Publications by authors named "Debra Litzelman"

Substance use disorders among reproductive aged women are a major public health issue. There is little work investigating the validity and reliability of electronic health record (EHR) data for measuring substance use in this population. This study examined the concordance of self-reported substance use with clinical diagnoses of substance use, substance abuse and substance use disorder in EHR data.

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To identify program characteristics that influence the retention of women of reproductive age in the ommunity-based ddiction duction program (CARE), mixed-method analyses of CARE survey data and CARE Peer Recovery Coach (PRC) narrative entries of participant encounters were performed. About 251 women were enrolled in this prospective community-based implementation science intervention. We compared survey responses by race for treatment status, treatment motivation scales, and retention in the program at intake, 2-, 6-, 9-, and 12-month follow ups using Chi-square/-tests.

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Unilateral approaches to global health innovations can be transformed into cocreative, uniquely collaborative relationships between low-income and middle-income countries (LMICs) and high-income countries (HIC), constituted as 'reciprocal innovation' (RI). Since 2018, the Indiana Clinical and Translational Sciences Institute (CTSI) and Indiana University (IU) Center for Global Health Equity have led a grants programme sculpted from the core elements of RI, a concept informed by a 30-year partnership started between IU (Indiana) and Moi University (Kenya), which leverages knowledge sharing, transformational learning and translational innovations to address shared health challenges. In this paper, we describe the evolution and implementation of an RI grants programme, as well as the challenges faced.

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Objectives: Interprofessional (IP) collaboration and effective teamwork remain variable in healthcare organisations. IP bias, assumptions and conflicts limit the capacity of healthcare teams to leverage the expertise of their members to meet growing complexities of patient needs and optimise healthcare outcomes. We aimed to understand how a longitudinal faculty development programme, designed to optimise IP learning, influenced its participants in their IP roles.

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The COVID-19 pandemic disrupted social support networks as well as resource access for participants. The purpose of this study was to: analyze the experiences of older adults enrolled in a geriatric-focused community health worker (CHW) support program, to gain a better understanding of how CHWs might enhance care delivery, and to further understand how COVID-19 affected the social and emotional needs and well-being of older adults during the first 18 months of the pandemic. Qualitative analysis was performed on notes entered by CHWs based on 793 telephone encounters with 358 participants between March 2020 and August 2021.

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The Indiana Geriatrics Workforce Enhancement Program (GWEP) implemented a new longitudinal geriatrics curriculum for advanced practice registered nurse (APRN) and master of social work (MSW) learners to prepare them for interprofessional collaborative practice in the care of older adults. This paper reports program outcomes of a novel longitudinal interprofessional geriatrics curriculum involving immersive learning for these learners. Outcomes are described in terms of learner reaction, modification of attitudes/perceptions, acquisition of knowledge/skills, behavior change, impact on the organization, and impact on the patient or client using the Freeth/Kirkpatrick evaluation model.

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Article Synopsis
  • The WeCare program aimed to reduce infant mortality risks by offering tailored support for maternal and infant health through community health workers (CHWs), focusing on psycho-social-cultural-fiscal needs.
  • A study involving 1,513 women from high-risk areas in central Indiana over three years showed that the program successfully trained CHWs to deliver evidence-based social care, improving various health risk factors.
  • Participants in the WeCare program experienced a lower rate of low birth weight (8.9%) compared to the local average (10%), along with significant improvements in multiple risk behaviors, demonstrating the program's effectiveness in addressing health disparities.
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  • The study evaluated factors influencing program retention among 184 women of childbearing age with substance use disorders in a peer recovery program, half of whom were pregnant or postpartum.
  • Participants were paired with peer recovery coaches (PRCs) who provided support and navigational help, and various independent factors like anxiety and trauma were assessed for their impact on retention.
  • The findings indicated that moderate anxiety was linked to higher retention rates, while severe anxiety was associated with lower retention, suggesting that early mental health interventions could enhance recovery outcomes for these women.
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Global health researchers often discount mutual learning and benefit to address shared health challenges across high and low- and middle-income settings. Drawing from a 30-year partnership called AMPATH that started between Indiana University in the US and Moi University in Kenya, we describe an innovative approach and program for mutual learning and benefit coined 'reciprocal innovation.' Reciprocal innovation harnesses a bidirectional, co-constituted, and iterative exchange of ideas, resources, and innovations to address shared health challenges across diverse global settings.

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Background: The care of older adults with complex medical conditions requires effective team-based care.

Problem: Nursing and social work students need a curriculum that provides them with immersive experiences in geriatrics to prepare them for competent practice.

Approach: This Geriatric Workforce Enhancement Program supported 5 advanced practice nursing (APN) and 5 master of social work (MSW) student fellows in a 2-semester program, with 3 cohorts completing the fellowship over 3 years (N = 30).

