Public and Population Health in U.S. Medical Education: A Review of Guidance in Extraordinary Times.

Generations of medical educators have recommended including public and population health (PPH) content in the training of U.S. physicians.

Teaching Public and Population Health in Medical Education: An Evaluation Framework.

Curriculum models and training activities in medical education have been markedly enhanced to prepare physicians to address the health needs of diverse populations and to advance health equity. While different teaching and experiential learning activities in the public health and population health sciences have been implemented, there is no existing framework to measure the effectiveness of public and population health (PPH) education in medical education programs. In 2015, the Association of American Medical Colleges established the Expert Panel on Public and Population Health in Medical Education, which convened 20 U.

Preventive behaviors and knowledge of tick-borne illnesses: results of a survey from an endemic area.

Context: Lyme disease (LD) is the most commonly reported vector-borne illness in the United States. With physically and economically burdensome effects, it is a concern of public health officials.

Objectives: To assess knowledge and preventive behaviors of individuals in the endemic area of Martha's Vineyard, Massachusetts, to better understand how sociodemographic data and knowledge correlate with preventive behaviors, and to update previous island studies.

A new approach to ensuring oral health care for people living with HIV/AIDS: the dental case manager.

Introduction: The American Dental Association has identified several barriers to adequate dental care for vulnerable populations, including appropriate case management. The objective of this study was to examine the perceptions, attitudes, and beliefs of dental patients living with HIV/AIDS on the role and value of the dental case manager (DCM) and the effect of DCM services on their oral or overall health.

Methods: We used a qualitative descriptive study design and focus groups.

Partnering for health: collaborative leadership between a community health center and the YWCA central Massachusetts.

Background: A collaborative partnership among community-based organizations (CBOs)-a community-health center, a YWCA, and 2 academic health centers-developed and implemented open access to physical activity for health center patients.

Objective: To describe partnership approach taken by 2 CBOs; determine staffs' views of this unique partnership, highlight aspects of the partnership that contributed to its success, identify challenges and mechanisms for overcoming them, and note lessons learned. Assess health center patients' use of YWCA facility.

Weaving public health education into the fabric of a family medicine residency.

Policymakers and accrediting bodies have recognized the importance of integrating public health, population health, and prevention into graduate medical education programs. The high prevalence of chronic illness, coupled with the impact of behavioral and societal determinants of health, necessitate an urgent call for family medicine residencies to prepare future leaders to meet these challenges. The University of Massachusetts Worcester Family Medicine Residency recently developed an integrated curriculum that strives to develop a culture of incorporating fundamental public health principles into everyday practice.

Model approaches for advancing interprofessional prevention education.

Healthy People 2010 included an objective to "increase the proportion of … health professional training schools whose basic curriculum for healthcare providers includes the core competencies in health promotion and disease prevention." Interprofessional prevention education has been seen by the Healthy People Curriculum Task Force as a key strategy for achieving this objective and strengthening prevention content in health professions education programs. To fulfill these aims, the Association for Prevention Teaching and Research sponsored the Institute for Interprofessional Prevention Education in 2007 and in 2008.

A qualitative study of the meaning of fatherhood among young urban fathers.

Objective: To explore the beliefs, attitudes, and needs young men have regarding their role as a father.

Design And Sample: Exploratory, descriptive, qualitative design. Young fathers/young expectant fathers were recruited from service sites within a city in Massachusetts.

Family medicine residency characteristics associated with practice in a health professions shortage area.

Background And Objectives: While some family medicine residency programs are designed to train residents in community health centers (CHCs) for future careers serving underserved populations, there are few outcome studies on such programs. Our residency program provides three options for ambulatory health center training, but otherwise residents participate in the same curriculum. We analyzed relationships between ambulatory training site and likelihood of practice in health professions shortage areas (HPSAs).

Community dimensions and HPSA practice location: 30 years of family medicine training.

Background And Objectives: Our objective was to assess practicing family physicians' confidence and participation in a range of community-related activities. Additionally, we assessed the strength of the relationship between the physicians' reported medical school and residency training in community-related activities and their current community activities, as well as whether they were practicing in an underserved location.

Methods: All 347 graduates of the University of Massachusetts Family Medicine Residency were surveyed about practice location and type, involvement and training in community work, confidence in community-related skills, and sociodemographic characteristics.

The primary care physician workforce in Massachusetts: implications for the workforce in rural, small town America.

Context: Small towns across the United States struggle to maintain an adequate primary care workforce.

Purpose: To examine factors contributing to physician satisfaction and retention in largely rural areas in Massachusetts, a state with rural pockets and small towns.

