Health Promotion Services Research Articles

A three-arm randomised controlled trial to evaluate the efficacy of a positive psychology and social networking intervention in promoting mental health among HIV-infected men who have sex with men in China.

There is a lack of mental health promotion and treatment services targeting HIV-positive men who have sex with men (HIVMSM) in China. The aim of this study was to evaluate the mental health promotion efficacy of an online intervention that combined Three Good Things (TGT) with electronic social networking (TGT-SN) and an intervention that used TGT only (TGT-only), compared with a control group. We conducted a randomised controlled trial among HIVMSM in Chengdu, China. The participants were randomly assigned to the TGT-SN, TGT-only, and control groups. The participants in the TGT-SN group were divided into five social network groups and asked to post brief messages to the group about three good things that they had experienced and for which they felt grateful. The participants in the TGT-only group were only required to write down their three good things daily without sharing them with others. The control group received information about mental health promotion once a week for a month. The primary outcome was probable depression. Secondary outcomes were anxiety, positive and negative affect, gratitude, happiness and social support. These outcomes were assessed at baseline, 1, 3, 6 and 12 months after the intervention. Repeated-measures analyses were conducted using generalised estimation equations. The study was registered with the Chinese Clinical Trial Registry (ChiCTR-TRC-13003252). Between June 2013 and May 2015, 404 participants were enrolled and randomly assigned to either the TGT-SN (n = 129), TGT-only (n = 139) or control group (n = 136). The main effects of TGT-SN (adjusted odds ratio (aOR) = 0.75, 95% CI 0.52-1.09; p = 0.131) and TGT-only (aOR = 0.83, 95% CI 0.57-1.21; p = 0.332) in reducing depression were statistically non-significant. The participants of the TGT-SN group showed significantly lower anxiety symptoms (aOR = 0.62, 95% CI 0.43-0.89; p = 0.009) and negative affect (β = -1.62, 95% CI 2.98 to -0.26; p = 0.019) over time compared with those of the control group. No significant main effect was found for any secondary outcomes for the TGT-only group. The novel intervention combining the TGT exercise with electronic social networking was found effective in reducing anxiety and negative affect among HIVMSM.

Coverage assessment of maternal and child health services provided at Urban Health and Nutrition Day in urban slums of Jamnagar Municipal Corporation area

Introduction: Urban Health and Nutrition Day (UHND) is an initiative to provide preventive, promotive, and curative maternal and child health services monthly on fixed day. It is mainly designed to reach out to those who are living in urban slums and for serving vulnerable. The study was conducted to assess the utilization of services provided to mother and child at Mamta session. Materials and Methods: A cross-sectional study was conducted in urban slums of Jamnagar. In the first stage, 30 Anganwadi centers were chosen by systematic random sampling, and in the second stage, 8 postnatal women with 8 children were included. Results: Out of 240 participants, 80% of women registered their pregnancy at Mamta session and 86% were having Mother and Child Protection Card at the time of visit. Basic health checkups containing blood pressure and weight were measured for around 90%, three-fourth of women were checked for hemoglobin % and urine for albumin, and only 29% were done with abdominal examination. Health education component was found to be much-sidelined portion of UHND session in both mother and child care in this study. From surveyed children, 81.6% were registered at session site; from those registered, 62% attend the session regularly; 80% of children were weighed; only 12% of children's weight was recorded in Mamta card; and 50% of mothers were explained about weight and its interpretation. Fifty-four percent of women had given colostrum to their babies, and the same proportion of mother gave prelacteal feed to their children. Conclusion: There is a need to sensitize health workers about the importance of giving health education to mothers which is found to be the most poorly executed component of the study.

Health-promoting services provided in pharmacies: A systematic review

Health-promoting services provided in pharmacies: A systematic review

Title 1 Changes: Bringing the Older Americans Act Definitions to 2020

This session will review the changes to Title I of the Reauthorization of the Older Americans Act. This title provides important updates and modernization to the definitions used throughout the Older Americans Act. Some definitions were modified such as adding the prevention of sexually transmitted diseases, chronic pain management, and screening for suicide risk to evidence-based health promotion programs under the definition of disease prevention and health promotion services. Other changes include services to provide screening for fall-related injuries, services that are responses to public health emergencies, and services to prevent and address negative health effects associated with social isolation. Title I also includes a series of important including access to person-centered services and coordinating services provided by aging and disability resource centers. Several other changes to Title I will be discussed.

