education, old age pensions, premarital counseling, and other quality services.
Huber, Douglas; Curtis, Carolyn; Irani, Laili; Pappa, Sara; Arrington, Lauren
2016-01-01
ABSTRACT Worldwide 75 million women need postabortion care (PAC) services each year following safe or unsafe induced abortions and miscarriages. We reviewed more than 550 studies on PAC published between 1994 and 2013 in the peer-reviewed and gray literature, covering emergency treatment, postabortion family planning, organization of services, and related topics that impact practices and health outcomes, particularly in the Global South. In this article, we present findings from studies with strong evidence that have major implications for programs and practice. For example, vacuum aspiration reduced morbidity, costs, and time in comparison to sharp curettage. Misoprostol 400 mcg sublingually or 600 mcg orally achieved 89% to 99% complete evacuation rates within 2 weeks in multiple studies and was comparable in effectiveness, safety, and acceptability to manual vacuum aspiration. Misoprostol was safely introduced in several PAC programs through mid-level providers, extending services to secondary hospitals and primary health centers. In multiple studies, postabortion family planning uptake before discharge increased by 30–70 percentage points within 1–3 years of strengthening postabortion family planning services; in some cases, increases up to 60 percentage points in 4 months were achieved. Immediate postabortion contraceptive acceptance increased on average from 32% before the interventions to 69% post-intervention. Several studies found that women receiving immediate postabortion intrauterine devices and implants had fewer unintended pregnancies and repeat abortions than those who were offered delayed insertions. Postabortion family planning is endorsed by the professional organizations of obstetricians/gynecologists, midwives, and nurses as a standard of practice; major donors agree, and governments should be encouraged to provide universal access to postabortion family planning. Important program recommendations include offering all postabortion women family planning counseling and services before leaving the facility, especially because fertility returns rapidly (within 2 to 3 weeks); postabortion family planning services can be quickly replicated to multiple sites with high acceptance rates. Voluntary family planning uptake by method should always be monitored to document program and provider performance. In addition, vacuum aspiration and misoprostol should replace sharp curettage to treat incomplete abortion for women who meet eligibility criteria. PMID:27571343
Price, David; Howard, Michelle; Hilts, Linda; Dolovich, Lisa; McCarthy, Lisa; Walsh, Allyn E; Dykeman, Lynn
2009-09-01
The new family health teams (FHTs) in Ontario were designed to enable interprofessional collaborative practice in primary care; however, many health professionals have not been trained in an interprofessional environment. To provide health professional learners with an interprofessional practice experience in primary care that models teamwork and collaborative practice skills. The 2 academic teaching units of the FHT at McMaster University in Hamilton, Ont, employ 6 types of health professionals and provide learning environments for family medicine residents and students in a variety of health care professions. Learners engage in formal interprofessional education activities and mixed professional and learner clinical consultations. They are immersed in an established interprofessional practice environment, where all team members are valued and contribute collaboratively to patient care and clinic administration. Other contributors to the success of the program include the physical layout of the clinics, the electronic medical record communications system, and support from leadership for the additional clinical time commitment of delivering interprofessional education. This academic FHT has developed a program of interprofessional education based partly on planned activities and logistic enablers, and largely on immersing learners in a culture of long-standing interprofessional collaboration.
The Future of Family Engagement in Residential Care Settings
ERIC Educational Resources Information Center
Affronti, Melissa L.; Levison-Johnson, Jody
2009-01-01
Residential programs for children and youth are increasingly implementing engagement strategies to promote family-centered and family-driven models of care (Leichtman, 2008). The practice of engagement is a fairly new area of research, especially in residential care. Driven by their goal to increase the use of state-of-the-art family engagement…
Preparing School Counseling Students to Aid Families: Integrating a Family Systems Perspective
ERIC Educational Resources Information Center
Paylo, Matthew John
2011-01-01
In this article, the value of integrating family systems theory into a school counseling curriculum is explored. Some programs have historically placed school counselors in a difficult position by not adequately preparing them for the demands of incorporating family systems and community collaboration into clinical practice. The rationale for…
Strengthening Family Practices for Latino Families
ERIC Educational Resources Information Center
Chartier, Karen G.; Negroni, Lirio K.; Hesselbrock, Michie N.
2010-01-01
This study examined the effectiveness of a culturally adapted Strengthening Families Program (SFP) for Latinos to reduce risks for alcohol and drug use in children. Latino families, predominantly Puerto Rican, with a 9- to 12-year-old child and a parent(s) with a substance abuse problem participated in the study. Pre- and post-tests were conducted…
Building Trust, Elevating Voices, and Sharing Power in Family Partnership
ERIC Educational Resources Information Center
Davidson, Kristen; Case, Madeleine
2018-01-01
Research has shown that traditional ways of promoting family involvement in school are often ineffective, especially among families whose approach does not align with the middle-class child-rearing practices embraced in many U.S. schools. To encourage greater family involvement, a Colorado school district is piloting a program in which educators…
2010-01-01
Engaging and retaining families in mental health prevention and intervention programs is critically important to insure maximum public health impact. We evaluated randomized-controlled trials testing methods to improve family engagement and retention in child mental health programs published since 1980 (N = 17). Brief, intensive engagement interventions in which providers explicitly addressed families’ practical (e.g. schedules, transportation) and psychological (e.g. family members’ resistance, beliefs about the treatment process) barriers as they entered treatment were effective in improving engagement in early sessions. The few interventions found to produce long-term impact on engagement and retention integrated motivational interviewing, family systems, and enhanced family stress and coping support strategies at multiple points throughout treatment. Few interventions have been tested in the context of prevention programs. There are promising approaches to increasing engagement and retention; they should be replicated and used as a foundation for future research in this area. PMID:20823946
Huang, Rui; Yang, Muzhe
2015-01-01
California was the first state in the United States to implement a paid family leave (PFL) program in 2004. We use data from the Infant Feeding Practices Study to examine the changes in breastfeeding practices in California relative to other states before and after the implementation of PFL. We find an increase of 3-5 percentage points for exclusive breastfeeding and an increase of 10-20 percentage points for breastfeeding at several important markers of early infancy. Our study supports the recommendation of the Surgeon General to establish paid leave policies as a strategy for promoting breastfeeding. Copyright © 2014 Elsevier B.V. All rights reserved.
Effects of wellness programs in family medicine.
McGrady, Angele; Brennan, Julie; Lynch, Denis
2009-06-01
The objective of this research was to determine the effects of wellness programs on quality of life and utilization in an academic family medicine practice in two small controlled studies. One offered stress management and problem solving; the second offered a broader wellness intervention. Outcome measures consisted of scores on the Beck Anxiety Inventory, Hamilton Depression Inventory, CES-D (depression), Health Related Quality of Life, SF-12, and the number of office visits in 6 months. Subjects were randomly assigned to intervention or control groups. Statistical analysis compared pre-test and post-test values of the dependent variables between groups. In study one, where the focus was on relaxation, significant differences between groups were observed in anxiety at post-test (p < .03); the intervention group had lower anxiety levels. In study two which had a more general focus, significant group differences were found in days of poor mental health and number of days of depressed mood; the intervention group had fewer days of poor mental health (p < .05) and depression (p < .05) at post-test. No differences were found in utilization in either study. Based on the results of this research, short term wellness programs can be implemented in family practice and are effective in improving quality of life, but not in deceasing utilization in family practice patients. Matching the design of the program to specific patient needs may increase retention and effectiveness.
Inside the Black Box: An Exploration of Service Delivery in a Family Reunification Program.
ERIC Educational Resources Information Center
Staff, Ilene; Fein, Edith
1994-01-01
Describes a three-month study of a family reunification program for abused and neglected children that explored the process and outcomes of service delivery. The coding scheme measured both the time used in and purposes of activities of the service workers. Discusses the implications of this method for practice, planning, and research. (TM)
Family Policy and Practice in Early Child Care. Advances in Early Education and Day Care.
ERIC Educational Resources Information Center
Reifel, Stuart, Ed.; Dunst, Carl J., Ed.; Wolery, Mark, Ed.
Family issues are an abiding concern for members of the profession of early education, and debate regarding government policies about families and child care continues to be timely. This volume provides a foundation for understanding programs, families, and the current social context, as well as particular areas of concern for families and child…
Participation of Colorado pediatricians and family physicians in the Medicaid program.
Berman, S.; Wasserman, S.; Grimm, S.
1991-01-01
The Pediatric Health Policy Group of the University of Colorado Health Sciences Center (Denver) surveyed 650 family physicians and 296 pediatricians in 1988, with 50% of family physicians and 48% of pediatricians responding. Half of the pediatricians in private practice and 35% of family physicians in private practice accepted all children who were Medicaid beneficiaries into their practice; 42% of pediatricians and 50% of family physicians accepted all non-Medicaid patients but only some new Medicaid patients; and 8% of pediatricians and 15% of family physicians accepted new non-Medicaid patients but no Medicaid patients. Practice location was associated with the level of Medicaid participation for these primary care physicians: Significantly more rural pediatricians and family physicians than those with urban practices accepted Medicaid patients. The average reimbursement level for these physicians was shown to be an important determinant of whether physicians would accept Medicaid patients. Nonparticipatory physicians were more concerned about excessive paperwork compared with physicians with limited participation. Among physicians with limited participation, family physicians and pediatricians both cited problems of excessive paperwork, reimbursement delays, and retroactive denials of payment as important deterrents to accepting Medicaid patients. PMID:1812643
Valdez, Carmen R; Abegglen, Jessica; Hauser, Claire T
2013-09-01
The purpose of this article is to describe Fortalezas Familiares (FF; Family Strengths), a community-based prevention program designed to address relational family processes and promote well-being among Latino families when a mother has depression. Although depression in Latina women is becoming increasingly recognized, risk and protective mechanisms associated with children's outcomes when a mother has depression are not well understood for Latino families. We begin by reviewing the literature on risk and protective psychosocial mechanisms by which maternal depression may affect Latino youth, using family systems theory and a developmental psychopathology framework with an emphasis on sociocultural factors shaping family processes. Next, we describe the theoretical basis and development of the FF program, a community-based 12-week intervention for Latina immigrant women with depression, other caregivers, and their children. Throughout this article, we use a case study to illustrate a Latina mother's vulnerability to depression and the family's response to the FF program. Recommendations for future research and practice include consideration of sociocultural processes in shaping both outcomes of Latino families and their response to interventions. © FPI, Inc.
Generalizability of the NAMI Family-to-Family Education Program: Evidence From an Efficacy Study.
Mercado, Micaela; Fuss, Ashley Ann; Sawano, Nanaho; Gensemer, Alexandra; Brennan, Wendy; McManus, Kinsey; Dixon, Lisa B; Haselden, Morgan; Cleek, Andrew F
2016-06-01
Previous studies conducted in Maryland of the Family-to-Family (FTF) education program of the National Alliance on Mental Illness (NAMI) found that FTF reduced subjective burden and distress and improved empowerment, mental health knowledge, self-care, and family functioning, establishing it as an evidence-based practice. In the study reported here, the FTF program of NAMI-NYC Metro was evaluated. Participants (N=83) completed assessments at baseline and at completion of FTF. Participants had improved family empowerment, family functioning, engagement in self-care activities, self-perception of mental health knowledge, and emotional acceptance as a form of coping. Scores for emotional support and positive reframing also improved significantly. Displeasure in caring for the family member, a measure of subjective burden, significantly declined. Despite the lack of a control group and the limited sample size, this study further supports the efficacy of FTF with a diverse urban population.
Postgraduate Medical Education for Rural Family Practice in Canada.
ERIC Educational Resources Information Center
Rourke, James T. B.
2000-01-01
To produce more rural physicians, the College of Family Physicians of Canada recommends providing earlier and more extensive rural medicine experience for all undergraduate medical students, developing rural postgraduate training programs, providing third-year optional special and advanced rural family-medicine skills training, and making advanced…
Boulé, Richard; Girard, Gilles
2003-01-01
OBJECTIVE: To identify the problems encountered by residents during training and the solutions they proposed. DESIGN: Qualitative study. SETTING: Family practice program at Sherbrooke University. PARTICIPANTS: Sixty-eight residents in the Family practice program between 1999 and 2000. METHOD: We used the nominal group technique with four groups of participants. Then we held five 3-hour discussion groups to explore difficulties and solutions in depth. Finally, data were validated with a written questionnaire. MAIN FINDINGS: At least 20% of respondents confirmed 65 difficulties and 61 solutions. Three major themes emerged: the many demands of the residence program, residents' personal experience of the program, and the lack of time for personal life. CONCLUSION: Publication of these results could help residents develop proactive adaptive strategies to deal with the stress of their training programs. Certain adjustments will be made by the program administration to make it easier for residents to manage their stress. PMID:12729243
Where Are "Their" Voices? Examining Power and Privilege in a Family Literacy Text
ERIC Educational Resources Information Center
Kumar, Tracey
2014-01-01
The purpose of this study was to examine how a family literacy text linked to a large-scale, U.S.-based family literacy program either privileged or disprivileged dominant, Eurocentric literacy practices. More specifically, this study investigated the ways in which the family literacy text: (1) conceptualized literacy; and (2) constructed the role…
Some factors affecting acceptance of family planning in Manus.
Avue, B; Freeman, P
1991-12-01
This paper examines selected factors affecting the acceptance and delivery of modern family planning from health centres in Manus. A survey was carried out of mothers attending Maternal and Child Health clinics and a written questionnaire was given to health workers. The survey of mothers demonstrated the importance of the husband's approval for contraceptive practice and showed that knowledge about traditional methods of family planning is widespread. The health workers' questionnaire demonstrated a high level of dissatisfaction with the current family planning program delivered by health clinics: 45% found the program ineffective; 68% wrote that health workers' attitudes discouraged mothers from attending for family planning. The perceived and actual benefits and costs of children and the role of men should be assessed locally before planning future family planning programs. Widespread retraining and motivating of health workers is essential if improved coverage is to be achieved through health services. The efficacy of alternative methods of delivery of family planning such as local community-based and social marketing programs should also be investigated.
29 CFR 825.700 - Interaction with employer's policies.
Code of Federal Regulations, 2011 CFR
2011-07-01
... LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Effect of Other Laws, Employer Practices, and Collective... employer must observe any employment benefit program or plan that provides greater family or medical leave...., provides lesser pay) is superseded by FMLA. If an employer provides greater unpaid family leave rights than...
29 CFR 825.700 - Interaction with employer's policies.
Code of Federal Regulations, 2014 CFR
2014-07-01
... LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Effect of Other Laws, Employer Practices, and Collective... employer must observe any employment benefit program or plan that provides greater family or medical leave...., provides lesser pay) is superseded by FMLA. If an employer provides greater unpaid family leave rights than...
29 CFR 825.700 - Interaction with employer's policies.
Code of Federal Regulations, 2013 CFR
2013-07-01
... LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Effect of Other Laws, Employer Practices, and Collective... employer must observe any employment benefit program or plan that provides greater family or medical leave...., provides lesser pay) is superseded by FMLA. If an employer provides greater unpaid family leave rights than...
29 CFR 825.700 - Interaction with employer's policies.
Code of Federal Regulations, 2012 CFR
2012-07-01
... LAWS THE FAMILY AND MEDICAL LEAVE ACT OF 1993 Effect of Other Laws, Employer Practices, and Collective... employer must observe any employment benefit program or plan that provides greater family or medical leave...., provides lesser pay) is superseded by FMLA. If an employer provides greater unpaid family leave rights than...
Mediators and Metaphorical Analysis: A Phenomenological Study of Florida Family Court Mediators
ERIC Educational Resources Information Center
Storrow, Rebecca A.
2012-01-01
Florida family court mediation programs have typically been assessed with quantitative analysis. To understand the complexity of the experience of being a family mediator, it was necessary to explore how mediators practiced through qualitative research. Metaphors have been considered to be representations of mediators' mental models regarding…
Business Administration Scale for Family Child Care, BAS
ERIC Educational Resources Information Center
Talan, Teri N.; Bloom, Paula Jorde
2009-01-01
The "BAS for Family Child Care" is the first valid and reliable tool for measuring and improving the overall quality of business and professional practices in family child care settings. It is applicable for multiple uses, including program self-improvement, technical assistance and monitoring, training, research and evaluation, and public…
Business Administration Scale for Family Child Care (BAS). Second Edition
ERIC Educational Resources Information Center
Talan, Teri N.; Bloom, Paula Jorde
2018-01-01
The "Business Administration Scale for Family Child Care" (BAS) is the first valid and reliable tool for measuring and improving the overall quality of business and professional practices in family child care settings. It is applicable for multiple uses, including program self-improvement, technical assistance and monitoring, training,…
Birth control practices and levels of development in India.
Karan, P P; Bladen, W A; Singh, G
1978-11-01
The paper examines the acceptance of birth control practices in India, and examines the relationhsip of these patterns to levels of economic development. A study of selected couples with markedly low incomes revealed that fertility tended to increase until a certain level of per capita income was reached. From this level onward, fertility and desired family size goals declined with increasing economic status. The study reveals an association in India between those less developed states and poor acceptance of family planning. The level of medical and administrative personnel for family planning services is superior in the more developed states and, logically, adoption of family planning practices is also higher. In higher-income states, characterized by relatively higher spatial mobility and literacy rates, the spread of family planning practices is relatively rapid. In less developed states, characterized by poorly developed centralized systems of communication and distribution, a lower spatial mobility of people, and a lower diffusion of knowledge through personal contact, family planning methods tend to spread very slowly or become less and less popular. A classification of Indian states as related to their acceptance of formal family planning policy and governmental efforts has been helpful in developing regionally-oriented program strategies for the future. Such strategies would take into account varying socioeconomic, cultural and administrative infrastructure differences in order to better assure delivery of services. As India also faces a shortage of trained physicians and personnel for the National Family Planning program, a regionally-based spatial allocation policy must be formulated that will divert some family planning personnel from states with high-acceptance patterns to the more densely populated, less developed regions of the country.
Valdez, Carmen R.; Abegglen, Jessica; Hauser, Claire T.
2013-01-01
The purpose of this article is to describe Fortalezas Familiares (FF; Family Strengths), a community-based prevention program designed to address relational family processes and promote wellbeing among Latino families when a mother has depression. Although depression in Latina women is becoming increasingly recognized, risk and protective mechanisms associated with children’s outcomes when a mother has depression are not well understood for Latino families. We begin by reviewing the literature on risk and protective psychosocial mechanisms by which maternal depression may affect Latino youth, using family systems theory and a developmental psychopathology framework with an emphasis on sociocultural factors shaping family processes. Next, we describe the theoretical basis and development of the FF program, a community-based 12-week intervention for Latina immigrant women with depression, other caregivers, and their children. Throughout this article, we use a case study to illustrate a Latina mother’s vulnerability to depression and the family’s response to the FF program. Recommendations for future research and practice include consideration of sociocultural processes in shaping both outcomes of Latino families and their response to interventions. PMID:24033237
ERIC Educational Resources Information Center
Richardson, Susanna, Ed.; Izard, John, Ed.
This collection of papers focuses on practical approaches to resolving behavior problems in the Australian school system. The papers are divided into four general categories: perspectives on behavior problems, focusing on families, schools and system initiatives, and programs in special settings. The papers include: (1) "Beyond…
ERIC Educational Resources Information Center
Connard, Christie; And Others
Educators and service providers often have little opportunity to work cooperatively with families to enhance outcomes for children. This document is the first in a four-part training module that was developed by Northwest Regional Educational Laboratory's Child, Family, and Community Program. The modules are based on an ecological, family-centered…
ERIC Educational Resources Information Center
Sweeney, Eileen; Schott, Liz; Lazere, Ed; Fremstad, Shawn; Goldberg, Heidi; Guyer, Jocelyn; Super, David; Johnson, Clifford
This report describes an array of innovative strategies and practical ideas for helping low-income families with children. There is a window of opportunity for these new strategies as many states have tremendous financial resources available. The Temporary Assistance For Needy Families (TANF) program rules have been clarified, and families are…
NASA Family Science Night: Changing perceptions one family at a time
NASA Astrophysics Data System (ADS)
Mitchell, Sara E.; Drobnes, Emilie; Sol Colina-Trujillo, M.; Noel-Storr, Jacob
2008-12-01
Parents and families have the greatest influence on children's attitudes towards education and career choices. If students' attitudes towards science, particularly the physical sciences, are not influenced positively by parental/familial attitudes, efforts to improve the quality of content and teaching of these subjects in school may be futile. Research shows that parental involvement increases student achievement outcomes, and family-oriented programs have a direct impact on student performance. Based on this premise, the NASA Goddard Space Flight Center started a series of Family Science Nights for middle school students and their families. The program provides a non-threatening venue for families to explore the importance of science and technology in our daily lives by engaging in learning activities that change their perception and understanding of science - making it more practical and approachable for participants of all ages. Family Science Night strives to change the way that students and their families participate in science, within the program and beyond.
Supporting Family Engagement in Home Visiting with the Family Map Inventories.
Kyzer, Angela; Whiteside-Mansell, Leanne; McKelvey, Lorraine; Swindle, Taren
2016-01-01
The purpose of this study was to examine the feasibility and usefulness of a universal screening tool, the Family Map Inventory (F MI), to assess family strengths and needs in a home visiting program. The FMI has been used successfully by center-based early childcare programs to tailor services to family need and build on existing strengths. Home visiting coordinators (N = 39) indicated the FMI would provide useful information, and they had the capacity to implement. In total, 70 families who enrolled in a Home Instruction for Parents of Preschool Youngsters (HIPPY) program were screened by the coordinator. The results of the FMI provided meaningful information about the home and parenting environment. Overall, most caregivers provided high levels of school readiness and parental warmth and low levels of family conflict and parenting stress. On the other hand, many families did not provide adequate food quality, exhibited chaotic home environments, and practiced negative discipline. This study demonstrated that the FMI is a feasible and useful option to assess comprehensive family needs in home visiting programs. It also demonstrated that the FMI provided home visiting coordinators a system to measure family strengths and needs. This could provide an assessment of program effectiveness and changes in the family's environment.
Temcheff, Caroline E; Letarte, Marie-Josée; Boutin, Stéphanie; Marcil, Katherine
2018-06-01
Child maltreatment can lead to a variety of negative outcomes in childhood including physical and mental health problems that can extend into adulthood. Given the transactional nature of child maltreatment and the difficulties that many maltreating families experience, child protection services typically offer various kinds of programs to maltreated children, their parents, and/or their families. Although the specific difficulties experienced by these families may vary, sub-optimal parenting practices are typically part of the picture and may play a central role in maltreated children's development. Hence, to deal with child maltreatment, programs that focus on parenting practices are essential, and identifying the common components of effective programs is of critical importance. The objectives of the present study were to: 1) describe the components of evidence-based parenting programs aimed at parents who have maltreated their elementary school-aged children or are at-risk for doing so and 2) identify the components that are common to these programs, using the approach proposed by Barth and Liggett-Creel (2014). Fourteen evidence-based parenting programs aimed at parents who had maltreated their elementary school-aged children (ages 6-12) or were at-risk for doing so were identified using both a review of relevant online databases of evidence-based programs (California Evidence-Based Clearinghouse for Child Welfare, Blueprints for Healthy Youth Development, Youth.gov, and the National Registry of Evidence-based Programs and Practices). Common components were identified (operationalized as components present in two thirds of programs) and discussed. The identification of common components of evidence-based programs may help clinicians choose the best intervention methods. Copyright © 2018. Published by Elsevier Ltd.
ERIC Educational Resources Information Center
Bergeron, Jessica Page
2013-01-01
The purpose of this study was to examine the effects of parent training on shared reading practices in families of children with hearing loss. This intervention augmented a multifaceted school program in emergent literacy. In a community based format, parents were explicitly taught three shared reading strategies that have evidence to support the…
Iglar, Karl; Murdoch, Stuart; Meaney, Christopher; Krueger, Paul
2018-01-01
To determine the number of patient visits, patient demographic information, and diagnoses in an urban ambulatory care setting in a family medicine residency program, and assess the correlation between the number of patient visits and residents' in-training examination (ITE) scores. Retrospective analysis of data from resident practice profiles, electronic medical records, and residents' final ITE scores. Family medicine teaching unit in a community hospital in Barrie, Ont. Practice profile data were from family medicine residents enrolled in the program from July 1, 2013, to June 30, 2014, and electronic medical record and ITE data were from those enrolled in the program from July 1, 2010, to June 30, 2015. Number of patient visits, patient characteristics (eg, sex, age), priority topics addressed in clinic, resident characteristics (eg, age, sex, level of residency), and residents' final ITE scores. Between July 1, 2013, and June 30, 2014, there were 11 115 patient visits. First-year residents had a mean of 5.48 patient visits per clinic, and second-year residents had a mean of 5.98 patient visits per clinic. A Pearson correlation coefficient of 0.68 was found to exist between the number of patients seen and the final ITE scores, with a 10.5% difference in mean score between residents who had 1251 or more visits and those who had 1150 or fewer visits. Three diagnoses (ie, epistaxis, meningitis, and neck pain) deemed important for Certification by the College of Family Physicians of Canada were not seen by any of the residents in clinic. There is a moderate correlation between the number of patients seen by residents in ambulatory care and ITE scores in family medicine. It is important to assess patients' demographic information and diagnoses made in resident practices to ensure an adequate clinical experience. Copyright© the College of Family Physicians of Canada.
Labrador program prepares MDs for northern, remote practice
Gray, S
1997-01-01
Across Canada, residency programs are attempting to train more physicians to practise in rural and remote areas. The Northern Family Education Program developed in Newfoundland and Labrador is proving that physicians can learn to like life in remote areas. PMID:9371078
Focus on Families! How to Build and Support Family-Centered Practices in After School
ERIC Educational Resources Information Center
Kakli, Zenub; Kreider, Holly; Little, Priscilla; Buck, Tania; Coffey, Maryellen
2006-01-01
Children benefit when their parents or caregivers are actively involved in their out-of-school learning. Yet a new report by the Harvard Family Research Project and United Way of Massachusetts Bay finds that only a quarter of programs surveyed had effectively incorporated families. This guide, funded by the Wallace Foundation under its Parents and…
Moeller, Mary Pat; Carr, Gwen; Seaver, Leeanne; Stredler-Brown, Arlene; Holzinger, Daniel
2013-10-01
A diverse panel of experts convened in Bad Ischl, Austria, in June of 2012 for the purpose of coming to consensus on essential principles that guide family-centered early intervention with children who are deaf or hard of hearing (D/HH). The consensus panel included parents, deaf professionals, early intervention program leaders, early intervention specialists, and researchers from 10 nations. All participants had expertise in working with families of children who are D/HH, and focus was placed on identifying family-centered practice principles that are specific to partnering with these families. Panel members reported that the implementation of family-centered principles was uneven or inconsistent in their respective nations. During the consensus meeting, they identified 10 agreed-upon foundational principles. Following the conference, they worked to refine the principles and to develop a document that described the principles themselves, related program and provider behaviors, and evidence supporting their use (drawing upon studies from multiple disciplines and nations). The goal of this effort was to promote widespread implementation of validated, evidence-based principles for family-centered early intervention with children who are deaf and hard of hearing and their families.
Jamieson, Jean L; Kernahan, Jill; Calam, Betty; Sivertz, Kristin S
2013-01-01
Numerous strategies have been suggested to increase recruitment of family physicians to rural communities and smaller regional centers. One approach has been to implement distributed postgraduate education programs where trainees spend substantial time in such communities. The purpose of the current study was to compare the eventual practice location of family physicians who undertook their postgraduate training through a single university but who were based in either metropolitan or distributed, non-metropolitan communities. Since 1998, the Department of Family Practice at the University of British Columbia in Canada has conducted an annual survey of its residents at 2, 5, and 10 years after completion of training. The authors received Ethics Board approval to use this anonymized data to identify personal and educational factors that predict future practice location. The overall response rate was 45%. At 2 years (N=222), residents trained in distributed sites were 15 times more likely to enter practice in rural communities, small towns and regional centers than those who trained in metropolitan teaching centers. This was even more predictive for retention in non-urban practice sites. Among the subgroup of physicians who remained in a single practice location for more than a year preceding the survey, those who trained in smaller sites were 36 times more likely to choose a rural or regional practice setting. While the vast majority of those trained in metropolitan sites chose an urban practice location, a subgroup of those with some rural upbringing were more likely to practice in rural or regional settings. Trainees from distributed sites considered themselves more prepared for practice regardless of ultimate practice location. Participation in a distributed postgraduate family medicine training site is an important predictor of a non-urban practice location. This effect persists for 10 years after completion of training and is independent of other predictors of non-urban practice including gender, rural upbringing, and rural undergraduate training. It is hypothesized that this is due not only to a curriculum that supports preparedness for this type of practice but also to opportunities to develop personal and professional roots in these communities.
Family welfare and health practices increase after exposure to population education.
1994-01-01
Since 1987, the State Resource Center of Jamia Millia Islamia of New Delhi has been implementing a program which integrates population education contents into its literacy education classes for adult learners. Using the core messages on family size, spacing of children, responsible parenthood, right age of marriage, population-related beliefs and customs and population and development, the Center undertook many activities such as: i) integrating population contents in literacy primers, readers and supplementary reading books; ii) development of teaching aids and instructor's resource materials; iii) organization of training for instructors and iv) holding outreach activities such as street corner plays, fairs, etc. To evaluate the impact of the program, the Center undertook an impact survey to measure the level of knowledge, attitude and practices of randomly selected beneficiaries of the project, i.e. 934 learners from 85 literacy learning centers, 5 years after the introduction of the population education program. The study used pre-test and post-test method for collecting data and to compare results. In terms of practice, the study has shown that the respondents having knowledge about family planning methods increased from 67 to 87%, after being exposed to the project's activities. There was also an increase of 61% in cases adopting family planning methods over the pre-measurement level. More importantly, there was not only an increase in awareness of public health and family welfare services but a 137% increase was registered in the use of public health and family welfare facilities for family planning counseling and services. With regard to knowledge and attitude on the various population education messages promoted by the project, the study has shown a 40% increase in "high" knowledge category and 25% increase in favorable attitude after the exposure to the project. full text
McCalman, Janya; Searles, Andrew; Bainbridge, Roxanne; Ham, Rachael; Mein, Jacki; Neville, Johanna; Campbell, Sandra; Tsey, Komla
2015-05-21
Evaluating program outcomes without considering how the program was implemented can cause misunderstandings and inefficiencies when initiating program improvements. In conjunction with a program evaluation, reported elsewhere, this paper theorises the process of implementing an Indigenous Australian maternal and child health program. The Baby Basket program was developed in 2009 for the remote Cape York region and aimed to improve the attendance and engagement of Indigenous women at antenatal and postnatal clinics through providing three baskets of maternal and baby goods and associated health education. Constructivist grounded theory methods were used to generate and analyse data from qualitative interviews and focus groups with Indigenous women who received the baskets, their extended family members, and healthcare workers who delivered them. Data was coded in NVivo with concepts iteratively compared until higher order constructs and their relationships could be modelled to explain the common purpose for participants, the process involved in achieving that purpose, key strategies, conditions and outcomes. Theoretical terms are italicised. Program implementation entailed empowering families through a process of engaging and relating Murri (Queensland Indigenous) way. Key influencing conditions of the social environment were the remoteness of communities, keeping up with demand, families' knowledge, skills and roles and organisational service approaches and capacities. Engaging and relating Murri way occurred through four strategies: connecting through practical support, creating a culturally safe practice, becoming informed and informing others, and linking at the clinic. These strategies resulted in women and families taking responsibility for health through making healthy choices, becoming empowered health consumers and advocating for community changes. The theoretical model was applied to improve and revise Baby Basket program implementation, including increased recognition of the importance of empowering families by extending the home visiting approach up to the child's third birthday. Engaging and relating Murri way was strengthened by formal recognition and training of Indigenous health workers as program leaders. This theoretical model of program implementation was therefore useful for guiding program improvements, and could be applicable to other Indigenous maternal and child health programs.
Solo and Small Practices: A Vital, Diverse Part of Primary Care.
Liaw, Winston R; Jetty, Anuradha; Petterson, Stephen M; Peterson, Lars E; Bazemore, Andrew W
2016-01-01
Solo and small practices are facing growing pressure to consolidate. Our objectives were to determine (1) the percentage of family physicians in solo and small practices, and (2) the characteristics of and services provided by these practices. A total of 10,888 family physicians seeking certification through the American Board of Family Medicine in 2013 completed a demographic survey. Their practices were split into categories by size: solo, small (2 to 5 providers), medium (6 to 20 providers), and large (more than 20 providers). We also determined the rurality of the county where the physicians practiced. We developed 2 logistic regression models: one assessed predictors of practicing in a solo or small practice, while the other was restricted to solo and small practices and assessed predictors of practicing in a solo practice. More than one-half of respondents worked in solo or small practices. Small practices were the largest group (36%) and were the most likely to be located in a rural setting (20%). The likelihood of having a care coordinator and medical home certification increased with practice size. Physicians were more likely to be practicing in small or solo practices (vs medium-sized or large ones) if they were African American or Hispanic, had been working for more than 30 years, and worked in rural areas. Physicians were more likely to be practicing in small practices (vs solo ones) if they worked in highly rural areas. Family physicians in solo and small practices comprised the majority among all family physicians seeking board certification and were more likely to work in rural geographies. Extension programs and community health teams have the potential to support transformation within these practices. © 2016 Annals of Family Medicine, Inc.
Protected block time for teaching and learning in a postgraduate family practice residency program
Jung, Piera; Kennedy, Maggie; Winder, Mary J.
2012-01-01
Abstract Objective To explore the elements necessary for a high-quality educational experience in a family practice residency program with respect to scheduling, learning environment, and approaches to teaching and learning. Design An interpretative, qualitative study using a generative-inquiry approach. Setting The Nanaimo Site of the University of British Columbia Family Practice Residency Program. Participants Fifteen physician instructors and 16 first- and second-year residents. Methods Data were gathered from 2 qualitative focus group interviews with residents; 2 qualitative focus group interviews with physician instructors; and structured and semistructured observation of 2 in-class seminars, with a focus on residents’ engagement with the class. Results were analyzed and categorized into themes independently and collectively by the researchers. Main findings Protected block time for teaching and learning at the Nanaimo Site has been effective in fostering a learning environment that supports collegial relationships and in-depth instruction. Residents and physician instructors benefit from the week-long academic schedule and the opportunity to teach and learn collaboratively. Participants specifically value the connections among learning environment, collegiality, relationships, reflective learning, and the teaching and learning process. Conclusion These findings suggest that strategic planning and scheduling of teaching and learning sessions in residency programs are important to promoting a comprehensive educational experience. PMID:22700741
Supporting Family Engagement in Home Visiting with the Family Map Inventories
Kyzer, Angela; Whiteside-Mansell, Leanne; McKelvey, Lorraine; Swindle, Taren
2015-01-01
The purpose of this study was to examine the feasibility and usefulness of a universal screening tool, the Family Map Inventory (F MI), to assess family strengths and needs in a home visiting program. The FMI has been used successfully by center-based early childcare programs to tailor services to family need and build on existing strengths. Home visiting coordinators (N = 39) indicated the FMI would provide useful information, and they had the capacity to implement. In total, 70 families who enrolled in a Home Instruction for Parents of Preschool Youngsters (HIPPY) program were screened by the coordinator. The results of the FMI provided meaningful information about the home and parenting environment. Overall, most caregivers provided high levels of school readiness and parental warmth and low levels of family conflict and parenting stress. On the other hand, many families did not provide adequate food quality, exhibited chaotic home environments, and practiced negative discipline. This study demonstrated that the FMI is a feasible and useful option to assess comprehensive family needs in home visiting programs. It also demonstrated that the FMI provided home visiting coordinators a system to measure family strengths and needs. This could provide an assessment of program effectiveness and changes in the family’s environment. PMID:26681837
Disaster Research Team Building: A Case Study of a Web-based Disaster Research Training Program.
Beaton, Randal D; Johnson, L Clark; Maida, Carl A; Houston, J Brian; Pfefferbaum, Betty
2012-11-19
This case study describes the process and outcomes of the Northwest Center for Public Health Practice Child and Family Disaster Research Training (UWDRT) Program housed at the University of Washington, which used web-based distance learning technology. The purposes of this program were to provide training and to establish a regional cadre of researchers and clinicians; to increase disaster mental health research capacity and collaboration; and to improve the scientific rigor of research investigations of disaster mental health in children and families. Despite a number of obstacles encountered in development and implementation, outcomes of this program included increased team member awareness and knowledge of child and family disaster mental health issues; improved disaster and public health instruction and training independent of the UWDRT program; informed local and state disaster response preparedness and response; and contributions to the child and family disaster mental health research literature.
A Short Course in Family Therapy: Translating Research Into Practice
ERIC Educational Resources Information Center
Williams, Robert
2005-01-01
This article outlines a graduate-level, one-time-only family therapy course that prepares counseling trainees to be competent at entry-level family therapy in the United States. The approach outlined addresses the training concerns of programs that significantly emphasize individual-focused paradigms and that have limited time to train counseling…
24 CFR 982.305 - PHA approval of assisted tenancy.
Code of Federal Regulations, 2010 CFR
2010-04-01
... tenant-based program, within fifteen days after the family and the owner submit a request for approval of... practicable, such inspection and determination must be completed within fifteen days after the family and the... family of the assisted tenancy, or execute a HAP contract, until the PHA has determined that all the...
ERIC Educational Resources Information Center
Boscardin, Mary Lynn; Brown-Chidsey, Rachel; Gonzalez-Martinez, Julio C.
2001-01-01
This article urges educators and administrators to collaborate closely with families of students with disabilities from diverse linguistic, racial, and cultural backgrounds and participate in training activities that stress best practices for facilitating the participation of the family. The role of the Individualized Education Program in forging…
Canada's Families Today: Some Policy Implications of Changing Forms and Patterns.
ERIC Educational Resources Information Center
Glossop, Robert
A summary review of facts, figures, and trends concerning family life in Canada reveals patterns of continuity and patterns of change. Generalizations about the average family no longer suffice (if ever they did) as the basis for government policies and programs, corporate personnel practices, and the organization and administration of schools.…
Community pharmacist-delivered Medicare Annual Wellness Visits within a family medicine practice.
Evans, Taylor A; Fabel, Patricia H; Ziegler, Bryan
To identify the steps to implement a community pharmacist into a family medicine practice to deliver Medicare Annual Wellness Visits (AWVs). Medicine Mart Pharmacy is a locally owned and operated pharmacy that has served the West Columbia, SC, area for over 30 years. The services offered by the pharmacy have expanded over the past 3 years through the addition of a community pharmacy resident. A stepwise approach was developed for a community pharmacist to identify, market, and establish an AWV service through a collaborative practice agreement with a local family medicine practice. The pharmacy team contacted each office and obtained information about the physician practices and their willingness to participate in the program. Two financial models were created and evaluated to determine budget implications. Many patients were seen at the physician offices; they were eligible for AWV, but had not received them. Meetings were scheduled with 3 of the 6 offices; however, none of the offices moved forward with the proposed program. Integrating a pharmacist into the AWV role may be profitable to both the pharmacy and the medical office with persistence and time to have a successful collaboration. Copyright © 2017 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.
ERIC Educational Resources Information Center
Schatz, Mona Struhsaker; Horejsi, Charles R.
This module is part of a training program for foster parents and foster care workers offered at Colorado State University. The module examines religious practices in foster homes. The module's learning objectives address: (1) the religious background of a foster child's birth family; (2) the rights of a foster child's birth parents concerning the…
Lim, Younghee; DeJohn, Tara V; Murray, Drew
2012-04-01
As the United States' economy continues to experience challenges, more families at or near the poverty level fall prey to predatory financial practices. Their vulnerability to these operations is increased by a lack of knowledge of asset-building resources and alternative financial services. This article focuses on Volunteer Income Tax Assistance (VITA)--a free income tax preparation program, which is a vital resource available to low-income families. Unfortunately, VITA is largely underused and often unknown to economically strained families and to the social workers and other professionals to whom these families turn for assistance. This article concludes with policy and practice implications for social workers and other professionals engaged in providing services to financially vulnerable families.
Family Science Night: Changing Perceptions One Family at a Time
NASA Technical Reports Server (NTRS)
Pesnell, W. D.; Drobnes, E.; Mitchell, S.; Colina-Trujillo, M.
