On-site Trainings Research Articles

Rapid Scale-Up of Screening for Early Detection of Sudan Virus Disease (SVD) in Healthcare Facilities (HCFs) during the 2022 Outbreak in Uganda

Background: The Uganda Ministry of Health (MoH) and implementing partners instituted an infection prevention and control (IPC) response strategy during the Uganda SVD outbreak in 2022 that involved rapid enhancement of screening capacity at HCFs. Rapid scale-up of screening for infectious diseases, such as SVD, is critical for early identification and triage of suspected or confirmed cases in HCFs. We describe the rapid deployment of a multimodal IPC strategy implemented in response to the SVD outbreak and the resulting impact on screening measures at HCFs. Methods: We implemented a multimodal IPC strategy in HCFs from five high risk districts to improve screening practices from November 2022–January 2023. The strategy included training health workers (HCWs) identified as IPC mentors; establishing screening areas; and providing screening supplies and communication materials. The three-day training utilized an MoH standardized training package with didactic and practice sessions. The mentors then cascaded screening information and skills to other HCWs through onsite trainings and mentorships and established screening areas. Baseline and endline (3 months after baseline) cross-sectional assessments were conducted using the MoH IPC Assessment Tool adapted from the WHO Ebola IPC Scorecard. The five main screening parameters assessed included presence of ≥ 1 meter distance between screener and the person screened, availability of a functional handwashing facility and infrared thermometer, correct record of each person’s temperature, and appropriate referral process for those suspected of having SVD to holding areas. IPC capacity was measured through the summation of each of these parameter results and calculated as an overall percentage. IBM SPSS Statistics 20 software was used for data analysis and a paired t-test done to determine any significant findings between mean scores (percentage) at baseline and endpoint. Results: A total of 296 IPC mentors were trained, screening information was cascaded to 3,899 HCWs, and screening areas were established in 1,135 HCFs. Based on the screening results from the MoH IPC assessment tool, capacity improved from 44% (SD=37) at baseline to 67% (SD=34) at endpoint. Screening capacity improved from baseline to endpoint among level II and public HCFs from 33% (SD=35) to 60% (SD=35) (p < 0 .05) and from 54% (SD=38) to 76% (SD=31) (p < 0 .05), respectively. Conclusion: Rapid implementation of a multimodal IPC strategy was successful in enhancing screening capacity across Uganda’s HCFs during a SVD response, which is critical for early identification of infected patients to interrupt transmission. This multimodal approach should be recommended for future response actions.

Online training for hearing implant surgery : Anew approach to otological training.

Education in microsurgery of the ear includes staged training to allow for mastering of the complex microsurgical procedures, particularly in the context of middle ear reconstruction and cochlear implantation. Traditional surgical training includes temporal bone preparations by cadaver dissection and supervised operating room practice. As these on-site trainings are limited, there is aneed to broaden education facilities in an on-line format. Therefore, afirst basic on-line training for otosurgery was developed. The system consists of an artificial temporal bone model together with aset of basic surgical instruments and implant dummies. As an essential part of the training kit, ahigh-resolution camera set is included that allows for connection to avideo streaming platform and enables remote supervision of the trainees' surgical steps by experienced otological surgeons. In addition, apre-learning platform covering temporal bone anatomy and instrumentation and pre-recorded lectures and instructional videos has been developed to allow trainees to review and reinforce their understanding before hands-on practice. Over the three courses held to date, 28participants with varying levels of prior surgical experience took part in this otological surgical training program. The immediate feedback of the participants was evaluated by means of aquestionnaire. On this basis, the high value of the program became apparent and specific areas could by identified where further refinements could lead to an even more robust training experience. The presented program of an otosurgical online training allows for basal education in practical exercises on aremote system. In this way, trainees who have no direct access to on-site instruction facilities in ear surgery now have the chance to start their otosurgical training in an educational setting adapted to modern technologies.

Online training for hearing implant surgery : Anew approach to otological training. German version

Education in microsurgery of the ear includes staged training to allow for mastering of the complex microsurgical procedures, particularly in the context of middle ear reconstruction and cochlear implantation. Traditional surgical training includes temporal bone preparations by cadaver dissection and supervised operating room practice. As these on-site trainings are limited, there is aneed to broaden education facilities in an on-line format. Therefore, afirst basic on-line training for otosurgery was developed. The system consists of an artificial temporal bone model together with aset of basic surgical instruments and implant dummies. As an essential part of the training kit, ahigh-resolution camera set is included that allows for connection to avideo streaming platform and enables remote supervision of the trainees' surgical steps by experienced otological surgeons. In addition, apre-learning platform covering temporal bone anatomy and instrumentation and pre-recorded lectures and instructional videos has been developed to allow trainees to review and reinforce their understanding before hands-on practice. Over the three courses held to date, 28participants with varying levels of prior surgical experience took part in this otological surgical training program. The immediate feedback of the participants was evaluated by means of aquestionnaire. On this basis, the high value of the program became apparent and specific areas could by identified where further refinements could lead to an even more robust training experience. The presented program of an otosurgical online training allows for basal education in practical exercises on aremote system. In this way, trainees who have no direct access to on-site instruction facilities in ear surgery now have the chance to start their otosurgical training in an educational setting adapted to modern technologies.

