Measuring wraparound fidelity to make quality improvements.

Wraparound care coordination has offered an individualized family approach to providing services to families in our county for the past decade. Instigated by our county mental health department interested in providing quality improvements to mental health services for families, we assessed the wraparound care coordination process through use of the Wraparound Fidelity Index (WFI), which measures adherence to established principles of wraparound. This article reports on findings from WFI data collected over three summers and reported back to the management team and family organization.

Social supports for youth and families.

Social supports for youth and families receiving mental health services are important for family success and sustainability of systems of care. The goal of our study was to determine what help and support families and youth receive and from whom they receive it. We surveyed youth and families enrolled in community wraparound care coordination to determine the support they receive.

Adolescent substance use and abuse: recognition and management.

Substance abuse in adolescents is undertreated in the United States. Family physicians are well positioned to recognize substance use in their patients and to take steps to address the issue before use escalates. Comorbid mental disorders among adolescents with substance abuse include depression, anxiety, conduct disorder, and attention-deficit/ hyperactivity disorder.

Cultural awareness through medical student and refugee patient encounters.

Purpose: This paper presents findings from a qualitative investigation of cultural awareness that medical students developed in the context of providing medical care to refugees. Our evaluation question was: What kinds of cultural awareness and communication lessons do medical students derive from clinical encounters with refugee patients?

Methods: Thirty-eight semi-structured interviews were conducted to debrief a sample of 27 medical students. A multidisciplinary research team analyzed the debriefing texts following an interpretive "immersion-crystallization" approach.

Refugees and medical student training: results of a programme in primary care.

Context: Medical schools have responded to the increasing diversity of the population of the USA by incorporating cultural competency training into their curricula. This paper presents results from pre- and post-programme surveys of medical students who participated in a training programme that included evening clinical sessions for refugee patients and related educational workshops.

Methods: A self-assessment survey was administered at the beginning and end of the academic year to measure the cultural awareness of participating medical students.

Seriously emotionally disturbed youth: a needs assessment.

A desire to improve outcomes for children and families led Erie County, New York to collaborate with the University at Buffalo Department of Family Medicine on a needs assessment of children with emotional disturbance. Demographic and behavioral characteristics, as well as service needs were identified through case-based interviews conducted with key informants who provided services to children with emotional disturbance. Family interviews were conducted whenever possible.

Primary care education: measuring instruction to improve quality.

The authors describe a validated instrument to measure instructional quality, using responses from first- and third-year medical students to assess ambulatory training sites.