2007-01-01
If students are not encouraged to succeed in science, mathematics, and technology classes at school, efforts to improve the quality of content and teaching in these subjects may be futile. Parents and families are in a unique position to encourage children to enroll and achieve in these classes. The NASA Goddard Space Flight Center Family Science Night program invites middle school students and their families to explore the importance of science and technology in our daily lives by providing a venue for families to comfortably engage in learning activities that change their perception and understanding of science - making it more practical and approachable for participants of all ages. Family Science Night strives to change the way that students and their families participate in science, within the program and beyond.
Ghanma, M A; Rider, R V; Sirageldin, I
1984-01-01
The Lorenz Curve, originally developed to measure the concentration of wealth in a population, was used to describe the distribution of contraceptive practice in Jordan. Data from the 1976 Jordan Fertility Study, carried out as part of the World Fertility Survey program, was used in the analysis. The application of the Automatic Interaction Detector program to the survey's sample population of 3611 women of reproductive age divided the sample into 6 mutually exclusive groups on the basis of residence, education, and whether desired family size was attained or not attained. These 3 characteristics accounted for a major portion of the variation in contraceptive practice. These subgroups, in ascending order by the proportion practicing contraception, were: 1) rural women with unattained desired family size; 2) urban, illiterate women with unattained desired family size; 3) rural women with attained desired family size; 4) urban, literate women with unattained desired family size; 5) urban, illiterate women with attained desired family size; and 6) urban, literate women with attained desired family size. The cumulative proportion of the sample in each ordered subdivision was plotted on the X axis of a graph, and the cumulative proportion of those practicing contraception was plotted on the Y axis of the graph. A line connecting the intersection of the points on the X and Y axis was then drawn. The resultant line was a concave ascending line. If contraceptive practice was evenly distributed in the population, the line would be a straight diagonal line. The plotted curved line indicated that contraceptive practice was unevenly distributed in the population. 2 indexes for measuring the area between the diagonal and the line resulting from plotting the observed distribution for each subgroup was used to assess the degree of concentration of contraceptive practice in the population. The indexes also indicated that contraceptive practice was unequally distributed. When separate curves were plotted for the subgroups with attained desired family size and the subgroups without attained desired family size, it was apparent that the distribution of contraceptive practice was more uniform among those with attained desired family size than among the other 3 subgroups. A curve for the distribution of births was then plotted on the same graph. This curve was not a true application of the Lorenz Curve since it was based on the order of the subdivisions by birth rates. The resultant line approached the straight diagonal line and indicated that the distribution of births was fairly evenly distributed in the population. The uneven distribution of contraceptive practice and the uniform distribution of births suggests that contraceptive practice in this population is ineffective. This may be a characteristic of populations in the early stages of fertility control.
Orpinas, Pamela; Reidy, Mary Clare; Lacy, Mary Elizabeth; Kogan, Steven M; Londoño-McConnell, Angela; Powell, Gwynn
2014-11-01
Families Fuertes (FF) is a seven-session, family-centered program for supporting positive youth development of Latino children aged 10 to 14 years. The Pan American Health Organization adapted it from the Strengthening Families Program for Parents and Youth for Spanish-speaking countries. The suitability of FF for recent immigrants to the United States is, however, unknown. This feasibility study assessed the appropriateness of FF with 12 low-income Mexican immigrant families residing in Georgia. Participants, a community liaison, and program staff evaluated (a) recruitment, retention, and evaluation strategies; and (b) the acceptability and promise of the curriculum. Recruitment and retention were very high; feedback of evaluation strategies was uniformly positive. Participants perceived that the program improved family relationships and that family members changed for the better. We detail practical and cultural adaptations to enhance the potential effectiveness of the program for this population. A version adapted to address acculturation-related stressors would increase the potential public health impact. © 2014 Society for Public Health Education.
Preparing for an influenza pandemic: model of an immunization clinic in an urban family practice
Bourgeois, Nicole; Franke, Carolyn; O’Connor, Shirlee A.; Shaw, Holly; Hum, Susan; Dunn, Sheila
2011-01-01
Abstract Problem addressed The surge in patient demand for the H1N1 influenza vaccine during the 2009 pandemic. Objective of the program To facilitate timely delivery of the 2009 H1N1 influenza vaccine to a family practice population while preserving regular clinic function and to create a model of effective vaccination delivery for future outbreaks. Program description An academic family practice in Toronto, Ont, adopted a process-improvement approach and implemented 3 Saturday stand-alone H1N1 vaccination clinics to accommodate increased demand for the vaccine. Medical directives were developed to give nurses the authority to vaccinate patients. Consent forms with eligibility criteria and risks versus benefits sheets were provided to patients in the waiting area to make optimal use of time. The clinic with “appointment blocks” for patients had improved efficiency (ie, fewer bottlenecks from waiting area to vaccination room), which was satisfactory to both staff and patients. Conclusion During a pandemic, when patient demand for vaccination is high, such stand-alone vaccination clinics in conjunction with family practices can deliver vaccines to patients in a timely and acceptable manner while promoting continuity of care. This model requires the commitment of extra staffing resources if regular primary care delivery is to be maintained. PMID:21998244
Tools for the Job: The POMR in Preventive Medicine
Dixon-Warren, Brian
1977-01-01
There is increasing interest in practical preventive care in the family doctor's office. The concepts underlying the problem oriented medical record (POMR) include the principles of preventive medicine, and it is thus an excellent vehicle for implementation. However, the classical POMR model must be modified to the context of family practice, and priorities defined by each practice. This article describes how elements of the POMR can be used in planning preventive care. An appraisal of one's own practice is a valuable part of the planning; follow up can assess patient compliance and the effectiveness of the program. PMID:21304858
Olin, S Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E
2014-01-01
Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs-those targeting the program and staff-were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed.
Olin, S. Serene; Williams, Nate; Pollock, Michele; Armusewicz, Kelsey; Kutash, Krista; Glisson, Charles; Hoagwood, Kimberly E.
2013-01-01
Quality measurement is an important component of healthcare reform. The relationship of quality indicators (QIs) for parent-delivered family support services to organizational social contexts known to improve quality is unexamined. This study employs data collected from 21 child mental health programs that deliver team-based family support services. Performance on two levels of QIs —those targeting the program and staff -- were significantly associated with organizational social context profiles and dimensions. High quality program policies are associated with positive organizational cultures and engaging climates. Inappropriate staff practices are associated with resistant cultures. Implications for organizational strategies to improve service quality are discussed. PMID:23709286
Relationship Education for Military Couples: Recommendations for Best Practice.
Bakhurst, Melissa G; Loew, Benjamin; McGuire, Annabel C L; Halford, W Kim; Markman, Howard J
2017-06-01
Military couples have a number of distinctive strengths and challenges that are likely to influence their relationship adjustment. Military couples' strengths include stable employment, financial security, and subsidized health and counseling services. At the same time, military couples often experience long periods of separation and associated difficulties with emotional disconnect, trauma symptoms, and reintegrating the family. This paper describes best practice recommendations for working with military couples, including: addressing the distinctive challenges of the military lifestyle, ensuring program delivery is seen as relevant by military couples, and providing relationship education in formats that enhance the accessibility of programs. © 2016 Family Process Institute.
ERIC Educational Resources Information Center
Pinard, Courtney A.; Hart, Michael H.; Hodgkins, Yvonne; Serrano, Elena L.; McFerren, Mary M.; Estabrooks, Paul A.
2012-01-01
This pre-post study used a mixed-methods approach to examine the impact of a family-based weight management program among a low-income population. Smart Choices for Healthy Families was developed through an integrated research-practice partnership and piloted with 26 children and parents (50% boys; mean age = 10.5 years; 54% Black) who were…
Men and family planning in Africa. Les hommes et la planification familiale en Afrique.
Diallo, A
1984-09-01
Male responsibility with regard to family planning and its practice is a major action focus of the International Planned Parenthood Federation. The campaign has been aimed at developing programs to educate men about family planning, encouraging men to practice contraception, and changing the attitudes of male opinion leaders. Since the African male's opinion is paramount within the family unit, the village, and the broader society, this approach is considered essential to the success of family planning efforts in Africa. Although a wide range of programs in Anglophone Africa are now oriented toward men, little progress has been made in the Francophone countries. Obstacles include traditionalism, pro-natalism, illiteracy, religion, and a hostility to Western concepts. Efforts have further been hindered by the way that family planning has been promoted in the region in the past: as a birth spacing method to improve maternal and child health. Medical and paramedical personnel in the region have been trained to treat only mothers and children, not couples or families. However, women's changing status and increased awareness of the connection between demography and development have created an atmosphere more favorable to well designed family welfare programs that are integrated with other development activities. If family planning is to become entrenched in the African region, attention must be given to 3 areas: information and education, integrated development, and research and training. Within the framework of educational activities, men can be made aware that they may practice contraception without any threat to their virility. Given the complexity of the task of introducing family planning on a broad scale in Africa, an integrated appraoch (social, cultural, health, economic, political, and legislative), involving both governments and voluntary organizations as well as the population, is required. Decision makers must be convinced to give family planning a central role in primary health care. Key to the implementation of this strategy is the selection of promoters who have a knowledge of the area in which they work, a commitment to family planning, and the necessary communication skills.
Protect Your Family from Lead in Your Home
... to Renovate Right, to learn about the lead-safe work practices that contractors are required to follow when ... lead-based paint is present and use lead-safe work practices There are state and federal programs in ...
Danucalov, Marcelo Ad; Kozasa, Elisa H; Afonso, Rui F; Galduroz, José Cf; Leite, José R
2017-01-01
To investigate the effects of the practice of yoga in combination with compassion meditation on the quality of life, attention, vitality and self-compassion of family caregivers of patients with Alzheimer's disease. A total of 46 volunteers were randomly allocated to two groups, the yoga and compassion meditation program group (n = 25), and the control group (CG) that received no treatment (n = 21). The program lasted 8 weeks, and comprised three yoga and meditation practices per week, with each session lasting 1 h and 15 min. Quality of life, attention, vitality, and self-compassion scores were measured pre- and postintervention. The yoga and compassion meditation program group showed statistically significant improvements (P < 0.05) on quality of life, attention, vitality and self-compassion scores as compared with the control group, which showed no statistical significant differences at the postintervention time-point. The findings of the present study suggest that an 8-week yoga and compassion meditation program can improve the quality of life, vitality, attention, and self-compassion of family caregivers of Alzheimer's disease patients. Geriatr Gerontol Int 2017; 17: 85-91. © 2015 Japan Geriatrics Society.
Factors influencing the provision of long-acting reversible contraception in California.
Biggs, M Antonia; Harper, Cynthia C; Malvin, Jan; Brindis, Claire D
2014-03-01
To assess long-acting reversible contraception (LARC) beliefs and practices among site directors who represent the family planning services delivered in their practices. Medical directors from 1,000 sites listed in the Family Planning Access Care and Treatment program (California's family planning Medicaid program) provider database were mailed a survey in the fall of 2011 regarding their LARC beliefs and practices. Participants responded by mail, online, or telephone. Data on family planning clients served and LARC dispensing were obtained from administrative claims data. All analyses were limited to advanced practice clinician respondents. General estimating equation models identified the respondent and practice characteristics associated with LARC provision. After three follow-up mailings and telephone calls, 68% of eligible sites responded to the survey (636/939). Most respondents were physicians (448/587). They were most likely to consider women with a history of pelvic inflammatory disease unsuitable for hormonal (27%, n=161) and copper (26%, n=154) intrauterine devices. Smokers were the most likely to be considered unsuitable for the implant (16%, n=96). Nearly three fourths of respondents routinely discussed intrauterine devices (413/561) and half (271/558) discussed implants with their contraceptive patients. Characteristics that predicted onsite LARC provision included LARC training, beliefs, and health care provider type. Although there has been significant progress in expanding access and understanding about LARC, many clinicians from sites offering family planning services held beliefs limiting the provision of intrauterine devices and were unfamiliar with the implant, suggesting the need for targeted trainings aimed at informing clinicians of recent developments in LARC recommendations.
[Psychosocial research and family planning services in Mexico].
Urbina Fuentes, M; Vernon Carter, R
1985-01-01
Psychosocial and service studies round out data from the demographic and contraceptive prevalence studies that have been conducted every 3 years since 1976 in Mexico. The studies can be formative, providing basic information for development of a program, or evaluative, indicating how well a program is performing. Among formative psychosocial studies in Mexico have been knowledge, attitude, and practice (KAP) studies, which are usually helpful in the initial stages of family planning program implementation. A 1964 study of knowledge and practice in 7 Mexican cities showed that attitudes toward family planning were more traditional and disapproving in Mexico City than in other areas, but that many women wanted no more children. About 1/4 of the population of Mexico City knew no contraceptive methods and about 1/2 knew only less effective traditional methods. By 1979, 72% of women knew at least 1 effective method. KAP studies have demonstrated differences in the family size desires of men and women and in the determinants of attitudes toward birth control. Formative studies of surgical contraception have been psychologically oriented, and have helped provide a rational basis for making the operation accessible to the public. Despite some passing problems, most women have adapted to sterilization and their libidos have normalized by 18 months postoperative. Studies of the knowledge and attitudes of physicians conducted in the early days of family planning programs have helped in the design of programs to inform them of the advantages and side affects of contraceptive methods. Other studies have helped identify traditional midwives with large practices in rural areas who could be trained to deliver family planning services and have demonstrated that they develop a good understanding of contraindications and side effects of oral contraceptives. Teaching materials for IEC programs have been evaluated with small samples, but minimal attention has been given to research on the best ways of providing family planning education for physicians, nurses, students, promoters, husbands, or other population groups. The greatest effort appears to have focused on development of educational materials for illiterates. Evaluative research on messages transmitted in IEC campaigns has however been abundant since the start of the programs. Careful studies of IEC c ampaigns in 1980-81 indicated that they improved knowledge of basic aspects of family planning considerably but had little effect on values and beliefs associated with family planning. Data on new acceptors in Mexico have come primarily from institutional registration systems, special studies, and as a subproduct of demographic surveys. Careful studies done by private organizations have provided information needed to reformulate commercial distribution programs and design supporting IEC campagns for their users and agents. Evaluative service studies have focuses on identifying factors in differential continuation rates for different methods and programs. Research on service delivery in rural areas has helped identify the most productive type of community worker and has uncovered causes of dissatisfaction and high turnover among workers which impairs their performance.
Friedman, Lori; Schreiber, Lisa
2007-01-01
In an era of fiscal constraints and increased accountability for social service programs, having a centralized and efficient infrastructure is critical. A well-functioning infrastructure helps a state reduce duplication of services, creates economies of scale, coordinates resources, supports high-quality site development and promotes the self-sufficiency and growth of community-based programs. Throughout the Healthy Families America home visitation network, both program growth and contraction have been managed by in-state collaborations, referred to as "state systems." This article explores the research base that supports the rationale for implementing state systems, describes the evolution of state systems for Healthy Families America, and discusses the benefits, challenges and lessons learned of utilizing a systems approach.
Coordinated and Evidence-Based Policy and Practice for Protecting Children outside of Family Care
ERIC Educational Resources Information Center
Boothby, Neil; Balster, Robert L.; Goldman, Philip; Wessells, Michael G.; Zeanah, Charles H.; Huebner, Gillian; Garbarino, James
2012-01-01
The 2011 U.S. Government Evidence Summit on Protecting Children Outside of Family Care brought together leading researchers and technical experts to assess the available evidence to inform policies, strategies, and programs relevant to protecting children outside of family care in lower and middle income countries. While child vulnerabilities are…
Family Supports for Children with Severe Disabilities and Chronic Illnesses in Maryland.
ERIC Educational Resources Information Center
Walker, Pam
This report focuses on positive practices in providing support services to families of children with severe disabilities and chronic illnesses, based on visits to three sites in Maryland: the Family Support Program at the Kennedy Institute in Baltimore, the Coordinating Center for Home and Community Care, and Sick Kids Need Involved People (SKIP).…
Fees, Bronwyn; Trost, Stewart; Bopp, Melissa; Dzewaltowski, David A
2009-01-01
To examine family child care home (FCCH) providers' perceptions of appropriate physical activity (PA), current practices, and perceived barriers to inclusion of PA within their programs. A trained facilitator lead 4 focus group sessions of FCCH providers. Questions addressed providers' planning for PA, resources and barriers, and perceptions of children's engagement. Family child care homes. 32 FCCH providers (100% female) caring for children 6 weeks to 5 years old in predominantly mixed-age programs. Types of and extent to which PA was offered for children and perceived barriers to PA in this setting. Authors coded and analyzed transcriptions based on a socioecological framework using qualitative data analysis software. Majority of providers reported running and dancing to music as the most common PA, generally in an unstructured context. Frequency varied from none to twice a day. Few providers reported planning intentionally for PA; any plans followed children's interests. Barriers to inclusion of PA included personal, programming, parent, environmental, and financial reasons. Providers requested training on PA, particularly ideas for experiences in mixed-age groups. Type, frequency, consistency, and duration of PA among FCCH homes vary widely. Implications include training on PA and resources tailored to the unique characteristics of family child care homes.
Dowling, Patrick T; Bholat, Michelle Anne
2012-12-01
After identifying many unlicensed Hispanic international medical graduates (IMGs) legally residing in southern California, University of California, Los Angeles developed an innovative program to prepare these sidelined physicians to enter family medicine residency programs and become licensed physicians. On completion of a 3-year family medicine residency-training program, these IMGs have an obligation to practice in a federally designated underserved community in the state for 2 to 3 years. As the US health care system moves from physician-centered practices to patient-focused teams, with primary care serving as the foundation for building patient-centered medical homes, attention to educating IMGs in these concepts is crucial. Copyright © 2012 Elsevier Inc. All rights reserved.
Five Weekend National Family Medicine Fellowship. Program for faculty development.
Talbot, Y; Batty, H; Rosser, W W
1997-12-01
PROBLEM ADDRESSEDMany faculty development programs are thought time-consuming and inaccessible to academic family physicians or physicians wanting to move into academic positions. This is largely due to difficulty in leaving their practices for extended periods. Canadian family medicine needs trained leaders who can work in teams and are well grounded in the principles of their discipline as they relate to education, management, research, and policy making.OBJECTIVE OF PROGRAMTo develop a team of leaders in family medicine.MAIN COMPONENTS OF PROGRAMThe Five Weekend National Family Medicine Fellowship Program focuses on the essentials of education, management, communication, critical appraisal skills, and the principles of family medicine to develop leadership and team-building skills for faculty and community-based family physicians entering academic careers. This unique 1-year program combines intensive weekend seminars with small-group projects between weekends. It emphasizes a broader set of skills than just teaching, has regional representation, and focuses on leadership and teamwork using a time-efficient format.CONCLUSIONThe program has graduated 34 Fellows over the last 3 years. More than 90% of the 35 projects developed through course work have been presented in national or provincial peer-reviewed settings. Quantitative ratings of program structure, course content, and course outcomes have been positive.
Leung, Janice M; Bhutani, Mohit; Leigh, Richard; Pelletier, Dan; Good, Cathy; Sin, Don D
2015-01-01
BACKGROUND: Patients with chronic obstructive pulmonary disease (COPD) and asthma depend on inhalers for management, but critical errors committed during inhaler use can limit drug effectiveness. Outpatient education in inhaler technique remains inconsistent due to limited resources and inadequate provider knowledge. OBJECTIVE: To determine whether a simple, two-session inhaler education program can improve physician attitudes toward inhaler teaching in primary care practice. METHODS: An inhaler education program with small-group hands-on device training was instituted for family physicians (FP) in British Columbia and Alberta. Sessions were spaced one to three months apart. All critical errors were corrected in the first session. Questionnaires surveying current inhaler teaching practices and attitudes toward inhaler teaching were distributed to physicians before and after the program. RESULTS: Forty-one (60%) of a total 68 participating FPs completed both before and after program questionnaires. Before the program, only 20 (49%) reported providing some form of inhaler teaching in their practices, and only four (10%) felt fully competent to teach patients inhaler technique. After the program, 40 (98%) rated their inhaler teaching as good to excellent. Thirty-four (83%) reported providing inhaler teaching in their practices, either by themselves or by an allied health care professional they had personally trained. All stated they could teach inhaler technique within 5 min. Observation of FPs during the second session by certified respiratory educators found that none made critical errors and all had excellent technique. CONCLUSION: A physician inhaler education program can improve attitudes toward inhaler teaching and facilitate implementation in clinical practices. PMID:26436910
How do IMGs compare with Canadian medical school graduates in a family practice residency program?
Andrew, Rodney F.
2010-01-01
ABSTRACT OBJECTIVE To compare international medical graduates (IMGs) with Canadian medical school graduates in a family practice residency program. DESIGN Analysis of the results of the in-training evaluation reports (ITERs) and the Certification in Family Medicine (CCFP) examination results for 2 cohorts of IMGs and Canadian-trained graduates between the years 2006 and 2008. SETTING St Paul’s Hospital (SPH) in Vancouver, BC, a training site of the University of British Columbia (UBC) Family Practice Residency Program. PARTICIPANTS In-training evaluation reports were examined for 12 first-year and 9 second-year Canadian-trained residents at the SPH site, and 12 first-year and 12 second-year IMG residents at the IMG site at SPH; CCFP examination results were reviewed for all UBC family practice residents who took the May 2008 examination and disclosed their results. MAIN OUTCOME MEASURES Pass or fail rates on the CCFP examination; proportions of evaluations in each group of residents given each of the following designations: exceeds expectations, meets expectations, or needs improvement. The May 2008 CCFP examination results were reviewed. RESULTS Compared with the second-year IMGs, the second-year SPH Canadian-trained residents had a greater proportion of exceeds expectations designations than the IMGs. For the first-year residents, both the SPH Canadian graduates and IMGs had similar results in all 3 categories. Combining the results of the 2 cohorts, the Canadian-trained residents had 310 (99%) ITERs that were designated as either exceeds expectations or meets expectations, and only 3 (1%) ITERs were in the needs improvement category. The IMG results were 362 (97.6%) ITERs in the exceeds expectations or meets expectations categories; 9 (2%) were in the needs improvement category. Statistically these are not significant differences. Seven of the 12 (58%) IMG candidates passed the CCFP examination compared with 59 of 62 (95%) of the UBC family practice residents. CONCLUSION The IMG residents compared favourably with their Canadian-trained colleagues when comparing ITERs but not in passing the CCFP examination. Further research is needed to elucidate these results. PMID:20841570
Promising Practices for Home/School Partnerships.
ERIC Educational Resources Information Center
Salerno, Anne; Fink, Mary
This report contains profiles of 18 innovative and successful parent involvement programs for migrant families. The programs were selected based on recommendations from State Directors of Migrant Education and migrant educators and on a search of the ERIC database. Each profile includes sponsoring institution or agency, program format, program…
Distelberg, Brian; Tapanes, Daniel; Emerson, Natacha D; Brown, Whitney N; Vaswani, Deepti; Williams-Reade, Jackie; Anspikian, Ara M; Montgomery, Susanne
2018-03-01
Psychosocial interventions for pediatric chronic illness (CI) have been shown to support health management. Interventions that include a family systems approach offer potentially stronger and more sustainable improvements. This study explores the biopsychosocial benefits of a novel family systems psychosocial intervention (MEND: Mastering Each New Direction). Forty-five families participated in a 21-session intensive outpatient family systems-based program for pediatric CI. Within this single arm design, families were measured on five domains of Health-Related Quality of Life (HRQL) self-report measures; Stress, Cognitive Functioning, Mental Health, Child HRQL, Family Functioning. Both survey and biological measures (stress: catecholamine) were used in the study. Results from multivariate general linear models showed positive pre-, post-, and 3-month posteffects in all five domains. The program effects ranged from small to moderate (η 2 = .07-.64). The largest program effects were seen in the domains of cognitive functioning (η 2 = .64) and stress (η 2 = .27). Also, between disease groups, differences are noted and future implications for research and clinical practice are discussed. Conclusions suggest that the MEND program may be useful in helping families manage pediatric chronic illnesses. Study results also add to the growing body of literature suggesting that psychosocial interventions for pediatric chronic illness benefit from a family systems level of intervention. © 2017 Family Process Institute.
Bergman-Marković, Biserka; Katić, Milica; Kern, Josipa
2007-01-01
Well-organised medical records are the prerequisite for achieving a high level of performance in primary healthcare settings. Recording balanced structured and coded data as well as free text can improve both quality and organisation of work in the office. It provides a more substantiated support of financial transactions and accountancy, allows better communication with other facilities and institutions, and is a source of valuable scientific research material. This article is the result of an individual experience gained in general practice use of various programs/systems employed within the family medicine frame, and the frame of evaluation of available and commonly-exploited program solutions. The use of various programs allows for systematic adjustments as to the increasingly complex requirements imposed on electronic medical records (EMRs). The experience of a general practitioner, presented in this paper, confirms the assumption that an adequate program to be employed with EMRs should be developed, provided that family medicine practitioners, that is, the final users, have been involved in each and every stage of its development, adjustment, implementation and evaluation.
[Working Education Program in Health: transforming experience of nursing teaching and practice].
Santos, Débora de Souza; Santos de Almeida, Lenira Maria Wanderley; Reis, Renata Karina
2013-12-01
This is an experience report of tutors from nursing Working Education Program in Health ( PET- Saúde ) from the Federal University of Alagoas, from May 2009 to April 2010. The objective of the nursing PET-Saúde was to develop health education actions aimed at the needs of the communities attended by the Family Health Units in Maceio, Alagoas. We conducted a health planning guided by the problem-based methodology. The activities resulted in changes in student learning and in the practice of nurses PET-Saúde , indicating the importance of this program for teaching and practice of nursing.
Integrating improvement learning into a family medicine residency curriculum.
Pensa, Mellisa; Frew, Patty; Gelmon, Sherril B
2013-06-01
Knowledge of improvement practices is a critical skill for family medicine residents who will lead patient-centered medical homes. The Accreditation Council for Graduate Medical Education includes systems-based practice and improvement knowledge as a core competency for residency education. The objective of this report is to describe the 6-year implementation and development of our practice-based improvement curriculum in a family medicine residency. In 2006, Oregon Health and Science University Family Medicine Residency implemented an improvement curriculum that focused on clinic-based improvement and involved longitudinal didactics. Over the course of 6 years, the curriculum has been refined to include longitudinal instruction of improvement principles according to the levels of training and clinic-based didactics and experientials that are team oriented. Residents complete ambulatory improvement projects over the cycle of 12 months and present outcomes each year. Residents evaluated their knowledge, experience, confidence, and satisfaction at the end of the academic year. Ninety percent of residents designed and lead improvement projects upon graduation from residency in 2011. Resident confidence to make a change in local health care settings at the end of the curriculum was high and improved from 2009/2010 to 2010/2011. Upon graduation from the program, 100% of residents reported competence or proficiency in their ability to apply knowledge to an improvement project and present results. We describe a longitudinal, practical, developmental, and clinically based experiential improvement curriculum that has been successfully integrated into a family medicine residency program.
Heckman, James J.
2009-01-01
This paper discusses (a) the role of cognitive and noncognitive ability in shaping adult outcomes, (b) the early emergence of differentials in abilities between children of advantaged families and children of disadvantaged families, (c) the role of families in creating these abilities, (d) adverse trends in American families, and (e) the effectiveness of early interventions in offsetting these trends. Practical issues in the design and implementation of early childhood programs are discussed. PMID:20119503
ERIC Educational Resources Information Center
Feinberg, Sandra; Jordan, Barbara; Deerr, Kathleen; Langa, Michelle
This publication is a guide to assist librarians in taking a proactive stance to include families of children with special needs in programs and services. The focus is on families with children up to age five, and covers the basic principles underlying inclusion, family-centered service, resource-based practice, and the provision of library…
Patterson, Jo Ellen; Vakili, Susanna
2014-03-01
Recent research is providing family therapists with new information about the complex interaction between an individual's biological makeup and his/her social and physical environment. Family and social relationships, particularly during sensitive periods early in life, can affect a child's biological foundation. Additionally, stress during the early years can have a lasting effect on an individual's physical and mental health and contribute to the onset of severe mental illness. Community programs have been developed to intervene early with families who have an at-risk child to prevent or minimize the onset of mental illness including providing partnerships with at-risk mothers of infants to shape attachment relationships. Programs are also developing individual and family interventions to prevent the onset of psychosis. Practicing family therapists can incorporate emerging neuroscience and early intervention research and leverage the growing base of community programs to enhance the effectiveness and sustainability of mental health outcomes for clients. Additionally, family therapy education programs should broaden student training to incorporate the growing body of information about how family relationships affect individual mental health development. © 2013 FPI, Inc.
Celebrating indigenous communities compassionate traditions.
Prince, Holly
2018-01-01
Living in a compassionate community is not a new practice in First Nations communities; they have always recognized dying as a social experience. First Nations hold extensive traditional knowledge and have community-based practices to support the personal, familial, and community experiences surrounding end-of-life. However, western health systems were imposed and typically did not support these social and cultural practices at end of life. In fact, the different expectations of western medicine and the community related to end of life care has created stress and misunderstanding for both. One solution is for First Nations communities to develop palliative care programs so that people can receive care at home amongst their family, community and culture. Our research project "Improving End-of-Life Care in First Nations Communities" (EOLFN) was funded by the Canadian Institutes of Health Research [2010-2015] and was conducted in partnership with four First Nations communities in Canada (see www.eolfn.lakeheadu.ca). Results included a community capacity development approach to support Indigenous models of care at end-of-life. The workshop will describe the community capacity development process used to develop palliative care programs in First Nations communities. It will highlight the foundation to this approach, namely, grounding the program in community values and principles, rooted in individual, family, community and culture. Two First Nations communities will share stories about their experiences developing their own palliative care programs, which celebrated cultural capacity in their communities while enhancing medical palliative care services in a way that respected and integrated with their community cultural practices. This workshop shares the experiences of two First Nations communities who developed palliative care programs by building upon community culture, values and principles. The underlying model guiding development is shared.
Family intervention in Indigenous communities: emergent issues in conducting outcome research.
Turner, Karen; Sanders, Matthew
2007-01-01
Indigenous children and youth are at greater risk of emotional and behavioural problems than non-Indigenous youth, with family life stresses and parenting style identified as common risk factors. There is substantial evidence that parenting programs can improve family relationships and improve child outcomes, however little research has focused on Indigenous communities. Our team is conducting research to evaluate a culturally sensitive adaptation of a mainstream intervention, the Group Triple P---Positive Parenting Program, for Indigenous families. This paper shares some of the insights into research and clinical issues gained as non-Indigenous researchers working with urban, rural and remote Indigenous communities. The experience of the research team and feedback from practitioners and parents have been drawn on for this discussion. Parenting programs need to be sensitive to the political and cultural context in which parenting takes place, flexibly incorporate cultural practices and expectations, and develop an evidence base of outcomes for families in diverse communities. As research is needed to evaluate the acceptability and effectiveness of these programs, culturally sensitive research practices are also necessary and the value of program evaluation and its benefit to the community must be clear. Community acceptance of the research process and the intervention itself is vital and may be influenced by community perceptions, current priorities, and local issues. If our overall aim is to increase the skilled health and mental health workforce in Indigenous communities and their use of evidence-based interventions, ongoing collaborative relationships between research institutions and service providers will serve to further this aim.
Mulvania, P; Mehakovic, E; Wise, C; Cass, Y; Daly, T A; Nathan, H M
2014-01-01
Australian donation leaders recognized that to increase organ donation outcomes, health professionals conducting family donation conversations (FDCs) required support and specialist training. An international training institute with programs based on proven results was engaged to create and implement a customized training program to influence change in FDC practice and culture. The goal was to increase donation rates by developing and implementing a customized, self-sustaining training program to enhance FDC practices of health professionals. Other goals included providing training and communications skills to lead FDC, supporting families in making decisions, and influencing health professionals to adopt FDC practices. To gain support and determine program suitability, two 1-day pilot training sessions were provided to 45 Australian donation leaders in 2011. Training was further customized with an emphasis on creating changes to achieve and sustain desired results. A comprehensive national training plan was implemented over 18 months. Twenty-six 2-day FDC training workshops were held in 8 cities (646 participants). Program evaluations and debriefings showed distinct shifts in perspectives and an enthusiasm to implement new processes. In 2012 to 2013, an instructor program was developed to transition training facilitation. The training institute remains involved in development and training to build and sustain skill and expertise. There was a 58% increase in organ donors in Australia from 2009 to 2013 (data reflect 2013 Australian end-of-year organ donation information). This represents a 36% increase in organ donors (2009-2011); the remaining 22% increase was achieved in the 2 years since the FDC training was implemented in Australia (2011-2013). Improved skills training in the conduct of FDCs seem to have contributed to improved donation outcomes in national identification, request, and consent rates. The integration of another organization's process poses distinct challenges; thoughtful collaboration, sensitive to cultural aspects and family care, communication, and donation practices, can result in successful customized training that shifts perspectives, provides new skills, and achieves and sustains an increase in organ donation rates. Copyright © 2014 Elsevier Inc. All rights reserved.
Primary Care Interventions to Reduce Childhood Obesity in Latino Families.
Gonzalez, Giulliana
2016-01-01
Increasing rates of obesity in Latino children call for culturally sensitive primary care interventions. Despite recent efforts to address this growing disparity, little is known about cultural variables that influence obesity management programs in Latino children. A literature search was conducted using CINHAL, Scopus, PubMed, and PsycINFO to review the state of the science regarding primary care interventions to decrease obesity in Latino children. The author analyzed the effects of several cultural practices on obesity and made recommendations based on their clinical implications for weight reduction management programs. Obesity in Latino children is a multifactorial problem influenced by family behaviors, cultural perceptions of weight and health, traditional dietary norms, and socioeconomic status. Current practice lags behind national obesity management recommendations and is further hindered by a lack of consideration of the roles of key cultural differences in Latino families. It is imperative to recognize the importance of family preferences and culture when developing weight reduction programs so as to foster long-term behavior changes. More research assessing the efficacy of culturally competent interventions is necessary to guide national efforts to address this increasing disparity. Copyright © 2015 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.
Solo and Small Practices: A Vital, Diverse Part of Primary Care
Liaw, Winston R.; Jetty, Anuradha; Petterson, Stephen M.; Peterson, Lars E.; Bazemore, Andrew W.
2016-01-01
PURPOSE Solo and small practices are facing growing pressure to consolidate. Our objectives were to determine (1) the percentage of family physicians in solo and small practices, and (2) the characteristics of and services provided by these practices. METHODS A total of 10,888 family physicians seeking certification through the American Board of Family Medicine in 2013 completed a demographic survey. Their practices were split into categories by size: solo, small (2 to 5 providers), medium (6 to 20 providers), and large (more than 20 providers). We also determined the rurality of the county where the physicians practiced. We developed 2 logistic regression models: one assessed predictors of practicing in a solo or small practice, while the other was restricted to solo and small practices and assessed predictors of practicing in a solo practice. RESULTS More than one-half of respondents worked in solo or small practices. Small practices were the largest group (36%) and were the most likely to be located in a rural setting (20%). The likelihood of having a care coordinator and medical home certification increased with practice size. Physicians were more likely to be practicing in small or solo practices (vs medium-sized or large ones) if they were African American or Hispanic, had been working for more than 30 years, and worked in rural areas. Physicians were more likely to be practicing in small practices (vs solo ones) if they worked in highly rural areas. CONCLUSIONS Family physicians in solo and small practices comprised the majority among all family physicians seeking board certification and were more likely to work in rural geographies. Extension programs and community health teams have the potential to support transformation within these practices. PMID:26755778
Early Childhood Programs for Language Minority Students. ERIC Digest.
ERIC Educational Resources Information Center
Nissani, Helen
Early childhood programs should be designed to serve the whole child's development within the context of the family and community. This is especially important for children who speak a language other than English at home. Programs must employ developmentally and culturally appropriate practices that respect individual differences and choices and…
Guaranteed Loans: Just Plain Expensive
ERIC Educational Resources Information Center
Petri, Thomas E.
2007-01-01
The investigation of New York State's attorney general, Andrew M. Cuomo, into the questionable practices of lenders in federal student-loan programs has helped raise public awareness of one of the greatest scams in our government: The Federal Family Education Loan program, otherwise known as the guaranteed-student-loan program, is unnecessarily…
Teaching Your Child. Televised Parent Training Program.
ERIC Educational Resources Information Center
CEMREL, Inc., Minneapolis, MN.
"Teaching Your Child" was a televised parent training program conducted in Minneapolis, Minnesota. The program was designed to reach parents in low income areas and was intended to assist families with young children by presenting practical applications of basic psychological theory. This booklet was the main workbook for the entire…
Birth Control Practices and Levels of Development in India.
ERIC Educational Resources Information Center
Karan, P.P.; And Others
1978-01-01
Analyzes the spatial patterns of acceptance of birth control practices in India and examines the relationship between these patterns and levels of economic development. Suggests implications of the area differences in acceptance patterns for family planning program policymakers. (Author)
ERIC Educational Resources Information Center
Washington Office of the State Superintendent of Public Instruction, Olympia.
This curriculum guide was designed to help teachers in strengthening the ability of students from middle school through grade 12 to recognize complex problems, examine competing points of view, and engage in dialogue leading to practical solutions for issues that affect individuals and families and ultimately the world. The course integrates the…
Housing Matters for Families: Promising Practices from Child Welfare Agencies.
Cunningham, Mary; Pergamit, Michael
There is growing acknowledgement that housing can provide more than shelter, a basic need. Housing can also act as a foundation, helping families stay together.The provision of housing as a prevention or protective strategy against child maltreatment has not been widely used by child welfare agencies. A small subset of child welfare agencies across the country, however, is incorporating housing into their response to cases of child abuse and neglect. Using qualitative data from ongoing studies of HUD's Family Unification Program (FUP) and the Children's Bureau supportive housing demonstration for high-need child welfare involved families, we describe some of the promising practices agencies are implementing and testing. Though evaluations of these programs are not yet complete, there is a lot the field can learn from these approaches. This paper provides an overview of seven promising strategies: (1) partnering with public housing agencies and leveraging resources; (2) assessing the housing needs of child welfare involved families; (3) triaging and providing housing resources based on needs; (4) providing housing first, not. last; (5) developing housing stability plans and shared case plans; (6) screening families into housing, rather than screening out; and (7) providing housing search assistance.
Gittelman, Michael A; Carle, Adam C; Denny, Sarah; Anzeljc, Samantha; Arnold, Melissa Wervey
2018-04-10
Many pediatric providers struggle to screen families for the majority of age-appropriate injury risks and educate them when appropriate. Standardized tools have helped physicians provide effective, more purposeful counseling. In this study, pediatricians utilized a standardized, injury prevention screening tool to increase targeted discussions and families were re-screened at subsequent visits to determine changes in their behavior. Pediatric practices, recruited from the Ohio Chapter, American Academy of Pediatrics database, self-selected to participate in a quality improvement program. Two screening tools, for children birth-4 month and 6-12 month, with corresponding talking points, were to be implemented into every well child visit. During the 7-month collaborative, screening results and pediatrician counseling for reported unsafe behaviors were calculated. Patients who completed a screening tool at subsequent visits were followed up at a later visit to determine self-reported behavior changes. We examined statistically significant differences in frequencies using the X 2 test. Providers received maintenance of certification IV credit for participation. Seven practices (39 providers) participated. By the second month, participating providers discussed 75% of all inappropriate responses for birth-4 month screenings and 87% for 6-12 months. Of the 386 families who received specific counseling and had a follow-up visit, 65% (n = 94/144) of birth-4 month and 65% (n = 59/91) of 6-12 month families made at least one behavior change. The X 2 test showed that families who received counseling versus those that did not were significantly more likely to change inappropriate behaviors (p < 0.05). Overall, of all the risks identified, 45% (136) of birth-4 month and 42% (91) of 6-12 month behaviors reportedly changed after a practitioner addressed the topic area. Participation in a quality improvement program within pediatric offices can increase screening for injury risks and encourage tailored injury prevention discussions during an office encounter. As a result, significantly more families reported to practice safer behaviors at later visits.
Robbins, Michael S.; Alonso, Elizabeth; Horigian, Viviana E.; Bachrach, Ken; Burlew, Kathy; Carrión, Ibis S.; Hodgkins, Candace C.; Miller, Michael; Schindler, Eric; VanDeMark, Nancy; Henderson, Craig; Szapocznik, José
2010-01-01
This paper describes the development and implementation of a trial of Brief Strategic Family Therapy (BSFT), an evidence-based drug intervention for adolescents, in eight community substance abuse treatment programs. Researchers and treatment programs collaborated closely to identify and overcome challenges, many of them related to achieving results that were both scientifically rigorous and applicable to the widest possible variety of adolescent substance abuse treatment programs. To meet these challenges, the collaborative team drew on lessons and practices from efficacy, effectiveness, and implementation research. PMID:22002455
Practice patterns of graduates of 2- and 3-year family medicine programs: in Ontario, 1996 to 2004.