A supervisão em Psicologia como espaço de formação e de acolhimento

The psychological duty is a type of clinical pratice that aims to receive the demand of the client at the time of mobilization, a proposal usually offered in institutions. It represents a type of intervention that can help to reposition Clinical Psychology towards a democratization of the population's access to a health promotion service. The complexity of this clinical practice consists of dealing with multifaceted forces. The present study aimed to investigate the contributions of the supervision to the practices of psychological duty. A data collection instrument was developed to investigate important reflections, significant facts and feelings that were mobilized during the supervisions. The records produced were analyzed by the Grounded Theory, a qualitative methodology. Two important aspects that emerged from the investigation were the contributions of supervision to training and the supervision as a supportive space. Supervision was constituted as a place for training and guidance, both technical and theoretical, underpinning the clinical practice, promoting the potential of students and contributing to professional development. The supervision group transcends the theoretical and technical aspects of guidance, demanding a context of trust and affective involvement. In this sense, it demands that the supervisor take care of the relations of the group, cultivating group cohesion.

Social Work Services at Dakto District Health Center, Kon Tum Province, Vietnam: Challenges and Policy Recommendations

ABSTRACT The provision of social work services at district health centers are not well reported in previous studies. This study aimed to report the results of the provision of social work services at Dakto District Health Center, Kon Tum province, Vietnam, and to find out factors affecting this provision. This was a cross-sectional study that used secondary data, 13 in-depth interviews, and 2 focus group discussions to collect data. Among the social work services prescribed by the Ministry of Health, Dakto District Health Center provided the following four services: information instruction and consultation services, and psychological support for patients; communication and health promotion services; services in support of health workers; and resources mobilization and coordination services. Our study found factors that hinder the provision of social work services at the center and suggested policies to the related parties.

HEALTH LITERACY AND HEALTH CARE SEEKING BEHAVIOR OF THE ELDERLY IN HUE CITY

Objectives: To assess the health literacy and identify the relationship between the health literacy and health care seeking behavior among the older persons in Hue city. Methods: A cross-sectional study was conducted in Hue city. 400 older persons were interviewed directly using a structured questionnaire. Health literacy was assessed by HLS- Asian- Q. Multivariate logistic regression model was used to identify the relationship between health literacy and health care seeking behavior. Results: 20.0% of the respondents got inadequate health literacy. The proportion of the elderly who achieved health literacy in health care, health prevention and health promotion were 25.7%, 10.0% and 28.0%, respectively. The percentage of the elderly who have sought health care services and health promotion services were 76.7% and 68,0%, respectively. There was a relationship between health literacy and treatment seeking behaviour (OR= 3.71; 95% CI: 1.25-11.01) and health prevention service seeking behaviour among participants (OR=3.30; 95% CI:1.16-9.40). Conclusions: Health literacy of the elderly was still low in Hue city. There is influence of health literacy on health care seeking behavior among them. Enhancing health literacy for the older persons should be a necessary solution to improve their health status. Keywords: Health literacy, health seeking behavior, older persons, Hue city.

Leadership, governance and management for improving district capacity and performance: the case of USAID transform: primary health care

BackgroundPrimary health care (PHC) in Ethiopia serves as the main entry point for preventive, promotive and curative health services. The district health office is responsible for the planning, implementation and evaluation of all district health activities. In addition, district health offices manage service delivery facilities working on provision of PHC – primary hospitals, health centers and health posts. As the leader of the health care system tier, district health management must ensure direction, alignment and commitment within teams and organizations and make sure that achievements are consistent with the vision, values and strategy of the organization. USAID Transform: Primary Health Care provides diverse support to improve district health manager competencies including in-service trainings followed by planning and implementation of performance improvement projects and on-the-job mentoring and support.MethodsThis study was conducted to compare district level capacity and performances between leadership, management and governance (LMG) and non-LMG districts. Project outcome monitoring data that shows the performance of districts was collected from 284 districts from January to December 2019. The study was carried out using a comparative-cross sectional study design, which assessed and compared district health office level indicators. Districts were classified into two categories: LMG and non-LMG districts. The study compared data from 94 LMG and 190 non-LMG districts. Propensity score matching was used to control the effect of differences between LMG and non-LMG districts.ResultsResults of the independent samples t-test revealed that LMG districts scored better average performances of 61.8 ± 121.45 standard deviation (SD) compared to non-LMG districts 56.89 ± 110.39 SD, with t (282243) = − 3.407317 and p < 0.001, two-tailed. The difference of 4.9 percentage unit in the average performance indicated a statistically significant difference between the LMG and non-LMG districts.ConclusionDistrict level leadership development program contributes to improving district capacity, structure and management practices, and quality of care.