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The objective of this study was to increase screening for falls and dementia by improving interprofessional (IP) providers' and staffs' knowledge and attitudes toward the care of older patients and team-based care. An intervention, including education about screening and an electronic health record (EHR) flowsheet, was rolled-out across eight Federally Qualified Health Centers (FQHC). Participants were 262 IP health providers who served 6670 patients ≥ age 65 > age 65 .

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Article Synopsis
  • Community health workers (CHWs) play a crucial but under-explored role in enhancing surgical care by assisting with patient linkage to operative and post-operative care, beyond their established role in disease screening.
  • A scoping review of literature from 2000 to 2020 identified 10 relevant studies showing that CHWs improve surgical enrollment, provide vital resources, and monitor post-operative care, helping to address the complex needs of surgical patients.
  • The findings suggest that while current research is limited, CHWs help navigate barriers in surgical care and it highlights the need for well-designed studies to better understand their potential contributions in this area.
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Introduction: As use of electronic medical records (EMRs) increases in healthcare, multiple accreditation organizations recommend training future clinicians on EMRs as part of the academic curriculum. Therefore, some pharmacy programs now utilize an academic EMR. Our objective was to examine pharmacy instructors' early experiences with a commercially available teaching EMR (tEMR) in order to identify current and future priorities along with benefits and barriers to academic EMR use in pharmacy education.

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The objective of this study is to provide an overview of the Regenstrief Teaching Electronic Medical Record (tEMR), how the tEMR could be used, and how it is currently being used in health professions education. The tEMR is a derivative of a real-world electronic health record (EHR), a large, pseudonymized patient database, and a population health tool designed to support curricular goals. The tEMR has been successfully adopted at 12 health professional, public health, and health information technology (HIT) schools, with over 11 800 unique student users and more than 74 000 logins, for case presentation, to develop diagnostic and therapeutic plans, and to practice documentation skills.

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Older adults are vulnerable to risks associated with medications. This study explores the roles of Social Workers in facilitating medication safety for older adults. Eight social workers from federally qualified health centers participated in a case-based and interactive medication safety curriculum.

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Background: There is strong interest among healthcare trainees and academic institutions in global health rotations. There are a number of guidelines detailing the ethical principles for equitable and ethical global health rotations and bilateral exchanges, but it is often challenging to know to implement those principles and develop longstanding partnerships.

Objectives: The Academic Model Providing Access to Healthcare (AMPATH) is a 30-year continuous partnership between a consortium of 12 universities in North America and Moi University in Kenya.

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Health outcomes for complex older adults are enhanced by interprofessional collaboration. Funded by a Geriatrics Workforce Enhancement Program (GWEP), an interprofessional team of educators developed a short-term geriatrics experience, including four hours of pre-clinical education and 12-20 hours of immersion in team-based care for advanced learners in nursing (n = 70 APN), social work (n = 48 MSW), and medicine (n = 122 medical students). Content focused on five areas: medication management, dementia, depression, falls, and myths about aging.

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As interest in global health education continues to increase, residency programs seeking to accommodate learners' expectations for global health learning opportunities often face challenges providing high-quality global health training. To address these challenges, some residency programs collaborate across medical specialties to create interdisciplinary global health residency tracks or collaborative interdisciplinary global health tracks (CIGHTs). In this Perspective, the authors highlight the unique aspects of interdisciplinary tracks that may benefit residency programs by describing 3 established U.

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Objective: To explore leadership perspectives on how to maintain high quality efficient care that is also person-centered and humanistic.

Methods: The authors interviewed and collected narrative transcripts from a convenience sample of 32 institutional healthcare leaders at seven U.S.

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Background: Changes in the organization of medical practice have impeded humanistic practice and resulted in widespread physician burnout and dissatisfaction.

Objective: To identify organizational factors that promote or inhibit humanistic practice of medicine by faculty physicians.

Design: From January 1, 2015, through December 31, 2016, faculty from eight US medical schools were asked to write reflectively on two open-ended questions regarding institutional-level motivators and impediments to humanistic practice and teaching within their organizations.

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Objective: We tested a novel, web-based teaching electronic medical record to teach and assess residents' ability to enter appropriate admission orders for patients admitted to the intensive care unit. The primary objective was to determine if this tool could improve the learners' ability to enter an evidence-based, comprehensive initial care plan for critically ill patients.

Methods: The authors created three modules using de-identifed real patient data from selected patients that were admitted to the intensive care unit.

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Background: Globalization has increased the demand for international experiences in medical education. International experiences improve medical knowledge, clinical skills, and self-development; influence career objectives; and provide insights on ethical and societal issues. However, global health rotations can end up being no more than tourism if not structured to foster personal transformation and global citizenship.

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