Green, Michael; Birtwhistle, Richard; Macdonald, Ken; Kane, John; Schmelzle, Jason
2009-09-01
To compare patterns of practice between graduates of core 2-year family medicine (FM) training programs and those completing an additional postgraduate year (PGY3) of training. Retrospective cohort study using administrative data from the Ontario Health Insurance Plan. Ontario. Graduates of Ontario FM residency programs from 1996 to 2002 who provided insured services in Ontario for 1 or more fiscal years between 1996 and 2004. Proportion of physician years of service in which a minimum number of services were provided in each of the following categories: anesthesia, emergency medicine (EM), home visits, hospital visits, nursing home visits, intrapartum obstetrics, palliative care, office-only practice, and rural locations, as well as deciles for proportion of billings for emergency department work and "quasi-specialty" designations based on billing patterns. Results are stratified by type of training and years in practice. Graduates of PGY3 programs are significantly more likely to practise in a range of nonoffice settings than their counterparts who completed core 2-year FM training programs. Differences were the most marked in areas in which additional training had been undertaken, but also extended to other categories. There was no effect on the proportion practising in rural locations, unless the training was undertaken in a rural setting or in anesthesia. Physicians including EM in their practices were more likely to practise mostly or almost all EM if they had undertaken either EM programs or self-directed programs at non-northern training sites. Very few graduates of any type were classified as belonging to a quasi-specialty group, other than those who completed care of the elderly or palliative care (hospitalist) and anesthesia programs. Completion of a PGY3 program is strongly associated with increased participation in practice outside the office, particularly in the area of the training provided.
Increasing Independent Reading Practice through Family Involvement and Motivational Strategies.
ERIC Educational Resources Information Center
Clark, Angela W.; McDonnell, Karen L.
This study describes a program designed to increase reading practice at home and at school. The targeted population consisted of elementary students from separate river communities located in the Midwest. Evidence for the existence of the problem included teacher observation of apathy to reading practice, student attitude surveys to gauge…
45 CFR 213.12 - Time of hearing.
Code of Federal Regulations, 2010 CFR
2010-10-01
... Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND PROCEDURE FOR...-Notice and Parties § 213.12 Time of hearing. The hearing shall be scheduled not less than 30 days nor...
A teaching bank of audiovisual materials for family practice.
Geyman, J P; Brown, T C
1975-10-01
Although increasing emphasis has been placed in recent years on the production and use of audiovisual materials in medical education, little work has yet been done on the identification and application of these materials in family practice teaching programs. This paper describes the content, uses, limitations, and initial experience of a Teaching Bank developed to support family practice teaching in varied settings. Video cassette and tape-slide units are most useful; audio cassettes alone are less likely to be selected. The evaluation of content, quality, and effectiveness of audiovisual media poses a particular problem. Although audiovisual materials can enhance learning based on different individual learning needs and styles, they cannot stand alone and usually must be supplemented by other teaching methods.
Cleek, Elizabeth N; Wofsy, Matt; Boyd-Franklin, Nancy; Mundy, Brian; Howell Lcsw, Tamika J
2012-06-01
The family empowerment program (FEP) is a multi-systemic family therapy program that partners multi-stressed families with an interdisciplinary resource team while remaining attached to a "traditional" mental health clinic. The rationale for this model is that far too often, families presenting at community mental health centers struggle with multiple psychosocial forces, for example problems with housing, domestic violence, child care, entitlements, racism, substance abuse, and foster care, as well as chronic medical and psychiatric illnesses, that exacerbate symptoms and impact traditional service delivery and access to effective treatment. Thus, families often experience fragmented care and are involved with multiple systems with contradictory and competing agendas. As a result, services frequently fail to harness the family's inherent strengths. The FEP partners the family with a unified team that includes representatives from Entitlements Services, Family Support and Parent Advocacy, and Clinical Staff from the agency's Outpatient Mental Health Clinic practicing from a strength-based family therapy perspective. The goal of the FEP is to support the family in achieving their goals. This is accomplished through co-construction of a service plan that addresses the family's needs in an efficient and coherent manner-emphasizing family strengths and competencies and supporting family self-sufficiency. © FPI, Inc.
ERIC Educational Resources Information Center
Platt, Jason James
2012-01-01
This article describes the philosophical foundations and educational methods of a Spanish language and cultural immersion program based in Mexico City, Mexico. The program is designed to assist U.S. graduate students in marriage and family therapy and clinical psychology programs to improve clinical service delivery with Latino clients. Utilizing…
Smith, Leann E.; Greenberg, Jan; Mailick, Marsha R.
2013-01-01
Synopsis In this review, we report the findings from our longitudinal program of research examining the bidirectional influences of the family environment on the behavioral phenotype of autism, and describe a newly developed family psychoeducation program, titled Transitioning Together, designed to reduce family stress, address behavior problems, and improve the overall quality of life of adolescents with autism and their families. In our search for characteristics of the family environment that influence the behavioral phenotype of adolescents and adults with autism, we focus on both positive dimensions of family life, such as warmth and positive remarks that may promote adaptive behavior in individuals with autism, as well as negative dimensions, such as high levels of criticism that may result in an escalation of behavior problems. We find that high levels of maternal warmth and positive remarks are associated with the abatement of behavior problems over time, while high levels of maternal criticism are associated with increasing levels of behavior problems in adolescents and adults with autism. These patterns of relationships have been replicated in a longitudinal study of families of children and adolescents with fragile X syndrome, and are consistent with other studies examining the impact of the family on the behavior of children with developmental disabilities. These findings suggest that the family environment is an important target for interventions not only to reduce family stress but also to improve the behavioral functioning of children, adolescents or adults with ASD. Building upon a well-developed intervention for families of individuals with psychiatric conditions, we report on the development of Transitioning Together, a psychoeducation program targeted to families with adolescents with autism who are approaching high school exit, a difficult transition stage for individuals with autism that is often marked by negative changes in behavior problems. The 8-week Transitioning Together program involves education on a variety of topics relevant to ASD and guided practice in helping families better manage problem behavior in adolescents with autism. Preliminary data suggest that the program can improve the parent-child relationship and increase parental expressions of warmth. A case study is presented that illustrates how Transitioning Together helps reduce family stress and improve the overall quality of the family environment. We conclude the article with a discussion of directions for future research on best practices in working with families of children, adolescents and adults with autism. PMID:24231173
Residents' perceptions of an integrated longitudinal curriculum: a qualitative study.
Lubitz, Rebecca; Lee, Joseph; Hillier, Loretta M
2015-01-01
The purpose of this study was to explore family medicine residents' perceptions of a newly restructured integrated longitudinal curriculum. A purposeful sample of 16 family medicine residents participated in focus group interviews conducted from a grounded theory perspective to identify the characteristics of this training model that contribute to and that challenge learning. Eight key themes were identified: continuity of care, relevance to family medicine, autonomy, program-focused preparation, professional development as facilitated by role modeling, patient volume, clarity of expectations for learners, and logistics. Positive learning experiences were marked by high levels of autonomy, continuity, and relevance to family medicine. Less favorable learning experiences were characterized by limited opportunities for continuity of care, limited relevance to family medicine practice and unclear expectations for the resident's role. Family physician-led learning experiences contributed to residents' understanding of the full scope of family medicine practice, more so than specialist-led experiences. The logistics of implementing the integrated block were challenging and negatively impacted continuity and learning. This study suggests that an integrated longitudinalized family medicine block training model has the potential to support the principles of a longitudinal integrated competency-based curriculum to effectively prepare residents for family medicine practice.
Pal, Ranabir; Kumar, Raman
2017-01-01
Family medicine or general practice is the practicing discipline of the majority doctors in India, however formal academic departments of general practice (or family medicine) do not exist in India, as it is not a mandatory requirement as prescribed by the Medical Council of India; the principal regulator of medical education. Currently India has capacity to produce more than 60,000 medical graduates per year, majority of whom are expected to become general practitoners or primary care doctors without under going any vocational training in general practice or family medicine. The 92 nd parliamentary standing committee report (on health and family welfare) of the Indian Parliament recommended that Government of India in coordination with State Governments should establish robust postgraduate programs in Family Medicine and facilitate introducing Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous health care for the individuals and families. The authors concur with the parliament of India and strongly feel that "Family Medicine" (community-based comprehensive clinical practice) deserves dedicated and distinct department at all medical colleges in India in order to availability of qualified medical doctors in the community-based health system. AIIMS, New Delhi, along with other newly established AIIMS, should rise to their foundation mandate of supporting excellence in all disciplines of medical science and to this historic responsibility; and not just remain an ivory tower of tertiary care based fragmented (into sub specialties) hospital culture.
Pal, Ranabir; Kumar, Raman
2017-01-01
Family medicine or general practice is the practicing discipline of the majority doctors in India, however formal academic departments of general practice (or family medicine) do not exist in India, as it is not a mandatory requirement as prescribed by the Medical Council of India; the principal regulator of medical education. Currently India has capacity to produce more than 60,000 medical graduates per year, majority of whom are expected to become general practitoners or primary care doctors without under going any vocational training in general practice or family medicine. The 92nd parliamentary standing committee report (on health and family welfare) of the Indian Parliament recommended that Government of India in coordination with State Governments should establish robust postgraduate programs in Family Medicine and facilitate introducing Family Medicine discipline in all medical colleges. This will not only minimize the need for frequent referrals to specialist and decrease the load on tertiary care but also provide continuous health care for the individuals and families. The authors concur with the parliament of India and strongly feel that “Family Medicine” (community-based comprehensive clinical practice) deserves dedicated and distinct department at all medical colleges in India in order to availability of qualified medical doctors in the community-based health system. AIIMS, New Delhi, along with other newly established AIIMS, should rise to their foundation mandate of supporting excellence in all disciplines of medical science and to this historic responsibility; and not just remain an ivory tower of tertiary care based fragmented (into sub specialties) hospital culture. PMID:29302511
Simon, Melissa A; Gunia, Brian; Martin, Emily J; Foucar, Charles E; Kundu, Tapas; Ragas, Daiva M; Emanuel, Linda L
2013-10-01
Rising costs and a workforce talent shortage are two of the health care industry's most pressing challenges. In particular, serious illnesses often impose significant costs on individuals and their families, which can place families at an increased risk for multigenerational economic deprivation or even an illness-poverty trap. At the same time, family caregivers often acquire a wide variety of health care skills that neither these caregivers nor the health care industry typically use. As these skills are marketable and could be paired with many existing medical certifications, this article describes a possible "path toward economic resilience" (PER) through a program whereby family caregivers could find meaningful employment using their new skills. The proposed program would identify ideal program candidates, assess and supplement their competencies, and connect them to the health care industry. We provide a set of practical steps and recommended tools for implementation, discuss pilot data on the program's appeal and feasibility, and raise several considerations for program development and future research. Our analysis suggests that this PER program could appeal to family caregivers and the health care industry alike, possibly helping to address two of our health care system's most pressing challenges with one solution.
Outcome evaluation of a community center-based program for mothers at high psychosocial risk.
Rodrigo, María José; Máiquez, María Luisa; Correa, Ana Delia; Martín, Juan Carlos; Rodríguez, Guacimara
2006-09-01
This study reported the outcome evaluation of the "Apoyo Personal y Familiar" (APF) program for poorly-educated mothers from multi-problem families, showing inadequate behavior with their children. APF is a community-based multi-site program delivered through weekly group meetings in municipal resource centers. A total of 340 mothers referred by the municipal social services of Tenerife, Spain were assessed; 185 mothers participated in the APF program that lasted 8 months, and 155 mothers were in the control group. Pre-post test comparisons for the intervention group and post-test comparisons with the control group on self-rating measures of maternal beliefs, personal agency and child-rearing practices were performed. Multivariate tests, t tests and effect sizes (ES) were calculated to determine the program effectiveness on the outcome measures. Mothers' support of nurturist and nativist beliefs and the reported use of Neglect-permissive and Coercive practices significantly decreased after program completion whereas the reported use of Inductive practices significantly increased. Increases in self-efficacy, internal control and role difficulty were also significant in relation to those of the control group. The program was especially effective for older mothers, with fewer children, living in a two-parent family, in urban areas and with either low or medium educational levels. The program was very effective in changing the mothers' perceived competences and modestly effective in changing their beliefs about child development and education and reported child-rearing practices. Changes in personal agency are very important for at-risk parents who feel helpless and with no control over their lives.
Mold, J W; Mehr, D R; Kvale, J N; Reed, R L
1995-04-01
The role of geriatrics and geriatricians in family medicine remains unsettled. Despite a rapidly aging population, a tremendous shortage now exists of faculty with interest and expertise in geriatrics. Relatively few family practice residents choose to enter geriatric fellowship programs, and federal funding for such programs has been reduced. Despite accreditation requirements, residency programs are not always able to provide the range of geriatric experiences needed to properly prepare graduates to provide care for the broad range of older patients. Medical students' exposure to geriatrics remains limited. The Group on Geriatric Education of the Society of Teachers of Family Medicine believes that family medicine faculty must recognize and be committed to the notion that geriatrics is integral to family medicine. Both undergraduate and residency training programs should emphasize experience with geriatric patients in multiple settings. In particular, the nursing home should not be the main focus of geriatric training. The small number of certified geriatric faculty will be able to provide leadership, but a broad range of faculty must become involved in teaching geriatrics. Faculty development activities and continuing education programs to foster the necessary expertise will be essential to the accomplishment of this task.
Training Family Medicine Residents to Perform Home Visits: A CERA Survey.
Sairenji, Tomoko; Wilson, Stephen A; D'Amico, Frank; Peterson, Lars E
2017-02-01
Home visits have been shown to improve quality of care, save money, and improve outcomes. Primary care physicians are in an ideal position to provide these visits; of note, the Accreditation Council for Graduate Medical Education no longer requires home visits as a component of family medicine residency training. To investigate changes in home visit numbers and expectations, attitudes, and approaches to training among family medicine residency program directors. This research used the Council of Academic Family Medicine Educational Research Alliance (CERA) national survey of family medicine program directors in 2015. Questions addressed home visit practices, teaching and evaluation methods, common types of patient and visit categories, and barriers. There were 252 responses from 455 possible respondents, representing a response rate of 55%. At most programs, residents performed 2 to 5 home visits by graduation in both 2014 (69% of programs, 174 of 252) and 2015 (68%, 172 of 252). The vast majority (68%, 172 of 252) of program directors expect less than one-third of their graduates to provide home visits after graduation. Scheduling difficulties, lack of faculty time, and lack of resident time were the top 3 barriers to residents performing home visits. There appeared to be no decline in resident-performed home visits in family medicine residencies 1 year after they were no longer required. Family medicine program directors may recognize the value of home visits despite a lack of few formal curricula.
Practice Facilitators' and Leaders' Perspectives on a Facilitated Quality Improvement Program.
McHugh, Megan; Brown, Tiffany; Liss, David T; Walunas, Theresa L; Persell, Stephen D
2018-04-01
Practice facilitation is a promising approach to helping practices implement quality improvements. Our purpose was to describe practice facilitators' and practice leaders' perspectives on implementation of a practice facilitator-supported quality improvement program and describe where their perspectives aligned and diverged. We conducted interviews with practice leaders and practice facilitators who participated in a program that included 35 improvement strategies aimed at the ABCS of heart health (aspirin use in high-risk individuals, blood pressure control, cholesterol management, and smoking cessation). Rapid qualitative analysis was used to collect, organize, and analyze the data. We interviewed 17 of the 33 eligible practice leaders, and the 10 practice facilitators assigned to those practices. Practice leaders and practice facilitators both reported value in the program's ability to bring needed, high-quality resources to practices. Practice leaders appreciated being able to set the schedule for facilitation and select among the 35 interventions. According to practice facilitators, however, relying on practice leaders to set the pace of the intervention resulted in a lower level of program intensity than intended. Practice leaders preferred targeted assistance, particularly electronic health record documentation guidance and linkages to state smoking cessation programs. Practice facilitators reported that the easiest interventions were those that did not alter care practices. The dual perspectives of practice leaders and practice facilitators provide a more holistic picture of enablers and barriers to program implementation. There may be greater opportunities to assist small practices through simple, targeted practice facilitator-supported efforts rather than larger, comprehensive quality improvement projects. © 2018 Annals of Family Medicine, Inc.
Lai, Agnes Y.; Mui, Moses W.; Wan, Alice; Stewart, Sunita M.; Yew, Carol; Lam, Tai-hing; Chan, Sophia S.
2016-01-01
Evidence-based practice and capacity-building approaches are essential for large-scale health promotion interventions. However, there are few models in the literature to guide and evaluate training of social service workers in community settings. This paper presents the development and evaluation of the “train-the-trainer” workshop (TTT) for the first large scale, community-based, family intervention projects, entitled “Happy Family Kitchen Project” (HFK) under the FAMILY project, a Hong Kong Jockey Club Initiative for a Harmonious Society. The workshop aimed to enhance social workers’ competence and performance in applying positive psychology constructs in their family interventions under HFK to improve family well-being of the community they served. The two-day TTT was developed and implemented by a multidisciplinary team in partnership with community agencies to 50 social workers (64% women). It focused on the enhancement of knowledge, attitude, and practice of five specific positive psychology themes, which were the basis for the subsequent development of the 23 family interventions for 1419 participants. Acceptability and applicability were enhanced by completing a needs assessment prior to the training. The TTT was evaluated by trainees’ reactions to the training content and design, changes in learners (trainees) and benefits to the service organizations. Focus group interviews to evaluate the workshop at three months after the training, and questionnaire survey at pre-training, immediately after, six months, one year and two years after training were conducted. There were statistically significant increases with large to moderate effect size in perceived knowledge, self-efficacy and practice after training, which sustained to 2-year follow-up. Furthermore, there were statistically significant improvements in family communication and well-being of the participants in the HFK interventions they implemented after training. This paper offers a practical example of development, implementation and model-based evaluation of training programs, which may be helpful to others seeking to develop such programs in diverse communities. PMID:26808541
Lai, Agnes Y; Mui, Moses W; Wan, Alice; Stewart, Sunita M; Yew, Carol; Lam, Tai-Hing; Chan, Sophia S
2016-01-01
Evidence-based practice and capacity-building approaches are essential for large-scale health promotion interventions. However, there are few models in the literature to guide and evaluate training of social service workers in community settings. This paper presents the development and evaluation of the "train-the-trainer" workshop (TTT) for the first large scale, community-based, family intervention projects, entitled "Happy Family Kitchen Project" (HFK) under the FAMILY project, a Hong Kong Jockey Club Initiative for a Harmonious Society. The workshop aimed to enhance social workers' competence and performance in applying positive psychology constructs in their family interventions under HFK to improve family well-being of the community they served. The two-day TTT was developed and implemented by a multidisciplinary team in partnership with community agencies to 50 social workers (64% women). It focused on the enhancement of knowledge, attitude, and practice of five specific positive psychology themes, which were the basis for the subsequent development of the 23 family interventions for 1419 participants. Acceptability and applicability were enhanced by completing a needs assessment prior to the training. The TTT was evaluated by trainees' reactions to the training content and design, changes in learners (trainees) and benefits to the service organizations. Focus group interviews to evaluate the workshop at three months after the training, and questionnaire survey at pre-training, immediately after, six months, one year and two years after training were conducted. There were statistically significant increases with large to moderate effect size in perceived knowledge, self-efficacy and practice after training, which sustained to 2-year follow-up. Furthermore, there were statistically significant improvements in family communication and well-being of the participants in the HFK interventions they implemented after training. This paper offers a practical example of development, implementation and model-based evaluation of training programs, which may be helpful to others seeking to develop such programs in diverse communities.
A Framework for Engaging Parents in Prevention
ERIC Educational Resources Information Center
Randolph, Karen A.; Fincham, Frank; Radey, Melissa
2009-01-01
The literature on engaging families in prevention programs is informed by the Health Beliefs Model (HBM), Theory of Reasoned Action (TRA), and Family Systems theory. Although useful, these frameworks have not facilitated the development of prevention-based practice strategies that recognize different levels of prevention (i.e., universal,…
New Strategies for Improving Rural Family Life.
ERIC Educational Resources Information Center
Coombs, Philip H.
Presented in capsule form for the convenience of busy policy makers, planners, and program managers, this booklet summarizes major findings of a three-year study on practical aspects of rural development, with particular emphasis on ways of alleviating extreme poverty among disadvantaged rural families. Using case studies from Bangladesh, India,…
Educating Gerontologists for Cultural Proficiency in End-of-Life Care Practice
ERIC Educational Resources Information Center
Stein, Gary L.; Sherman, Patricia A.; Bullock, Karen
2009-01-01
An educational program was developed to train practitioners to provide care for patients and families that are responsive to cultural concerns. The aim was to increase knowledge and improve attitudes toward providing culturally proficient and culturally sensitive care for patients and families facing life-threatening illnesses. The program…
45 CFR 213.2 - Records to be public.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 45 Public Welfare 2 2010-10-01 2010-10-01 false Records to be public. 213.2 Section 213.2 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND PROCEDURE FOR...
45 CFR 213.2 - Records to be public.
Code of Federal Regulations, 2011 CFR
2011-10-01
... 45 Public Welfare 2 2011-10-01 2011-10-01 false Records to be public. 213.2 Section 213.2 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND PROCEDURE FOR...
45 CFR 213.2 - Records to be public.
Code of Federal Regulations, 2013 CFR
2013-10-01
... 45 Public Welfare 2 2013-10-01 2012-10-01 true Records to be public. 213.2 Section 213.2 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND PROCEDURE FOR...
45 CFR 213.2 - Records to be public.
Code of Federal Regulations, 2012 CFR
2012-10-01
... 45 Public Welfare 2 2012-10-01 2012-10-01 false Records to be public. 213.2 Section 213.2 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND PROCEDURE FOR...
45 CFR 213.2 - Records to be public.
Code of Federal Regulations, 2014 CFR
2014-10-01
... 45 Public Welfare 2 2014-10-01 2012-10-01 true Records to be public. 213.2 Section 213.2 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND PROCEDURE FOR...
ERIC Educational Resources Information Center
Vogel, Cheri A.; Caronongan, Pia; Thomas, Jaime; Bandel, Eileen; Xue, Yange; Henke, Juliette; Aikens, Nikki; Boller, Kimberly; Murphy, Lauren
2015-01-01
The Early Head Start Family and Child Experiences Survey (Baby FACES) is a descriptive study of Early Head Start programs designed to inform policy and practice at both national and local levels. Baby FACES follows two cohorts of children through their time in Early Head Start, starting in 2009, the first wave of data collection. The Newborn…
Fischer, Ellen P; Sherman, Michelle D; McSweeney, Jean C; Pyne, Jeffrey M; Owen, Richard R; Dixon, Lisa B
2015-08-01
Combat deployment and reintegration are challenging for service members and their families. Although family involvement in mental health care is increasing in the U.S. Department of Veterans Affairs (VA) system, little is known about family members' preferences for services. This study elicited the perspectives of returning Afghanistan and Iraq war veterans with posttraumatic stress disorder and their families regarding family involvement in veterans' mental health care. Semistructured qualitative interviews were conducted with 47 veterans receiving care for posttraumatic stress disorder at the Central Arkansas Veterans Healthcare System or Oklahoma City VA Medical Center and 36 veteran-designated family members. Interviews addressed perceived needs related to veterans' readjustment to civilian life, interest in family involvement in joint veteran/family programs, and desired family program content. Interview data were analyzed using content analysis and constant comparison. Both groups strongly supported inclusion of family members in programs to facilitate veterans' postdeployment readjustment and reintegration into civilian life. Both desired program content focused on information, practical skills, support, and gaining perspective on the other's experience. Although family and veteran perspectives were similar, family members placed greater emphasis on parenting-related issues and the kinds of support they and their children needed during and after deployment. To our knowledge, this is the first published report on preferences regarding VA postdeployment reintegration support that incorporates the perspectives of returning male and female veterans and those of their families. Findings will help VA and community providers working with returning veterans tailor services to the needs and preferences of this important-to-engage population. (c) 2015 APA, all rights reserved).
Chamratrithirong, Aphichat; Miller, Brenda A.; Byrnes, Hilary F.; Rhucharoenpornpanich, Orratai; Cupp, Pamela K.; Rosati, Michael J.; Fongkaew, Warunee; Atwood, Katharine A.; Todd, Michael
2012-01-01
This study examines the intergenerational transmission of family religion as measured by parent’s and adolescent’s beliefs and practices in Buddhism, and its relation to delinquent behaviors among early adolescents in Thailand. The data set is from the Thai Family Matters Project 2007, a representative sample of 420 pairs of parents and teens in Bangkok. A structural equation model is employed for the analysis. The intergenerational transmission and the direct and indirect association between parents’ and adolescents’ beliefs and practices in Buddhism and adolescents’ minor and serious delinquent behaviors are revealed to be significant, controlling for secular parental monitoring. Spirituality within the family can play an important role in preventing delinquency among early adolescents. Policies in the areas related to family empowerment and delinquency prevention may need to consider integrating both secular and non-secular program inputs in their implementation design. PMID:23218782
ERIC Educational Resources Information Center
King, Gillian; Tam, Cynthia; Fay, Linda; Pilkington, Martha; Servais, Michelle; Petrosian, Hasmik
2011-01-01
There is growing interest in understanding the usefulness of mentorship programs for children's rehabilitation service providers. This evaluation study examined the effects of an occupational therapy mentorship program on the skills and behaviors of 8 new and 17 experienced occupational therapists practicing at a regional children's rehabilitation…
ERIC Educational Resources Information Center
Curtis, Michael J.; Batsche, George M.
1991-01-01
Notes that graduate training programs face challenges, as well as opportunities, in fulfillment of their responsibilities to prepare school psychologists for entry into professional practice. Examines nature and origins of potential changes facing school psychology and discusses adequacy of current training programs. Discusses future implications…
The Feasibility of an Evening LPN to RN Transition Program.
ERIC Educational Resources Information Center
Donsky, Aaron P.; Cox, Samuel C.
In an attempt to handle the shortage of registered nurses (RN's), many institutions have designed articulation programs to move licensed practical nurses (LPN's) into RN programs. Research describes LPN's as nontraditional adult learners with family responsibilities who must work full-time while in school. Many are anxious about returning to the…
Lai, Agnes Y.; Stewart, Sunita M.; Wan, Alice; Fok, Helen; Lai, Hebe Y. W.; Lam, Tai-hing; Chan, Sophia S.
2017-01-01
This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled “Learning Families Project”, under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees’ knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees’ reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents’ survey results before and after participating in the community activities delivered by the trainees. The trainees’ learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen’s d: 0.5–1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen’s d: 0.4–0.6). The application of planning skills to implement community activities was higher at one year (Cohen’s d: 0.4), compared with baseline. At one year, the residents’ survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. Trial registration: ClinicalTrials.gov NCT02844244 PMID:28841677
Lai, Agnes Y; Stewart, Sunita M; Wan, Alice; Fok, Helen; Lai, Hebe Y W; Lam, Tai-Hing; Chan, Sophia S
2017-01-01
This paper presents the development and evaluation of the train-the-trainer (TTT) workshop for lay resident leaders to be lay health promoters. The TTT workshop aimed to prepare the trainees to implement and/or assist in conducting a series of community-based family well-being activities for the residents in a public low rent housing estate, entitled "Learning Families Project", under the FAMILY project. The four-hour TTT workshop was conducted for 32 trainees (72% women, 43% aged ≥ 60, 41% ≤ elementary school education). The workshop aimed to promote trainees' knowledge, self-efficacy, attitude and practice of incorporating the positive psychology themes into their community activities and engaging the residents to join these activities and learn with their family members. Post-training support was provided. The effectiveness of the TTT was examined by self-administered questionnaires about trainees' reactions to training content, changes in learning and practice at three time points (baseline, and immediately and one year after training), and the difference in residents' survey results before and after participating in the community activities delivered by the trainees. The trainees' learning about the general concepts of family well-being, learning family, leadership skills and planning skills increased significantly with medium to large effect sizes (Cohen's d: 0.5-1.4) immediately after the training. The effects of perceived knowledge and attitude towards practice were sustained to one year (Cohen's d: 0.4-0.6). The application of planning skills to implement community activities was higher at one year (Cohen's d: 0.4), compared with baseline. At one year, the residents' survey results showed significant increases in the practice of positive communication behaviours and better neighbour cohesions after joining the family well-being activities of LFP. Qualitative feedback supported the quantitative results. Our TTT workshop could serve as a practical example of development and evaluation of training programs for lay personnel to be lay health promoters. ClinicalTrials.gov NCT02844244.
Marcon, Tamara Davidson; Girz, Laura; Stillar, Amanda; Tessier, Carole; Lafrance, Adele
2017-01-01
Objectives Best practice guidelines encourage the involvement of parents in the assessment and treatment of child/adolescent eating disorders (ED). This study investigated medical residents’ perspectives regarding parental involvement as well as their expectations for future practice in the assessment and treatment of ED. Method Five hundred and eighty-four medical residents from 17 Canadian residency programs specializing in family medicine, pediatrics, and psychiatry completed a web-based survey. Questions pertained to assessment and treatment practices for child/adolescent ED. Analyses included ANOVAs, paired t-tests, and, for residents who endorsed family involvement (N = 444), qualitative content analysis. Results Overall, residents reported that they “mostly” agreed with the involvement of family in the assessment and treatment of ED. Residents’ endorsement of family involvement in both domains increased according to the extent of ED training received. Four major themes emerged from the content analysis of family involvement and included recommendations in line with evidence-based models and unspecified, passive involvement in the assessment and recovery process. Conclusions Many residents endorse family involvement in both assessment and treatment; however, understanding of the nature of such involvement is often vague. Training in evidence-based protocols is necessary for residents planning to engage in multi-disciplinary assessment, referral, and/or treatment in their future practice. PMID:28747930
Spirituality and Comprehensive School Counseling Programs
ERIC Educational Resources Information Center
Sink, Christopher A.
2004-01-01
Comprehensive school counseling programs (CSCPs) have evolved into well-articulated organizational frameworks that will successfully guide school counseling practice for years to come (American School Counselor Association [ASCA], 2003; Gysbers & Henderson, 2000, 2005). At their heart, CSCPs emphasize that as society and families continue to…
Building a community of practice in rural medical education: growing our own together.
Longenecker, Randall L; Schmitz, David
2017-01-01
This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice. However, by the 1980s, these programs were not yet producing the desired numbers of rural physicians. In response, in 1986, Maudlin and others at the family medicine residency in Spokane developed the first 1-2 RTT in Colville, Washington. In the 1990s, and by 2000, early news of success led to a peak of 35 active programs. However, over the next decade these programs experienced significant hardship due to a lack of funding and a general decline in student interest in family medicine. By 2010, only 25 programs remained. In 2010, in an effort to sustain the 1-2 RTT as a national strategy in training physicians for rural practice, a federally funded consortium of individuals and programs established the RTT Technical Assistance program (RTT TA). Building on the pattern of peer support and collaboration set by earlier groups, the RTT TA consortium expanded the existing community of practice in rural medical education in support of RTTs. In-person meetings, peer consultation and visitation, coordinated efforts at student recruitment, and collaborative rural medical education research were all elements of the consortium's strategy. Rather than anchoring its efforts in medical schools or hospitals, this consortium engaged as partners a wider variety of stakeholders. This included physician educators still living and practicing in rural communities ('local experts'), rural medical educator peers, program directors, professional groups, academic units, governmental entities such as state offices of rural health, and national associations with a stake in rural medical education. The consortium has succeeded in (1) supporting established and new RTTs, (2) increasing medical student interest in these programs, and (3) demonstrating the effectiveness of this strategy through a minimum dataset and registry of RTT trainees. From a low of 21 programs in 2012, the number has grown to 32, accounting for a total of 68 positions in each year of training. The RTT Collaborative, the non-profit that has emerged as the sustainable product of that federal funding, is now supported by a national cooperative of participating rural programs and continues the work. Growing a community of practice in this fashion requires the organic building of relationships over time. The RTT TA consortium, and now the RTT Collaborative as a sustainable successor, have laid a strong foundation for community-engaged rural health professions education into the future - from each growing their own, to 'growing our own … together.
Malaysia family-planning centers strive to maintain gains won in 15-year period.
Roemer, R
1968-09-12
Family planning in Malaysia is discussed. Family planning began in Malaysia about 15 years ago through the efforts of voluntary family Planning Associations in the various Malay states. In 1966 the Malaysian Parliament passed the National Family Planning Act setting up the National FAmily Planning Board to formulate policies and methods for the promotion and spread of family planning knowledge and practice on the grounds of health of mothers and children and welfare of the family. In 1967, the board set a target of 40,000 new acceptors of family planning and 90% of the target was reached. This represents 3% of the child-bearing married women aged 15-49. The target for 1968 of 65,000 new acceptors is being achieved. A survey of acceptors is to be carried out from December 1968 to April 1969 to ascertain how many women who accepted family planning continue to practice it. Malaysia's crude birth rate declined from 46.2 in 1957 to 37.3 in 1966 before the government program was instituted. Abortion attempts have been frequent. The main method of contraception used is oral contraceptives. According to a 1957 survey, 31% of the married women in the metropolitan areas and 2% of rural women were using contraception. Presently, in Malaysia there is a need to: 1) train personnel to provide services, 2) inform and motivate families to accept family planning, 3) continue a broad educational program, 4) reform Malaysia's antiquated abortion law, and 5) integrate family planning services more fully into the general health services of the country.
Kulis, Stephen S; Ayers, Stephanie L; Harthun, Mary L; Jager, Justin
2016-08-01
Parenting in 2 Worlds (P2W) is a culturally grounded parenting intervention that addresses the distinctive social and cultural worlds of urban American Indian (AI) families. P2W was culturally adapted through community-based participatory research in three urban AI communities with diverse tribal backgrounds. This paper reports the immediate outcomes of P2W in a randomized controlled trial, utilizing data from 575 parents of AI children (ages 10-17). Parents were assigned to P2W or to the comparison group, an informational family health curriculum, Healthy Families in 2 Worlds (HF2W). Both the P2W and HF2W curricula consisted of 10 workshops delivered weekly by AI community facilitators. Pretests were administered at the first workshop and a post-test at the last workshop. Tests of the efficacy of P2W versus HF2W on parenting skills and family functioning were analyzed with pairwise t tests, within intervention type, and by baseline adjusted path models using FIML estimation in Mplus. Intervention effect sizes were estimated with Cohen's d. Participants in P2W reported significant improvements in parental agency, parenting practices, supervision and family cohesion, and decreases in discipline problems and parent-child conflict. Compared to HF2W, P2W participants reported significantly larger increases in parental self-agency and positive parenting practices, and fewer child discipline problems. Most of these desired program effects for P2W approached medium size. Culturally adapted parenting interventions like P2W can effectively strengthen parenting practices and family functioning among urban AI families and help address their widespread need for targeted, culturally grounded programs.
Kulis, Stephen S.; Ayers, Stephanie L.; Harthun, Mary L.; Jager, Justin
2016-01-01
Parenting in 2 Worlds (P2W) is a culturally grounded parenting intervention that addresses the distinctive social and cultural worlds of urban American Indian (AI) families. P2W was culturally adapted through community-based participatory research in three urban AI communities with diverse tribal backgrounds. This paper reports the immediate outcomes of P2W in a randomized controlled trial, utilizing data from 575 parents of AI children (ages 10–17). Parents were assigned to P2W or to the comparison group, an informational family health curriculum, Healthy Families in 2 Worlds (HF2W). Both the P2W and HF2W curricula consisted of 10 workshops delivered weekly by AI community facilitators. Pretests were administered at the first workshop and a post-test at the last workshop. Tests of the efficacy of P2W versus HF2W on parenting skills and family functioning were analyzed with pairwise t-tests, within intervention type, and by baseline adjusted path models using FIML estimation in Mplus. Intervention effect sizes were estimated with Cohen’s d. Participants in P2W reported significant improvements in parental agency, parenting practices, supervision and family cohesion, and decreases in discipline problems and parent-child conflict. Compared to HF2W, P2W participants reported significantly larger increases in parental self-agency and positive parenting practices, and fewer child discipline problems. Most of these desired program effects for P2W approached medium size. Culturally adapted parenting interventions like P2W can effectively strengthen parenting practices and family functioning among urban AI families and help address their widespread need for targeted, culturally grounded programs. PMID:27129476
Campbell, Sandra; McCalman, Janya; Redman-MacLaren, Michelle; Canuto, Karla; Vine, Kristina; Sewter, Jenny; McDonald, Malcolm
2018-03-24
A healthy start predicts better health in later life. Many remote-living Aboriginal and Torres Strait Islander Australian families lack access to consistent, culturally-safe health services. This paper presents a study of implementation of the Baby One Program (BOP). The BOP was designed as a family-centred, Indigenous Healthworker-led, home-visiting model of care focused on promoting family health to give children the best start to life. It was developed by Aboriginal community-controlled Apunipima Cape York Health Council and delivered in Queensland Cape York remote communities. We aimed to determine how the BOP was implemented, enablers, strategies used and formative implementation outcomes. The qualitative approach utilised theoretical and purposive sampling to explore people's experiences of a program implementation process. Data were generated from semi-structured interviews with four family members enrolled in the BOP and 24 Apunipima staff members. In addition, twenty community members, including two program users, participated in a men's community focus group. The findings are presented according to themes arising from the data. The BOP was rolled out in nine remote Cape York communities between July 2014 and December 2015 and there was high uptake. Indigenous Healthworkers were supported by midwives and maternal and child health nurses to deliver health education to 161 eligible families. The key to effective implementation of family-centred care appeared to be the relationships formed between health practitioners, especially Indigenous Healthworkers, and families. The data revealed the following themes: challenging environments for new families and valuing cultural ways, resourcing program delivery, working towards a team approach, negotiating the cultural interface, engaging families, exchanging knowledge through 'yarning', strengthening the workforce, and seeing health changes in families. Healthworker education and training, and knowledge exchange between Healthworkers, midwives and nurses was critical to program effectiveness. The program continues to grow despite substantial logistic, financial and practical challenges. This study describes an evolving process and explores how health providers connect with families and how the program responds to family and cultural issues. Program development is ongoing; strengthened by more community-level involvement, embedded strategies for ongoing self-evaluation and continuous quality improvements that are responsive to family needs.
Effective/efficient mental health programs for school-age children: a synthesis of reviews.
Browne, Gina; Gafni, Amiram; Roberts, Jacqueline; Byrne, Carolyn; Majumdar, Basanti
2004-04-01
The prevalence of mental health problems, some of which seem to be occurring among younger cohorts, leads researchers and policy-makers to search for practical solutions to reduce the burden of suffering on children and their families, and the costs to society both immediate and long term. Numerous programs are in place to reduce or alleviate problem behaviour or disorders and/or assist positive youth development. Evaluated results are dispersed throughout the literature. To assess findings and determine common elements of effective children's services, a literature search was undertaken for evidence-based evaluations of non-clinical programs for school-age children. Prescriptive comments aim to inform service-providers, policy-makers and families about best practices for effective services such as: early, long-term intervention including reinforcement, follow-up and an ecological focus with family and community sector involvement; consistent adult staffing; and interactive, non-didactic programming adapted to gender, age and cultural needs. Gaps are identified in our understanding of efficiencies that result from effective programs. Policy implications include the need to develop strategies for intersectoral interventions, including: new financing arrangements to encourage (not penalize) interagency cooperation and, to ensure services reach appropriate segments of the population; replication of best practices; and publicizing information about benefits and cost savings. In many jurisdictions legislative changes could create incentives for services to collaborate on service delivery. Joint decision-making would require intersectoral governance, pooling of some funding, and policy changes to retain savings at the local level. Savings could finance expansion of services for additional youth.
Olson, Kaitlyn B
2017-05-04
The optimal care of children with medical complexity (CMC) requires involvement from a network of professionals that includes physicians, nurses, ancillary service providers, and educators. Pediatric health care providers typically have early and frequent contact with the families of CMC. Therefore, they are in a unique position to connect families to developmental, educational, and psychosocial supports. This article reviews important government and community programs that support CMC living in the United States. It outlines the educational rights of children with disabilities and offers practical tips for collaborating with Early Intervention and the public school system. The article also provides an overview of financial assistance programs, respite care services, and support groups that are beneficial to CMC and their families.