Assessing Managers’ Attitudes Toward Health Promoting Hospitals at a Teaching Hospital in Tehran, Iran

Background: Hospitals are the most important and largest providers of health services in the health system. Objectives: This study aimed to examine hospital managers’ attitudes toward health promotion policies at a teaching hospital in Tehran, Iran. Methods: This research was a descriptive-analytical study. The study population consisted of 75 senior and middle managers of a teaching hospital in Tehran, Iran in 2018. Sampling was conducted through a census. The study instrument was a researcher-made questionnaire assessing managers’ attitudes toward health promotion. The questionnaire was validated. Data were collected and then analyzed using SPSS 20 software. Results: Total score of health promotion policies was estimated to be 84.5 ± 10.6 out of 100. The highest scores of the components associated with health promotion policies were 94.9 ± 9.34 and 93.8 ± 10.36 of 100 belonging to “Awareness of hospital staff of health promotion policies” and “Enjoyment of a written health promotion policy” items, respectively; while the lowest score was 75.4 ± 20.68 out of 100 belonging to “Informing patients, their companions, and staff about factors associated with the disease whose health is supported by the hospital”. The highest score of components associated with health promotion activities was 94.1 ± 9.74 out of 100 belonging to “Increasing patients’ trust by providing health promotion services” item and the lowest was 72.2 ± 19.4 out of 100 belonging to “Assessment of patient’s needs for health promotion” item. Conclusion: Hospital managers’ attitudes score was high toward health promotion policies and activities, but there are still problems with health promotion activities, the most important of which is a therapeutic-centered perspective.

Model to assess workload of village doctors in the National Essential Public Health Services Program in six provinces of China

BackgroundNo studies, particularly quantitative analyses, have been conducted regarding the workload of village doctors in the National Essential Public Health Services (NEPHS) program and differences in service delivery by village doctors, according to region and services. In this study, we developed a quantitative analysis approach to measure the workload of NEPHS provided by village doctors in six provinces of China in 2016. We aimed to identify areas and services of the NEPHS needing improvement, so as to implement targeted measures to ensure adequate delivery of NEPHSs in rural remote underserved areas.MethodsBased on survey data from 300 town hospital centers (THCs) located in 60 counties in the six selected provinces, we calculated village doctors’ share of workload under the NEPHS using the equivalent value (EV) model. To define the workload and corresponding EV of each NEPHS, a series of five meetings was held with THC managers, public health workers, family physicians, nurses and village doctors. Field observations were conducted to verify the workload and EV of each service.ResultsVillage doctors’ share of the workload under the NEPHS program was 43.71% across the 300 sampled THCs in six provinces. The village doctors’ workload shares for different NEPHS ranged from 17.14 to 57.00%. The percentage workload undertaken by village doctors under the NEPHS program varied across different provinces, with the highest proportion 63.4% and the lowest 28.5%.ConclusionsThe total NEPHS workload assigned to village doctors by THCs in the six sampled provinces exceeded the Chinese government’s requirement of 40%, but the workload proportion in some provinces was less than 40%. In addition, the percentage workload for some NEPHS undertaken by village doctors was lower than others. We suggest conducting district-level analysis of the workload among village doctors under the NEPHS program using the EV method, to identify areas and services needing improvement, to implement targeted measures to expand and promote health service provision in China’s rural underserved areas.