Small Farm Resource Centers as Informal Extension Hubs in Underserved Areas: Case Studies from Southeast Asia

A Small Farm Resource Center (SFRC) is an informal in-situ extension model used for testing promising agricultural and rural livelihoods options on a physical central site, with some measure of extension methodology. There is a need to evaluate SFRCs as research-extension models operating outside of formal government extension and advisory services. Seven SFRCs located in Southeast Asia were studied to classify extension methodologies adopted by those centers, evaluate extension efficacy, and to provide recommendations for amplifying their services. On average in 2013, SFRCs were 21.1 years old, covered 24.2 ha, cost 242,000 USD to establish and had a yearly operating cost of 28,500 USD. The work of the seven SFRCs could be classified into five predominant extension methodologies: on-site and off-site demonstrations, on-site and off-site trainings, and off-site extension outreach. Most of the SFRCs utilized combinations of these and tailored their methods to the particular context. Besides agricultural production, SFRCs also offered socio-cultural and socio-economic assistance, owing to a cycle of extension knowledge refinement. SFRCS were re-engaged in 2021 and all 7 were still operational, and the majority provided the same number or more services (57%) as in 2013, utilized the same amount of space (71%), and were perceived to have the same or more efficacy (71%) even in the face of decreasing or stagnating funding (71%) due to the COVID-19 pandemic. Overall, SFRCs continue to be used successfully throughout Southeast Asia and provide cost-effective and needs-based extension and advisory services to underserved populations outside of formal extension services.

Perspectives from Training the Care Coordinators—A New Cadre to Support Team-Based Diabetes and Depression Care in India

Purpose: Comorbid depression and type 2 diabetes are associated with poor glycemic control, increased complications, and poor self-management, compared to either condition alone. The Integrating Depression and Diabetes Treatment (INDEPENDENT) clinical trial demonstrated the effectiveness of an integrated care model in improving diabetes and depression outcomes, in diabetes-specialty clinics in India. The INDEPENDENT model used task sharing to address the shortage of mental health professionals in India. Care coordinators (CCs) who were dietitians or counsellors were a key component of this care model. This article details the training and support provided to the CCs during the INDEPENDENT trial. Materials and Methods: CCs were nonphysician and nonpsychiatrist health specialists who supported patients in self-management of diabetes and depression, helping them set achievable goals and monitored progress. During the clinical trial, the CCs underwent both offsite and on-site trainings. The trainings equipped them with various lifestyle management tools for self-care, including one-on-one education sessions and motivational interviewing for self-monitoring, adherence to medication, diet, exercise regimes, and cessation of smoking, among others. Results: Nine CCs from the four sites were trained effectively during the course of the INDEPENDENT study from 2014 to 2018. Conclusions: Given the paucity of mental health professionals in India, the use of collaborative care and a team of well-trained CCs may be an effective strategy for the management of comorbid depression and diabetes. This model of care could help fill deficiencies in the delivery of care for comorbidity of depression and diabetes care in India.

Assessing virtual and on-site technical trainings during the first year of covid-19 pandemic

In 2020, Covid-19 pandemic firstly hit many countries including Indonesia. Since then, the methods on disseminating the agricultural technology have evolved accordingly. This paper assessed nine series of virtual and on-site technical trainings (or the so-called Bimtek in this paper) carried out from February to November 2020 in nine sub-districts from five provinces. Zoom application was used to deliver the materials during virtual Bimtek. Whilst, on-site training applied such methods: meeting in the classroom and field visit to practice the technology. The participants were diverse, among others: farmers and millennial farmers, extension officers, lecturers, college students and community (551 in total). The nature of participants depended on the type of Bimtek. Results showed that both Bimtek had the range of value between 70-85% in term of materials to meet the needs, materials to be applied, motivation and technical assistance from resource person. However, the percentage of knowledge change in virtual was higher than that in on-site Bimtek. Initial assessment showed that participants had good knowledge in remembering the technology, even some had also applied the technology in their farming practice. Thus, both Bimtek could improve farmers’ knowledge, from which the intention to change the farming practice could be persuaded.