Petrany, Stephen M; Gress, Todd
2013-06-01
The Marshall University Family Medicine Residency (MUFMR) implemented its rural track (RT) in 1994 to help achieve its mission of producing primary care physicians for practice in rural areas and West Virginia. This study examined the impact of the RT on the program's training outcomes and assessed the academic equivalence of the RT and traditional track (TT) curricula. The authors analyzed academic outcomes (in-training examination [ITE] scores, board certification rates) and practice outcomes (location and type following graduation) for the 174 MUFMR graduates who entered the program from 1984 through 2006. They compared RT and TT graduates who entered after RT implementation (1994-2006) with each other and with graduates who entered during the decade before implementation (1984-1993). There were differences between the 12 RT and 94 TT graduates in rural practice upon graduation (RT: 83% versus TT: 40%; P<.01) and practice in West Virginia (RT 83% versus TT 68%; P=.34). RT and TT graduates had similar mean increases in ITE scores and board certification rates. The 106 post-implementation graduates had a significantly higher rate of West Virginia practice than did the 68 pre-implementation graduates (70% versus 52%; P=.02). RT development was associated with a substantial increase in MUFMR graduates practicing in West Virginia. RT graduates were more likely than TT graduates to practice in rural areas and in the state upon graduation. RT graduates seem to advance academically as well as their TT counterparts.
ERIC Educational Resources Information Center
Hindin, Alisa; Steiner, Lilly M.; Dougherty, Susan
2017-01-01
This article focuses on two programs that were created to enhance parent involvement practices in literacy. The goal of both programs was to create for parents enjoyable and rich experiences around literacy in the home, while demonstrating for parents how teachers approach reading instruction in the classroom. Programs to increase and support…
Domínguez-Martinez, Tecelli; Rascon-Gasca, Maria Luisa; Alcántara-Chabelas, Humberto; Garcia-Silberman, Sara; Casanova-Rodas, Leticia; Lopez-Jimenez, Jorge Luis
2017-04-01
This study examined the effects of a three-month Family-to-Family (FTF) Education Program on expressed emotion and subjective knowledge about mental illness among relatives of Mexican patients with severe mental disorders. A total of 230 relatives of patients with severe mental disorders completed self-reported questionnaires before (pretest) and after (posttest) the FTF program. FTF led to reductions in negative emotional attitudes and improved the understanding of the disorder, regardless of sex or age of the relative. This study supported the evidence-based practice of FTF in a Mexican population and confirmed the importance of providing routine family psychoeducation as an additional component of health care service provision for relatives of people with severe mental illness in the community.
A new, but old business model for family physicians: cash.
Weber, J Michael
2013-01-01
The following study is an exploratory investigation into the opportunity identification, opportunity analysis, and strategic implications of implementing a cash-only family physician practice. The current market dynamics (i.e., increasing insurance premiums, decreasing benefits, more regulations and paperwork, and cuts in federal and state programs) suggest that there is sufficient motivation for these practitioners to change their current business model. In-depth interviews were conducted with office managers and physicians of family physician practices. The results highlighted a variety of issues, including barriers to change, strategy issues, and opportunities/benefits. The implications include theory applications, strategic marketing applications, and managerial decision-making.
A realist review of family-based interventions for children of substance abusing parents.
Usher, Amelia M; McShane, Kelly E; Dwyer, Candice
2015-12-18
Millions of children across North America and Europe live in families with alcohol or drug abusing parents. These children are at risk for a number of negative social, emotional and developmental outcomes, including an increased likelihood of developing a substance use disorder later in life. Family-based intervention programs for children with substance abusing parents can yield positive outcomes. This study is a realist review of evaluations of family-based interventions aimed at improving psychosocial outcomes for children of substance abusing parents (COSAPs). The primary objectives were to uncover patterns of contextual factors and mechanisms that generate program outcomes, and advance program theory in this field. Realist review methodology was chosen as the most appropriate method of systematic review because it is a theory-driven approach that seeks to explore mechanisms underlying program effectiveness (or lack thereof). A systematic and comprehensive search of academic and grey literature uncovered 32 documents spanning 7 different intervention programs. Data was extracted from the included documents using abstraction templates designed to code for contexts, mechanisms and outcomes of each program. Two candidate program theories of family addiction were used to guide data analysis: the family disease model and the family prevention model. Data analysis was undertaken by a research team using an iterative process of comparison and checking with original documents to determine patterns within the data. Programs originating in both the family disease model and the family prevention model were uncovered, along with hybrid programs that successfully included components from each candidate program theory. Four demi-regularities were found to account for the effectiveness of programs included in this review: (1) opportunities for positive parent-child interactions, (2) supportive peer-to-peer relationships, (3) the power of knowledge, and (4) engaging hard to reach families using strategies that are responsive to socio-economic needs and matching services to client lived experience. This review yielded new findings that had not otherwise been explored in COSAP program research and are discussed in order to help expand program theory. Implications for practice and evaluation are further discussed.
Ready for practice: what child and family health nurses say about education.
Fowler, Cathrine; Schmied, Virginia; Psaila, Kim; Kruske, Sue; Rossiter, Chris
2015-02-01
Australia has a well-established universal child and family health service predominately staffed by specialist/qualified child and family health nurses. Two common and interrelated concerns are the need for nurses to be ready for practice after completing a nursing education program and the means to ensure ongoing nursing competence. To investigate the readiness of CFH nurses to practise after qualification and their continuing engagement with learning. The study used an interpretive descriptive approach. This paper presents data from four questions from a larger survey of child and family health nurses across Australia. 1098 child and family health nurses responded to the survey. Qualitative survey responses from the four education questions were analysed using inductive thematic content analysis. Five significant themes were identified: hands-on experience (student clinical practice/placement); drawing on prior experience; learning on the job; learning (learning over time); and barriers to learning. This paper provides insights into nurses' readiness for practice at the completion of a postgraduate child and family health nursing qualification and their maintenance of competence and specialist knowledge. It highlights: the need for clinical placement to be retained and enhanced; the significant contribution of more experienced child and family health nurses mentoring newly graduated child and family health nurses; the need for minimum education standards; the importance of reviewing education courses in relation to graduates' readiness for child and family health nursing practice; the importance of supporting ongoing professional development; and the removal of barriers to accessing education opportunities. Copyright © 2014 Elsevier Ltd. All rights reserved.
[Family planning. A survey of United Nations around the world].
1974-01-01
Responses to the second worldwide survey of 80 nations on their population policy can be divided into 3 categories. First are countries with large official programs of family planning in existence: Egypt, Kenya, Tunisia, Barbados, Colombia, Panama, Trinidad and Tobago, China, India, Iran, Japan, Nepal, Pakistan, Philippines, Republic of Viet-nam, Singapore, Sri Lanka, Thailand, Turkey, Denmark, Netherlands, United Kingdom, Yugoslavia, Canada, and Fiji. Madagascar and New Zealand are starting programs. The second category is countries that encourage private family planning programs: Tanzania, Mexico, Israel, Cambodia, Bahrain, Jordan, Laos, Syria, Austria, France, West Germany, Finland, and Norway. Third are listed countries that do not officially support, or that forbid contraception: Gabon, Malawi, Zambia, Greece, Italy, and Spain. Thus Asia and North Africa have the most ambitious programs, but Europe and North America practice contraception universally.
On any Saturday--a practical model for diabetes education.
Carter, Inge R; Nash, Creshelle; Ridgway, Andrea
2002-02-01
Patient self-management is an important part of treating chronic diseases. However, many primary care physicians face barriers in offering office-based diabetes education. This paper will discuss a practical program of community-based diabetes education that can be easily modified for a practitioner's office. Half-day diabetes education workshops geared toward local health care providers and patients with diabetes and their families were conducted in two rural communities in Arkansas. Participants were surveyed with respect to the effectiveness of the program and how they would use what they learned in the program. Thirty-one health care providers and 59 patients with diabetes and their families attended. Program evaluation scores were between 4.1 and 5 on a 5-point Likert scale. One third of the patients commented that they had a better understanding of diet and medication use. Feedback from community health care providers noted that attendance in local diabetes support groups increased after the workshops. Diabetes complications have a large impact on the health of the population and a growing economic impact on the health care industry. Although there are many barriers to diabetes education and control, a practical half-day diabetes workshop on any Saturday can be effectively developed and implemented.
Barriers of modern contraceptive practices among Asian women: a mini literature review.
Najafi-Sharjabad, Fatemeh; Zainiyah Syed Yahya, Sharifah; Abdul Rahman, Hejar; Hanafiah Juni, Muhamad; Abdul Manaf, Rosliza
2013-07-22
Family planning has been cited as essential to the achievement of Millennium Development Goals (MDG). Family planning has a direct impact on women's health and consequence of each pregnancy. The use of modern contraception among Asian women is less than global average. In Asia a majority of unintended pregnancies are due to using traditional contraceptive or no methods which lead to induced unsafe abortion. Cultural attitudes, lack of knowledge of methods and reproduction, socio demographic factors, and health service barriers are the main obstacles to modern contraceptive practice among Asian women. Culturally sensitive family planning program, reforming health system, and reproductive health education through mass media to create awareness of the benefits of planned parenthood are effective strategies to improve modern contraceptive practice among Asian women.
Barriers of Modern Contraceptive Practices among Asian Women: A Mini Literature Review
Najafi-Sharjabad, Fatemeh; Syed Yahya, Sharifah Zainiyah; Rahman, Hejar Abdul; Hanafiah, Muhamad; Abdul Manaf, Rosliza
2013-01-01
Family planning has been cited as essential to the achievement of Millennium Development Goals (MDG). Family planning has a direct impact on women's health and consequence of each pregnancy. The use of modern contraception among Asian women is less than global average. In Asia a majority of unintended pregnancies are due to using traditional contraceptive or no methods which lead to induced unsafe abortion. Cultural attitudes, lack of knowledge of methods and reproduction, socio demographic factors, and health service barriers are the main obstacles to modern contraceptive practice among Asian women. Culturally sensitive family planning program, reforming health system, and reproductive health education through mass media to create awareness of the benefits of planned parenthood are effective strategies to improve modern contraceptive practice among Asian women. PMID:23985120
Barriers and enablers of kangaroo mother care practice: a systematic review.
Seidman, Gabriel; Unnikrishnan, Shalini; Kenny, Emma; Myslinski, Scott; Cairns-Smith, Sarah; Mulligan, Brian; Engmann, Cyril
2015-01-01
Kangaroo mother care (KMC) is an evidence-based approach to reducing mortality and morbidity in preterm infants. Although KMC is a key intervention package in newborn health initiatives, there is limited systematic information available on the barriers to KMC practice that mothers and other stakeholders face while practicing KMC. This systematic review sought to identify the most frequently reported barriers to KMC practice for mothers, fathers, and health practitioners, as well as the most frequently reported enablers to practice for mothers. We searched nine electronic databases and relevant reference lists for publications reporting barriers or enablers to KMC practice. We identified 1,264 unique publications, of which 103 were included based on pre-specified criteria. Publications were scanned for all barriers / enablers. Each publication was also categorized based on its approach to identification of barriers / enablers, and more weight was assigned to publications which had systematically sought to understand factors influencing KMC practice. Four of the top five ranked barriers to KMC practice for mothers were resource-related: "Issues with the facility environment / resources," "negative impressions of staff attitudes or interactions with staff," "lack of help with KMC practice or other obligations," and "low awareness of KMC / infant health." Considering only publications from low- and middle-income countries, "pain / fatigue" was ranked higher than when considering all publications. Top enablers to practice were included "mother-infant attachment" and "support from family, friends, and other mentors." Our findings suggest that mother can understand and enjoy KMC, and it has benefits for mothers, infants, and families. However, continuous KMC may be physically and emotionally difficult, and often requires support from family members, health practitioners, or other mothers. These findings can serve as a starting point for researchers and program implementers looking to improve KMC programs.
Development of a Health Education Program to Promote the Self-Management of Cystic Fibrosis.
ERIC Educational Resources Information Center
Bartholomew, L. Kay; And Others
1991-01-01
Social learning theory formed the basis of a program to develop self-management skills in cystic fibrosis patients. Strategies for practical learning activities for patients and their families included goal setting, reinforcement, modeling, skill training, and self-monitoring. (SK)
Family communication coordination: a program to increase organ donation.
Linyear, A S; Tartaglia, A
1999-09-01
To improve organ donation performance, the Medical College of Virginia Hospitals implemented a comprehensive family support and communication program, consisting of a standard family communications protocol, a hospital-based team from the Department of Pastoral Care, targeted staff education, and an ongoing quality assurance measuring and monitoring system. The 3 best-demonstrated request practices, private setting, "decoupling," and collaboration in the request between the organ procurement organization and hospital staff, were incorporated into the program. Improvement in the consent and donation rate was evident in the second calendar year of the program; the consent rate was 72% and the donation rate was 50%. During the second year, there was also a positive correlation between "decoupling," appropriate requestor, and the consent rate. Implementation of a hospital-based team and a standard protocol facilitated the clarification of roles and responsibilities toward clearer and more consistent family communication and support. Data suggest that staff experience is a major contributor to a positive donation outcome.
Simon, Melissa A.
2013-01-01
Rising costs and a workforce talent shortage are two of the health care industry’s most pressing challenges. In particular, serious illnesses often impose significant costs on individuals and their families, which can place families at an increased risk for multigenerational economic deprivation or even an illness–poverty trap. At the same time, family caregivers often acquire a wide variety of health care skills that neither these caregivers nor the health care industry typically use. As these skills are marketable and could be paired with many existing medical certifications, this article describes a possible “path toward economic resilience” (PER) through a program whereby family caregivers could find meaningful employment using their new skills. The proposed program would identify ideal program candidates, assess and supplement their competencies, and connect them to the health care industry. We provide a set of practical steps and recommended tools for implementation, discuss pilot data on the program’s appeal and feasibility, and raise several considerations for program development and future research. Our analysis suggests that this PER program could appeal to family caregivers and the health care industry alike, possibly helping to address two of our health care system’s most pressing challenges with one solution. PMID:23633216
Bell, Paul F; Semelka, Michael W; Bigdeli, Laleh
2015-03-01
Despite well-established negative consequences, high rates of substance use and related disorders continue to be reported. Physicians in training are not immune from this, or the associated risks to their health and careers, while impaired physicians are a threat to patient safety. We surveyed family medicine residency programs' practices relating to drug testing of medical students and incoming residents. The survey asked about the extent to which residency programs are confronted with trainees testing positive for prohibited substances, and how they respond. The survey was sent to the directors of family medicine residency programs. A total of 205 directors (47.2%) completed the survey. A majority of the responding programs required drug testing for incoming residents (143, 68.9%). Most programs did not require testing of medical students (161, 81.7%). Few programs reported positive drug tests among incoming residents (9, 6.5%), and there was only 1 reported instance of a positive result among medical students (1, 3.3%). Respondents reported a range of responses to positive results, with few reporting that they would keep open training spots or offer supportive services for a medical student who tested positive. Changing laws legalizing certain drugs may require corresponding changes in the focus on drug testing and associated issues in medical training; however, many residency program directors were not aware of their institution's current policies. Programs will need to reexamine drug testing policies as new generations of physicians, growing up under altered legal circumstances concerning drug use, progress to clinical training.
School-Based Early Childhood Centers: Secrets of Success from Early Innovators.
ERIC Educational Resources Information Center
Jewett, Janet L.; Katzev, Aphra
School-based early childhood centers have the potential for responding effectively to a broad range of child and family needs and to society's demands for more effective schools. They have four defining features: (1) implementation of quality programs and developmentally appropriate practices for young children through age eight; (2) families as…
ERIC Educational Resources Information Center
Muhlenhaupt, Mary; Pizur-Barnekow, Kris; Schefkind, Sandra; Chandler, Barbara; Harvison, Neil
2015-01-01
Occupational therapy provides a unique contribution in early intervention programs for families and their children from birth to 3 years old who are at risk for, or who have, identified disabilities. This article describes occupational therapy's distinct value and presents the profession's perspective on services to enhance families' caregiving…
Family Planning for Inner-City Adolescent Males: Pilot Study.
ERIC Educational Resources Information Center
Reis, Janet; And Others
1987-01-01
Describes a pilot family planning program in an inner-city pediatric practice. Male adolescents were more likely to accept contraceptives if the provider first raised the topic of birth control to them. Identified a desire for anonymity/confidentiality and embarrassment or discomfort as the key reasons for not seeking contraceptives. Emphasizes…
Parent Expectations and Planning for College. Statistical Analysis Report. NCES 2008-079
ERIC Educational Resources Information Center
Lippman, Laura; Guzman, Lina; Keith, Julie Dombrowski; Kinukawa, Akemi; Shwalb, Rebecca; Tice, Peter
2008-01-01
This report uses data from the 2003 National Household Education Surveys Program (NHES) Parent and Family Involvement Survey (PFI) to examine the characteristics associated with the educational expectations parents had for their children and the postsecondary education planning practices families and schools engaged in. The results presented in…
Supporting English and Spanish Literacy through a Family Literacy Program
ERIC Educational Resources Information Center
Wessels, Stephanie
2014-01-01
Family literacy studies have shown that the role of parental storybook reading has an impact on children's success in school-based literacy instruction. However, many children who are English language learners come from homes or cultures where storybook readings are not common practice. The purpose of this qualitative research study explored…
ERIC Educational Resources Information Center
Collier, Margo; Keefe, Elizabeth B.; Hirrel, Laura A.
2015-01-01
A serious gap exists within special education preparation programs; many neglect to adequately prepare teacher candidates to engage with parents of children with disabilities to create effective family-school-community collaboration. The following article describes the impact on the practices and dispositions of teacher candidates resulting from…
ERIC Educational Resources Information Center
Baird, Bil
This document focuses on the use of puppets for educating the illiterate populations of the world in food production and family planning. It is presented as one practical and effective tool for the adult educator and literacy worker. When used as part of a total program of functional literacy for family life planning, it can help young adults gain…
ERIC Educational Resources Information Center
Hepburn, Kathy Seitzinger
2004-01-01
The purpose of this tool kit is to provide guidance, tools, and resources that will assist communities in building culturally and linguistically competent services, supports, programs, and practices related to young children, their families. By offering services in culturally and linguistically meaningful ways, communities can engage all families…
Families at a Disadvantage: Class, Culture, and Literacies.
ERIC Educational Resources Information Center
Tett, Lyn; Crowther, Jim
1998-01-01
Addresses the issue of diverse literacies and the problems of privileging a dominant form of literacy at the expense of those from non-mainstream cultures. Illustrates how the literacy practices of working-class families and communities can be incorporated into learning programs. Stresses the need to legitimate the vernacular literacies of the…
Family Literacy Practices and Parental Involvement of Latin American Immigrant Mothers
ERIC Educational Resources Information Center
Rivera, Lorna; Lavan, Nicole
2012-01-01
This article draws upon three years of interviews and participant observation research in the Chelsea Public Schools, to discuss the impact of the Chelsea Family Literacy Program on promoting Latin American immigrant mothers' involvement in their children's education. The authors present the voices of Latin American immigrant mothers who describe…
Family Feathers. [Videotape Series].
ERIC Educational Resources Information Center
1999
Family Feathers is a set of 18 videotapes for parents of preschool children, created by the Alaska Native Home Base Video Project of the Tlingit and Haida Head Start Program. This series offers culturally relevant solutions to the challenges of parenting, drawing on practical advice from Tlingit and Haida parents, wisdom from elders, and some of…
Building Bridges to Family-Supporting Jobs.
ERIC Educational Resources Information Center
Pennington, Hilary; Seltzer, Marlene
2001-01-01
Jobs for the Future (JFF) has identified the following best practice programs that support what is known to work best in moving women into family-supporting employment: (1) Cessna Aircraft Company in Wichita, Kansas, trains welfare recipients to work as sheet metal assemblers while providing a support services counselor and support for child care…
Family Poicy in Canada: Some Theoretical Considerations and a Practical Application.
ERIC Educational Resources Information Center
Hepworth, H. Philip
Frequently implicit in Canadian social policy addressing other issues, family policy is generally assumed to be a good thing, is bound up with social structure, and, when made explicit, is prescriptive and potentially embarrassing to government. Historically important as a forerunner of more recent income assistance programs, the provision of…
Roche, Abigail; Goto, Keiko; Zhao, Yanling; Wolff, Cindy
2015-01-01
To examine perceived social and cultural capitals associated with family eating practices among Hmong, Latino, and white mothers and fathers. Six focus groups composed of 52 Hmong, Latino, and white mothers and fathers of young children were conducted to examine parental perceptions of social and cultural capitals associated with eating practices. Whereas Hmong participants unanimously emphasized the healthfulness of their traditional food, Latino groups had divergent views on their traditional foods' healthfulness. Hmong parents highly valued their traditional foods whereas white and Latino mothers were more accepting of new foods from other cultures. Participants noted divergent views on gender roles in family eating practices and food culture preservation efforts. Identifying and promoting bonding and bridging of cultural assets for healthy dietary practices among different cultural groups may be important for developing successful nutrition education programs across ethnicities in the community. Copyright © 2015 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Chamratrithirong, Aphichat; Miller, Brenda A; Byrnes, Hilary F; Rhucharoenpornpanich, Orratai; Cupp, Pamela K; Rosati, Michael J; Fongkaew, Warunee; Atwood, Katharine A; Chookhare, Warunee
2010-01-01
This study investigates the influences of a family's spiritual beliefs and practices on substance use and sexual risk behaviors among young adolescents 13 to 14 years old in Bangkok, Thailand. Independent predictor variables are the parents' and teens' spiritual beliefs and practices in Buddhism and parental monitoring behaviors. The study uses data from the 2007 Baseline Survey of the Thai Family Matters Project, which adapted a U.S. based family prevention program for Thai culture. A representative sample of 420 pairs of parents and teens from the Bangkok metropolitan area was recruited to participate in the study. Structural equation models indicate that positive direct and indirect associations of the spirituality of parents and teens within a family and the prevention of adolescent risk behaviors are significant and consistent. PMID:20926170
An Interactive Web-Based Program for Stepfamilies: Development and Evaluation of Efficacy
ERIC Educational Resources Information Center
Gelatt, Vicky A.; Adler-Baeder, Francesca; Seeley, John R.
2010-01-01
This study evaluated the efficacy of a family life education program for stepfamilies that is self-administered, interactive, and web-based. The program uses behavior-modeling videos to demonstrate effective couple, parenting, and stepparenting practices. A diverse sample of 300 parents/stepparents of a child aged 11-15 years were randomized into…
Brett J. Butler; Marla Markowski-Lindsay; Stephanie Snyder; Paul Catanzaro; David B. Kittredge; Kyle Andrejczyk; Brenton J. Dickinson; Derya Eryilmaz; Jaketon H. Hewes; Paula Randler; Donna Tadle; Michael A. Kilgore
2014-01-01
The USDA Forest Service's Forest Stewardship Program (FSP) is the nation's most prominent private forestry assistance program. We examined the FSP using a multiple analytic approach: analysis of annual FSP accomplishments, survey of state FSP coordinators, analytic comparison of family forest owners receiving and not receiving forestry practice assistance,...
ERIC Educational Resources Information Center
Metz, Allison; Bartley, Leah
2012-01-01
Over the past decade the science related to developing and identifying evidence-based programs and practices for children and families has improved significantly. However, the science related to implementing these programs in early childhood settings has lagged far behind. In this article, the authors outline how the science of implementation and…
Culture and Child Development in Early Childhood Programs: Practices for Quality Education and Care
ERIC Educational Resources Information Center
Howes, Carollee
2009-01-01
Early childhood education programs are expected to provide exemplary care for all children--poor and affluent; children of color and White children--while also adapting care to include children's families and cultures. These two sets of expectations are often difficult for teachers and programs to meet. In this book, Carollee Howes shows how…
ERIC Educational Resources Information Center
Duindam, Ton
Orthopedagogisch Centrum (OC) Michiel is a multifunctional regional institution in the Netherlands that serves troubled families and youth at risk. Outdoor programs are used as a treatment modality for adolescents with behavior disorders, drug addictions, or criminal records. Outward Bound was the first experiential outdoor program in the…
Lee, Angel C K; Leung, Sharron S K; Mak, Y W
2012-01-01
There is little research on nursing students' application of family health assessment in clinical practice. To examine the effect of an elective course, Family in Health and Illness (FHI), on year 4 nursing students' family health assessment and practice. A quasi-experimental design was used. One hundred and twenty students completed pre- and post-course questionnaires, after taking FHI (n=49) or a course in Women's Health (WH; n=71) in a baccalaureate nursing program in Hong Kong. Students rated their interest in family assessment and appraised their own confidence and competence in practicing family nursing before the courses commenced, immediately after, and three months post course completion. In addition, their perceived ease of applying family assessment in practice was measured. Students who had taken FHI reported significantly higher interest than those who had not immediately after the course and three months later. The perceived ease of functional assessment immediate after the course was the only predictor of confidence and competence in practicing family nursing (B=0.76, 95% CI=1.37-8.23, p=0.011) at the 3-month follow-up after controlling for age and baseline measures. Level of interest (B=0.44, 95% CI=4.55-0.13, p=0.040) was an additional predictor of nurse-patient relationship at the 3-month follow-up. Educational input to nursing students may foster their interest and confidence in working with families in clinical settings. Further studies are needed to examine the factors impeding actual application of family nursing assessment. Copyright © 2011 Elsevier Ltd. All rights reserved.
Brown, Carina M; Cronholm, Peter F; Wright, Jessica; Warning, William J; Radosh, Lee; Gabbay, Robert
2014-01-01
The Pennsylvania Academy of Family Physicians (PAFP) developed a statewide Residency Program Collaborative (RPC) to facilitate family medicine residency practices in Pennsylvania becoming recognized patient-centered medical homes (PCMHs). This report outlines the methods and a brief evaluation of the RPC, which included 20 residency practices. Participants attended tri-annual learning sessions and monthly conference calls, received physician faculty mentorship, and reported clinical quality data monthly on diabetes and ischemic vascular disease. Two years after the start of the RPC, surveys were sent to residents, staff, providers, and administrators at participating practices to measure attendance and usefulness of collaborative sessions, mentors, and monthly reports. Evaluators also mapped the RPC curriculum to the Accreditation Council of Graduate Medical Education (ACGME) Core Competencies. All 20 participating practices achieved National Committee for Quality Assurance (NCQA) PCMH recognition, with 17 attaining Level 3 recognition. A total of 295 surveys were collected (92 residents, 71 faculty, and 132 office staff/administrators). Survey data showed higher collaborative attendance for residents and faculty compared to office staff/administrators (~84% versus 45%). No differences were noted between resident and faculty respondents regarding perceived helpfulness of collaborative sessions (6.3 and 6.5, respectively), mentors (6.6 and 6.2) and monthly reports (6.4 and 6.5), with both groups rating these components more highly than staff/administrators (5.3, 5.3, and 5.4 for each category). Learning collaboratives can assist residency practices in achieving PCMH recognition while concurrently providing an educational framework aligned with residency program Core Competencies. The RPC intervention, including learning sessions, monthly conference calls, data reporting, and faculty mentors, also can effectively guide residency practices in the PCMH transformation process and can serve as a means to experientially imbue future family physicians with the attitudes and skills to create and effectively operate their practices under PCMH principles.
Attitudes toward family planning.
Gille, H
1984-06-01
Many of the 135 countries participating in the 1974 UN World Population Conference were far from accepting the basic human right to decide freely and responsibly the number and spacing of their children and to have the information, education, and means to do so. Considerable progress has been made since then, and the number of developing countries that provide direct government support for family planning has increased to over 60%. Many have liberalized laws and regulations which restricted access to modern contraceptive methods, and a growing number provide family planning services within their health care programs. A few have recognized the practice of family planning as a constitutional right. In late 1983 at the Second African Population Conference, recognition of family as a human right was strongly contested by several governments, particularly those of West Africa. in developed countries most of the women at risk of unwanted pregnancy are using contraceptives. Of the major developing regions the highest use level is in Latin America, wherein most countries 1/3 to 1/2 of married women are users. Levels in Asian countries range from up to 10% in Afghanistan, Nepal, and Pakistan to up to 40% in the southeastern countries. China, a special case, now probably exceeds an overall use level of 2/3 of married women. Contraceptive use is lowest in Africa. There is room for improvement even among many of the successful family planning programs, as access to contraceptives usually is not sufficient to overcome limiting factors. To ensure the individual's free choice and strengthen the acceptability and practice of family planning, all available methods should be provided in service programs and inluded in information and education activities. Family planning programs should engage local community groups, including voluntary organizations, in all aspects of planning, management, and allocation of resources. At the government level a clear political commitment to family planning and population policies is essential as is administrative support. All government agencies concerned with socioeconomic benefit to the family and the community need to be involved in the coordinated planning and implementation.
Gender training: creating change.
Craun-selka, P
1997-01-01
Over the last 20 years, the Centre for Development and Population Activities (CEDPA) has developed a training program concerning gender policies and practices; it includes a curriculum, "Gender and Development," and a handbook, "Gender Equity: Concepts and Tools for Development." Gender training focuses on increasing individual awareness of gender issues and incorporating gender practices in programs. CEDPA has expanded its programs to include projects promoting increased decision-making power for women regarding their own lives. Family planning and reproductive health projects now include programs designed to increase "women's literacy, credit and income-generation opportunities, and participation in civil society and the political process." Projects address reproductive and human rights, land distribution, economic expansion, credit and savings, and violence against women. Youth programs focus on the changing nature of gender roles, the equal rights of women and girls, and the shared responsibility and mutual respect of the sexes. In the Better Life Options projects, youth of both sexes attend family life and sex education programs. The curriculum "Choose a Future" provides life skills training for young women; a version for young men will be provided in the future. Including men (community health workers and supervisors, educators, trainers, leaders, fathers, and husbands) in the CEDPA programs is essential for the empowerment of women.
Family-Centered Care in Juvenile Justice Institutions: A Mixed Methods Study Protocol.
Simons, Inge; Mulder, Eva; Rigter, Henk; Breuk, René; van der Vaart, Wander; Vermeiren, Robert
2016-09-12
Treatment and rehabilitation interventions in juvenile justice institutions aim to prevent criminal reoffending by adolescents and to enhance their prospects of successful social reintegration. There is evidence that these goals are best achieved when the institution adopts a family-centered approach, involving the parents of the adolescents. The Academic Workplace Forensic Care for Youth has developed two programs for family-centered care for youth detained in groups for short-term and long-term stay, respectively. The overall aim of our study is to evaluate the family-centered care program in the first two years after the first steps of its implementation in short-term stay groups of two juvenile justice institutions in the Netherlands. The current paper discusses our study design. Based on a quantitative pilot study, we opted for a study with an explanatory sequential mixed methods design. This pilot is considered the first stage of our study. The second stage of our study includes concurrent quantitative and qualitative approaches. The quantitative part of our study is a pre-post quasi-experimental comparison of family-centered care with usual care in short-term stay groups. The qualitative part of our study involves in-depth interviews with adolescents, parents, and group workers to elaborate on the preceding quantitative pilot study and to help interpret the outcomes of the quasi-experimental quantitative part of the study. We believe that our study will result in the following findings. In the quantitative comparison of usual care with family-centered care, we assume that in the latter group, parents will be more involved with their child and with the institution, and that parents and adolescents will be more motivated to take part in therapy. In addition, we expect family-centered care to improve family interactions, to decrease parenting stress, and to reduce problem behavior among the adolescents. Finally, we assume that adolescents, parents, and the staff of the institutions will be more satisfied with family-centered care than with usual care. In the qualitative part of our study, we will identify the needs and expectations in family-centered care as well as factors influencing parental participation. Insight in these factors will help to further improve our program of family-centered care and its implementation in practice. Our study results will be published over the coming years. A juvenile justice institution is a difficult setting to evaluate care programs. A combination of practice-based research methods is needed to address all major implementation issues. The study described here takes on the challenge by means of practice-based research. We expect the results of our study to contribute to the improvement of care for adolescents detained in juvenile justice institutions, and for their families.
Evaluation of a Nutrition Education Program for Family Practice Residents.
ERIC Educational Resources Information Center
Gray, David S.; And Others
1988-01-01
A nutrition education program at the University of South Alabama Medical Center that was based on the "co-counseling model" as described by Moore and Larsen is described. Patients with one of three problem areas were selected for evaluation: hypertension, diabetes mellitus, and pregnancy. (MLW)
Interdisciplinary Training: Preparing Counselors for Collaborative Practice
ERIC Educational Resources Information Center
Okech, Jane E. Atieno; Geroski, Anne M.
2015-01-01
This article utilizes one counselor education program's experience as a framework for exploring how to prepare counselors to work in interdisciplinary teams. Based on an interdisciplinary training program that involves faculty and graduate students from counseling, social work, nursing, internal medicine and family medicine, the article explores…
Conflict Resolution: Preparing Preservice Special Educators to Work in Collaborative Settings
ERIC Educational Resources Information Center
Bradley, Janetta Fleming; Monda-Amaya, Lisa E.
2005-01-01
Collaborative practice to provide effective programs for students with special needs and their families has increased with many positive results. But as this collaborative practice increases, so does the potential for conflict. Constructive conflict resolution occurs when disputants have knowledge and skills to produce positive outcomes, maintain…
Family Advocacy Program Standards and Self-Assessment Tool
1992-08-01
child abuse and neglect and spouse abuse. The standards are based upon a complete review of relevant criteria, accepted professional practices and current military FAP practices. Standards are... Child Abuse and Neglect Cases; Intervention and Treatment in Spouse Abuse Cases; Case Accountability in FAP Cases; Staffing for FAP Services;
Collaboration in Pennsylvania: Rapidly Spreading Improved Chronic Care for Patients to Practices
ERIC Educational Resources Information Center
Bricker, Patricia L.; Baron, Richard J.; Scheirer, Jorge J.; DeWalt, Darren A.; Derrickson, John; Yunghans, Suzanne; Gabbay, Robert A.
2010-01-01
Introduction: Pennsylvania's Improving Performance in Practice (IPIP) program is administered by the Pennsylvania (PA) chapters of the American Academy of Family Physicians, American College of Physicians, and American Academy of Pediatrics. The project has provided coaching, monthly measurement, and patient registry support for 155 primary-care…
Mental Health Practice Guidelines for Child Welfare
ERIC Educational Resources Information Center
Annie E. Casey Foundation, 2009
2009-01-01
The guidelines and supporting rationale presented in this paper were developed from the October 2007 "Best Practices for Mental Health in Child Welfare Consensus Conference" sponsored by Casey Family Programs, the Annie E. Casey Foundation and the REACH Institute (REsource for Advancing Children's Health). The purpose of the conference was to…
Effectively Addressing Mental Health Issues in Permanency-Focused Child Welfare Practice
ERIC Educational Resources Information Center
Ornelas, Laura A.; Silverstein, Deborah N.; Tan, Sherylle
2007-01-01
Children and families built by adoption or relative caregiving have specialized needs. This paper proposes a rubric for the central elements of permanency-focused mental health services in child welfare practice. Kinship Center provides an innovative mental health service delivery system, weaving foster and adoptive placement programs, adoption…
Byrne, S; Rodrigo, M J; Máiquez, M L
2014-03-01
In the area of child maltreatment prevention, little is known about the typology of changes that individuals undergo in response to parent-training interventions. In this study, we examined the patterns of change observed in parents immediately after their completion of the Apoyo Personal y Familiar (APF, Personal and Family Support) parenting program. We identified five clusters and classified 496 parents according to two criteria: (a) the amount of pre-post changes (total or partial) as reflected in their self-reports on implicit theories, parental agency and childrearing practices, and (b) the positive, negative or mixed character of these changes. The study also included a follow-up of a subset of 95 participants intended to examine the extent to which the patterns of change identified in the first part of the study might predict the quality of the childrearing environment at home and the successful integration of the APF program into social services structures one year on. In this follow-up study, external evaluators observed families' home environments and collected the parenting program facilitators' self-reports on changes to their work environment. The evaluators found higher-quality childrearing environments and more positive appraisals of the changes to the teams' work with families in those cases where participants had experienced partial or total positive changes as a result of the APF. This approach offers insights into processes of individual change that have practical implications for the successful implementation of parenting programs in child maltreatment prevention services. Copyright © 2014 Elsevier Ltd. All rights reserved.
Preparation for practice in family medicine: before and after duty hours.
Carek, Peter J; Diaz, Vanessa; Dickerson, Lori M; Peterson, Lars; Johnson, Sharleen
2012-09-01
In July of 2003, the Accreditation Council for Graduate Medical Education (ACGME) adopted requirements limiting the duty hours of resident physicians. The impact of these restrictions on education and patient care activities is not clear. The purpose of this study is to examine the perception of graduates of family medicine residency programs immediately prior to and following implementation of duty hours regarding preparedness to practice and board certification status, as well as current patient care activities. Surveys of graduates of family medicine residency programs in South Carolina were conducted. Preparation for practice and professional activities of program graduates prior to (1999--2003) and following (2005--2009) implementation of duty hours were compared. Response rates were 54.4% and 53.1%, respectively. No significant differences by survey years in the average age, gender, or race was noted. Recent graduates felt as well prepared for practice in most curricular areas except surgery (OR=0.50 [0.27, 0.91]) and performed similar procedures with the following exceptions: central line placement (OR=0.32 [0.11, 0.95]), flexible sigmoidoscopy (OR=0.12 [0.02, 0.80]), ICU care (OR=0.39 [0.22, 0.70]), and ventilator management (OR=0.54 [0.29, 0.99]). Higher proportion of recent graduates do not take after hours call (22.3% versus 8.6%). Similarly, fewer recent graduates care for patients in nursing homes (22.0% versus 44.9%) and hospitals (46.2% versus 68.0%). Implementation of resident duty hours appears to have little overall association with self-reported preparedness for practice. An association was noted in the patient care services and procedures performed.
[Family physicians attitude towards quality indicator program].
Shani, Michal; Nakar, Sasson; Azuri, Yossi
2012-10-01
Quality indicator programs for primary care are implanted throughout the world improving quality in health care. In this study, we have assessed family physicians attitudes towards the quality indicators program in Israel. Questionnaires were distributed to family physicians in various continuing educational programs. The questionnaire addressed demographics, whether the physician dealt with quality indicators, time devoted by the physician to quality indicators, pressure placed on the physician related to quality indicators, and the working environment. A total of 140 questionnaires were distributed and 91 (65%) were completed. The average physician age was 49 years (range 33-65 years]; the average working experience as a family physician was 17.8 years (range 0.5-42); 58 physicians were family medicine specialist (65.9%). Quality indicators were part of the routine work of 94% of the physicians; 72% of the physicians noted the importance of quality indicators; 84% of the physicians noted that quality indicators demand better team work; 76% of the physicians noted that quality indicators have reduced their professional independence. Pressure to deal with quality indicators was noted by 72% of the family physicians. Pressure to deal with quality indicators was related to reduced loyalty to their employer (P = 0.001), reducing their interest to practice family medicine (p < 0.001), and increasing their burnout at work (p = 0.001). It is important that policy makers find the way to leverage the advantages of quality indicator programs, without creating a heavy burden on the work of family physicians.
Family Planning Practice Among Rural Reproductive-Age Married Women in Myanmar.
Jirapongsuwan, Ann; Latt, Kyaw Thu; Siri, Sukhontha; Munsawaengsub, Chokchai
2016-05-01
A cross-sectional study was undertaken to investigate family planning (FP) practices and associated factors among reproductive-age married women. Data were collected by interviewing the 300 married women living in a rural area of Myanmar. The questionnaire had reliability coefficients ranging from .8 to .9. Results indicated that 73.3% of women performed FP, and contraceptive injection was the most common method. Significant associations were found with age 21 to 35 years (adjusted odds ratio [adj OR] = 3.748, 95% CI = 2.179-6.445), adequacy of income (adj OR = 2.520, 95% CI = 1.477-4.290), good attitude toward FP (adj OR = 0.386, 95% CI = 0.228-0.656), good support from health care providers (adj OR = 0.129, 95% CI = 0.054-0.313), good support from family (adj OR = 0.304, 95% CI = 0.163-0.565), good support from friends (adj OR = 0.344, 95% CI = 0.193-0.613), and FP practice. It is recommended that designing FP programs with peers and family involvement could increase the practice of FP among rural Myanmar women. © 2016 APJPH.