Pendidikan Kesehatan Pencegahan Stroke dan Asam Urat pada Lanjut Usia

Along with economic progress, environmental improvement and advancement of science and technology, especially in health sciences, health promotion, disease prevention and health services have resulted in increased life expectancy for humans. Our society now sees the elderly as people who are less productive, less attractive, less energetic, easy to forget, therefore to realize healthy, productive elderly people at dusk, efforts are needed, one of which is by improving healthy lifestyles. Survey conducted by the Team, The number of elderly people in Posyandu is 79 people. There are only 2 active Posyandu cadres active, the elderly rarely visit the Posyandu, and the lack of knowledge on how to cope with problems related to elderly diseases, such as gout, stroke. Therefore it is necessary to hold counseling for the Elderly to better understand about health problems in the elderly and be more active in participating in the Posyandu for the elderly so that "Healthy Elderly People in Old Age" is realized. This activity was done in May-June 2019 at the elderly in the homes of residents of RT 11 Kelurahan Kenali Asam Bawah, with the service method using a survey approach, lecture, discussion, demonstration / simulation. The results obtained by the Posyandu officers are active and able to identify the elderly and health problems of the elderly and recognize and understand frequent diseases such as gout and stroke

Health promotion and preventive health care service guidelines for the care of people with spina bifida.

Individuals with Spina Bifida (SB) have unique lifelong medical and social needs. Thus, when considering how to promote health and offer preventive care, providers must adapt general healthcare screening and counseling recommendations to their patients’ physical and cognitive impairments along with discerning how to monitor secondary or chronic conditions common to the population. This article provides an update on the health promotion and preventive health care guidelines developed as part of the Spina Bifida Association’s fourth edition of the Guidelines for the Care of People with Spina Bifida. The guidelines highlight accommodations needed to promote general preventive health, common secondary/chronic conditions such as obesity, metabolic syndrome, hypertension, musculoskeletal pain, and considerations for preventing acute care utilization for the SB population throughout the lifespan. Further research is needed to understand the effectiveness of preventive care interventions in promoting positive health outcomes and mitigating potentially preventable acute care utilization.

Evaluation of an Integrated Health Promotion Program for a low-income urban population: Findings and lessons learned.

ObjectivesTo evaluate a multicomponent pilot program for low‐income individuals with, or at risk for, hypertension, diabetes, and/or overweight.DesignPre‐post evaluation including baseline and follow‐up assessments, satisfaction surveys, program utilization data, and focus groups.SampleThe evaluation included 138 participants. The majority were Latinx (88%), female (82%), born outside the United States (80%), and had not graduated from high school (52%). The most common health conditions were hypertension (59%), overweight or obesity (55%), high cholesterol (53%), and diabetes (34%).MeasurementsEngagement in program activities, health indicators (e.g., blood pressure), and behavior change. Qualitative data focused on perceptions of the program and its impacts.InterventionThe program offered a number of health promotion services, including consultation with a nurse and a community health worker (CHW), health and nutrition talks, subsidized farm shares, cooking classes, exercise classes, and home visits.ResultsThere were improvements in general health, blood pressure, and knowledge and behavior related to disease management and healthy eating.ConclusionsProgram success was attributed to the wide range of complementary program components. The staffing model was also a strength: the CHW/nurse collaboration combined clinical expertise with cultural, language, and community knowledge to create a program that was accessible and empowering.

How and to what extent can pensions facilitate increased use of health services by older people: evidence from social pension expansion in rural China

BackgroundThe proportion of people aged 60 years or over is growing faster than other age groups. Traditionally, retirement has been considered as both a loss to the labour market and an additional economic burden on the nation. More recently, it is widely accepted that retired people can still contribute to society in many ways, though the extent of their contributions will depend heavily on their state of health. In this context, a significant practical issue is how to encourage older people to use the health services they need. This study aims to evaluate the effects of pensions on older adults’ health service utilization, and estimate the level of pension required to influence such utilization.MethodsUsing data from a nationally representative sample survey, the China Health and Retirement Longitudinal Study, we adopted a fuzzy regression discontinuity design and undertook segmented regression analysis.ResultsIt was found that a pension did encourage low-income people to use both outpatient (OR = 1.219, 95% 1.018–1.460) and inpatient services (OR = 1.269, 95% 1.020–1.579); but also encouraged both low- and high-income people to choose self-treatment, specifically over-the-counter (OR = 1.208, 95% 1.037–1.407; OR = 1.206, 95% 1.024–1.419; respectively) and traditional Chinese medicines (OR = 1.452, 95% 1.094–1.932; OR = 1.456, 95% 1.079–1.955; respectively). However, receiving a pension had no effect on the frequency of outpatient and inpatient service use. Breakpoints for a pension to promote health service utilization were mainly located in the range 55–95 CNY (7.1–12.3 EUR or 8.0–13.8 USD).ConclusionsA pension was found to have mixed effects on health service utilization for different income groups. Our study enriches existing evidence on the impact of pensions on healthcare-seeking behaviour and can be helpful in policy design and the formulation of improved models relating to pensions and healthcare utilisation.