Methods: A survey mailed in 2004-2005 to primary care physicians, practicing in areas designated by the state as rural, queried respondents about personal and practice characteristics as well as workforce concerns.

Service-learning: an integral part of undergraduate public health.

In 2003, the Institute of Medicine (IOM) described public health as "an essential part of the training of citizens," a body of knowledge needed to achieve a public health literate citizenry. To achieve that end, the IOM recommended that "all undergraduates should have access to education in public health." Service-learning, a type of experiential learning, is an effective and appropriate vehicle for teaching public health and developing public health literacy.

Development of a brief questionnaire to identify families in need of legal advocacy to improve child health.

Objective: To determine whether the medical-legal advocacy screening questionnaire (MASQ), a simple 10-item questionnaire, is able to screen families in a primary care setting for possible referral to legal services more effectively than the clinical interview alone.

Methods: Family Advocates of Central Massachusetts (FACM) is a medical-legal collaboration that assists low-income families with legal issues that affect child health. A convenience sample of parents seen at each of 5 medical practices associated with FACM was recruited to complete the MASQ prior to a routine child health care visit.

The power and the promise: working with communities to analyze data, interpret findings, and get to outcomes.

Although the intent of community-based participatory research (CBPR) is to include community voices in all phases of a research initiative, community partners appear less frequently engaged in data analysis and interpretation than in other research phases. Using 4 brief case studies, each with a different data collection methodology, we provide examples of how community members participated in data analysis, interpretation, or both, thereby strengthening community capacity and providing unique insight. The roles and skills of the community and academic partners were different from but complementary to each other.

Creating open access to exercise for low-income patients through a community collaboration for quality improvement: if you build it, they will come.

Community health centers face the need for safe, accessible, and affordable exercise for low-income patients to implement self-management strategies. This study reports on one federally qualified health center's experience developing a partnership with a local YWCA to offer open access to patients for physical activity. Over a 24-month period, 1060 adult patients made at least 1 visit to the YWCA, logging a total of 14,276 visits.

Adolescent mothers' attitudes toward contraceptive use before and after pregnancy.

Study Objective: To understand attitudes and beliefs influencing use and nonuse of contraceptive methods pre- and postpartum among a group of adolescent mothers.

Design And Setting: Qualitative descriptive study utilizing focus groups conducted between May, 2005 and January, 2006 in Central Massachusetts.

Participants: Adolescent mothers attending a federally funded multi-professional medical program.

The body mass index of teen mothers and their toddler children.

Objectives: To evaluate: change in Body Mass Index (BMI) of adolescent mothers (14-19 years of age) from pre-pregnancy to 36 months postpartum; BMI of their children age 2 or older; relationship between maternal BMI and children's BMI.

Methods: Retrospective medical record abstraction of adolescent mothers attending a medical program in Massachusetts between 2001 and 2005 who had self-reported pre-pregnancy BMI data at first prenatal visit, at least one BMI measure 12 or more months postpartum, and who did not experience a repeat pregnancy (n = 52). Children of adolescent mothers were included if they had received their 2 (n = 41) and/or 3 (n = 28) year physical.

The visiting specialist model of rural health care delivery: a survey in Massachusetts.

Context: Hospitals in rural communities may seek to increase specialty care access by establishing clinics staffed by visiting specialists.

Purpose: To examine the visiting specialist care delivery model in Massachusetts, including reasons specialists develop secondary rural practices and distances they travel, as well as their degree of satisfaction and intention to continue the visiting arrangement.

Methods: Visiting specialists at 11 rural hospitals were asked to complete a mailed survey.

Characteristics of frequent attenders at a community health center.

Background: As high utilizers of health care resources, frequent attenders to medical practices pose a significant issue for primary health care. Studies documenting content of visits and characteristics of frequent attenders have paid limited attention to community health center populations. This study profiles these high utilizers comparing them to non-frequent attenders.

Effect of a low-cost intervention on recording body mass index in patients' records.

Purpose: Evaluate the effectiveness of body mass index (BMI) tables placed in exam rooms as an intervention to encourage providers to calculate and record BMI scores in patients' medical records.

Design: In a prospective cohort design, medical record data for 276 adult patients at a federally funded community health center in New England were examined from August 2000 to August 2002 following the intervention.

Methods: Prominent, multicolored, laminated BMI tables were posted in the exam rooms of one of the study site's three primary health care teams.

Patient health status and appointment keeping in an urban community health center.

This study examines the relationship between patient health status and the likelihood of missing appointments in a community health center serving low-income patients. Medical records of 465 adult patients scheduled to be seen during one week in February 1999 were audited for an 18-month period. Seventy-three percent of patients failed to keep one or more appointments; 43% missed one or two; 30% missed three or more.