Elmusharaf, Khalifa; Byrne, Elaine; O'Donovan, Diarmuid
2017-01-17
Understanding what determines family size is crucial for programmes that aim to provide family planning services during and after conflicts. Recent research found that development agents in post conflict settings do not necessarily take time to understand the context adequately, translate their context understanding into programming, or adjust programming in the light of changes. South Sudan, a country that has been suffering from war for almost 50 years, has one of the highest maternal death rates and the lowest contraceptive utilization rates in the world. This research used Participatory Ethnographic Evaluation and Research (PEER) to provide a contextualised understanding of social and traditional practices and their implications for family planning. Fourteen women were recruited from 14 villages in Renk County in South Sudan in the period 2010-2012. They were trained to design research instruments, conduct interviews, collect narratives and stories and analyse data to identify, prioritize and address their maternal health concerns. As a result of wars, people are under pressure to increase their family sizes and thus increase the nation's population. This is to compensate for the men perished in war and the high child death rates. Large family size is regarded as a national obligation. Women are caught up in a vicious cycle of high fertility and a high rate of child mortality. Determinants of large family size include: 1) Social and cultural practices, 2) Clan lineage and 3) Compensation for loss of family members. Three strategies are used to increase family size: 1) Marry several women, 2) Husbands taking care of women, and 3) Financial stability. Consequences of big families include: 1) Financial burden, 2) Fear of losing children, 3) Borrowing children and 4) Husband shirking responsibility. The desire to have a big family will remain in South Sudan until families realise that their children will live longer, that their men will not be taken by the war, and that the costs of living will be met. In order to generate demand for family planning in South Sudan, priority should be given first to improve infant and child health.
ERIC Educational Resources Information Center
Weinstein-Shr, Gail, Ed.; Quintero, Elizabeth, Ed.
Teachers' and developers' descriptions of intergenerational literacy programs for immigrants are collected here. Topics addressed include appropriate program design, the quality of intergenerational collaboration, student journals, learner-centered curriculum design, traditional and personal storytelling as a literacy approach, education and…
Supporting Individuals with Autism Spectrum Disorder in Recreation
ERIC Educational Resources Information Center
Coyne, Phyllis; Fullerton, Ann
2004-01-01
This book was developed to assist recreation service providers, as well as families, to understand strategies for supporting individuals with ASD in community and school recreation programs. The ideas have many practical uses in generic and specialized recreation programs. A variety of audiences, including teachers, recreation service providers,…
Inviting the Faculty to Prayer: A Practical Packet.
ERIC Educational Resources Information Center
Walsh, Maria Joseph
Many principals want to respond to their faculty's increasing interest in and need for meaningful community prayer. This publication was prepared for the teaching community with selections of prayer forms and programs, and plans for extending the program to spouses and family. Part 1, "Introduction," is comprised of scriptural…
ERIC Educational Resources Information Center
McClary, Cheryl
The Health Promotion Program began with establishment of a one-credit course in health promotion and wellness and the training of family practice residents at the Mountain Area Health Education Center to serve as lab leaders in the course. The course later became part of the university's general education requirements. In addition, a health…
Mediators of weight loss in a family-based intervention presented over the internet.
White, Marney A; Martin, Pamela D; Newton, Robert L; Walden, Heather M; York-Crowe, Emily E; Gordon, Stewart T; Ryan, Donna H; Williamson, Donald A
2004-07-01
To assess the process variables involved in a weight loss program for African-American adolescent girls. Several process variables have been identified as affecting success in in vivo weight loss programs for adults and children, including program adherence, self-efficacy, and social support. The current study sought to broaden the understanding of these process variables as they pertain to an intervention program that is presented using the Internet. It was hypothesized that variables such as program adherence, dietary self-efficacy, psychological factors, and family environment factors would mediate the effect of the experimental condition on weight loss. Participants were 57 adolescent African-American girls who joined the program with one obese parent; family pairs were randomized to either a behavioral or control condition in an Internet-based weight loss program. Outcome data (weight loss) are reported for the first 6 months of the intervention. Results partially supported the hypotheses. For weight loss among adolescents, parent variables pertaining to life and family satisfaction were the strongest mediating variables. For parental weight loss, changes in dietary practices over the course of 6 months were the strongest mediators. The identification of factors that enhance or impede weight loss for adolescents is an important step in improving weight loss programs for this group. The current findings suggest that family/parental variables exert a strong influence on weight loss efforts for adolescents and should be considered in developing future programs. Copyright 2004 NAASO
A successful integrated project.
Zheng, P
1994-10-01
The experiences of the Juxian County Family Planning Committee of Shandong Province, China, were discussed in terms of the integration of family planning with income generation activities in rural areas. The integrated program was initiated in 1988 with pilot programs established by the Qiaoshan Family Planning Association to develop marketable skills in carpet weaving and grass braiding in Xiazhuang Town and Qiaoshan Township. The program gave priority of admission to women with only children and those who practiced family planning. 1400 women were recruited in these factories. Other income generation programs were developed for silkworm breeding and silk reeling, woolen embroidery, and printing. High ranking officials of the China Family Planning Association commended the work in income generation and family planning in Juxian County. This recognition spurred the second phase of development by the county family planning association: the establishment of village operated factories and mills for native products. By the end of 1991, there were 26 such projects in the county and per capita income to women increased by RMB 678 yuan. In the third stage of 1992, the number of association enterprises increased to 196 with recruitment of over 18,000 reproductive age women. The programs were initiated with collective funds from farmers and villages. The 170 projects in 1992 were developed with an investment of 9.6 million yuan, of which 2.26 million yuan was from individuals (23.5%). Emphasis was placed on self-reliance and recruitment of women with one child, women with 2 daughters and tubal ligations, and family planning motivators. The consequences of the integrated program were weakening traditional customs of marriage and childbearing, improvement in socioeconomic status of women, and effective service delivery of family planning and maternal and child health care services.
IUD knowledge and experience among family medicine residents.
Schubert, Finn D; Herbitter, Cara; Fletcher, Jason; Gold, Marji
2015-06-01
The intrauterine device (IUD) is a highly effective contraceptive method with few contraindications; however, clinician lack of training in insertion and misconceptions about IUD risks are barriers to utilization. Previous research has shown gaps in IUD training in family medicine residency programs. An online survey addressing experience with IUD insertion, knowledge of patient eligibility and IUD risks, and intent to insert IUDs in practice was circulated to residents at 15 US family medicine residency programs. Programs were eligible to participate if they were receiving funding to enhance training in family planning and abortion care and interested in additional support to enhance IUD training. The overall response rate for the surveys was 76.1% (332/436). Experience with the levonorgestrel intrauterine system was more common than with the copper IUD. Residents performed well on knowledge questions, but many would not insert in common patient scenarios in which insertion was not contraindicated, including a history of sexually transmitted infection in the past 6 months (48.2% would not insert), a history of ectopic pregnancy (37.0%), no pap smear in the past year (30.7%), or if the patient was not in a monogamous relationship (29.2%). The vast majority of residents (88.7%) reported that they were likely or very likely to provide IUDs in their future family medicine practice. Although residents overwhelmingly expressed interest in providing IUDs after residency, our results suggest that additional clinical and didactic training is needed, particularly interventions targeted at dispelling misconceptions about patient eligibility for IUDs.
ERIC Educational Resources Information Center
Frey, Andy J.; Small, Jason W.; Lee, Jon; Walker, Hill M.; Seeley, John R.; Feil, Edward G.; Golly, Annemeike
2015-01-01
This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary FirstStep was developed to engage families more effectively and influence and improve parenting practices for children having challenging…
Family Literacy in Cultural Context: Lessons from Two Case Studies.
ERIC Educational Resources Information Center
Puchner, Laurel D.
A study examined the literature to determine the veracity of the criticism of some educators who say that family literacy programs in the United States fail to take into account important cultural issues when dealing with certain target groups. Issues invoked included the need to take traditional cultural values and practices into account in…
45 CFR 213.11 - Notice of hearing or opportunity for hearing.
Code of Federal Regulations, 2010 CFR
2010-10-01
... 45 Public Welfare 2 2010-10-01 2010-10-01 false Notice of hearing or opportunity for hearing. 213.11 Section 213.11 Public Welfare Regulations Relating to Public Welfare OFFICE OF FAMILY ASSISTANCE (ASSISTANCE PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND PROCEDURE FOR HEARINGS TO STATE...
ERIC Educational Resources Information Center
Frey, Andy J.; Small, Jason W.; Lee, Jon; Walker, Hill M.; Seeley, John R.; Feil, Edward G.; Golly, Annemeike
2015-01-01
This study presents the findings of a quasi-experimental feasibility study examining the Tertiary First Step intervention, an enhanced version of the First Step to Success early intervention program. Tertiary First Step was developed to engage families more effectively and influence and improve parenting practices for children having challenging…
ERIC Educational Resources Information Center
Dumas, Jean E.; Arriaga, Ximena; Begle, Angela Moreland; Longoria, Zayra
2010-01-01
This paper describes the Spanish adaptation of PACE--"Parenting Our Children to Excellence." Successfully offered in preschools and daycare centers since 2002, PACE is a research-based preventive intervention to support families in their parenting task through discussions and activities that address practical childrearing issues and promote child…
Food and Nutrition: Supplemental Lessons for Training Extension Aides: Food Preparation.
ERIC Educational Resources Information Center
Johnson, Evelyn H.; And Others
The lessons were written to help trainer agents prepare aides for work with families in Extension's Expanded Food and Nutrition Program. The purpose is to enrich the aides' background in food preparation and to provide practical teaching methods that can be used in presenting food preparation information to families. The 21 lessons are an…
ERIC Educational Resources Information Center
Child Welfare League of America, Inc., Washington, DC.
Child welfare program standards based on current knowledge, children's developmental needs, and tested ways of meeting these needs most effectively provide benchmarks of excellence that can be used as goals to advance and guide contemporary practice. This book delineates standards for services for abused or neglected children and their families.…
Pilot Study for the Active TV Viewer Scholar Education. Final Report. Years 1984-1985.
ERIC Educational Resources Information Center
Torres, Miguel Reyes
The purposes of the "Pilot Study for the Active TV Viewer Scholar Education" project were to find low cost teaching methods that developed critical television viewing skills among elementary and secondary students, and to develop a parallel program of family education in an effort to modify family viewing practices to encourage critical…
ERIC Educational Resources Information Center
Stacy, Jen; Aguilar, Jodi
2018-01-01
Mobile technology is now ubiquitous in families' lives and, as such, provides fertile ground for organic technology learning embedded within everyday home practices, like oral storytelling. This article explores the experiences of three Latinx women participating in a family digital storytelling program held at an East Los Angeles Head Start…
Starling, Suzanne P; Heisler, Kurt W; Paulson, James F; Youmans, Eren
2009-04-01
The objective of this study was to determine the level of knowledge, comfort, and training related to the medical management of child abuse among pediatrics, emergency medicine, and family medicine residents. Surveys were administered to program directors and third-year residents at 67 residency programs. The resident survey included a 24-item quiz to assess knowledge regarding the medical management of physical and sexual child abuse. Sites were solicited from members of a network of child abuse physicians practicing at institutions with residency programs. Analyzable surveys were received from 53 program directors and 462 residents. Compared with emergency medicine and family medicine programs, pediatric programs were significantly larger and more likely to have a medical provider specializing in child abuse pediatrics, have faculty primarily responsible for child abuse training, use a written curriculum for child abuse training, and offer an elective rotation in child abuse. Exposure to child abuse training and abused patients was highest for pediatric residents and lowest for family medicine residents. Comfort with managing child abuse cases was lowest among family medicine residents. On the knowledge quiz, pediatric residents significantly outperformed emergency medicine and family medicine residents. Residents with high knowledge scores were significantly more likely to come from larger programs and programs that had a center, provider, or interdisciplinary team that specialized in child abuse pediatrics; had a physician on faculty responsible for child abuse training; used a written curriculum for child abuse training; and had a required rotation in child abuse pediatrics. By analyzing the relationship between program characteristics and residents' child abuse knowledge, we found that pediatric programs provide far more training and resources for child abuse education than emergency medicine and family medicine programs. As leaders, pediatricians must establish the importance of this topic in the pediatric education of residents of all specialties.
Ciftci, Bestami; Uzel, Nesibe; Ozel, M Onur; Zergeroglu, Sema; Deger, Cetin; Turasan, S Sare; Karakoc, Ayse Gul; Ozbalci, Semra
2016-01-01
Aim This study aims to assess the educational needs of family practitioners and evaluate the efficacy of the ongoing “Maternal Health and Family Planning Distance Education” program conducted by the General Directorate of Health Research (SAGEM) of the Turkish Ministry of Health. Methods This study consisted of three phases. In the first phase, an online survey on maternal health and family planning educational needs was sent to 20,611 physicians via e-mail. Of the 20,611 physicians, 4,729 completed the survey. In the second phase, of the 1,061 physicians registered to the education program, 632 physicians with active participation were included. In the third phase, the preeducation expectations of 287 physicians and posteducation satisfaction of 54 physicians were analyzed with a questionnaire. Results The majority of the physicians were employed in a family health center (97.4%) and practicing for 16–20 years (23.2%) without any prior in-service training (60.9%). High-to-very high educational need was expressed by 56.4% of physicians for pregnancy, delivery, and puerperality. Topics that the physicians, including both those with ≥16 years in practice and without prior in-service training, expressed need for more detailed content were pregnancy, delivery, and puerperality (37.5%); emergency obstetric approach in the primary care setting (33.1%); and gynecological infectious diseases and treatment approach (32.4%). Following the education program, the participants’ expectations were fulfilled in terms of refreshing their knowledge, particularly in the field of Maternal Health and Family Planning (87.1% and 75.9%) and the percentage of participants who expressed that they had sufficient high level knowledge increased from 55% to 68.5%. Conclusion The education on Maternal Health and Family Planning refreshed the knowledge of participants and highly met the preeducation expectations. Determining the educational needs and expectations of the target population prior to the education program seems to have an important role on determining its overall success. PMID:27354837
Ciftci, Bestami; Uzel, Nesibe; Ozel, M Onur; Zergeroglu, Sema; Deger, Cetin; Turasan, S Sare; Karakoc, Ayse Gul; Ozbalci, Semra
2016-01-01
This study aims to assess the educational needs of family practitioners and evaluate the efficacy of the ongoing "Maternal Health and Family Planning Distance Education" program conducted by the General Directorate of Health Research (SAGEM) of the Turkish Ministry of Health. This study consisted of three phases. In the first phase, an online survey on maternal health and family planning educational needs was sent to 20,611 physicians via e-mail. Of the 20,611 physicians, 4,729 completed the survey. In the second phase, of the 1,061 physicians registered to the education program, 632 physicians with active participation were included. In the third phase, the preeducation expectations of 287 physicians and posteducation satisfaction of 54 physicians were analyzed with a questionnaire. The majority of the physicians were employed in a family health center (97.4%) and practicing for 16-20 years (23.2%) without any prior in-service training (60.9%). High-to-very high educational need was expressed by 56.4% of physicians for pregnancy, delivery, and puerperality. Topics that the physicians, including both those with ≥16 years in practice and without prior in-service training, expressed need for more detailed content were pregnancy, delivery, and puerperality (37.5%); emergency obstetric approach in the primary care setting (33.1%); and gynecological infectious diseases and treatment approach (32.4%). Following the education program, the participants' expectations were fulfilled in terms of refreshing their knowledge, particularly in the field of Maternal Health and Family Planning (87.1% and 75.9%) and the percentage of participants who expressed that they had sufficient high level knowledge increased from 55% to 68.5%. The education on Maternal Health and Family Planning refreshed the knowledge of participants and highly met the preeducation expectations. Determining the educational needs and expectations of the target population prior to the education program seems to have an important role on determining its overall success.
Chamratrithirong, Aphichat; Miller, Brenda A; Byrnes, Hilary F; Rhucharoenpornpanich, Orratai; Cupp, Pamela K; Rosati, Michael J; Fongkaew, Warunee; Atwood, Katharine A; Todd, Michael
2013-02-01
This study examines the intergenerational transmission of family religion as measured by parent's and adolescent's beliefs and practices in Buddhism, and its relation to delinquent behaviors among early adolescents in Thailand. The data set is from the Thai Family Matters Project 2007, a representative sample of 420 pairs of parents and teens in Bangkok. A structural equation model is employed for the analysis. The intergenerational transmission and the direct and indirect association between parents' and adolescents' beliefs and practices in Buddhism and adolescents' minor and serious delinquent behaviors are revealed to be significant, controlling for secular parental monitoring. Spirituality within the family can play an important role in preventing delinquency among early adolescents. Policies in the areas related to family empowerment and delinquency prevention may need to consider integrating both secular and non-secular program inputs in their implementation design. Copyright © 2012 The Foundation for Professionals in Services for Adolescents. Published by Elsevier Ltd. All rights reserved.
McNeil Smith, Shardé; Reynolds, Jamila E; Fincham, Frank D; Beach, Steven R H
2016-04-01
Parents experiencing racial discrimination are likely to transmit racial socialization messages to their children to protect them from future injustices. This study was conducted to better understand the role of parents' racial discrimination in their racial socialization practices for 2-parent African American families. Using a sample from the Promoting Strong African American Families (N = 322 couples) program, we examined the effects of experienced discrimination on one's own and one's partner's racial socialization practices with male (n = 154) and female (n = 168) offspring. Multiple-group actor-partner interdependence models showed that racial discrimination was associated with racial socialization practices. In addition, maternal experiences of discrimination had stronger relations to socialization messages relayed to daughters and greater paternal experiences of discrimination had stronger relations to socialization messages given to sons. This study demonstrates variability in how male and female children in African American families are socialized as a result of their parents' experiences with racial discrimination. (c) 2016 APA, all rights reserved).
Growing Your Business by Adapting Employer Child Care Practices
ERIC Educational Resources Information Center
Spencer, Becky
2012-01-01
As an early childhood professional for 30 years operating both traditional and employer child care programs, the author believes that traditional center owners and operators have an opportunity to grow their business, serve more children and families, and stay relevant for future workforce needs by integrating employer child care practices into…
ERIC Educational Resources Information Center
Theadore, Geraldine; Laurent, Amy; Kovarsky, Dana; Weiss, Amy L.
2011-01-01
Reflective practice requires that professionals carefully examine and integrate multiple sources of information when designing intervention and evaluating its effectiveness. This article describes the use of focus group discussion as a form of qualitative research for understanding parents' perspectives of a university-based intervention program…
Code of Federal Regulations, 2012 CFR
2012-10-01
... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...
Code of Federal Regulations, 2014 CFR
2014-10-01
... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...
Code of Federal Regulations, 2013 CFR
2013-10-01
... emergency care service, if the number of providers of that basic health service who will provide the service... includes general practice, family practice, general internal medicine, general pediatrics, and general... after-hours services. (Medically necessary emergency services must be available 24 hours a day, 7 days a...
Hixon, Allen L; Buenconsejo-Lum, Lee E; Racsa, C Philip
2012-04-01
Access to care for patients in Hawai'i is compromised by a significant primary care workforce shortage. Not only are there not enough primary care providers, they are often not practicing in locations of high need such as rural areas on the neighbor islands or in the Pacific. This study used geographic information systems (GIS) spatial analysis to look at practice locations for 86 University of Hawai'i Family Medicine and Community Health graduates from 1993 to the 2010. Careful alumni records were verified and entered into the data set using the street address of major employment. Questions to be answered were (1) what percentage of program graduates remain in the state of Hawai'i and (2) what percentage of graduates practice in health professional shortage areas (HPSAs) throughout the United States. This study found that 73 percent of graduates remain and practice in Hawai'i with over 36 percent working in Health Professional Shortage Areas. Spatial analysis using GIS residency footprinting may be an important analytic tool to ensure that graduate medical education programs are meeting Hawai'i's health workforce needs.
How can policy strengthen community support for children in military families?
Boberiene, Liepa V; Hornback, Bradley J
2014-09-01
The extraordinary demands of recent wars have increased burdens on many military families and existing systems of care. The sacrifices made by service members are made also by their children and families, and these sacrifices can have long-term consequences. Therefore, military children and families cannot go unrecognized and unsupported. Policy responses should be less about diagnosing and treating individuals and more about recognizing and supporting families' and communities' resilience in the face of wartime deployment. Policy should focus on identifying military children in diverse communities and supporting them where they live, learn, and receive care. A range of community-based prevention strategies could decrease stress before it escalates into serious mental health issues. Efforts to develop family resilience during deployment and reintegration are extremely important in facilitating children's healthy development and veterans' recovery. Military personnel should partner with community leaders to implement effective programs providing emotional, social, and practical support to families. Emphasizing family cohesion, community social support, and comprehensive programs through education and health care organizations would go a long way in fostering families' resilience. At the same time, pro- grams should be monitored and evaluated, and military and civilian researchers should share data on family risk and resilience to improve evidence- based approaches. Such efforts would benefit not only military children, but also larger populations as programs improve family and community capacity to support thriving and mitigate challenges in the face of adversity.
On any Saturday--a practical model for diabetes education.
Carter, Inge R.; Nash, Creshelle; Ridgway, Andrea
2002-01-01
PURPOSE: Patient self-management is an important part of treating chronic diseases. However, many primary care physicians face barriers in offering office-based diabetes education. This paper will discuss a practical program of community-based diabetes education that can be easily modified for a practitioner's office. PROCEDURE: Half-day diabetes education workshops geared toward local health care providers and patients with diabetes and their families were conducted in two rural communities in Arkansas. Participants were surveyed with respect to the effectiveness of the program and how they would use what they learned in the program. FINDINGS: Thirty-one health care providers and 59 patients with diabetes and their families attended. Program evaluation scores were between 4.1 and 5 on a 5-point Likert scale. One third of the patients commented that they had a better understanding of diet and medication use. Feedback from community health care providers noted that attendance in local diabetes support groups increased after the workshops. CONCLUSIONS: Diabetes complications have a large impact on the health of the population and a growing economic impact on the health care industry. Although there are many barriers to diabetes education and control, a practical half-day diabetes workshop on any Saturday can be effectively developed and implemented. PMID:11853048
Jones, Deborah J; Forehand, Rex; Cuellar, Jessica; Parent, Justin; Honeycutt, Amanda; Khavjou, Olga; Gonzalez, Michelle; Anton, Margaret; Newey, Greg A
2014-01-01
Early onset disruptive behavior disorders are overrepresented in low-income families; yet these families are less likely to engage in behavioral parent training (BPT) than other groups. This project aimed to develop and pilot test a technology-enhanced version of one evidence-based BPT program, Helping the Noncompliant Child (HNC). The aim was to increase engagement of low-income families and, in turn, child behavior outcomes, with potential cost-savings associated with greater treatment efficiency. Low-income families of 3- to 8-year-old children with clinically significant disruptive behaviors were randomized to and completed standard HNC (n = 8) or Technology-Enhanced HNC (TE-HNC; n = 7). On average, caregivers were 37 years old; 87% were female, and 80% worked at least part-time. More than half (53%) of the youth were boys; the average age of the sample was 5.67 years. All families received the standard HNC program; however, TE-HNC also included the following smartphone enhancements: (a) skills video series, (b) brief daily surveys, (c) text message reminders, (d) video recording home practice, and (e) midweek video calls. TE-HNC yielded larger effect sizes than HNC for all engagement outcomes. Both groups yielded clinically significant improvements in disruptive behavior; however, findings suggest that the greater program engagement associated with TE-HNC boosted child treatment outcome. Further evidence for the boost afforded by the technology is revealed in family responses to postassessment interviews. Finally, cost analysis suggests that TE-HNC families also required fewer sessions than HNC families to complete the program, an efficiency that did not compromise family satisfaction. TE-HNC shows promise as an innovative approach to engaging low-income families in BPT with potential cost-savings and, therefore, merits further investigation on a larger scale.
Jones, Deborah J.; Forehand, Rex; Cuellar, Jessica; Parent, Justin; Honeycutt, Amanda; Khavjou, Olga; Gonzalez, Michelle; Anton, Margaret; Newey, Greg A.
2013-01-01
Objective Early onset Disruptive Behavior Disorders (DBDs) are overrepresented in low-income families; yet, these families are less likely to engage in Behavioral Parent Training (BPT) than other groups. This project aimed to develop and pilot test a technology-enhanced version of one evidence-based BPT program, Helping the Noncompliant Child (HNC). The aim was to increase engagement of low-income families and, in turn, child behavior outcomes, with potential cost-savings associated with greater treatment efficiency. Method Low-income families of 3-to-8 year old children with clinically-significant disruptive behaviors were randomized to and completed standard HNC (n =8) or technology-enhanced HNC (TE-HNC) (n = 7). On average, caregivers were 37 years old, female (87%), and most (80%) worked at least part-time. Half (53%) of the youth were boys, average age of the sample was 5.67 years. All families received the standard HNC program; however, TE-HNC also included the following smartphone-enhancements: (1). Skills video series; (2). Brief daily surveys; (3). Text message reminders; (4). Video recording home practice; and (5). Mid-week video calls. Results TE-HNC yielded larger effect sizes than HNC for all engagement outcomes. Both groups yielded clinically significant improvements in disruptive behavior; however, findings suggest that the greater program engagement associated with TE-HNC boosted child treatment outcome. Further evidence for the boost afforded by the technology is revealed in family responses to post-assessment interviews. Finally, cost analysis suggests that TE-HNC families also required fewer sessions than HNC families to complete the program, an efficiency that did not compromise family satisfaction. Conclusions TE-HNC shows promise as an innovative approach to engaging low-income families in BPT with potential cost-savings and, therefore, merits further investigation on a larger scale. PMID:23924046
Cultural transition of international medical graduate residents into family practice in Canada.
Triscott, Jean A C; Szafran, Olga; Waugh, Earle H; Torti, Jacqueline M I; Barton, Martina
2016-05-04
To identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice. This was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically. Participants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths. At the same time, IMG residents appeared to experience challenges in the areas of: (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada's health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning, unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles. Residency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum. IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning.
Kabir, Ashraful; Maitrot, Mathilde Rose Louise
2017-01-01
Nutritional status differs between infants and young children living in slum and non-slum conditions-infants and young children living in City Corporation slums are likely to have worse nutritional status compared to those from non-slums. Furthermore, families in slums tend to engage female labor in cash-earning activities as a survival strategy; hence, a higher percentage of mothers stay at work. However, little is known about feeding practices for infants and young children in families with working mothers in slums. This study aims to understand the factors that determine feeding practices for infants and young children living in families with working mothers in Dhaka slums. This study adopted a qualitative approach. Sixteen In-depth Interviews, five Key Informant Interviews, and Focused Group Discussions were conducted with family members, community leaders, and program staff. Method triangulation and thematic analyses were conducted. Feeding practices for infants and young children in families with working mothers are broadly determined by mothers' occupation, basis civic facilities, and limited family buying capacity. Although mothers have good nutritional knowledge, they negotiate between work and feeding their infants and young children. Household composition, access to cooking facilities, and poverty level were also found to be significant determining factors. The results suggest a trade-off between mothers' work and childcare. The absence of alternative care support in homes and/or work places along with societal factors outweighs full benefits of project interventions. Improving alternative childcare support could reduce the burden of feeding practice experienced by working mothers and may improve nutritional outcomes.
Taleb, Fahmida; Perkins, Janet; Ali, Nabeel Ashraf; Capello, Cecilia; Ali, Muzahid; Santarelli, Carlo; Hoque, Dewan Md Emdadul
2015-03-29
Since 2008, Participatory Action for Rural Development Innovation (PARI) Development Trust, with the support of Enfants du Monde, has been implementing a maternal and newborn health (MNH) program based on the World Health Organization's (WHO) framework for Working with Individuals, Families and Communities (IFC) to improve MNH in Netrokona district, Bangladesh. This program aims to empower women and families and increase utilization of quality health services, thereby helping women realize their rights related to maternal health. Birth preparedness and complication readiness and working with traditional birth attendants (TBAs) to exercise a new role in MNH and have formed key interventions of this program. The purpose of this study was to explore how the program has contributed to changing social norms and practices surrounding MNH at midpoint. This study relied primarily on qualitative data collection. Two focus group discussions (FGDs) were conducted with women who were pregnant or had recently given birth and one FGD with each of the following groups: husbands, family members, TBAs, and health workers. In-depth interviews were conducted with women who were pregnant or had recently given birth, family members of these women, health care providers, TBAs and community health workers in selected intervention areas. Since implementation of interventions informants report an increase in planning for birth and complications and a shift in preference toward skilled care at birth. However, women still prefer to receive services at home. TBAs report encouraging women to access skilled care for both routine and emergency services. While community members' understanding of rights related to maternal health remains limited, they report increased women's participation in household decision- making processes, an important indicator of the realization of rights. Results suggest that community-level interventions aiming to affect change in social norms and practices surrounding MNH can influence knowledge and practices even after a short period of time. Further evaluations will be required to quantify the degree to which these changes are having an impact on health services utilization.
Qureshi, Nadeem; Armstrong, Sarah; Dhiman, Paula; Saukko, Paula; Middlemass, Joan; Evans, Philip H; Kai, Joe
2012-02-21
Evidence of the value of systematically collecting family history in primary care is limited. To evaluate the feasibility of systematically collecting family history of coronary heart disease in primary care and the effect of incorporating these data into cardiovascular risk assessment. Pragmatic, matched-pair, cluster randomized, controlled trial. (International Standardized Randomized Controlled Trial Number Register: ISRCTN 17943542). 24 family practices in the United Kingdom. 748 persons aged 30 to 65 years with no previously diagnosed cardiovascular risk, seen between July 2007 and March 2009. Participants in control practices had the usual Framingham-based cardiovascular risk assessment with and without use of existing family history information in their medical records. Participants in intervention practices also completed a questionnaire to systematically collect their family history. All participants were informed of their risk status. Participants with high cardiovascular risk were invited for a consultation. The primary outcome was the proportion of participants with high cardiovascular risk (10-year risk ≥ 20%). Other measures included questionnaire completion rate and anxiety score. 98% of participants completed the family history questionnaire. The mean increase in proportion of participants classified as having high cardiovascular risk was 4.8 percentage points in the intervention practices, compared with 0.3 percentage point in control practices when family history from patient records was incorporated. The 4.5-percentage point difference between groups (95% CI, 1.7 to 7.2 percentage points) remained significant after adjustment for participant and practice characteristics (P = 0.007). Anxiety scores were similar between groups. Relatively few participants were from ethnic minority or less-educated groups. The potential to explore behavioral change and clinical outcomes was limited. Many data were missing for anxiety scores. Systematically collecting family history increases the proportion of persons identified as having high cardiovascular risk for further targeted prevention and seems to have little or no effect on anxiety. Genetics Health Services Research program of the United Kingdom Department of Health.
Shah, Prakesh S.; McDonald, Sarah D.; Barrett, Jon; Synnes, Anne; Robson, Kate; Foster, Jonathan; Pasquier, Jean-Charles; Joseph, K.S.; Piedboeuf, Bruno; Lacaze-Masmonteil, Thierry; O'Brien, Karel; Shivananda, Sandesh; Chaillet, Nils; Pechlivanoglou, Petros
2018-01-01
Background: Preterm birth (birth before 37 wk of gestation) occurs in about 8% of pregnancies in Canada and is associated with high mortality and morbidity rates that substantially affect infants, their families and the health care system. Our overall goal is to create a transdisciplinary platform, the Canadian Preterm Birth Network (CPTBN), where investigators, stakeholders and families will work together to improve childhood outcomes of preterm neonates. Methods: Our national cohort will include 24 maternal-fetal/obstetrical units, 31 neonatal intensive care units and 26 neonatal follow-up programs across Canada with planned linkages to provincial health information systems. Three broad clusters of projects will be undertaken. Cluster 1 will focus on quality-improvement efforts that use the Evidence-based Practice for Improving Quality method to evaluate information from the CPTBN database and review the current literature, then identify potentially better health care practices and implement identified strategies. Cluster 2 will assess the impact of current practices and practice changes in maternal, perinatal and neonatal care on maternal, neonatal and neurodevelopmental outcomes. Cluster 3 will evaluate the effect of preterm birth on babies, their families and the health care system by integrating CPTBN data, parent feedback, and national and provincial database information in order to identify areas where more parental support is needed, and also generate robust estimates of resource use, cost and cost-effectiveness around preterm neonatal care. Interpretation: These collaborative efforts will create a flexible, transdisciplinary, evaluable and informative research and quality-improvement platform that supports programs, projects and partnerships focused on improving outcomes of preterm neonates. PMID:29348260
Allan, G Michael; Korownyk, Christina; Tan, Amy; Hindle, Hugh; Kung, Lina; Manca, Donna
2008-06-01
There is general consensus in the academic community that evidence-based medicine (EBM) teaching is essential. Unfortunately, many postgraduate programs have significant weakness in their EBM programs. The Family Medicine Residency committee at the University of Alberta felt their EBM curriculum would benefit from critical review and revision. An EBM Curriculum Committee was created to evaluate previous components and develop new strategies as needed. Input from stakeholders including faculty and residents was sought, and evidence regarding the teaching and practical application of EBM was gathered. The committee drafted goals and objectives, the primary of which were to assist residents to (1) become competent self-directed, lifelong learners with skills to effectively and efficiently keep up to date, and 2) develop EBM skills to solve problems encountered in daily practice. New curriculum components, each evidence based, were introduced in 2005 and include a family medicine EBM workshop to establish basic EBM knowledge; a Web-based Family Medicine Desktop promoting easier access to evidence-based Internet resources; a brief evidence-based assessment of the research project enhancing integration of EBM into daily practice; and a journal club to support peer learning and growth of rapid appraisal skills. Issues including time use, costs, and change management are discussed. Ongoing evaluation of the curriculum and its components is a principal factor of the design, allowing critical review and adaptation of the curriculum. The first two years of the curriculum have yielded positive feedback from faculty and statistically significant improvement in multiple areas of residents' opinions of the curriculum and comfort with evidence-based practice.
Kelley, Frances J; Klopf, Maria Ignacia
2008-10-01
To describe the Clinical Communication Program developed to integrate second language learning (L2), multimedia, Web-based technologies, and the Internet in an advanced practice nursing education program. Electronic recording devices as well as audio, video editing, Web design, and programming software were used as tools for developing L2 scenarios for practice in clinical settings. The Clinical Communication Program offers opportunities to support both students and faculty members to develop their linguistic and cultural competence skills to serve better their patients, in general, and their students who speak a language other than English, in particular. The program provided 24 h on-demand access for using audio, video, and text exercises via the Internet. L2 education for healthcare providers includes linguistic (listening, speaking, reading, and writing) experiences as well as cultural competence and practices inside and outside the classroom environment as well as online and offline the Internet realm.
Evaluation of an Ongoing Diabetes Group Medical Visit in a Family Medicine Practice.
Cunningham, Amy T; Delgado, David J; Jackson, Joseph D; Crawford, Albert G; Jabbour, Serge; Lieberthal, Robert D; Diaz, Victor; LaNoue, Marianna
2018-01-01
Group medical visits (GMVs), which combine 1-on-1 clinical consultations and group self-management education, have emerged as a promising vehicle for supporting type 2 diabetes management in primary care. However, few evaluations exist of ongoing diabetes GMVs embedded in medical practices. This study used a quasi-experimental design to evaluate diabetes GMV at a large family medicine practice. We examined program attendance and attrition, used propensity score matching to create a matched comparison group, and compared participants and the matched group on clinical, process of care, and utilization outcomes. GMV participants (n = 230) attended an average of 1 session. Participants did not differ significantly from the matched comparison group (n = 230) on clinical, process of care or utilization outcomes. The diabetes GMV was not associated with improvements in outcomes. Further studies should examine diabetes GMV implementation challenges to enhance their effectiveness in everyday practice. © Copyright 2018 by the American Board of Family Medicine.
Erinosho, Temitope; Vaughn, Amber; Hales, Derek; Mazzucca, Stephanie; Gizlice, Ziya; Ward, Dianne
2018-05-01
Describe foods and beverages offered, nutrition practices, and nutrition policies of family child care homes in Mississippi and differences by participation in the Child and Adult Care Food Program (CACFP). Cross-sectional study conducted between fall, 2015 and spring, 2016. Mississippi. Random, stratified sample of 134 family child care homes that enroll 3- to 5-year-olds. Providers completed a modified version of the Environment and Policy Assessment and Observation-self-report tool. Foods and beverages offered at lunch, provider practices regarding nutrition, and presence or absence of written nutrition policies. Descriptive statistics, likelihood ratio chi-square, and t tests. Most homes (>75%) provided components from the fruit, vegetable, grain/bread, meat/meat alternative, and milk food groups at lunch. At some homes, the food and beverage selections offered were high in fat, sugar, and refined grains. Providers at CACFP-participating homes (P < .05) reported healthier beverage selections, more healthful nutrition practices, and more written nutrition policies compared with providers at non-CACFP homes. Interventions and regulatory standards are needed, particularly in non-CACFP homes, to ensure that food and beverage offerings, provider practices, and policies regarding nutrition support the development of healthful dietary behaviors in early childhood. Copyright © 2017 Society for Nutrition Education and Behavior. Published by Elsevier Inc. All rights reserved.
Integrating nutrition services into primary care
Crustolo, Anne Marie; Kates, Nick; Ackerman, Sari; Schamehorn, Sherri
2005-01-01
PROBLEM BEING ADDRESSED Nutrition services can have an important role in prevention and management of many conditions seen by family physicians, but access to these services in primary care is limited. OBJECTIVE OF PROGRAM To integrate specialized nutrition services into the offices of family physicians in Hamilton, Ont, in order to improve patient access to those services, to expand the range of problems seen in primary care, and to increase collaboration between family physicians and registered dietitians. PROGRAM DESCRIPTION Registered dietitians were integrated into the offices of 80 family physicians. In collaboration with physicians, they assessed, treated, and consulted on a variety of nutrition-related problems. A central management team coordinated the dietitians’ activities. CONCLUSION Registered dietitians can augment and complement family physicians’ activities in preventing, assessing, and treating nutrition-related problems. This model of shared care can be applied to integrating other specialized services into primary care practices. PMID:16805083
Sotomayor-Peterson, Marcela; Figueredo, Aurelio J; Christensen, Donna H; Taylor, Angela R
2012-06-01
This study tested a model of shared parenting as its centerpiece that incorporates cultural values as predictors and family emotional climate as the outcome variable of interest. We aimed to assess the predictive power of the Mexican cultural values of familismo and simpatia over couples' shared parenting practices. We anticipated that higher levels of shared parenting would predict family emotional climate. The participants were 61 Mexican American, low income couples, with at least one child between 3 and 4 years of age, recruited from a home-based Head Start program. The predictive model demonstrated excellent goodness of fit, supporting the hypothesis that a positive emotional climate within the family is fostered when Mexican American couples practice a sufficient level of shared parenting. Empirical evidence was previously scarce on this proposition. The findings also provide evidence for the role of cultural values, highlighting the importance of family solidarity and avoidance of confrontation as a pathway to shared parenting within Mexican American couples. © FPI, Inc.
Replication: A "Model" Approach to the Healthy Development of Young Children
ERIC Educational Resources Information Center
Krieg, Iris; Lewis, Jan
2005-01-01
The authors, directors of the Chicago-based Pritzker Early Childhood Foundation, advocate "replication," the adaptation of a successful model program or practice to new locations or to new populations. Studies have shown that successful replications of early childhood programs that help at-risk children and their families can have long-term,…
Instilling Success in an Internship Program: A Dietetic Case Study
ERIC Educational Resources Information Center
Shows, Amy R.; Killough, Jill E.; Jackson, Samantha; Lui, Janet
2015-01-01
Educators in the field of family and consumer science (FCS) must be able to foster intellectual curiosity and critical thinking skills in students (Schumacher, 2014), and internships are one way to do so. Internships are formal programs that provide practical experience for beginners in an occupation or profession. Interns are temporarily placed…
Developing a Practical Parenting Workshop: A Case Study in Family Sexual Communication
ERIC Educational Resources Information Center
Croatt, Heidi S.
2012-01-01
This dissertation discusses the development and assessment of a parent intervention and training program. Out of concern for the sexual health of adolescents in the United States, both parents and researchers have called for programs assisting parents in the sexual education of their children. Encouraging sexual communication and increasing the…
ERIC Educational Resources Information Center
Powers, Stefanie
2012-01-01
Fostering healthy social and emotional development provides the foundation for school readiness in programs serving infants, toddlers, and their families. In this article, the author explores four key concepts that make the link between social and emotional development and early learning: 1) Cognitive and social-emotional development are…
Small Business Management Volume III: Curriculum. An Adult Education Program.