Time-varying associations of pre-migration and post-migration stressors in refugees' mental health during resettlement: a longitudinal study in Australia

Understanding the time-varying association of pre-migration and post-migration stressors in refugees' mental health could help in designing tailored health promotion services at different resettlement stages and improving the efficiency of resource allocation. In this study, we explored these time-varying associations. We used data from the first four waves (October, 2013, to February, 2017) of a national refugee-based longitudinal study, the Building a New Life in Australia (BNLA) project. Post-traumatic stress disorder (PTSD) and high risk of severe mental illness (HR-SMI) were used to assess mental health. The independent variables included the number of potentially traumatic events experienced during the pre-migration process, and a range of post-migration stressors. We used logistic regression models to analyse the relative importance of variables and time-varying associations between the pre-migration potentially traumatic events, post-migration resettlement stressors, and refugees' mental health. Analyses were stratified by gender, and sociodemographic covariates included age, marital status, education level, country of birth, and weekly income. 2399 participants were surveyed in Wave 1 of the BNLA project in 2013-14, of whom 2009 (83·7%) responded in Wave 2 in 2014-15, 1894 (78·9%) in Wave 3 in 2015-16, and 1929 (80·4%) in Wave 4 in 2016-17. The three most important factors associated with mental health in each wave differed for male and female refugees, but the socioeconomic stressors of loneliness and adjustment to life in Australia were consistently prominent. Positive associations between socioeconomic stressors and mental ill-health were found for both genders, with a peak at Wave 2 (adjusted odds ratio [AOR] among men, 1·60 [95% CI 1·26-2·03], p=0.0001 for PTSD; AOR 1·86 [1·35-2·55], p=0·0001 for HR-SMI; and among women, AOR 1·81 [1·27-2·57], p=0·0009 for PTSD; AOR 2·24 [1·49-3·38], p=0·0001 for HR-SMI). Associations between loneliness and mental health fluctuated, but were significant for both genders in Wave 4 (among men, AOR 1·90 [1·21-2·99], p=0·0051 for PTSD; AOR 3·70 [2·18-6·27], p<0·0001 for HR-SMI; and among women, AOR 3·65 [2·08-6·39], p<0·0001 for PTSD; AOR 3·68 [2·02-6·69], p<0·0001 for HR-SMI). The association between difficulties in adjustment to life in Australia and male refugees' mental ill-health increased continuously during the resettlement period. Gender-specific and time-sensitive services should be considered to improve refugees' mental health. For both genders, improved economic conditions that complement social security benefits deserve attention and are relevant throughout the resettlement process. At the later stage of resettlement, services to reduce loneliness could be carried out, and reducing stressors related to adjustment to life in the host country is especially needed for male refugees. None.

Effects of COVID-19 on the mental health of black and brown racialized populations in the U.S.

Effects of COVID-19 on the mental health of black and brown racialized populations in the U.S.

The modules of mental health programs implemented in schools in low- and middle-income countries: findings from a systematic literature review

BackgroundSecondary schools in low- and middle-income countries (LMICs) provide health promotion, preventive, and early intervention services. Nevertheless, literature indicates that the modules of these services are either adapted or modified from existing mental health programs in developed countries. The literature also highlights the provision of non-comprehensive services (mental health promotion, prevention, and early intervention), in LMICs. These findings inform the need for undertaking this systematic literature review. The aim of this review was thus to identify the modules of school-based mental health programs (SBMHP) that have been implemented in LMICs to guide the development of a culturally sensitive comprehensive mental health program for adolescents in a LMIC country.MethodsThe Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) statement was used to guide this review. The following databases were searched in September 2018, to identify the relevant literature: PubMed, CINAHL, Scopus, Web of Science, PsycINFO, and ERIC. The search was conducted by the first author and reviewed by the authors.ResultsFollowing the screening process, a total of 11 papers were identified and reviewed for quality. The systematic review highlighted that the mental health programs provided in schools included: an introduction module, a communication and relationship module, a psychoeducation module, a cognitive skills module, a behavioral skills module, establishing social networks for recovery and help seeking behavioral activities and a summary/conclusion module.ConclusionThis review sheds light on the characteristics of the programs in LMICs. Two programs were found to be universal in nature. Five programs were directed at key risk factors or at-risk groups, and four were early intervention programs. The review also revealed that only one program out of the 11 programs included modules for parents. The synthesis indicated that all the identified programs were adapted or modified from existing programs. The dearth of comprehensive programs in LMICs was also revealed. Lastly, the review revealed seven modules that can be useful for developing a SBMHP.