ERIC Educational Resources Information Center
Persons, Edgar A.; Swanson, Gordon I.
The small business management adult education program outlined in this curriculum guide is designed to help small business entrepreneurs solve their business management problems and attain the goals they have established for their businesses and their families. (An instructor's manual and practice problems are in separate volumes.) The 3-year…
Going Too Far?: Sex, Sin and Social Policy
ERIC Educational Resources Information Center
Rose, Susan
2005-01-01
This paper examines the impact of the Religious Right on American social policy as it relates to family, sexuality and reproductive health. The article focuses on the current debates and practices of abstinence-until-marriage programs vs. comprehensive sex education programs--and the ways in which they reflect and affect cultural attitudes about…
2012-01-01
Background Academic detailing is an interactive, convenient, and user-friendly approach to delivering non-commercial education to healthcare clinicians. While evidence suggests academic detailing is associated with improvements in prescribing behavior, uncertainty exists about generalizability and scalability in diverse settings. Our study evaluates different models of delivering academic detailing in a rural family medicine setting. Methods We conducted a pilot project to assess the feasibility, effectiveness, and satisfaction with academic detailing delivered face-to-face as compared to a modified approach using distance-learning technology. The recipients were four family medicine clinics within the Oregon Rural Practice-based Research Network (ORPRN). Two clinics were allocated to receive face-to-face detailing and two received outreach through video conferencing or asynchronous web-based outreach. Surveys at midpoint and completion were used to assess effectiveness and satisfaction. Results Each clinic received four outreach visits over an eight month period. Topics included treatment-resistant depression, management of atypical antipsychotics, drugs for insomnia, and benzodiazepine tapering. Overall, 90% of participating clinicians were satisfied with the program. Respondents who received in person detailing reported a higher likelihood of changing their behavior compared to respondents in the distance detailing group for five of seven content areas. While 90%-100% of respondents indicated they would continue to participate if the program were continued, the likelihood of participation declined if only distance approaches were offered. Conclusions We found strong support and satisfaction for the program among participating clinicians. Participants favored in-person approaches to distance interactions. Future efforts will be directed at quantitative methods for evaluating the economic and clinical effectiveness of detailing in rural family practice settings. PMID:23276303
Hansen, C M
1972-06-01
Family planning services should be of prime interest to all pediatricians because of their direct relationship to the health and well-being of mothers and children. The Tufts Delta Health Center is a pilot demonstration project in community health services which serves a poor rural black population in northern Bolivar County in Mississippi. 154 women were seen for family planning services during the first 1 1/2 years. They were given oral contraceptives or IUDs and during the initial 15 months of the program, contraception was effective in 82% of the cases. 62% of the original 154 mothers were still effective contraceptors after about 3 1/2 years in the program. Family planning services are important where maternal and infant death rates are high, since they allow for child spacing in poor families which may already have large numbers of children. Due to lack of funds or inability to obtain oral contraceptives on behalf of the physician, many patients were unable to practice family planning before this program. Family planning represents only one of a number of services that must be made available to poor families in the context of their total health needs.
Engaging military parents in a home-based reintegration program: a consideration of strategies.
Ross, Abigail M; DeVoe, Ellen R
2014-02-01
For more than a decade, the long wars in Afghanistan and Iraq have placed tremendous and cumulative strain on U.S. military personnel and their families. The high operational tempo, length, and number of deployments-and greater in-theater exposure to threat-have resulted in well-documented psychological health concerns among service members and veterans. In addition, there is increasing and compelling evidence describing the significant deleterious impact of the deployment cycle on family members, including children, in military-connected families. However, rates of engagement and service utilization in prevention and intervention services continue to lag far below apparent need among service members and their families, because of both practical and psychological barriers. The authors describe the dynamic and ultimately successful process of engaging military families with young children in a home-based reintegration program designed to support parenting and strengthen parent-child relationships as service member parents move back into family life. In addition to the integration of existing evidence-based engagement strategies, the authors applied a strengths-based approach to working with military families and worked from a community-based participatory foundation to enhance family engagement and program completion. Implications for engagement of military personnel and their loved ones are discussed.
Halaas, Gwen Wagstrom; Zink, Therese; Finstad, Deborah; Bolin, Keli; Center, Bruce
2008-01-01
Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with hands-on participation, mentoring, and one-to-one teaching. Students complete an online curriculum, participate in online discussion with fellow students, and meet face-to-face with RPAP faculty 6 times during the 9-month rotation. Projects designed to bring value to the community, including an evidence-based practice and community health assessment, are completed. To examine RPAP outcomes in recruiting and retaining rural primary care physicians. The RPAP database, including moves and current practice settings, was examined using descriptive statistics. On average, 82% of RPAP graduates have chosen primary care, and 68% family medicine. Of those currently in practice, 44% have practiced in a rural setting all of the time, 42% in a metropolitan setting and 14% have chosen both, with more than 50% of their time in rural practice. Rural origin has only a small association with choosing rural practice. RPAP data suggest that the 9-month longitudinal experience in a rural community increases the number of students choosing primary care practice, especially family medicine, in a rural setting.
ERIC Educational Resources Information Center
Ager, Alastair; Zimmerman, Cathy; Unlu, Kathy; Rinehart, Richard; Nyberg, Beverly; Zeanah, Charles; Hunleth, Jean; Bastiaens, Ida; Weldy, Andre; Bachman, Gretchen; Blum, Alexander B.; Strottman, Kathleen
2012-01-01
Objectives: To strengthen the evidence-base for policy and practice for support of children outside of family care requires effective, efficient and sustainable mechanisms for monitoring and evaluation. Toward that end, two core questions guided a systematic review of evidence: What strategies are appropriate for monitoring the needs and…
ERIC Educational Resources Information Center
Inman, Arpana G.; Meza, Marisol M.; Brown, Andrae L.; Hargrove, Byron K.
2004-01-01
Although the marriage and family therapy field's recent attention to multicultural issues is laudable, there appears to be little clarity on what constitutes an effective multicultural competence. The field continues to be challenged at different levels-training, practice, research, the setting of the standards and the work of the commission on…
ERIC Educational Resources Information Center
Vandenhoudt, Hilde; Miller, Kim S.; Ochura, Juliet; Wyckoff, Sarah C.; Obong'o, Christopher O.; Otwoma, Nelson J.; Poulsen, Melissa N.; Menten, Joris; Marum, Elizabeth; Buve, Anne
2010-01-01
We evaluated Families Matter! Program (FMP), an intervention designed to improve parent-child communication about sexual risk reduction and parenting skills. Parents of 10- to 12-year-olds were recruited in western Kenya. We aimed to assess community acceptability and FMP's effect on parenting practices and effective parent-child communication.…
ERIC Educational Resources Information Center
Antony, Pavan John; Banks-Joseph, Susan Rae
2010-01-01
A grounded theory approach is used to explore the "lived experiences" of two upper-middle-class families from India who have children with disabilities. Findings provide insight into the parents' beliefs and perceptions about disabilities, their goals and expectations for their children, and their views of inclusive education programs.…
ERIC Educational Resources Information Center
Knitzer, Jane; Lefkowitz, Jill
2006-01-01
Compelling evidence from neuroscience about how early relationships and experience influence the architecture of the brain, and in turn early school success, has led to increasing policy and practice attention to implementing child development and family support programs like Early Head Start for infants and toddlers. But, there is also a group of…
ERIC Educational Resources Information Center
Lau, Anna S.; Fung, Joey J.; Ho, Lorinda Y.; Liu, Lisa L.; Gudino, Omar G.
2011-01-01
We studied the efficacy and implementation outcomes of a culturally responsive parent training (PT) program. Fifty-four Chinese American parents participated in a wait-list controlled group randomized trial (32 immediate treatment, 22 delayed treatment) of a 14-week intervention designed to address the needs of high-risk immigrant families.…
ERIC Educational Resources Information Center
Utah State Office of Education, Salt Lake City.
This guide, which has been developed for Utah's home economics and family life education program, contains materials for use in teaching a life management course emphasizing the problem-solving skills required for independent living. Discussed first are the assumptions underlying the curriculum, development of the guide, and suggestions for its…
Rourke, James; Asghari, Shabnam; Hurley, Oliver; Ravalia, Mohamed; Jong, Michael; Parsons, Wanda; Duggan, Norah; Stringer, Katherine; O'Keefe, Danielle; Moffatt, Scott; Graham, Wendy; Sturge Sparkes, Carolyn; Hippe, Janelle; Harris Walsh, Kristin; McKay, Donald; Samarasena, Asoka
2018-03-01
This report describes the community context, concept and mission of The Faculty of Medicine at Memorial University of Newfoundland (Memorial), Canada, and its 'pathways to rural practice' approach, which includes influences at the pre-medical school, medical school experience, postgraduate residency training, and physician practice levels. Memorial's pathways to practice helped Memorial to fulfill its social accountability mandate to populate the province with highly skilled rural generalist practitioners. Programs/interventions/initiatives: The 'pathways to rural practice' include initiatives in four stages: (1) before admission to medical school; (2) during undergraduate medical training (medical degree (MD) program); (3) during postgraduate vocational residency training; and (4) after postgraduate vocational residency training. Memorial's Learners & Locations (L&L) database tracks students through these stages. The Aboriginal initiative - the MedQuest program and the admissions process that considers geographic or minority representation in terms of those selecting candidates and the candidates themselves - occurs before the student is admitted. Once a student starts Memorial's MD program, the student has ample opportunities to have rural-based experiences through pre-clerkship and clerkship, of which some take place exclusively outside of St. John's tertiary hospitals. Memorial's postgraduate (PG) Family Medicine (FM) residency (vocational) training program allows for deeper community integration and longer periods of training within the same community, which increases the likelihood of a physician choosing rural family medicine. After postgraduate training, rural physicians were given many opportunities for professional development as well as faculty development opportunities. Each of the programs and initiatives were assessed through geospatial rurality analysis of administrative data collected upon entry into and during the MD program and PG training (L&L). Among Memorial MD-graduating classes of 2011-2020, 56% spent the majority of their lives before their 18th birthday in a rural location and 44% in an urban location. As of September 2016, 23 Memorial MD students self-identified as Aboriginal, of which 2 (9%) were from an urban location and 20 (91%) were from rural locations. For Year 3 Family Medicine, graduating classes 2011 to 2019, 89% of placement weeks took place in rural communities and 8% took place in rural towns. For Memorial MD graduating classes 2011-2013 who completed Memorial Family Medicine vocational training residencies, (N=49), 100% completed some rural training. For these 49 residents (vocational trainees), the average amount of time spent in rural areas was 52 weeks out of a total average FM training time of 95 weeks. For Family Medicine residencies from July 2011 to October 2016, 29% of all placement weeks took place in rural communities and 21% of all placement weeks took place in rural towns. For 2016-2017 first-year residents, 53% of the first year training is completed in rural locations, reflecting an even greater rural experiential learning focus. Memorial's pathways approach has allowed for the comprehensive training of rural generalists for Newfoundland and Labrador and the rest of Canada and may be applicable to other settings. More challenges remain, requiring ongoing collaboration with governments, medical associations, health authorities, communities, and their physicians to help achieve reliable and feasible healthcare delivery for those living in rural and remote areas.
[Effects of an Individual Breast-feeding Promotion Program for Married Immigrant Women].
Park, Mi Kyoung; Moon, So Hyun
2016-02-01
This study was designed to evaluate the effects of an individual breast-feeding promotion program to address breast-feeding knowledge, attitude, method and rate of practice for married immigrant women. A non-equivalent control group quasi-experimental design was used (experimental group=16, control group=17). The intervention consisted of 3 phases: (1) Within 2 hours of delivery - individual breast-feeding training through video/verbal/practical training education and demonstration (2) After 1~2 days - group training using video, model doll, and breast models (3) After 7 days - family visit, counseling, retraining and reinforcement training. The data were analyzed using non-parametric tests with the SPSS program. Married immigrant women who participated in the individual breast-feeding program scored high in knowledge, attitude, method and rate of practice compared to the control group. The results indicate that the individual breast-feeding program is very effective in increasing breast-feeding knowledge, attitude, method and rate of practicing breast feeding for married immigrant women. So, nurses are encouraged to aggressively utilize individual breast-feeding programs to help married immigrant women, who are exposed to vulnerability due to various situations.
Sanders, James
2007-01-01
This study describes a different approach to increase the number of family medicine physicians trained with specific competencies in the management of chronic disease. In 1999 the Republic of Georgia initiated an ambitious program designed to retrain practicing physicians in the specialty of family medicine. At 2 of the implementation sites, the Center for International Health worked with local health authorities to augment the official 940-hour curriculum to include lesson plans, workshops, and practicum experiences emphasizing a model of chronic disease management, giving particular attention to hypertension. The population served by the training sites has benefited in a cost-effective manner by achieving blood pressure control for as little as $8 per year per patient; the physician learners have performed above their peer group on standardized national testing. Family medicine training programs in resource-poor settings can incorporate chronic disease management models into their curriculum and achieve high-quality patient care outcomes.
A Randomized Pilot Study of the Engaging Moms Program for Family Drug Court
Dakof, Gayle A.; Cohen, Jeri B.; Henderson, Craig E.; Duarte, Eliette; Boustani, Maya; Blackburn, Audra; Venzer, Ellen; Hawes, Sam
2010-01-01
In response to the need for effective drug court interventions, the effectiveness of the Engaging Moms Program (EMP) versus intensive case management services (ICMS) on multiple outcomes for mothers enrolled in family drug court was investigated. In this intent-to-treat study, mothers (N = 62) were randomly assigned to either usual drug court care or the Engaging Moms drug court program. Mothers were assessed at intake, and 3, 6, 12, and 18 months following intake. Results indicated that at 18 months post drug court enrollment, 77% of mothers assigned to EMP versus 55% of mothers assigned to ICMS had positive child welfare dispositions. There were statistically significant time effects for both intervention groups on multiple outcomes including substance use, mental health, parenting practices, and family functioning. EMP showed equal or better improvement than ICMS on all outcomes. The results suggest that EMP in family drug court is a viable and promising intervention approach to reduce maternal addiction and child maltreatment. PMID:20116961
45 CFR 213.15 - Request to participate in hearing.
Code of Federal Regulations, 2013 CFR
2013-10-01
... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND... present witnesses. (3) Any party may, within 5 days of receipt of such petition, file comments thereon. (4...
45 CFR 213.15 - Request to participate in hearing.
Code of Federal Regulations, 2014 CFR
2014-10-01
... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND... present witnesses. (3) Any party may, within 5 days of receipt of such petition, file comments thereon. (4...
45 CFR 213.15 - Request to participate in hearing.
Code of Federal Regulations, 2012 CFR
2012-10-01
... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND... present witnesses. (3) Any party may, within 5 days of receipt of such petition, file comments thereon. (4...
45 CFR 213.15 - Request to participate in hearing.
Code of Federal Regulations, 2010 CFR
2010-10-01
... PROGRAMS), ADMINISTRATION FOR CHILDREN AND FAMILIES, DEPARTMENT OF HEALTH AND HUMAN SERVICES PRACTICE AND... present witnesses. (3) Any party may, within 5 days of receipt of such petition, file comments thereon. (4...
Mir, Azeem Sultan; Malik, Raees
2010-08-01
Unsafe abortion is a major Public health problem in developing countries, where women make several unsafe attempts at termination of the unintended pregnancy before turning to health services. Community health workers can act as a bridge between the community and their health facilities and can use Emergency Contraceptive Pills to significantly reduce the mortality and morbidity related to unsafe abortions. This study explores the knowledge, attitudes and practices of the Lady Health Supervisor of the National Program for Family Planning, district Rawalpindi, regarding emergency contraception pills. The cross sectional survey was conducted during the monthly meeting of Lady Health Supervisors. Self administered, anonymous and voluntary questionnaire consisting of 17 items, regarding demographic profile, awareness, knowledge, attitudes and practices, was used. Insufficient knowledge, high misinformation and strongly negative attitudes were revealed. More than half did not know that emergency contraceptive pills do not cause abortion. About four fifths believed that emergency contraceptive pills will lead to 'evil' practices in society. More than four fifths recognized that the clients of National Program for Family Planning need emergency contraceptive pills. The attitudes were significantly associated with knowledge (P=0.034, Fisher's Exact Test). The awareness of emergency contraceptive pills is high. Serious gaps in knowledge have been identified. There is a clear recognition of the need of emergency contraceptive pills for the clients of National Program for Family Planning. However, any strategy to introduce emergency contraceptive pills must cater for the misplaced beliefs of the work force.
Taloney, Linda; Flores, Gabriela
2013-01-01
The mission of our hospital states: "Patients and their families are treated with compassion in a family-centered care environment that recognizes their physical, emotional, financial, and spiritual needs." Family-centered care is an approach to health care that shapes policies, programs, facility design, and day-to-day interactions among patients and their families, physicians, nurses, and other health care professionals. Health care professionals across all disciplines and in all care environments have the opportunity to advance the practice of patient- and family-centered care. They do so by welcoming patients and their families as partners in care-acknowledging patient and family expertise and strengths, encouraging their input, and acknowledging the value of their observations and perceptions. There is a growing recognition of the importance of patient and family care experiences as a key part of quality care. Through this partnership, patients and their families are viewed as valuable sources of information that can impact the quality of the care they receive. Their perspective on the care they receive can be used to shape effective solutions and target practice improvements in the care delivery experience. As an organization, we have been focused on implementing patient- and family-centered care for many years. We are unique in that we have parents of patients on the hospital staff and regularly seek their input, along with that of our Family Advisory Boards (English and Spanish speaking) and Teen Advisory Board. You have to ask yourself the question, "Are you ready to incorporate patient- and family-centered care into your practice?"
Short, J D; Slusher, I L
1994-01-01
Kentucky has the fourth highest percentage of infants born to teenage mothers in the US. Risk factors for adolescent pregnancy are poor academic performance, family history of adolescent pregnancy, absence of one or both biological parents in the home, troubled family relationships, family violence, history of substance abuse, and poor self-concept. Pregnancy adds new developmental requirements to the continual developmental crisis of adolescence. Some of these developmental requirements are dealing with pregnancy and birth of a child and peer and family reactions and relationships. Pregnant teens are at high risk for anemia, preeclampsia, preterm delivery, and low birth weight infants. The health care team must assess the abilities, needs, practices, and priorities of teens. Nurses should promote health and positive health practices in teens. They should focus on prevention of adolescent pregnancy and on meeting the needs of pregnant teens. Adolescent pregnancy interventions include education and adolescent-centered special programs. Peer groups, role playing, videos, and computer games are individualized and effective education techniques for teens. Formal adolescent pregnancy prevention programs are abstinence education, knowledge-based programs, and clinic-focused or school-based programs. A combination of approaches is more effective than using just one approach. Adolescent pregnancy prevention interventions should promote the value of education, discourage substance abuse, and provide counseling for victims of child abuse. Pregnant teens should receive prenatal care as soon as possible. One health care agency should combine physical care, psychosocial support, and education for teens. Kentucky schools help pregnant teens continue their education and help them obtain information and support for care for themselves and their babies. Nurses can be effective at reducing the number of unwanted teen pregnancies.
Barriers and Enablers of Kangaroo Mother Care Practice: A Systematic Review
Seidman, Gabriel; Unnikrishnan, Shalini; Kenny, Emma; Myslinski, Scott; Cairns-Smith, Sarah; Mulligan, Brian; Engmann, Cyril
2015-01-01
Kangaroo mother care (KMC) is an evidence-based approach to reducing mortality and morbidity in preterm infants. Although KMC is a key intervention package in newborn health initiatives, there is limited systematic information available on the barriers to KMC practice that mothers and other stakeholders face while practicing KMC. This systematic review sought to identify the most frequently reported barriers to KMC practice for mothers, fathers, and health practitioners, as well as the most frequently reported enablers to practice for mothers. We searched nine electronic databases and relevant reference lists for publications reporting barriers or enablers to KMC practice. We identified 1,264 unique publications, of which 103 were included based on pre-specified criteria. Publications were scanned for all barriers / enablers. Each publication was also categorized based on its approach to identification of barriers / enablers, and more weight was assigned to publications which had systematically sought to understand factors influencing KMC practice. Four of the top five ranked barriers to KMC practice for mothers were resource-related: “Issues with the facility environment / resources,” “negative impressions of staff attitudes or interactions with staff,” “lack of help with KMC practice or other obligations,” and “low awareness of KMC / infant health.” Considering only publications from low- and middle-income countries, “pain / fatigue” was ranked higher than when considering all publications. Top enablers to practice were included “mother-infant attachment” and “support from family, friends, and other mentors.” Our findings suggest that mother can understand and enjoy KMC, and it has benefits for mothers, infants, and families. However, continuous KMC may be physically and emotionally difficult, and often requires support from family members, health practitioners, or other mothers. These findings can serve as a starting point for researchers and program implementers looking to improve KMC programs. PMID:25993306
ERIC Educational Resources Information Center
Hieneman, Meme; Childs, Karen; Sergay, Jane
2006-01-01
Now the theory and research behind the positive behavior support (PBS) process--an approach already proven effective in schools and community programs--has been transformed into a practical, easy-to-use guide that's perfect for sharing with parents. Developed by educators and families, this user-friendly handbook offers parents easy-to-follow…
Wainer, Jo
2004-04-01
To identify the impact of family life on the ways women practice rural medicine and the changes needed to attract women to rural practice. Census of women rural doctors in Victoria in 2000, using a self-completed postal survey. General and specialist practice. Two hundred and seventy-one female general practitioners and 31 female specialists practising in Rural, Remote and Metropolitan Area Classifications 3-7. General practitioners are those doctors with a primary medical degree and without additional specialist qualifications. Interaction of hours and type of work with family responsibilities. Generalist and specialist women rural doctors carry the main responsibility for family care. This is reflected in the number of hours they work in clinical and non-clinical professional practice, availability for on-call and hospital work, and preference for the responsibilities of practice partnership or the flexibility of salaried positions. Most of the doctors had established a satisfactory balance between work and family responsibilities, although a substantial number were overworked in order to provide an income for their families or meet the needs of their communities. Thirty-six percent of female rural general practitioners and 56% of female rural specialists preferred to work fewer hours. Female general practitioners with responsibility for children were more than twice as likely as female general practitioners without children to be in a salaried position and less likely to be a practice partner. The changes needed to attract and retain women in rural practice include a place for everyone in the doctor's family, flexible practice structures, mentoring by women doctors and financial and personal recognition. Women make up less than a quarter of the rural general practice workforce and an even smaller percentage of the specialist rural medical workforce. As a result their experiences are not well articulated in research on rural medical practice and their needs are not well represented in policies and programs for rural doctors. The incoming cohort of rural general practitioners has a majority of women and it is essential that the practice styles and needs of women doctors are understood in order to attract and retain women in rural medicine. This survey identifies some of the effects of family responsibilities on the work practices of female rural doctors and the changes needed to the structure of rural practice to include the way women work.
Parent Management Training-Oregon Model: Adapting Intervention with Rigorous Research.
Forgatch, Marion S; Kjøbli, John
2016-09-01
Parent Management Training-Oregon Model (PMTO(®) ) is a set of theory-based parenting programs with status as evidence-based treatments. PMTO has been rigorously tested in efficacy and effectiveness trials in different contexts, cultures, and formats. Parents, the presumed agents of change, learn core parenting practices, specifically skill encouragement, limit setting, monitoring/supervision, interpersonal problem solving, and positive involvement. The intervention effectively prevents and ameliorates children's behavior problems by replacing coercive interactions with positive parenting practices. Delivery format includes sessions with individual families in agencies or families' homes, parent groups, and web-based and telehealth communication. Mediational models have tested parenting practices as mechanisms of change for children's behavior and found support for the theory underlying PMTO programs. Moderating effects include children's age, maternal depression, and social disadvantage. The Norwegian PMTO implementation is presented as an example of how PMTO has been tailored to reach diverse populations as delivered by multiple systems of care throughout the nation. An implementation and research center in Oslo provides infrastructure and promotes collaboration between practitioners and researchers to conduct rigorous intervention research. Although evidence-based and tested within a wide array of contexts and populations, PMTO must continue to adapt to an ever-changing world. © 2016 Family Process Institute.
Key informants’ perspectives on development of family medicine training programs in Ethiopia
Gossa, Weyinshet; Wondimagegn, Dawit; Mekonnen, Demeke; Eshetu, Wondwossen; Abebe, Zerihun; Fetters, Michael D
2016-01-01
As a very low-income country, Ethiopia faces significant development challenges, though there is great aspiration to dramatically improve health care in the country. Family medicine has recently been recognized through national policy as one potential contributor in addressing Ethiopia’s health care challenges. Family medicine is a new specialty in Ethiopia emerging in the context of family medicine development in Sub-Saharan Africa. The Addis Ababa University family medicine residency program started in 2013 and is the first and the only family medicine program in the country as of March 2016. Stakeholders on the ground feel that family medicine is off to a good start and have great enthusiasm and optimism for its success. While the Ministry of Health has a vision for the development of family medicine and a plan for rapid upscaling of family medicine across the country, significant challenges remain. Continuing discussion about the potential roles of family medicine specialists in Ethiopia and policy-level strategic planning to place family medicine at the core of primary health care delivery in the country is needed. In addition, the health care-tier system needs to be restructured to include the family medicine specialists along with appropriately equipped health care facilities for training and practice. Key stakeholders are optimistic that family medicine expansion can be successful in Ethiopia through a coordinated effort by the Ministry of Health and collaboration between institutions within the country, other Sub-Saharan African countries, and international partners supportive of establishing family medicine in Ethiopia. PMID:27175100
Mental health practice and attitudes of family physicians can be changed!
MacCarthy, Dan; Weinerman, Rivian; Kallstrom, Liza; Kadlec, Helena; Hollander, Marcus J; Patten, Scott
2013-01-01
An adult mental health module was developed in British Columbia to increase the use of evidence-based screening and cognitive behavioral self-management tools as well as medications that fit within busy family physician time constraints and payment systems. Aims were to enhance family physician skills, comfort, and confidence in diagnosing and treating mental health patients using the lens of depression; to improve patient experience and partnership; to increase use of action or care plans; and to increase mental health literacy and comfort of medical office assistants. The British Columbia Practice Support Program delivered the module using the Plan-Do-Study-Act cycle for learning improvement. Family physicians were trained in adult mental health, and medical office assistants were trained in mental health first aid. Following initial testing, the adult mental health module was implemented across the province. More than 1400 of the province's 3300 full-service family physicians have completed or started training. Family physicians reported high to very high success implementing self-management tools into their practices and the overall positive impact this approach had on patients. These measures were sustained or improved at 3 to 6 months after completion of the module. An Opening Minds Survey for health care professionals showed a decrease in stigmatizing attitudes of family physicians. The adult mental health module is changing the way participants practice. Office-based primary mental health care can be improved through reimbursed training and support for physicians to implement practical, time-efficient tools that conform to payment schemes. The module provided behavior-changing tools that seem to be changing stigmatizing attitudes towards this patient population. This unexpected discovery has piqued the interest of stigma experts at the Mental Health Commission of Canada.
Maitrot, Mathilde Rose Louise
2017-01-01
Background Nutritional status differs between infants and young children living in slum and non-slum conditions—infants and young children living in City Corporation slums are likely to have worse nutritional status compared to those from non-slums. Furthermore, families in slums tend to engage female labor in cash-earning activities as a survival strategy; hence, a higher percentage of mothers stay at work. However, little is known about feeding practices for infants and young children in families with working mothers in slums. This study aims to understand the factors that determine feeding practices for infants and young children living in families with working mothers in Dhaka slums. Methods This study adopted a qualitative approach. Sixteen In-depth Interviews, five Key Informant Interviews, and Focused Group Discussions were conducted with family members, community leaders, and program staff. Method triangulation and thematic analyses were conducted. Results Feeding practices for infants and young children in families with working mothers are broadly determined by mothers’ occupation, basis civic facilities, and limited family buying capacity. Although mothers have good nutritional knowledge, they negotiate between work and feeding their infants and young children. Household composition, access to cooking facilities, and poverty level were also found to be significant determining factors. Conclusion The results suggest a trade-off between mothers’ work and childcare. The absence of alternative care support in homes and/or work places along with societal factors outweighs full benefits of project interventions. Improving alternative childcare support could reduce the burden of feeding practice experienced by working mothers and may improve nutritional outcomes. PMID:28207894
Engaging Scientists in Meaningful E/PO: NASA Science4Girls and Their Families
NASA Astrophysics Data System (ADS)
Meinke, B. K.; Smith, D. A.; Bleacher, L.; Hauck, K.; Soeffing, C.
2014-12-01
The NASA Science Mission Directorate (SMD) Science Education and Public Outreach Forums coordinate the participation of SMD education and public outreach (EPO) programs in Women's History Month through the NASA Science4Girls and Their Families initiative. The initiative partners NASA science education programs with public libraries to provide NASA-themed hands-on education activities for girls and their families. These NASA science education programs are mission- and grant-based E/PO programs are uniquely poised to foster collaboration between scientists with content expertise and educators with pedagogy expertise. As such, the initiative engages girls in all four NASA science discipline areas (Astrophysics, Earth Science, Planetary Science, and Heliophysics), which enables audiences to experience the full range of NASA science topics and the different career skills each requires. The events focus on engaging underserved and underrepresented audiences in Science, Technology, Engineering, and Mathematics (STEM) via use of research-based best practices, collaborations with libraries, partnerships with local and national organizations, and remote engagement of audiences.
Day, Kate; Starbuck, Rachael; Petrakis, Melissa
2017-08-01
The role of family in supporting service users in coping with illness and engaging in relapse prevention in early psychosis is important. Taking on this caring though is stressful and challenging, and it has been found that support and information for carers assists in their coping and reduces isolation. To evaluate the current utility of a psychoeducation group program in a public adult mental health service, for the families of people experiencing early psychosis. A purpose-designed pre- and post-intervention questionnaire was administered to quantitatively measure group participants' changes in perceptions of their understanding of mental illness and its treatment through attending the group. Additional qualitative items were used to determine other knowledge, benefits and any critical feedback. The group program continues to result in highly significant improvements in family members' understanding of psychosis, recovery, medications, relapse prevention and substance co-morbidities. Additional feedback reaffirmed previous findings that family members find group peer support valuable and that this reduces isolation and the experience of stigma. The current evaluation, conducted following 10 years of early psychosis group work, found there to be efficacy in family peer support groups and that it is important to provide family interventions in public early psychosis mental health services.
Growing Up: The Development of Psychosocial Maturity. Report No. 180.
ERIC Educational Resources Information Center
Greenberger, Ellen; And Others
The Center for Social Organization of Schools has two objectives: to develop a scientific knowledge of how schools affect their students, and to use this knowledge to develop better school practices and organization. One of the three programs sponsored by the center is the Schools and Maturity Program. It is studying the effects of school, family,…
ERIC Educational Resources Information Center
Mahmoud, Sahar; Elaziz, Nahla Ahmed Abd
2015-01-01
Leukemia is a significant public health and life-threatening problem for pediatric cancer patients. Family caregivers of cancer patients receive little preparation, information, or support to perform their care giving role. This study aims to assess the effect of psycho-educational training program to enhancing practice and psychosocial adaptation…
Prevention or Pork? A Hard-Headed Look at Youth-Oriented Anti-Crime Programs.
ERIC Educational Resources Information Center
Mendel, Richard A.
This report reviews the facts underlying the debate about delinquency in the United States, focusing on evidence of how well various approaches to crime succeed in practice. Do youth programs such as family therapies and recreation initiatives actually make a cost-effective contribution to controlling crime? Research supports a strong foundation…
ERIC Educational Resources Information Center
Zhang, Yan; Guo, Yan
2017-01-01
Chinese children of immigrant families are often perceived as good at memorization and rote learning or as polite, obedient, and passive students lacking creativity and criticality. Guided by Multiple Literacies Theory and translanguaging, this study explores how Chinese children in a Mandarin-English bilingual program skillfully navigate…
ERIC Educational Resources Information Center
Prater, Greg; And Others
1996-01-01
A Northern Arizona University program prepares preservice special education teachers to work with Native American children and families. University students live on the Navajo reservation and receive practical classroom experience at Kayenta Unified School District (Arizona). Anglo students are paired with Navajo students who act as "cultural…
Building Villages To Raise Our Children: Staffing. Guides to Comprehensive Family Support Services.
ERIC Educational Resources Information Center
Hochberg, Mona R.
This volume, part five of a six-part report, is a three-part guide that offers practical advice for recruiting, training, and managing staff for a family-support program; it includes discussions about typical problems and the ways practitioners have chosen to resolve them. Part 1 discusses how to determine the type of staff needed and how to hire…
ERIC Educational Resources Information Center
Knitzer, Jane; Lefkowitz, Jill
2006-01-01
Compelling evidence from neuroscience about how early relationships and experience influence the architecture of the brain, and in turn early school success, has led to increasing policy and practice attention to implementing child development and family support programs like Early Head Start for infants and toddlers. But, there is also a group of…
Military Stress-Busting Program for Family Caregivers
2014-05-20
aromatherapy and massage , enthusiastically approved by some, were noted as undesirable by others. The time spent in discussing and practicing coping skills...interviews, and facilitator notes. Findings: Caregivers reported study to be very effective ; they acquired skills to change their behaviors, thinking, and...to be very effective ; they acquired skills to change their behaviors, thinking, and family interactions, thereby improving their quality of life. It
The State of Communication Education in Family Medicine Residencies.
Jansen, Kate L; Rosenbaum, Marcy E
2016-06-01
Communication skills are essential to medical training and have lasting effects on patient satisfaction and adherence rates. However, relatively little is reported in the literature identifying how communication is taught in the context of residency education. Our goal was to determine current practices in communication curricula across family medicine residency programs. Behavioral scientists and program directors in US family medicine residencies were surveyed via email and professional organization listservs. Questions included whether programs use a standardized communication model, methods used for teaching communication, hours devoted to teaching communication, as well as strengths and areas for improvement in their program. Analysis identified response frequencies and ranges complemented by analysis of narrative comments. A total of 204 programs out of 458 family medicine residency training sites responded (45%), with 48 out of 50 US states represented. The majority of respondents were behavioral scientists. Seventy-five percent of programs identified using a standard communication model; Mauksch's patient-centered observation model (34%) was most often used. Training programs generally dedicated more time to experiential teaching methods (video review, work with simulated patients, role plays, small groups, and direct observation of patient encounters) than to lectures (62% of time and 24% of time, respectively). The amount of time dedicated to communication education varied across programs (average of 25 hours per year). Respondent comments suggest that time dedicated to communication education and having a formal curriculum in place are most valued by educators. This study provides a picture of how communication skills teaching is conducted in US family medicine residency programs. These findings can provide a comparative reference and rationale for residency programs seeking to evaluate their current approaches to communication skills teaching and develop new or enhanced curricula.
Cultural transition of international medical graduate residents into family practice in Canada
Triscott, Jean A.C.; Waugh, Earle H.; Torti, Jacqueline M.I.; Barton, Martina
2016-01-01
Objectives To identify the perceived strengths that international medical graduate (IMG) family medicine residents possess and the challenges they are perceived to encounter in integrating into Canadian family practice. Methods This was a qualitative, exploratory study employing focus groups and interviews with 27 participants - 10 family physicians, 13 health care professionals, and 4 family medicine residents. Focus group/interview questions addressed the strengths that IMGs possess and the challenges they face in becoming culturally competent within the Canadian medico-cultural context. Qualitative data were audiotaped, transcribed, and analyzed thematically. Results Participants identified that IMG residents brought multiple strengths to Canadian practice including strong clinical knowledge and experience, high education level, the richness of varied cultural perspectives, and positive personal strengths. At the same time, IMG residents appeared to experience challenges in the areas of: (1) communication skills (language nuances, unfamiliar accents, speech volume/tone, eye contact, directness of communication); (2) clinical practice (uncommon diagnoses, lack of familiarity with care of the opposite sex and mental health conditions); (3) learning challenges (limited knowledge of Canada’s health care system, patient-centered care and ethical principles, unfamiliarity with self-directed learning, unease with receiving feedback); (4) cultural differences (gender roles, gender equality, personal space, boundary issues; and (5) personal struggles. Conclusions Residency programs must recognize the challenges that can occur during the cultural transition to Canadian family practice and incorporate medico-cultural education into the curriculum. IMG residents also need to be aware of cultural differences and be open to different perspectives and new learning. PMID:27149322
Knowledge, attitude, and practice of reproductive behavior in Iranian minor thalassemia couples.
Kosaryan, Mehrnoosh; Vahidshahi, Koorosh; Siami, Rita; Nazari, Meisam; Karami, Hosein; Ehteshami, Sara
2009-06-01
To investigate the knowledge, attitude, and practice of reproductive behavior in Iranian minor thalassemia couples in Ghaemshahr City, Mazandaran, Iran. This is a cross-sectional descriptive survey conducted in 2006. Birth rates from 1997-2005 and the number of newly registered patients from at risk couples was recorded. Tools for data collection were a valid questionnaire containing epidemiologic characteristics of couples, knowledge (20 questions), attitude 20 statements, and practice by studying the family file in health centers. Questionnaires were completed by husband and wife separately. Actual versus expected numbers of patients born in that period were compared. The data were analyzed using the Statistical Package for Social Science version 13.00, and p<0.05 was interpreted as significant. Of the 240 at risk couples, 100 were studied. Of them, 82% had good knowledge of thalassemia, and 68.5% had a positive attitude toward thalassemia prevention program. Correlations of knowledge with attitude were significant (p<0.001), and 50% of the couples had unfavorable practice including unplanned pregnancy, fetal abortion without prenatal diagnosis (PND), delivery without PND, and having a child affected by thalassemia major (TM). Without PND, 4 TM patients were born. Ninety-eight episodes of unfavorable practice were reported. Meanwhile, the contraceptive method used by 12% of couples was unsafe. Suspected TM patients with no prevention program were 25; thus, the birth of 2 TM was prevented (92% reduction). We achieved great success during the last 9 years in the region, and TM prevention program improved knowledge, attitude, and practice in high-risk couples and carrier families.
Villas Bôas, Lygia Maria de Figueiredo Melo; Araújo, Marize Barros de Souza; Timóteo, Rosalba Pessoa de Souza
2008-01-01
This article deals with the educational and managerial actions of nurses in the Family Health Program (FHP). It traces the reality of the FHP within the institutional setting of the city of Natal/RN, raises some questions and analyzes the educational action of the program in the daily routine of the Health Units in the light of the literature. Its objective is to contribute to the reflection about the managerial action of the nurse in that setting, in connection with pedagogical and educational action. The study demonstrates that, as a result of its innovative nature, the Family Health Strategy is facing challenges such as the need to define the profile of competencies for these professionals, their qualification processes, continued and permanent education, and new managerial models for nursing that should specifically meet the daily demands.
The influence of concrete support on child welfare program engagement, progress, and recurrence.
Rostad, Whitney L; Rogers, Tia McGill; Chaffin, Mark J
2017-01-01
Families living in poverty are significantly more likely to become involved with child welfare services, and consequently, referred to interventions that target abusive and neglectful parenting practices. Program engagement and retention are difficult to achieve, possibly because of the concrete resource insufficiencies that may have contributed to a family's involvement with services in the first place. Various strategies have been used to enhance program completion, such as motivational interventions, monetary incentives, and financial assistance with concrete needs. This study examines the influence of adjunctive concrete support provided by home visitors on families' ( N = 1754) engagement, retention, and satisfaction with services as well as parenting outcomes. Using propensity stratification, mixed modeling procedures revealed that increasing concrete support predicted greater engagement, satisfaction, goal attainment, and lower short-term recidivism. Results suggest that adjunctive concrete support is a potentially beneficial strategy for promoting service engagement and satisfaction and increasing short-term child safety.
Experiences of Marriage and Family Therapists Working with Intimate Partner Violence
Karakurt, Gunnur; Dial, Shannonn; Korkow, Hannah; Mansfield, Ty; Banford, Alyssa
2014-01-01
The purpose of our study was to explore the experiences of marriage and family therapists in working with violent couples. In particular, we focused on therapists’ questions and feelings of competency pertaining to violence assessment and treatment, the difficulties they face during their practices, and the factors that affect their practice. Data for this study was collected via a focus group that lasted approximately an hour. The participants included five marriage and family therapists. A set of questions were used to explore experiences of therapists who were working with clients who are experiencing domestic violence. The research team recorded the answers to these questions as well as associated discussion. A grounded theory approach was used to analyze the data. Six themes were derived from the coded data: acknowledgment and reliance on systemic foundations, therapist factors, assessment, treatment considerations, sex of batterers, and training in Marriage and Family Therapy programs. PMID:24817787
Chu, Joanna T W; Chan, Sophia S; Stewart, Sunita M; Zhou, Qianling; Leung, Charles Sai-Cheong; Wan, Alice; Lam, Tai Hing
2017-01-01
Community engagement is a powerful tool in bringing about positive social and community change. Community stakeholders possess critical experience and knowledge that are needed to inform the development of community-based projects. However, limited literature is available on the practical experience involved with planning and implementing community-based family programs. Even less has been published documenting efforts in Chinese communities. This paper explores community stakeholders' experiences with the enhancing family well-being project-part of a citywide project entitled the "FAMILY Project," aimed at promoting family health, happiness, and harmony in Hong Kong. This qualitative evaluation examined the perspectives of community stakeholders. Four focus groups with social workers ( n = 24) and six in-depth interviews with steering committee members were conducted from December 2012 to May 2013 in Hong Kong. Focus groups and in-depths interview were audiotaped, transcribed, and analyzed using thematic analysis techniques. Rich accounts were given by our respondents on various aspects of the project. Main themes and subthemes were identified and grouped into four categories (project conception, project implementation, project consolidation, and the overall impact of the project). Respondents described the practical challenges associated with the project (e.g., recruitment, balancing scientific research, and lack of resources) and identified the elements that are important to the success of the project. These included the commitment to a shared goal, multi-agency collaboration, and a platform for knowledge exchange. Finally, respondents perceived benefits of the project at both the individual and community level. Our project sheds light on many of the practical considerations and challenges associated with a designing and implementing a community-based family intervention project. Community stakeholders input provided important information on their perceived benefits and barriers and can inform and improve future development of community-based family intervention programs.
A Leadership Education and Development Program for Clinical Nurses.
Fitzpatrick, Joyce J; Modic, Mary Beth; Van Dyk, Jennifer; Hancock, K Kelly
2016-11-01
The Leadership Education and Development (LEAD) Program was designed to transform care at the bedside by empowering clinical nurses as leaders. The heart of LEAD was enhancing communication skills of clinical nurses with clinical colleagues and, most importantly, patients and families. Key concepts of leadership/management were included: personal awareness, personal leadership skills/abilities, leading change, leading others individually and in teams, enhancing the patient/provider experience, and the leadership role in outcomes management. A quantitative, longitudinal, survey design was used with 2 cohorts. The program consisted of six 4-hour sessions for 3 to 6 months. Leadership practices were measured before program implementation, at the end of the program, and 3 months after program completion. There were significant increases in leadership practices sustained 3 months after program completion. A range of other outcome measures was included. There is a need for additional leadership development programs for clinical nurses.
Catinella, A Peter; Magill, Michael K; Thiese, Steven M; Turner, Deborah; Elison, Gar T; Baden, Daniel J
2003-01-01
Most graduates of rural residencies enter rural practice. Rural residencies therefore have emerged over the past 2 decades to increase the supply of rural physicians. However, researchers have published few descriptions of strategies to evaluate and select communities in which to locate rural residencies. This report describes the development and application of such a strategy to assess 7 rural communities in Utah as potential sites for family practice residency training. Criteria were developed on the basis of an examination of the literature, residency accreditation requirements, and characteristics of existing rural residency programs. Ten rural or frontier communities with hospitals were selected as study candidates, and 7 agreed to participate. Data were collected through hospital surveys, state hospital discharge records, and community site visits. Specific evaluation criteria that were developed included the presence of a medical practice of the appropriate specialty and size, a sufficient number of medical subspecialty physicians, an adequate number and mix of hospitalized patients, an adequate number of ambulatory patients, adequate outpatient facility space to accommodate learners, and a commitment by the practicing physician and hospital to lead the program and teach residents. Two communities were found to be potentially capable of supporting a residency if physicians and hospital leaders in the communities were to become motivated to lead program development. These criteria may be useful in other states, but they have not been tested for validity or reliability and are subject to limitations such as exclusion of alternate rural residency models. Future research should address data needs and the relationship of the evaluation criteria to the quality of resident learning.
Márquez-Rodas, Iván; López-Trabada, Daniel; Rupérez Blanco, Ana Belén; Custodio Cabello, Sara; Peligros Gómez, María Isabel; Orera Clemente, María; Calvo, Felipe A; Martín, Miguel
2012-01-01
Identification of patients at risk of hereditary cancer is an essential component of oncology practice, since it enables clinicians to offer early detection and prevention programs. However, the large number of hereditary syndromes makes it difficult to take them all into account in daily practice. Consequently, the National Cancer Institute (NCI) has suggested a series of criteria to guide initial suspicion. It was the aim of this study to assess the perception of the risk of hereditary cancer according to the NCI criteria in our medical oncology service. We retrospectively analyzed the recordings of the family history in new cancer patients seen in our medical oncology service from January to November 2009, only 1 year before the implementation of our multidisciplinary hereditary cancer program. The family history was recorded in only 175/621 (28%) patients. A total of 119 (19%) patients met 1 or more NCI criteria (1 criterion, n = 91; 2 criteria, n = 23; 3 criteria, n = 4; and 4 criteria, n = 1), and only 14 (11.4%) patients were referred to genetic counseling. This study shows that few clinicians record the family history. The perception of the risk of hereditary cancer is low according to the NCI criteria in our medical oncology service. These findings can be explained by the lack of a multidisciplinary hereditary cancer program when the study was performed. Copyright © 2012 S. Karger AG, Basel.
An evaluation of undergraduate family care programs.
Silberstein, E B; Scott, C J
1978-01-01
Evaluation of the many new family care programs (FCP), and others of similar intent, however defined, is as essential as determining the value of any other curriculum change. Replies to a questionnaire from 101 U.S. and 15 Canadian medical schools indicated that 80% of the former and 93% of the latter had FCPs; 35% and 29%, respectively, were not evaluating their program by any method. No single evaluative technique was used by more than 42% of the American medical schools. A review of the literature on FCPs frequently indicated that the conclusions that could be drawn about the programs were ambiguous. Students in the University of Cincinnati Medical Center FCPs elected family practice or pediatric internships significantly more often than did the FCP nonparticipants, but they indicated that the program had little effect on this choice, despite almost uniformly favorable testimonials. We discuss the possibility that FCPs may be educating the wrong students, that FCPs, if not reinforced in other clinical areas, may have few lasting effects on student attitudes or career choice, and that we may be asking the wrong questions, and with inadequate methods.
Family Medicine Research in the United States From the late 1960s Into the Future.
Bowman, Marjorie A; Lucan, Sean C; Rosenthal, Thomas C; Mainous, Arch G; James, Paul A
2017-04-01
When the new field of family medicine research began a half century ago, multiple individuals and organizations emphasized that research was a key mission. Since the field's inception, there have been notable research successes for which family medicine organizations, researchers, and leaders-assisted by federal and state governments and private foundations-can take credit. Research is a requirement for family medicine residency programs but not individual residents, and multiple family medicine departments offer research training in various forms for learners at all levels, including research fellowships. Family physicians have developed practice-based research networks (PBRNs) to conduct investigations and generate new knowledge. The field of family medicine has seen the creation of new journals to support the publication of research relevant to practicing family physicians. Nonetheless, in spite of much growth and many successes, family physicians and their research have been underrepresented in research funding. Clinical presentations in family medicine are often complex, poorly-differentiated, and exist as one of several patient complaints and diagnoses, and are not well-covered by the narrow basic-science and specialty research that defines most of the biomedical research enterprise. Overall health in the United States would benefit from a more robust research participation and greater support for family medicine research.
FAMILY MEDICINE RESEARCH IN THE UNITED STATES: FROM THE LATE 1960’S INTO THE FUTURE
Bowman, Marjorie A.; Lucan, Sean C.; Rosenthal, Thomas; Mainous, Arch; James, Paul
2017-01-01
When the new field of family medicine research began a half century ago, multiple individuals and organizations emphasized that research was a key mission. Since the field’s inception, there have been notable research successes for which family medicine organizations, researchers, and leaders – assisted by federal and state governments and private foundations - can take credit. Research is a requirement for family medicine residency programs but not individual residents, and multiple family medicine departments offer research training in various forms for learners at all levels, including research fellowships. Family physicians have developed practice-based research networks (PBRNs) to conduct investigations and generate new knowledge. The field of family medicine has seen the creation of new journals to support the publication of research relevant to practicing family physicians. Nonetheless, in spite of much growth and many successes, family physicians and their research have been underrepresented in research funding. Clinical presentations in family medicine are often complex, poorly-differentiated, and often exist as one of several patient complaints and diagnoses, and are not well-covered by the narrow basic-science and specialty research that defines most of the biomedical research enterprise. Overall health in the United States would benefit from a more robust research participation and greater support for family medicine research. PMID:28414408
ERIC Educational Resources Information Center
Nover, Aimee R.; Timberlake, Elizabeth M.
1989-01-01
The social work practice arena and professional preparation are described as they relate to infants and young children vulnerable to developmental problems and problems of psychosocial dysfunction. Curriculum structure of accredited Master's degree programs and the model curriculum project of the National Catholic School of Social Service are…
ERIC Educational Resources Information Center
Hristova, Adelina
2016-01-01
This participatory and grounded theory ethnography focuses on mobile learning practices of a group of adult Romani women and their families. Framed through the lens of cultural-historical activity theory (CHAT) and technofeminism, these practices challenge existing integration programs with their binary approach as insufficient to analyze informal…
Antunes, Leonardo dos Santos; Antunes, Lívia Azeredo Alves; Corvino, Marcos Paulo Fonseca
2008-01-01
School and family together play an important role in the individual development of children. Therefore, this study aimed at evaluating the practices and attitudes towards oral health care of 245 education professionals working in 24 public municipal pre-schools in Niterói, State of Rio de Janeiro, Brazil. The data were obtained from self-questionnaires consisting of both open and closed questions. The methodology was both quantitative and qualitative, and the quantitative analysis was based on frequency (%). Regarding oral health practices, it was observed that the majority of the education professionals emphasized toothbrushing as a vital method of oral hygiene. In addition, 70.7% of the education professionals performed other types of oral hygiene activities with the schoolchildren, and 17.1% did so with the children's families. All the participants of the study considered that education professionals have a key role in promoting healthy oral habits amongst the schoolchildren and they believe that involving the dentist in educative programs is important. It was therefore concluded that the education professionals surveyed have positive practices and attitudes regarding the children's care, and they recognize their role in fostering healthy habits and developing integrated pedagogic oral health programs.
Creating a culture of inquiry in family medicine.
Lawson, Peter J; Smith, Samantha; Mason, Mary Jane; Zyzanski, Stephen J; Stange, Kurt C; Werner, James J; Flocke, Susan A
2014-01-01
Strengthening the contribution of reflective practice and new knowledge generation to the learning relationships forged during graduate and undergraduate medical training offers a possibility to create a climate more conducive to the recruitment and retention of family physicians. The Culture of Inquiry (CI) fellowship, an immersive, experientially based training program, combines didactic instruction, workshops, and mentoring to develop the capacity of family medicine's teachers to imagine, implement, and disseminate clinically relevant research and stimulate collaborations with those whom they train. This article outlines the CI fellowship program, summarizes its outcomes, and offers insights about programmatic features contributing to its success. The Department of Family Medicine and Community Health at Case Western Reserve University selected CI fellows from interested local family physicians who train residents and medical students. Over 10 months, with 10% effort expected from fellows, the CI fellowship exposed each fellow to the entire research process and provided technical and logistical support for the design and completion of two research projects. Quantitative and qualitative program evaluation were used to assess outcomes. Scholarly productivity of fellows exceeded expectations. Collaborations with students and residents produced a ripple effect that amplified the fellowship's impact by strengthening those relationships crucial to the creation of a culture of inquiry among family medicine's teachers, learners, and practitioners. The CI fellowship represents a highly replicable program to connect committed and interested clinicians to research mentors with the goal of increasing scholarship and creating a growing culture of inquiry in family medicine.
Title VII funding and physician practice in rural or low-income areas.
Krist, Alex H; Johnson, Robert E; Callahan, David; Woolf, Steven H; Marsland, David
2005-01-01
Whether Title VII funding enhances physician supply in underserved areas has not clearly been established. To determine the relation between Title VII funding in medical school, residency, or both, and the number of family physicians practicing in rural or low-income communities. A retrospective cross sectional analysis was carried out using the 2000 American Academy of Family Physicians physician database, Title VII funding records, and 1990 U.S. Census data. Included were 9,107 family physicians practicing in 9 nationally representative states in the year 2000. Physicians exposed to Title VII funding through medical school and residency were more likely to have their current practice in low-income communities (11.9% vs 9.9%, P< or =.02) and rural areas (24.5% vs 21.8%, P< or =.02). Physicians were more likely to practice in rural communities if they attended medical schools (24.2% vs 21.4%; P =.009) and residencies (24.0% vs 20.3%; P =.011) after the school or program had at least 5 years of Title VII funding vs before. Similar increases were not observed for practice in low-income communities. In a multivariate analysis, exposure to funding and attending an institution with more years of funding independently increased the odds of practicing in rural or low-income communities. Title VII funding is associated with an increase in the family physician workforce in rural and low-income communities. This effect is temporally related to initiation of funding and independently associated with effect in a multivariate analysis, suggesting a potential causal relationship. Whereas the absolute 2% increase in family physicians in these underserved communities may seem modest, it can represent a substantial increase in access to health care for community members.
Xénos, John B.; Lafortune, Marthe
1978-01-01
The importance and advantages of organizing an occupational health service are demonstrated. A practical three point health program is described. The family physician is shown to be ideally prepared to head the health team. A brief description of the physical resources follows. PMID:21301506
Guidelines for Graduate Medical Education in Geriatrics.
ERIC Educational Resources Information Center
Robbins, Alan S.; Beck, John C.
1982-01-01
Performance objectives, core content, training experiences, and clinical exposure and program evaluations are described for geriatric fellows and house staff members in internal medicine, family practice, neurology, and psychiatry. A modified Delphi study was used. (Author/MLW)
Implementation fidelity of Multidimensional Family Therapy in an international trial.
Rowe, Cynthia; Rigter, Henk; Henderson, Craig; Gantner, Andreas; Mos, Kees; Nielsen, Philip; Phan, Olivier
2013-04-01
Implementation fidelity, a critical aspect of clinical trials research that establishes adequate delivery of the treatment as prescribed in treatment manuals and protocols, is also essential to the successful implementation of effective programs into new practice settings. Although infrequently studied in the drug abuse field, stronger implementation fidelity has been linked to better outcomes in practice but appears to be more difficult to achieve with greater distance from model developers. In the INternational CAnnabis Need for Treatment (INCANT) multi-national randomized clinical trial, investigators tested the effectiveness of Multidimensional Family Therapy (MDFT) in comparison to individual psychotherapy (IP) in Brussels, Berlin, Paris, The Hague, and Geneva with 450 adolescents with a cannabis use disorder and their parents. This study reports on the implementation fidelity of MDFT across these five Western European sites in terms of treatment adherence, dose and program differentiation, and discusses possible implications for international implementation efforts. Copyright © 2013 Elsevier Inc. All rights reserved.
[How to expand and improve the coverage of family planning services: a Latin American viewpoint].
Trias, M
1992-12-01
It is probably not possible to implant a family planning program that will have a reasonable demographic impact in areas lacking awareness of the disadvantages of overly high fertility. Rural-urban migration, increasing educational levels, women's labor force participation, and declining infant mortality are all factors that have been found to correlate with demand for family planning services. It has been recognized since the Bucharest World Population Conference in 1974 that development and family planning are both required for the fertility transition to begin. Where these conditions exist, a family planning program appropriate to the needs, limitations, preferences, and expectations of the target population has an excellent chance of success. Expanded and improved coverage results from tailoring programs to the specific groups served. Most programs are directed toward women. It has been found most effective to provide services for men in separate sessions. It is also useful to distinguish between services for adolescents, who require more information and fewer services, for mature women who require more services than information, and for premenopausal women whose needs for information and services are both declining. Contraceptive preferences vary with social class, but family planning programs in developing countries should concentrate on the lower middle and lower classes which comprise 80% of the population. Rural areas and marginal urban areas require special attention. In order to provide services that will attract all potential users, the maximum possible variety of methods should be available. A family planning program offering a variety of methods throughout the country and financially accessible to the population should be successful. Family planning programs, whether public or private, require adequate financial resources and the support or at least tolerance of the government. Knowledge of contraception is now almost universal. A major challenge of family planning programs is to prompt women who say they want to limit their reproduction but who do not practice family planning to adopt a method. Program leadership and interpersonal relations with clients should be competent. The experience of PROFAMILIA in Colombia suggests that charging fees for all services offered by the family planning program is a positive feature allowing the client to avoid feeling like a charity recipient and the program to account for materials and services more easily. Goals and objective indicators stimulate performance and allow progress to be assessed. It is recommended that client education focus on a synthesis of information concerning available methods and provision of somewhat greater detail on the method chosen. Integration of services is usually an enemy of family planning because, despite theoretical advantages, it usually means neglect of family planning in favor of curative care.
Porter, Jo; Cooper, Simon J; Sellick, Ken
2013-01-01
To undertake a review of the quantitative research literature, to determine emergency staff and public attitudes, to support the implementation and practice of family presence during resuscitation in the emergency department. FPDR although endorsed by numerous resuscitation councils, cardiac, trauma and emergency associations, continues to be topical, the extent to which it is implemented and practiced remains unclear. A review of the quantitative studies published between 1992 and October 2011 was undertaken using the following databases: CINAHL, Ovid Medline, PSYCHINFO, Pro-Quest, Theses Database, Cochrane, and Google Scholar search engine. The primary search terms were 'family presence', and 'resuscitation'. The final studies included in this paper were appraised using the Critical Appraisal Skills Programme criteria. Fourteen studies were included in this literature review. These included quantitative descriptive designs, pre and post-test designs and one randomized controlled trial (RCT). The studies were divided into three main research areas; investigation of emergency staff attitudes and opinions, family and general public attitudes, and four papers evaluating family presence programs in the emergency department. Studies published prior to 2000 were included in the background. FPDR in the emergency department is well recognised and documented among policy makers, the extent in which it is implemented and practiced remains unclear. Further research is needed to assess how emergency staff are educated and trained in order to facilitate family presence during resuscitation attempts. Copyright © 2012. Published by Elsevier Ltd.
Vir, Sheila C
2013-01-01
Research Question: Use of community based volunteers, frequently reaching and counseling a selected group of prioritized families, can make a substantial difference in improving maternal and child care practices and in reducing child undernutrition. Setting: Program Rural Uttar Pradesh, India. Study Design: A comparison of baseline and endline surveys following 4 years of community based project intervention Participants: “At risk” undernutrition families comprising mothers of under twos, newlyweds, and severely undernourished children below 6 years. Intervention: Mapping and counseling of “at risk” families. Measuring impact on maternal-child care practices, underweight status. Results: Trained community mobilizers identified and counseled selected “at risk” families. Following 4 years of implementation in 907 villages of 8 blocks of four districts, significant improvement was noted in practices of early initiation of breastfeeding, feeding colostrum, timely introduction of complementary feeding, and washing the hands after defecation. Percentage of mothers exclusively breastfeeding at 6 months was only 2.1% with 78% receiving prelacteal feeds. A small increase in normal and mild malnutrition and a significant reduction of 43% in severe malnutrition was noted. Conclusion: Frequently counseling by accredited social health activists by focusing on selected defined “at risk” families of under twos and those with severe malnourished children could result in increasing acceptability of correct child health, feeding, and care practices and in contributing to improving nutritional status scenario. PMID:24302825
Tilahun, Tizta; Coene, Gily; Temmerman, Marleen; Degomme, Olivier
2015-07-21
Family planning contributes substantially in achieving the Millennium Development Goals. Recently, male involvement has gained considerable attention in family planning programs but the implementation thereof remains a challenge. In that context, our study aimed at measuring the effect of a six-month-long family planning education program on male involvement in family planning, as well as on couples' contraceptive practice. We conducted a quasi-experimental research among 811 married couples in Jimma Zone, southwest Ethiopia. Our study consisted of an intervention and a control group for comparative purpose; and surveyed before and after the implementation of the intervention. The intervention consisted of family planning education, given to both men and women at the household level in the intervention arm, in addition to monthly community gatherings. During the intervention period, households in the control group were not subject to particular activities but had access to routine health care services. We obtained follow-up data from 760 out of 786 (96.7%) couples who were originally enrolled in the survey. Findings were compared within and between groups before and after intervention surveys. At the baseline, contraceptive use in both control and intervention households were similar. After the intervention, we observed among men in the intervention arm a significantly higher level of willingness to be actively involved in family planning compared to the men in the control arm (p < 0.001). In addition, the difference between spouses that discussed family planning issues was less reported within the control group, both in the case of men and women ((p = 0.031) and (p < 0.001)) respectively. In general, a significant, positive difference in male involvement was observed. Concerning contraceptive use, there was change observed among the intervention group who were not using contraception at baseline. This study showed that family planning educational intervention, which includes both spouses and promotes spousal communication, might be useful to foster contraceptive practice among couples. The results also offer practical information on the benefits of male involvement in family planning as a best means to increase contraceptive use. Thus, providing opportunities to reinforce family planning education may strengthen the existing family planning service delivery system.
Promising Parenting Programs for Reducing Adolescent Problem Behaviors
Haggerty, Kevin P.; McGlynn-Wright, Anne; Klima, Tali
2013-01-01
Purpose Adolescent problem behaviors (substance use, delinquency, school dropout, pregnancy, and violence) are costly not only for individuals, but for entire communities. Policymakers and practitioners that are interested in preventing these problem behaviors are faced with many programming options. In this review, we discuss two criteria for selecting relevant parenting programs, and provide five examples of such programs. Design/methodology/approach The first criterion for program selection is theory based. Well-supported theories, such as the social development model, have laid out key family-based risk and protective factors for problem behavior. Programs that target these risk and protective factors are more likely to be effective. Second, programs should have demonstrated efficacy; these interventions have been called “evidence-based programs” (EBP). This review highlights the importance of evidence from rigorous research designs, such as randomized clinical trials, in order to establish program efficacy. Findings Nurse-Family Partnership, The Incredible Years, Positive Parenting Program, Strengthening Families 10–14, and Staying Connected with Your Teen are examined. The unique features of each program are briefly presented. Evidence showing impact on family risk and protective factors, as well as long-term problem behaviors, is reviewed. Finally, a measure of cost effectiveness of each program is provided. Originality/value We propose that not all programs are of equal value, and suggest two simple criteria for selecting a parenting program with a high likelihood for positive outcomes. Furthermore, although this review is not exhaustive, the five examples of EBPs offer a good start for policymakers and practitioners seeking to implement effective programs in their communities. Thus, this paper offers practical suggestions for those grappling with investments in child and adolescent programs on the ground. PMID:24416068
Transforming Training to Build the Family Physician Workforce Our Country Needs.
Hughes, Lauren S; Tuggy, Michael; Pugno, Perry A; Peterson, Lars E; Brungardt, Stacy H; Hoekzema, Grant; Jones, Samuel; Weida, Jane; Bazemore, Andrew
2015-09-01
The Affordable Care Act has spurred significant change in the US health care system, including expansion of Medicaid and private insurance coverage to millions of Americans. As a result, the need for the medical education continuum to produce a family physician workforce that is sizable enough and highly skilled is significant. These two interdependent goals have emerged as top priorities for Family Medicine for America's Health, a new, 5-year, $21 million collaborative strategic effort of the eight US family medicine organizations to lead continued change in the US health care system. To achieve these important goals, reforms are needed across the entire educational continuum, including how we recruit, train, and help practicing family physicians refresh their skills. Such reforms must provide opportunities to acquire skills needed in new practice and payment environments, to incorporate new educational standards that reflect the public's expectations of family physicians, to collaborate with our primary care colleagues to develop effective interprofessional training, and to design educational programs that are socially accountable to the patients, families, and communities we serve. Through Family Medicine for America's Health, the discipline is well positioned to emerge as a leader in primary care workforce development and educational quality.
Al-Khaldi, Yahia M.; Al-Ghamdi, Essam A.; Al-Mogbil, Tariq I.; Al-Khashan, Hesham I.
2017-01-01
OBJECTIVES: The objectives of this study were to assess the current situation of the teaching and training of undergraduate and postgraduate programs in family medicine in KSA, assess the current practice of family medicine, and draw a roadmap to achieve Saudi vision 2020. MATERIALS AND METHODS: This study was conducted with the support and collaboration of the Primary Health Care Department of the Ministry of Health, Saudi Arabia, and World Health Organization (EMRO) in November 2015. Based on the literature review of previous studies conducted for similar purposes, relevant questionnaires were developed. These consisted of four forms, each of which was directed at a different authority to achieve the above-mentioned objectives. Data of all questionnaires were coded, entered, and analyzed using SPSS version 16. RESULTS: There are 2282 primary health-care centers (PHCCs), 60% of which are in rural areas. More than half of the PHCCs have a laboratory and more than one-third have a Radiology Department. Out of the 6107 physicians, 636 are family physicians (10%). All medical colleges have a family medicine department with a total staff of 170 medical teachers. Thirteen departments run family medicine courses of 4–8 weeks' duration for students. Fourteen colleges have internship programs in family medicine and four colleges have postgraduate centers for family medicine (27%). There are 95 training centers for Saudi Board (Saudi Board of Family Medicine [SBFM]) and 68 centers for Saudi Diploma (Saudi Diploma of Family Medicine [SDFM]). The total number of trainers was 241, while the total trainees were 756 in SBFM and 137 in SDFM. CONCLUSIONS: This survey showed that there is a shortage of qualified family physicians in all health sectors in Saudi Arabia as a result of the lack of a strategic plan for the training of family physicians. A national strategic plan with specific objectives and an explicit budget are necessary to deal with this shortage and improve the quality of health-care services at PHCCs. PMID:28932160
Al-Khaldi, Yahia M; Al-Ghamdi, Essam A; Al-Mogbil, Tariq I; Al-Khashan, Hesham I
2017-01-01
The objectives of this study were to assess the current situation of the teaching and training of undergraduate and postgraduate programs in family medicine in KSA, assess the current practice of family medicine, and draw a roadmap to achieve Saudi vision 2020. This study was conducted with the support and collaboration of the Primary Health Care Department of the Ministry of Health, Saudi Arabia, and World Health Organization (EMRO) in November 2015. Based on the literature review of previous studies conducted for similar purposes, relevant questionnaires were developed. These consisted of four forms, each of which was directed at a different authority to achieve the above-mentioned objectives. Data of all questionnaires were coded, entered, and analyzed using SPSS version 16. There are 2282 primary health-care centers (PHCCs), 60% of which are in rural areas. More than half of the PHCCs have a laboratory and more than one-third have a Radiology Department. Out of the 6107 physicians, 636 are family physicians (10%). All medical colleges have a family medicine department with a total staff of 170 medical teachers. Thirteen departments run family medicine courses of 4-8 weeks' duration for students. Fourteen colleges have internship programs in family medicine and four colleges have postgraduate centers for family medicine (27%). There are 95 training centers for Saudi Board (Saudi Board of Family Medicine [SBFM]) and 68 centers for Saudi Diploma (Saudi Diploma of Family Medicine [SDFM]). The total number of trainers was 241, while the total trainees were 756 in SBFM and 137 in SDFM. This survey showed that there is a shortage of qualified family physicians in all health sectors in Saudi Arabia as a result of the lack of a strategic plan for the training of family physicians. A national strategic plan with specific objectives and an explicit budget are necessary to deal with this shortage and improve the quality of health-care services at PHCCs.
de Vries, Sanne L A; Hoeve, Machteld; Assink, Mark; Stams, Geert Jan J M; Asscher, Jessica J
2015-02-01
There is a lack of knowledge about specific effective ingredients of prevention programs for youth at risk for persistent delinquent behavior. The present study combines findings of previous studies by examining the effectiveness of programs in preventing persistent juvenile delinquency and by studying which particular program, sample, and study characteristics contribute to the effects. Information on effective ingredients offers specific indications of how programs may be improved in clinical practice. A literature search in PsychINFO, ERIC, PubMed, Sociological Abstracts, Criminal Justice Abstracts, and Google Scholar was performed. Only (quasi)experimental studies and studies that focused on adolescents at risk for (persistent) delinquent behavior were included. Multilevel meta-analysis was conducted on 39 studies (N = 9,084). Participants' ages ranged from 6 to 20 years (M = 14 years, SD = 2.45). The overall effect size was significant and small in magnitude (d = 0.24, p < .001). Behavioral-oriented programs, focusing on parenting skills training, behavioral modeling, or behavioral contracting yielded the largest effects. Multimodal programs and programs carried out in the family context proved to be more beneficial than individual and group-based programs. Less intensive programs yielded larger effects. Prevention programs have positive effects on preventing persistent juvenile delinquency. In order to improve program effectiveness, interventions should be behavioral-oriented, delivered in a family or multimodal format, and the intensity of the program should be matched to the level of risk of the juvenile. © 2014 Association for Child and Adolescent Mental Health.
Bennett, Ian M; Coco, Andrew; Anderson, Janice; Horst, Michael; Gambler, Angela S; Barr, Wendy Brooks; Ratcliffe, Stephen
2009-01-01
Maternal medical care (prenatal and postpartum) involves a set of clinical interventions addressing risk factors associated with important maternal and infant outcomes. Programs to increase the rate of delivery of these interventions in clinical practice have not been widely implemented. A practice-based research network focused on developing continuous quality improvement (CQI) processes for maternal care among 10 family medicine residency training sites in the northeastern United States (the IMPLICIT Network) from January 2003 through September 2007. Documented delivery of 5 standard maternal care interventions was assessed before and after initiating a program to increase their frequency. Proportion chart analyses were conducted comparing the period before and after implementation of the CQI interventions. Data were available for 3936 pregnancies during the course of the study period. Results varied across the clinical interventions. Significant improvement in care processes was seen for 3 screening activities: (1) prenatal depression symptomatology (by 15 weeks' gestation); (2) screening for smoking at 30 weeks' gestation; (3) and postpartum contraception planning. Screening for smoking by 15 weeks' gestation and testing for asymptomatic bacteriuria were already conducted >90% of the time during the baseline period and did not increase significantly after initiating the CQI program. Screening for postpartum depression symptomatology was recorded in 50% to 60% of women before the CQI program and did not increase significantly. A practice-based research network of family medicine residency practices focused on CQI outcomes was successful in increasing the delivery of some maternal care interventions.
Samandari, Ghazaleh; Delamou, Alexandre; Traore, Pernamou; Diallo, Fatoumata Guilinty; Millimono, Sita; Camara, Bienvenu Salim; Laffe, Kira; Verani, Fabio; Tolliver, Maimouna
2016-06-01
Few programs exist to address Intimate Partner Violence (IPV) in Guinea. In 2014, Engender Health, in partnership with the local health authorities in Conakry, Guinea, piloted an integrated approach to IPV screening and counseling, within an existing family planning clinic. This article describes both the process of formulating and implementing this approach, as well as the results of an evaluation of the program. From January to June of 2014, Engender Health staff trained midwives at the Conakry International Planned Parenthood Federation family planning clinic staff in screening and counseling client for IPV. Program evaluators used project records, interview with program staff (n=3), midwives (n=3) and client exit interviews (n=53) to measure the outcomes of this pilot project. Regardless of their IPV status, clients appreciated having a venue in which to discuss IPV. Program staff also felt empowered by the additional training and support for IPV screening. The evaluation yielded valuable suggestions for improvement, including more time for staff training and mock client interview practice, additional skills in counseling, and stronger referral links for women who screen positive for IPV. Integrating IPV screening into family planning services is an important and feasible method for reaching vulnerable women with IPV services.
Physician assessments of the value of therapeutic information delivered via e-mail
Grad, Roland; Pluye, Pierre; Repchinsky, Carol; Jovaisas, Barbara; Marlow, Bernard; Marques Ricarte, Ivan L.; Galvão, Maria Cristiane Barbosa; Shulha, Michael; de Gaspé Bonar, James
2014-01-01
Abstract Problem addressed Although e-learning programs are popular and access to electronic knowledge resources has improved, raising awareness about updated therapeutic recommendations in practice continues to be a challenge. Objective of program To raise awareness about and document the use of therapeutic recommendations. Program description In 2010, family physicians evaluated e-Therapeutics (e-T) Highlights with a Web-based tool called the Information Assessment Method (IAM). The e-T Highlights consisted of information found in the primary care reference e-Therapeutics+. Each week, family physicians received an e-mail containing a link to 1 Highlight from a different chapter of e-Therapeutics+. Family physicians received continuing medical education credits for each Highlight they rated with the IAM. Of the 5346 participants, 85% of them were full-time or part-time practitioners. A total of 31 429 Highlights ratings were received in 2010 (median of 2 ratings per participant, range 1 to 49). Among participants who rated more than 2 Highlights, the median number of ratings was 7 (mean 11.9). The relevance of the information from individual Highlights varied widely; however, for 90% of the rated Highlights participants indicated total or partial relevance of the information for at least 1 patient. For 41% of rated Highlights, participants expected patient health benefits to result from implementing the recommendation, such as avoiding an unnecessary or inappropriate treatment, or a preventive intervention. Conclusion This continuing medical education program stimulated family physicians to rate therapeutic recommendations that were delivered weekly via e-mail. The process of rating e-T Highlights with the IAM raised awareness about treatment recommendations and documented self-reported use of this information in practice. PMID:24829020
Rostad, Whitney L; Moreland, Angela D; Valle, Linda Anne; Chaffin, Mark J
2018-04-01
Families experiencing child maltreatment or risk factors for child maltreatment often receive referrals to interventions focused on changing parenting practices. Compliance with specific parenting programs can be challenging as many of the stressors that place families at-risk may also interfere with program participation. Because families may receive limited benefit from programs they do not fully receive, it is critical to understand the relationship between parenting stress and barriers to program completion. We used structural equation modeling to examine the relationship among parenting stress, perceived barriers to program participation, and program completion in two datasets involving low-income parents. Data were collected at two time points from a sample of parents involved with child welfare services and a sample of parents considered at-risk of future involvement (total study n = 803). Direct paths from parenting stress at time 1 to barriers to participation and parenting stress at time 2, and from parenting stress at time 2 to program completion were significant. Interestingly, increased barriers to participation were related to increased parenting stress at time 2, and greater parenting stress was related to increased program completion. Results suggest that with increasing levels of parenting stress, parents have an increased likelihood of completing the program. Assessing and addressing the influence of perceived barriers and parenting stress on program participation may decrease the likelihood of treatment attrition.
Capurchande, Rehana; Coene, Gily; Roelens, Kristien; Meulemans, Herman
2017-08-22
By focusing upon family planning counselling services, the Mozambican government has significantly enhanced the general health of female and male clients. However, little is known about the experiences of family planning by female and male adults. This article focuses on knowledge, attitudes and practices regarding contraceptive methods and fertility intentions. An in-depth qualitative study of female and male clients was conducted in two settings in Maputo province - Ndlavela and Boane. A total of sixteen in-depth interviews, four informal conversations, and observations were equally divided between both study sites. The analysis followed a constructionist approach. Three steps were considered in the analysis: examining commonalities, differences and relationships. Although there was a high level of family planning knowledge, there were discrepancies in clients' everyday practices. Male and female clients are confronted with a variety of expectations concerning fertility intentions and family size, and are under pressure in numerous ways. Social pressures include traditional expectations and meanings connected to having children, as well as religious factors. Short interaction time between clients and health workers is a problem. Additionally, imposed contraceptive methods, and typically brief conversations about birth control between couples only adds to the burden. Because family planning is largely viewed as a woman's concern, most clients have never attended counselling sessions with their partners. Attitudes towards responsibility for contraceptive use and risk-taking are strongly gendered. Female and male clients have differing expectations about contraceptive use and fertility intentions. They participate differently in family planning programs leading to their inconsistent and ambivalent practices as well as vague perceptions of risk-taking. Therefore, policymakers must address the reasons behind ambivalence and inconsistency regarding contraceptives and family planning.
ERIC Educational Resources Information Center
Cornish, Mary; Noblit, George
Smart Start is North Carolina's partnership between state government and local leaders, service providers, and families to better serve children under age 6 and their families. The aim of the program is ensuring that all children enter school healthy and ready to learn. This study examined parent and business involvement in local Smart Start…
ERIC Educational Resources Information Center
Friedman, Dana E.
This paper addresses the feasibility of family support programs as a means by which management may constructively respond to the changes in the workforce in order to fulfill its own objectives. The analysis takes into account both theory and practice, applying learned concepts to the design and execution of an actual feasibility study at a small,…
Mir, Azeem Sultan; Malik, Raees
2010-01-01
Background: Unsafe abortion is a major Public health problem in developing countries, where women make several unsafe attempts at termination of the unintended pregnancy before turning to health services. Community health workers can act as a bridge between the community and their health facilities and can use Emergency Contraceptive Pills to significantly reduce the mortality and morbidity related to unsafe abortions. Aims: This study explores the knowledge, attitudes and practices of the Lady Health Supervisor of the National Program for Family Planning, district Rawalpindi, regarding emergency contraception pills. Materials and Methods: The cross sectional survey was conducted during the monthly meeting of Lady Health Supervisors. Self administered, anonymous and voluntary questionnaire consisting of 17 items, regarding demographic profile, awareness, knowledge, attitudes and practices, was used. Results: Insufficient knowledge, high misinformation and strongly negative attitudes were revealed. More than half did not know that emergency contraceptive pills do not cause abortion. About four fifths believed that emergency contraceptive pills will lead to ‘evil’ practices in society. More than four fifths recognized that the clients of National Program for Family Planning need emergency contraceptive pills. The attitudes were significantly associated with knowledge (P=0.034, Fisher's Exact Test). Conclusion: The awareness of emergency contraceptive pills is high. Serious gaps in knowledge have been identified. There is a clear recognition of the need of emergency contraceptive pills for the clients of National Program for Family Planning. However, any strategy to introduce emergency contraceptive pills must cater for the misplaced beliefs of the work force. PMID:22737673
Aboud, Frances E; Singla, Daisy R; Nahil, Md Imam; Borisova, Ivelina
2013-11-01
A stratified cluster design was used to evaluate a 10-month parenting program delivered to mothers of children in rural Bangladesh. Intervention mothers through a combination of group meetings and home visits received messages along with an illustrative card concerning hygiene, responsive feeding, play, communication, gentle discipline, and nutritious foods. Control mothers received the standard government care. Three months prior, 463 children between 4 and 14 months in a subdistrict of western Bangladesh were administered the cognitive, receptive language and expressive language Bayley III subtests, their length was taken and past week illness recorded. Gross motor milestones were reported by the mother and verified through observation. Mothers were interviewed concerning their practices: preventive health practices, dietary diversity, home stimulation, and knowledge about development milestones. Maternal depressive symptoms were assessed as a measure of emotional availability. Family sociodemographic variables included maternal education, family assets, decision-making and mobility autonomy. One month after the end of the program, mothers and their children were again assessed. Comparisons were made between intervention and control children who were under-12 months vs. 12 months and older at the start of the program. This may be a critical age, when children begin to be upright and mobile enough to explore on their own and be less dependent on parenting stimulation. Analyses yielded strong intervention effects on the three Bayley subtests and on parenting practices related to stimulation and knowledge of development milestones. Age effects were found only for dietary diversity in that younger children in the program benefited more than older ones. However, all children became more stunted. Findings are discussed in terms of theories of behaviour change and parenting, critical ages for parenting programs, and implications for program delivery. Copyright © 2013 Elsevier Ltd. All rights reserved.
ERIC Educational Resources Information Center
O'Neill, Barbara; Zumwalt, Andrew; Bechman, Janet
2011-01-01
This article describes results of an online survey conducted by the eXtension Financial Security for All (FSA) Community of Practice (CoP) to determine the social media capacity and activity of its members. The survey was conducted to inform two subsequent FSA CoP programs: an archived webinar on social media programs and impact evaluation methods…
Survey of Pharmaceutical Promotion in a Family Medicine Training Program
Fogel, Martin L.