The integration of sexual and reproductive health and rights into universal health coverage: a FIGO perspective

Universal health coverage (UHC) aims to make promotive, preventive, curative and rehabilitative health services available for the entire population. It ensures that quality healthcare services are ...

Enhancing the potential effects of text messages delivered via an m-health intervention to improve packing of healthy school lunchboxes.

The aim of the study was to assess the impact of different lunchbox messages on parents' intention to pack a healthy lunchbox. This study employed an experimental design. A series of messages were developed to align with the six constructs of the Health Belief Model. Messages were also developed that were (and were not) personalised and varied based on the source of the information provided (university, school, dietitian and health promotion service). During a telephone survey, participants were read the content of each message and asked about their intention to pack a healthy lunchbox. Parents of primary school-aged children were randomised to receive different messages to encourage the packing of healthy lunchboxes. The study was completed by 511 parents. Linear mixed regression analyses identified significant differences (P < 0·05) in intention scores between variant messages targeting the same behavioural constructs for 'susceptibility', 'severity', 'benefits' and 'barriers' but not 'cues to action' or 'self-efficacy'. The highest mean behavioural intention score was for 'benefits', whilst the lowest mean score was for 'barriers'. There were no significant differences in intention scores of parents receiving messages from a dietitian, university, health promotion team or school (P = 0·37). Intention scores did not differ in which messages were personalised based on child's name (P = 0·84) or grade level (P = 0·54). The findings suggest that messages that focus on the benefits of packing healthy lunchboxes may be particularly useful in improving intentions of parents to pack healthy foods for their children to consume at school.

417TF Climate Change and Human Health for the Practicing Clinician

In 2016, the American College of Physicians (ACP) published a position paper that identified tackling climate change as an opportunity to dramatically improve human health. It states that physicians should support efforts to mitigate and adapt to the effects of climate change and engage the public, their colleagues, community, and lawmakers about the health risks posed by climate change. However, many medical students and physicians feel that they have minimal understanding of the linkages between climate change and human health. A 2013 survey found that 34-40% of each year’s graduating medical students between 2009-2013 believed that their instruction in environmental health was inadequate. This curriculum aims to address this educational gap by leading all graduating 4th year medical students in a planetary health module. 1) Explain how shifts in climate, natural resources, technology, economy and demography may affect the provision of health care in the future; 2) Apply critical appraisal and science communication skills to describe climate health risks; 3) Apply systems thinking and multidisciplinary perspectives to develop strategies to promote health service sustainability; 4) Advocate for planetary health values in physicians groups and national conversation. All 4th year medical students graduating from the University of Rochester take a month-long course called “Successful Interning.” The planetary health module will be held as part of this course. Students will have prerequisite reading to complete before starting the course. There will be a 1-hour Power Point lecture outlining the basic principles behind climate change and the link to human health. Following this, the students will gather in small groups based on the region they will be in for their residency for a 2-hour workshop. Faculty mediators will facilitate discussion on how each region will be affected by climate change, assist students in outlining exposure pathways, and help students discover what their specialty should expect in terms of patient experience and health effects stemming from these changes. At the end of the workshop, each group will briefly present the following: How the region they are practicing, and their patients will be affected by climate change, and a strategy for climate adaptation/mitigation. Course evaluation will be conducted by pre- and post-course REDCap surveys determining self-perceived knowledge. At the end of their intern year, students will be emailed a follow-up survey asking how relevant they feel the course content is to their current practice. Due to changes in course scheduling related to COVID-19, this course could not be carried out as planned. A one-hour lecture on planetary health for the practicing clinician was substituted, with the intent to return to the original full-length format next spring. The goal of this curriculum is to provide future physicians with the background and skills to tackle climate change in order to improve human health and avoid dire environmental consequences. Participants will learn strategies for climate adaptation and mitigation specific to their region and future practice population.