1989-01-01
Some researchers have shown that advertising by the pharmaceutical industry has a significant impact on the prescribing habits of physicians. Promotional material invades the practice of physicians in many guises, including journal advertisements, drug samples, clinical symposia sponsored by drug manufacturers, and the ever-diligent detail person. The author analyzed the prevalence of drug advertising, and found that promotional material was present in all the offices and examining rooms of clinicians in a Canadian family practice teaching centre. On average, 10.5 promotional items were present in each individual patient care area and almost 750 items were found in each physician's office. PMID:21248863
Bringing Person- and Family-Centred Care Alive in Home, Community and Long-Term Care Organizations.
Bender, Danielle; Holyoke, Paul
2016-01-01
It is now more important than ever for person- and family-centred care (PFCC) to be at the forefront of program and service design and delivery; yet, to date, very little guidance is available to assist home, community and long-term care (LTC) organizations to operationalize this concept and overcome inherent challenges. This article provides a list of practical strategies for healthcare leaders to promote and support a culture shift towards PFCC in their organizations and identifies and addresses five common concerns. The unique opportunities and challenges for practicing PFCC in home, community and LTC settings are also discussed.
Turker, Yasemin; Aydin, Leyla Yilmaz; Baltaci, Davut; Erdem, Ozgur; Tanriverdi, Mehmet Halis; Sarigüzel, Yunus; Alasan, Fatih
2014-01-01
Family physicians (FPs) are cornerstone for tobacco control. It was aimed to compare the effect of training on their smoking cessation practice, knowledge level and attitudes towards smoking and tobacco control. The cross-sectional and multi-centered study was carried out using structured survey modified WHO based questionnaire. It was delivered to 1500 FPs randomly selected among approximately 23000 family physicians across the country. The study survey was self-reported by FPs, assessing their knowledge, attitudes, status of post-graduate training, and practice about tobacco control. Participants were assigned into two groups as non-trainee groups (Group 1) and post-graduate trainee (Group 2). The mean age was 38.4 ± 7.1 years-old. The percentage of male and female FPs in the study was 53.1% and 46.9%. The ratio of family physicians who participated in training program Group 2) was 26.5% (n = 327). The ratio of female FPs who participated the SCP training course was significantly higher than that of male FPs (27.3% versus 22.5%, p = 0.035). There was no significant difference for smoking status between groups (p = 0.686). When the number FPs whose consulted by the smokers over ≥ 5 a week was compared, the ratio of FPs was significantly higher in group 2 than group 1 (p < 0.001), but overall ratio of FPs (2.8%) who consulted within a week smokers was considerably lower Statements of Competence and confidence items stated by all FPs were 24.2% and 32.2%, respectively. Physicians who had attended post-graduate training on SCP were more competent and confident, compared to non-trained FPs (p = 0.002 and p = 0.001). Post-graduate training on tobacco control improved self-confidence and competence of FPs. With post-graduate training, significant improvement was seen in practical skills of physicians. A continuing training program should be introduced to FPs, to engage them for smoking cessation practice.
Managing Diabetes Mellitus: A Survey of Attitudes and Practices Among Family Physicians.
Fogelman, Yacov; Goldfracht, Margalit; Karkabi, Khaled
2015-10-01
Due to the increasing prevalence of diabetes and the shortage of endocrinologists, family physicians have an important role in diabetes management. The purpose of this study was to examine the sources of knowledge, attitudes and practices of family physicians regarding the management of type 2 diabetes. Attendees at continuous medical education (CME) programs in Israel were requested to respond anonymously to written questions about their sources of knowledge about diabetes, the methods of diabetes management they advise their patients, their knowledge of diabetes medication treatments, and their attitudes toward people with type 2 diabetes. Questionnaires were completed by 362 family physicians (79% response rate). Of them, 329 (91%) reported that they usually manage their patients' diabetes care, including that of patients with concomitant risk factors. Their most common recommendations for diabetes control were: to increase physical activity, decrease total calorie intake, consult with a dietitian and undergo weight loss counseling. Almost all physicians (97%) reported providing lifestyle change counseling. Sixty percent reported lacking knowledge about nutritional issues. Only 58% answered correctly regarding the effect of the anti-diabetic drug, GLP1 analog. Board certified family physicians and their residents exhibited more knowledge about diabetes practice than did non-board certified family physicians. The great majority of family physicians surveyed usually manage their patients' diabetes themselves, and do not refer them to diabetes specialists. The implementation of strategies that will enhance the competencies and confidence of family physicians in diabetes management are important for achieving successful treatment.
Buscemi, Joanna; Odoms-Young, Angela; Stolley, Melinda L; Blumstein, Lara; Schiffer, Linda; Berbaum, Michael L; McCaffrey, Jennifer; Montoya, Anastasia McGee; Braunschweig, Carol; Fitzgibbon, Marian L
2014-07-01
Low-income youth are at increased risk for excess weight gain. Although evidence-based prevention programs exist, successful adaptation to provide wide dissemination presents a challenge. Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized controlled trial, HH was found to be efficacious for prevention of excessive weight gain. The Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program-Education (SNAP-Ed) are USDA-funded nutrition education programs offered to low-income families, and may provide an ideal platform for the wide dissemination of evidence-based obesity prevention programs. A research-practice partnership was established in order to conduct formative research to guide the adaptation and implementation of HH through EFNEP and SNAP-Ed. We present the design and method of a comparative effectiveness trial that will determine the efficacy of HH when delivered by peer educators through these programs compared to the standard EFNEP and SNAP-Ed nutrition education (NE) curriculum. Results from this trial will inform larger scale dissemination. The dissemination of HH through government programs has the potential to increase the reach of efficacious obesity prevention programs that target low-income children and families. Copyright © 2014 Elsevier Inc. All rights reserved.
Buscemi, Joanna; Odoms-Young, Angela; Stolley, Melinda L.; Blumstein, Lara; Schiffer, Linda; Berbaum, Michael L.; McCaffrey, Jennifer; Montoya, Anastasia McGee; Braunschweig, Carol; Fitzgibbon, Marian L.
2014-01-01
Low-income youth are at increased risk for excess weight gain. Although evidence-based prevention programs exist, successful adaptation to provide wide dissemination presents a challenge. Hip-Hop to Health (HH) is a school-based obesity prevention intervention that targets primarily preschool children of low-income families. In a large randomized controlled trial, HH was found to be efficacious for prevention of excessive weight gain. The Expanded Food and Nutrition Education Program (EFNEP) and the Supplemental Nutrition Assistance Program--Education (SNAP-Ed) are USDA-funded nutrition education programs offered to low-income families, and may provide an ideal platform for the wide dissemination of evidence-based obesity prevention programs. A research-practice partnership was established in order to conduct formative research to guide the adaptation and implementation of HH through EFNEP and SNAP-Ed. We present the design and method of a comparative effectiveness trial that will determine the efficacy of HH when delivered by peer educators through these programs compared to the standard EFNEP and SNAP-Ed nutrition education (NE) curriculum. Results from this trial will inform larger scale dissemination. The dissemination of HH through government programs has the potential to increase the reach of efficacious obesity prevention programs that target low-income children and families. PMID:24952282
The primacy of the patient and family in a quality-improvement environment.
Walker, J K
1995-09-01
The primary customers of health care services are the patient and family. It is important to adopt a mission and philosophy that put the patient and family at the center of all quality improvement programs. The principles put forth by Deming in his 14 points can be applied to patient-focused quality improvement measures. Creating a foundation for the professional practice of nursing and using and expanding tools that are already in use can help care providers meet the needs of their customers and help people to live healthier, better lives.
Early Childhood Home Visiting.
Duffee, James H; Mendelsohn, Alan L; Kuo, Alice A; Legano, Lori A; Earls, Marian F
2017-09-01
High-quality home-visiting services for infants and young children can improve family relationships, advance school readiness, reduce child maltreatment, improve maternal-infant health outcomes, and increase family economic self-sufficiency. The American Academy of Pediatrics supports unwavering federal funding of state home-visiting initiatives, the expansion of evidence-based programs, and a robust, coordinated national evaluation designed to confirm best practices and cost-efficiency. Community home visiting is most effective as a component of a comprehensive early childhood system that actively includes and enhances a family-centered medical home. Copyright © 2017 by the American Academy of Pediatrics.
Madenwald, Kappy; Hoagwood, Kimberly E.
2017-01-01
The experience of parents in helping their children access and use mental health services is linked to service outcomes. Parent peer support service, based on the principles of family-centered care, is one model to improve parent experience and engagement in services. Yet, little is known about how best to integrate this service into the existing array of mental health services. Integration is challenged by philosophical differences between family-centered services and traditional children’s treatment services, and is influenced by the organizational social contexts in which these services are embedded. We describe an organizational and frontline team intervention that draws on research in behavior change, technology transfer, and organizational social context for youth with serious emotional disturbance. The two-pronged intervention, called FAMILY (FCC and ARC Model to Improve the Lives of Youth) is guided by the evidence-based Availability, Responsiveness, and Continuity (ARC) organizational intervention, targeted primarily at program and upper management leadership and includes a family-centered care (FCC) intervention, targeted at frontline providers. The approach employs multilevel implementation strategies to promote the uptake, implementation and sustainability of new practices. We include examples of exercises and tools, and highlight implementation challenges and lessons learned in facilitating program and staff level changes in family-centered service delivery. PMID:28781510
Légaré, F.; Bélanger, N.; Doyon, H.
2000-01-01
PROBLEM BEING ADDRESSED: Family medicine training programs are required to teach the four principles of family medicine, two of which deal with community responsibilities. Teachers in the Family Practice Unit at the Centre hospitalier de Québec, pavillon St-François d'Assise (UMF-SFA) have developed a learning activity that introduces residents to community agencies in the area. OBJECTIVE OF PROGRAM: To introduce family medicine residents to community aspects of the principles of family medicine, to help them identify community resources in the area served by UMF-SFA, to discuss these services so that they can use them effectively, and to offer new residents an opportunity to become better acquainted with these services and with the UMF-SFA team. MAIN COMPONENTS OF PROGRAM: In early September, a half-day is set aside for a rally during which mixed teams of supervisors and residents (four to eight to a team) visit about 10 community agencies in the vicinity of UMF-SFA. Walking from place to place, the teams spend 15 to 20 minutes with staff or users of each agency. The informal tone of the rally makes it easier for residents to understand these agencies. CONCLUSION: Each year for the past 10 years, all UMF-SFA members have taken part in a rally that introduces residents to the community-based resources of family medicine. PMID:11153411
Keisling, Bruce L; Bishop, Elizabeth A; Roth, Jenness M
2017-05-01
Background While the MCH Leadership Competencies and family as a discipline have been required elements of Leadership Education in Neurodevelopmental and related Disabilities (LEND) programs for over a decade, little research has been published on the efficacy of either programmatic component in the development of the next generation of leaders who can advocate and care for Maternal and Child Health (MCH) populations. Objective To test the effectiveness of integrating the family discipline through implementation of parent led curricula on trainees' content knowledge, skills, and leadership development in family-centered care, according to the MCH Leadership Competencies. Methods One hundred and two long-term (≥ 300 h) LEND trainees completed a clinical and leadership training program which featured intensive parent led curricula supported by a full-time family faculty member. Trainees rated themselves on the five Basic and Advanced skill items that comprise MCH Leadership Competency 8: Family-centered Care at the beginning and conclusion of their LEND traineeship. Results When compared to their initial scores, trainees rated themselves significantly higher across all family-centered leadership competency items at the completion of their LEND traineeship. Conclusions The intentional engagement of a full-time family faculty member and parent led curricula that include didactic and experiential components are associated with greater identification and adoption by trainees of family-centered attitudes, skills, and practices. However, the use of the MCH Leadership Competencies as a quantifiable measure of program evaluation, particularly leadership development, is limited.
Dev, Dipti A; Williams, Natalie; Iruka, Iheoma; Garcia, Aileen S; Guo, Yage; Patwardhan, Irina; Cummings, Katrina; Rida, Zainab; Hulse, Emily; Sedani, Ami
2018-06-01
To determine if family childcare homes (FCCH) in Nebraska meet best practices for nutrition and screen time, and if focusing on nutrition and screen time policies and practices improves the FCCH environment. A pre-post evaluation was conducted using the Go Nutrition and Physical Activity Self-Assessment for Childcare (Go NAP SACC). FCCH in Nebraska, USA. FCCH enrolled in the Child and Adult Care Food Program (CACFP; n 208) participated in a pre-post evaluation using Go NAP SACC. At baseline, all FCCH met the minimum childcare standards for fifty-four of fifty-six practices in nutrition and screen time. After the intervention, FCCH demonstrated significant improvement in fourteen of the forty-four Child Nutrition items and eleven of the twelve Screen Time items. However, FCCH providers did not meet best practices at post-intervention. Lowest scores were found in serving meals family-style, promoting visible support for healthy eating, planned nutrition education and written policy on child nutrition. For screen time, lowest scores were reported on the availability of television, offering families education on screen time and having a written policy on screen time. FCCH in Nebraska were able to strengthen their policies and practices after utilizing Go NAP SACC. Continued professional development and participation in targeted interventions may assist programmes in sustaining improved practices and policies. Considering the varying standards and policies surrounding FCCH, future studies comparing the current findings with childcare centres and non-CACFP programmes are warranted.
Aronson, Keith R; Kyler, Sandee J; Moeller, Jeremy D; Perkins, Daniel F
2016-07-01
Little is known about military families who have a dependent with special health care and/or educational needs. The Exceptional Family Member Program (EFMP) is designed to link these families to military/community support services through family support provider (FS providers). The aim of this study was to understand FS providers' perspectives on the kinds of current challenges the families with whom they work face. This is the first study to ascertain the perspectives of professionals FS providers. FS providers (N = 160) completed a survey either on the phone or via the web. The survey consisted of four areas regarding EFMP: (1) background information; (2) caseload and work composition; (3) perceptions of Military Family needs; and (4) adequacy of community support services. The most commonly encountered diagnoses in military families were Autism (94%) and Attention-Deficit Hyperactivity Disorder (93%). Between 80% and 90% of FS providers reported working with families dealing with Emotional/Behavioral Disorders, Speech & Language Disorders, Asthma, Developmental Delays, and Mental Health Problems. FS providers noted that relocations are particularly challenging for military families in the EFMP. Training and programming of social service professionals working with military families who have a dependent with special health care and/or educational needs should focus on commonly occurring challenges seen in this population. As much as possible, FS providers should be familiar with evidence-based programs and practices designed to address these pressing problems. The process and execution of relocations should be streamlined so as to enhance continuity of care. Copyright © 2016 Elsevier Inc. All rights reserved.
Pay for performance in thoracic surgery.
Varela, Gonzalo
2007-08-01
In the context of improving the quality of the medical practice, PFP programs have been developed to reward best medical practice. Early studies showed little gain in quality after implementing PFP family practice programs and some unintended consequences, like excluding high-risk patients from medical services when good outcomes were linked to payment. To date, no PFP programs have been implemented in surgical practice, but it is expected that value-based purchasing philosophy will be extended to surgical specialties in the near future. Quality initiatives in surgery can be based on outcome or process measures. Outcomes-focused quality approaches rely on accurate information obtained from multiinstitutional clinical databases for calculation of risk-adjusted models. Primary outcomes such surgical mortality are uncommon in modern thoracic surgery and outcome measures should rely on more prevalent intermediate outcomes such as specific postoperative morbidities or emergency readmission. Process-based quality approaches need to be based on scientific evidence linking process to outcomes. It is our responsibility to develop practice guidelines or international practice consensus to facilitate the parameters to be evaluated in the near future.
Dental family stress and coping patterns.
Nevin, R S; Sampson, V M
1986-10-01
This exploratory study of 28 married male dentists and their families was designed to gain an understanding about the stressors that dentists and their spouses experience, the life events and family strains they incur, the behavioral coping patterns they utilize, and their psychosocial characteristics. The study found that although stable dental families did encounter a significant number of stressors arising from both the dental practice and the family, they maintained their sense of balance through strong family coping skills and family resources. The effect of the dentist's office-related stress was directly felt in the family, especially by the spouse. Strong coping patterns resulted when dentists and spouses maintained a balance of time and responsibility, satisfaction in work and family activity, regular communication, sharing of decision making, good physical health, and the inclusion of an active exercise program within multiple demands on their time.
IFRP studies child-spacing trends in subSaharan Africa.
1981-10-01
The IFRP (International Fertility Research Program) conducted in late 1980 a study of the changing patterns of breast feeding, postpartum abstinence, and use of modern contraceptive methods among women of reproductive age in Lagos, Nigeria, the largest city in tropical Africa. There is concern among family planning experts that the traditional child-spacing practices are breaking down in subSaharan Africa without being replaced sufficiently with modern fertility control methods. The household survey showed a total fertility rate of 6.56. Compared to the mean cumulative fertility of 6.19 for women aged 45-49, it appears that fertility is actually increasing in Lagos. There were low levels of awareness and practice of modern family planning methods reported by these women. Less than 1/4 were using a method of family planning currently. Of these, 7% were using a modern method (mostly pills), 3% were using a conventional method (condoms), and 14% were using only a traditional method. Many of these women did not consider either breast feeding or sexual abstinence as means of contraception. Breast feeding was practiced by 85% of the women during the 1st 2 months, with rates falling off sharply after that. Child spacing rather than fertility limitation was the motivation of most of the women practicing family planning.
Engineering success: Undergraduate Latina women's persistence in an undergradute engineering program
NASA Astrophysics Data System (ADS)
Rosbottom, Steven R.
The purpose and focus of this narrative inquiry case study were to explore the personal stories of four undergraduate Latina students who persist in their engineering programs. This study was guided by two overarching research questions: a) What are the lived experiences of undergraduate Latina engineering students? b) What are the contributing factors that influence undergraduate Latina students to persist in an undergraduate engineering program? Yosso's (2005) community cultural wealth was used to the analyze data. Findings suggest through Yosso's (2005) aspirational capital, familial capital, social capital, navigational capital, and resistant capital the Latina student persisted in their engineering programs. These contributing factors brought to light five themes that emerged, the discovery of academic passions, guidance and support of family and teachers, preparation for and commitment to persistence, the power of community and collective engagement, and commitment to helping others. The themes supported their persistence in their engineering programs. Thus, this study informs policies, practices, and programs that support undergraduate Latina engineering student's persistence in engineering programs.
Effect of village midwife program on contraceptive prevalence and method choice in Indonesia.
Weaver, Emily H; Frankenberg, Elizabeth; Fried, Bruce J; Thomas, Duncan; Wheeler, Stephanie B; Paul, John E
2013-12-01
Indonesia established its Village Midwife Program in 1989 to combat high rates of maternal mortality. The program's goals were to address gaps in access to reproductive health care for rural women, increase access to and use of family planning services, and broaden the mix of available contraceptive methods. In this study, we use longitudinal data from the Indonesia Family Life Survey to examine the program's effect on contraceptive practice. We find that the program did not affect overall contraceptive prevalence but did affect method choice. Over time, for women using contraceptives, midwives were associated with increased odds of injectable contraceptive use and decreased odds of oral contraceptive and implant use. Although the Indonesian government had hoped that the Village Midwife Program would channel women into using longer-lasting methods, the women's "switching behavior" indicates that the program succeeded in providing additional outlets for and promoting the use of injectable contraceptives. © 2013 The Population Council, Inc.
Balogh, Sándor; Papp, Renáta; Busa, Csilla; Csikós, Ágnes
2016-12-01
The general purpose of TELL ME study was to give an insight into the experiences of European family physicians with management of H1N1 pandemic flu. Qualitative research methods (focus group discussions, one-to-one interviews, and online data collection) were used to explore family doctors' opinion and suggestions. Overall 158 family physicians took part in the study from six European countries. Family doctors' most important experience was that the official campaign was not able to compensate negative effects of the mass media. Due to the poor evidence-based information about new vaccines, it was difficult to convince the public and some health care professionals too. Lack of unified directives - under unclear circumstances - made the routine patient care more difficult and hampered the collaboration between different health care providers. Family physicians felt a pressure from health authorities to achieve high immunization rate, but got only a little support from them. Despite the difficulties, vaccination program was a success, mainly among high-risk population. For better handling of a future pandemic, Hungarian family physician made many general and practical suggestions.
[Community Health Agent: status adapted with Family Health Program reality?].
dos Santos, Karina Tonini; Saliba, Nemre Adas; Moimaz, Suzely Adas Saliba; Arcieri, Renato Moreira; Carvalho, Maria de Lourdes
2011-01-01
This study analyses the status and work reality of Community Health Agents, with the purpose of contributing to the improvement of the Brazilian Health System (SUS) in small cities. It was discussed aspects related to their participation in the team of the Family Health Program (PSF) and their interaction with the community. It was observed a lack of motivation and experience, which compromises the quality of Agents performance in the community. It is known that these findings are reflex and consequence of an established context. It is necessary the team rethink their practice, specially the managers, having always as a fundament the principles that guide the SUS and PSF.
Building effective working relationships across culturally and ethnically diverse communities.
Hosley, Cheryl A; Gensheimer, Linda; Yang, Mai
2003-01-01
Amherst H. Wilder Foundation's Social Adjustment Program for Southeast Asians is implementing two collaborative, best practice, mental health and substance abuse prevention service models in Minnesota. It faced several issues in effectively bridging multiple cultural groups, including building a diverse collaborative team, involving families and youth, reconciling cultural variation in meeting styles, and making best practice models culturally appropriate. Researchers and program staff used multiple strategies to address these challenges and build successful partnerships. Through shared goals, flexibility, and a willingness to explore and address challenges, collaboratives can promote stronger relationships across cultural communities and improve their service delivery systems.
Fagan, Ernest Blake; Gibbons, Claire; Finnegan, Sean C; Petterson, Stephen; Peterson, Lars E; Phillips, Robert L; Bazemore, Andrew W
2015-02-01
The US Graduate Medical Education (GME) system is failing to produce primary care physicians in sufficient quantity or in locations where they are most needed. Decentralization of GME training has been suggested by several federal advisory boards as a means of reversing primary care maldistribution, but supporting evidence is in need of updating. We assessed the geographic relationship between family medicine GME training sites and graduate practice location. Using the 2012 American Medical Association Masterfile and American Academy of Family Physicians membership file, we obtained the percentage of family physicians in direct patient care located within 5, 25, 75, and 100 miles and within the state of their family medicine residency program (FMRP). We also analyzed the effect of time on family physician distance from training site. More than half of family physicians practice within 100 miles of their FMRP (55%) and within the same state (57%). State retention varies from 15% to 75%; the District of Columbia only retains 15% of family physician graduates, while Texas and California retain 75%. A higher percentage of recent graduates stay within 100 miles of their FMRP (63%), but this relationship degrades over time to about 51%. The majority of practicing family physicians remained proximal to their GME training site and within state. This suggests that decentralized training may be a part of the solution to uneven distribution among primary care physicians. State and federal policy-makers should prioritize funding training in or near areas with poor access to primary care services.
Not Just Numbers: Creating a Partnership Climate to Improve Math Proficiency in Schools
Sheldon, Steven B.; Epstein, Joyce L.; Galindo, Claudia L.
2009-01-01
Although we know that family involvement is associated with stronger math performance, little is known about what educators are doing to effectively involve families and community members, and whether this measurably improves math achievement at their schools. This study used data from 39 schools to assess the effects of family and community involvement activities on school levels of math achievement. The study found that better implementation of math-related practices of family and community involvement predicted stronger support from parents for schools’ partnership programs, which, in turn, helped estimate the percentage of students scoring proficient on math achievement tests. PMID:20200592
Prevention of alcohol and drug abuse: what works?
Kumpfer, Karol L
2002-09-01
There is no single "best" prevention program, and no one program or approach will stop all drug use. There are many effective research-based programs; the best approach for any particular population requires selecting the best intervention for the target population on the basis of a knowledge of the risk and protective factors in that population. Unfortunately, the most highly marketed school or family programs are generally not those programs with the best outcomes. The best approach to prevention is to begin early to reduce emerging behavioral and emotional problems in youth. Longer-lasting effects should accrue from changing school, community, and family environmental conditions that promote and maintain drug problems in youth. More and more prevention specialists are considering moving from a focus on the individual to changes in total systems or the environmental contexts that promote or hinder drug use. On the basis of economic considerations, the "whole family" systems-change approach of family skills training classes is becoming popular even in the managed care environment. The greatest challenge facing the drug abuse prevention field is to get information out to practitioners and communities about the best prevention programs, approaches, and principles of effectiveness. Researchers and funding agencies must learn how to effectively market the most successful programs to bridge the gap between research and practice. We must become as effective at marketing drug prevention programs as drug dealers are at promoting and selling drugs. Communities need health care professionals who are knowledgeable about substance abuse prevention and who can advocate the implementation and ongoing improvement of prevention programs with known effectiveness.
Bi-national cross-validation of an evidence-based conduct problem prevention model.
Porta, Carolyn M; Bloomquist, Michael L; Garcia-Huidobro, Diego; Gutiérrez, Rafael; Vega, Leticia; Balch, Rosita; Yu, Xiaohui; Cooper, Daniel K
2018-04-01
To (a) explore the preferences of Mexican parents and Spanish-speaking professionals working with migrant Latino families in Minnesota regarding the Mexican-adapted brief model versus the original conduct problems intervention and (b) identifying the potential challenges, and preferred solutions, to implementation of a conduct problems preventive intervention. The core practice elements of a conduct problems prevention program originating in the United States were adapted for prevention efforts in Mexico. Three focus groups were conducted in the United States, with Latino parents (n = 24; 2 focus groups) and professionals serving Latino families (n = 9; 1 focus group), to compare and discuss the Mexican-adapted model and the original conduct problems prevention program. Thematic analysis was conducted on the verbatim focus group transcripts in the original language spoken. Participants preferred the Mexican-adapted model. The following key areas were identified for cultural adaptation when delivering a conduct problems prevention program with Latino families: recruitment/enrollment strategies, program delivery format, and program content (i.e., child skills training, parent skills training, child-parent activities, and child-parent support). For both models, strengths, concerns, barriers, and strategies for overcoming concerns and barriers were identified. We summarize recommendations offered by participants to strengthen the effective implementation of a conduct problems prevention model with Latino families in the United States. This project demonstrates the strength in binational collaboration to critically examine cultural adaptations of evidence-based prevention programs that could be useful to diverse communities, families, and youth in other settings. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
Perspectives on Procedure Importance: Residents, Faculty, and Community Practitioners.
Ludden-Schlatter, Alicia; Wells, Jack; Kruse, Robin L
2018-06-01
Procedural training is integral to family medicine residencies. Although accreditation bodies require that family medicine residency programs train residents in procedures relevant to their practices, there are no standards defining the scope of family medicine. We compared the perceived importance of 31 procedures by faculty, residents, and recent graduates of one institution. An online survey was sent to current residents and faculty of a large academic family medicine residency, as well as community practitioners who had graduated from that residency within the past 5 years. The survey asked participants to rate how important 31 procedures are for family medicine practices. The overall response rate was 37%. Most respondents provided outpatient care, and few provided or intended to provide obstetric care. Dermatologic and musculoskeletal procedures were rated as having high importance by all groups, whereas obstetric and inpatient procedures received lower ratings. Residents ascribed higher importance than faculty or recent graduates for nearly all procedures. Most residents, faculty, and community practitioners provided outpatient care and rated dermatologic and musculoskeletal procedures as important. Inpatient and obstetric care are less common career paths, and related procedures were rated as less important. Resident physicians ascribed greater importance than community practitioners for many procedures, which may be due misperceptions of their future practice needs or imposed requirements for graduation.
The Fit Family Challenge: A Primary Care Childhood Obesity Pilot Intervention.
Jortberg, Bonnie T; Rosen, Raquel; Roth, Sarah; Casias, Luke; Dickinson, L Miriam; Coombs, Letoynia; Awadallah, Nida S; Bernardy, Meaghann K; Dickinson, W Perry
2016-01-01
Childhood obesity has increased dramatically over several decades, and the American Academy of Pediatrics has recommended primary care practices as ideal sites for the identification, education, and implementation of therapeutic interventions. The objective of this study was to describe the implementation and results for the Fit Family Challenge (FFC), a primary care-based childhood obesity intervention. A single-intervention pilot project that trains primary care practices on childhood obesity guidelines and implementation of a family-focused behavior modification curriculum. A total of 29 family medicine and pediatric community practices in Colorado participated. Participants included 290 patients, aged 6 to 12 years, with a body mass index (BMI) above the 85th percentile. The main outcome measure included the feasibility of implementation of a childhood obesity program in primary care; secondary outcomes were changes in BMI percentile, BMI z-scores, blood pressure, and changes in lifestyle factors related to childhood obesity. Implementation of FFC is feasible, statically significant changes were seen for decreases in BMI percentile and BMI z-scores for participants who completed 9 to 15 months of follow-up; lifestyle factors related to childhood obesity in proved Spanish-speaking families and food insecurity were associated with less follow-up time (P < .01). A primary care-based childhood obesity intervention may result in significant clinical and lifestyle changes. © Copyright 2016 by the American Board of Family Medicine.
Brody, Gene H; Chen, Yi-fu; Kogan, Steven M; Yu, Tianyi; Molgaard, Virginia K; DiClemente, Ralph J; Wingood, Gina M
2012-01-01
The present research addressed the following important question in pediatric medicine: Can participation in a new family-centered preventive intervention, the Strong African American Families-Teen (SAAF-T) program, deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents across 22 months? Data were collected from 502 black families in rural Georgia, assigned randomly to SAAF-T or an attention control condition. The prevention condition consisted of 5 consecutive meetings at community facilities with separate, concurrent sessions for caregivers and adolescents followed by a caregiver-adolescent session in which families practiced skills they learned in the separate sessions. Adolescents self-reported conduct problem behaviors, substance use, substance use problems, and depressive symptoms at ages 16 years (pretest) and 17 years 10 months (long-term assessment). Adolescents who participated in SAAF-T evinced lower increases in conduct problem behavior, substance use, substance use problems, and depressive symptom frequencies than did adolescents in the attention control condition across the 22 months between pretest and long-term assessment. This is the first study to demonstrate efficacy in a prevention program designed to deter conduct problems, substance use, substance use problems, and depressive symptoms among rural black adolescents. Because SAAF-T is a manualized, structured program, it can be easily disseminated to public health agencies, schools, churches, boys' and girls' clubs, and other community organizations.
Wycliffe-Jones, Keith; Hecker, Kent G; Schipper, Shirley; Topps, Maureen; Robinson, Jeanine; Abedin, Tasnima
2018-02-01
To examine the consistency of the ranking of Canadian and US medical graduates who applied to Canadian family medicine (FM) residency programs between 2007 and 2013. Descriptive cross-sectional study. Family medicine residency programs in Canada. All 17 Canadian medical schools allowed access to their anonymized program rank-order lists of students applying to FM residency programs submitted to the first iteration of the Canadian Resident Matching Service match from 2007 to 2013. The rank position of medical students who applied to more than 1 FM residency program on the rank-order lists submitted by the programs. Anonymized ranking data submitted to the Canadian Resident Matching Service from 2007 to 2013 by all 17 FM residency programs were used. Ranking data of eligible Canadian and US medical graduates were analyzed to assess the within-student and between-student variability in rank score. These covariance parameters were then used to calculate the intraclass correlation coefficient (ICC) for all programs. Program descriptions and selection criteria were also reviewed to identify sites with similar profiles for subset ICC analysis. Between 2007 and 2013, the consistency of ranking by all programs was fair at best (ICC = 0.34 to 0.39). The consistency of ranking by larger urban-based sites was weak to fair (ICC = 0.23 to 0.36), and the consistency of ranking by sites focusing on training for rural practice was weak to moderate (ICC = 0.16 to 0.55). In most cases, there is a low level of consistency of ranking of students applying for FM training in Canada. This raises concerns regarding fairness, particularly in relation to expectations around equity and distributive justice in selection processes. Copyright© the College of Family Physicians of Canada.
Improving the Nurse–Family Partnership in Community Practice
Donelan-McCall, Nancy; O’Brien, Ruth; MacMillan, Harriet; Jack, Susan; Jenkins, Thomas; Dunlap, Wallace P.; O’Fallon, Molly; Yost, Elly; Thorland, Bill; Pinto, Francesca; Gasbarro, Mariarosa; Baca, Pilar; Melnick, Alan; Beeber, Linda
2013-01-01
BACKGROUND: Evidence-based preventive interventions are rarely final products. They have reached a stage of development that warrant public investment but require additional research and development to strengthen their effects. The Nurse-Family Partnership (NFP), a program of nurse home visiting, is grounded in findings from replicated randomized controlled trials. OBJECTIVE: Evidence-based programs require replication in accordance with the models tested in the original randomized controlled trials in order to achieve impacts comparable to those found in those trials, and yet they must be changed in order to improve their impacts, given that interventions require continuous improvement. This article provides a framework and illustrations of work our team members have developed to address this tension. METHODS: Because the NFP is delivered in communities outside of research contexts, we used quantitative and qualitative research to identify challenges with the NFP program model and its implementation, as well as promising approaches for addressing them. RESULTS: We describe a framework used to address these issues and illustrate its use in improving nurses’ skills in retaining participants, reducing closely spaced subsequent pregnancies, responding to intimate partner violence, observing and promoting caregivers’ care of their children, addressing parents’ mental health problems, classifying families’ risks and strengths as a guide for program implementation, and collaborating with indigenous health organizations to adapt and evaluate the program for their populations. We identify common challenges encountered in conducting research in practice settings and translating findings from these studies into ongoing program implementation. CONCLUSIONS: The conduct of research focused on quality improvement, model improvement, and implementation in NFP practice settings is challenging, but feasible, and holds promise for improving the impact of the NFP. PMID:24187112
Improving learning about familial risks using a multicomponent approach: the GRACE program
Arar, Nedal; Delgado, Elizabeth; Lee, Shuko; Abboud, Hanna E
2013-01-01
Aim To enhance learning (knowledge, attitudes and practices) about the importance of family health history (FHH) information and familial risks. Methods A pre–post design with one group was employed in this study. Five learning sessions were conducted with a community-based sample (n = 75) recruited from five counties in Texas, USA. Each learning session included: a short online video; enactive instructions on how to use the online Surgeon General FHH tool; and a presentation on how to assess familial risks. Participants completed the pre–post knowledge, attitudes and practices questionnaires and the study's satisfaction survey, and participated in a short focus group interview. Results Participants’ average age was 48.1 ± 13.3 years. Over half of the participants (79%) were female, and 55% described themselves as non-Hispanic White. Our findings showed significant changes (p < 0.05) in participants’ specific knowledge about factors that affect their familial risks. Similarly, significant changes (p < 0.05) in participants’ attitudes toward familial risks assessment for common disease complications and confidence in controlling these risks have been documented. Participants’ reported a high level of satisfaction in using online FHH tools, yet no significant change (p > 0.05) was detected in their reported practices regarding sharing FHH information with their providers or relatives. Focus group interviews revealed that participants were uncertain about providers’ or relatives’ reactions to sharing FHH information. Conclusion Using different learning styles may have a significant impact on improving knowledge and attitudes about familial risks. PMID:23682294
Adapting evidence-based interventions using a common theory, practices, and principles.
Rotheram-Borus, Mary Jane; Swendeman, Dallas; Becker, Kimberly D
2014-01-01
Hundreds of validated evidence-based intervention programs (EBIP) aim to improve families' well-being; however, most are not broadly adopted. As an alternative diffusion strategy, we created wellness centers to reach families' everyday lives with a prevention framework. At two wellness centers, one in a middle-class neighborhood and one in a low-income neighborhood, popular local activity leaders (instructors of martial arts, yoga, sports, music, dancing, Zumba), and motivated parents were trained to be Family Mentors. Trainings focused on a framework that taught synthesized, foundational prevention science theory, practice elements, and principles, applied to specific content areas (parenting, social skills, and obesity). Family Mentors were then allowed to adapt scripts and activities based on their cultural experiences but were closely monitored and supervised over time. The framework was implemented in a range of activities (summer camps, coaching) aimed at improving social, emotional, and behavioral outcomes. Successes and challenges are discussed for (a) engaging parents and communities; (b) identifying and training Family Mentors to promote children and families' well-being; and (c) gathering data for supervision, outcome evaluation, and continuous quality improvement. To broadly diffuse prevention to families, far more experimentation is needed with alternative and engaging implementation strategies that are enhanced with knowledge harvested from researchers' past 30 years of experience creating EBIP. One strategy is to train local parents and popular activity leaders in applying robust prevention science theory, common practice elements, and principles of EBIP. More systematic evaluation of such innovations is needed.
Brown, J Lynne; Wenrich, Tionni R
2012-08-01
Few Americans eat sufficient vegetables, especially the protective deep orange and dark green vegetables. To address this, a community-based wellness program to broaden vegetables served at evening meals targeting Appalachian food preparers and their families was tested in a randomized, controlled intervention. Food preparers (n=50) were predominately married (88%), white (98%), and female (94%), with several children living at home. Experimental food preparers (n=25) attended the program sessions and controls (n=25) were mailed relevant handouts and recipes. At program sessions, participants received nutrition information, hands-on cooking instruction, and prepared recipes to take home for family evaluation. As qualitative assessment, 10 couples from each treatment group (n=20 couples) were randomly selected for baseline and immediate post-intervention interviews to explore impact on the food preparer's family. These in-depth interviews with the food preparer and their adult partner were tape-recorded and transcribed verbatim. Two researchers conducted thematic analysis using constant comparison. Family flexibility about food choices was assessed using roles, rules, and power concepts from Family Systems Theory. Interviews at baseline revealed dinner vegetable variety was very limited because food preparers served only what everyone liked (a role expectation) and deferred to male partner and children's narrow vegetable preferences (power). Control couples reported no change in vegetable dinner variety post-intervention. Most experimental couples reported in-home tasting and evaluation was worthwhile and somewhat broadened vegetables served at dinners. But the role expectation of serving only what everyone liked and the practice of honoring powerful family members' vegetable preferences remained major barriers to change. Copyright © 2012 Academy of Nutrition and Dietetics. Published by Elsevier Inc. All rights reserved.
Assessing the predictive value of the American Board of Family Practice In-training Examination.
Replogle, William H; Johnson, William D
2004-03-01
The American Board of Family Practice In-training Examination (ABFP ITE) is a cognitive examination similar in content to the ABFP Certification Examination (CE). The ABFP ITE is widely used in family medicine residency programs. It was originally developed and intended to be used for assessment of groups of residents. Despite lack of empirical support, however, some residency programs are using ABFP ITE scores as individual resident performance indicators. This study's objective was to estimate the positive predictive value of the ABFP ITE for identifying residents at risk for poor performance on the ABFP CE or a subsequent ABFP ITE. We used a normal distribution model for correlated test scores and Monte Carlo simulation to investigate the effect of test reliability (measurement errors) on the positive predictive value of the ABFP ITE. The positive predictive value of the composite score was .72. The positive predictive value of the eight specialty subscales ranged from .26 to .57. Only the composite score of the ABFP ITE has acceptable positive predictive value to be used as part of a comprehension resident evaluation system. The ABFP ITE specialty subscales do not have sufficient positive predictive value or reliability to warrant use as performance indicators.
Family support and exclusive breastfeeding among Yogyakarta mothers in employment.
Ratnasari, Dewi; Paramashanti, Bunga Astria; Hadi, Hamam; Yugistyowati, Anafrin; Astiti, Dewi; Nurhayati, Eka
2017-06-01
Exclusive breastfeeding provides many benefits to both infants and mothers. Despite the introduction of laws aimed at protecting the practice of exclusive breastfeeding, the coverage of exclusive breastfeeding remains low, particularly for working mothers. This crosssectional study recruited working mothers employed in medium and large companies in Bantul District, Daerah Istimewa Yogyakarta, Indonesia. The study participants were 158 working mothers whose children were aged 6- 12 months, and they were selected using the probability proportional to size technique. The data were analyzed using descriptive statistics, chi-square tests, and multiple logistic regression. Adequate family support for breastfeeding (OR: 2.86; 95% CI: 1.25-6.53) and a high paternal education level (OR: 2.68; 95% CI: 1.11- 6.48) were significantly associated with the practice of exclusive breastfeeding among working mothers. However, the infant's sex and age, parity, and the mother's age and education level were unassociated with exclusive breastfeeding. Family support and a high paternal education level are crucial in enabling working mothers to practice exclusive breastfeeding. Interventions that promote exclusive breastfeeding should focus on involving the husband and other family members in health care programs related to breastfeeding.