The Ability to Look: Management of Breast Disease in the Democratic Republic of the Congo Using Smart Ultrasound Technology

The vast majority of women with breast cancer in sub-Saharan Africa present with advanced stage disease, due primarily to the lack of opportunities for early detection and treatment. As part of a larger effort to increase access to diagnostic and therapeutic services for women's cancers in the Democratic Republic of Congo (DRC), we implemented a curriculum to train the local workforce and a program to build the supportive infrastructure for the diagnosis and treatment of breast cancer at a private sector health facility (Biamba Marie Mutombo Hospital) in Kinshasa. After onsite trainings in the DRC by a US breast surgeon (RT), Congolese surgeons, general physicians, physician assistants, and nurses used the Phillips Lumify smart-phone ultrasound device to perform and interpret the results of whole breast ultrasound on symptomatic women. Surgeons were trained to perform ultrasound-guided core needle biopsy on those who met the criteria for tissue diagnosis, after which they trained nurses to do the same. Over 3 years, 5,211 patients were identified as having a breast abnormality on clinical breast examination. Ultrasound abnormalities were noted in 1,493 (27%) patients, of which 632 (42%) met the criteria for ultrasound-guided core needle biopsy or fine needle aspiration. Pathology reports were available on 368 (58%) patients who underwent biopsy, of which 164 were malignant and 204 benign. We demonstrated how the "ability to look" using smart technology can be successfully used to augment clinical breast exam and triage patients for biopsy in a resource-constrained African setting.

A neurophysiological approach to assess training outcome under stress: A virtual reality experiment of industrial shutdown maintenance using Functional Near-Infrared Spectroscopy (fNIRS)

Shutdown maintenance, i.e., turning off a facility for a short period for renewal or replacement operations is a highly stressful task. With the limited time and complex operation procedures, human stress is a leading risk. Especially shutdown maintenance workers often need to go through excessive and stressful on-site trainings to digest complex operation information in limited time. The challenge is that workers’ stress status and task performance are hard to predict, as most trainings are only assessed after the shutdown maintenance operation is finished. A proactive assessment or intervention is needed to evaluate workers’ stress status and task performance during the training to enable early warning and interventions. This study proposes a neurophysiological approach to assess workers’ stress status and task performance under different virtual training scenarios. A Virtual Reality (VR) system integrated with the eye-tracking function was developed to simulate the power plant shutdown maintenance operations of replacing a heat exchanger in both normal and stressful scenarios. Meanwhile, a portable neuroimaging device – Functional Near-Infrared Spectroscopy (fNIRS) was also utilized to collect user’s brain activities by measuring hemodynamic responses associated with neuron behavior. A human–subject experiment (n = 16) was conducted to evaluate participants’ neural activity patterns and physiological metrics (gaze movement) related to their stress status and final task performance. Each participant was required to review the operational instructions for a pipe maintenance task for a short period and then perform the task based on their memory in both normal and stressful scenarios. Our experiment results indicated that stressful training had a strong impact on participants’ neural connectivity patterns and final performance, suggesting the use of stressors during training to be an important and useful control factors. We further found significant correlations between gaze movement patterns in review phase and final task performance, and between the neural features and final task performance. In summary, we proposed a variety of supervised machine learning classification models that use the fNIRS data in the review session to estimate individual’s task performance. The classification models were validated with the k-fold (k = 10) cross-validation method. The Random Forest classification model achieved the best average classification accuracy (80.38%) in classifying participants’ task performance compared to other classification models. The contribution of our study is to help establish the knowledge and methodological basis for an early warning and estimating system of the final task performance based on the neurophysiological measures during the training for industrial operations. These findings are expected to provide more evidence about an early performance warning and prediction system based on a hybrid neurophysiological measure method, inspiring the design of a cognition-driven personalized training system for industrial workers.

Introduction to Telehealth for Clinical Psychologists: a Novel Course Designed to Improve General Knowledge and Hands-on Expertise with Technology-Based Modalities

Telehealth, or the integration of technology with healthcare services, has been identified as a rapidly developing field with implications for both clinical psychologists and patients. While some on-site trainings, as well as post-doctoral continuing education and professional certificate programs exist, research has identified the importance of formalized technology-focused training throughout one’s graduate school career. Unfortunately, minimal formalized coursework has been recognized for clinical psychology doctoral programs. To remedy this gap, the Introduction to Telehealth for Clinical Psychologists course was designed to enhance general evidence-informed knowledge and provide hands-on experiences with various applicable modalities. The development, instructional techniques, and pilot evaluation of a doctoral-level clinical psychology-focused course are detailed. Pre- to post-class evaluations suggested increases in student self-reported telehealth-related knowledge, as well as high satisfaction. The pilot course may serve as a template for future telehealth courses.

Learning from experience – a probe into the off-campus internships under the five-year cosmetology technical and vocational education program

PurposeThis paper aims to probe into the implementation of internship courses under the five-year cosmetology program in Taiwan from the perspective of Dewey's philosophies in hopes that the analysis can serve as reference for schools in planning their internship courses in the future.Design/methodology/approachThis paper probes into the off-campus internship courses under Taiwan's five-year junior college education program by applying Dewey's empirical philosophy.FindingsThe study aims to understand the learning experience acquired by students from learning by doing internship courses as reference for future internship design. The current internship courses comprise the follows: summer, during the semester and for a full academic year. The experience of summer internship is career exploration, the experience for semester internship is career experience and the experience from academic-year internship is career choice. The internship strategies are designed according to the three different internship approaches, so that the internship courses can implement the educational effect of “learning from experience”.Practical implicationsTo minimize the discrepancy between the cosmetology program under the five-year junior college education and the employment market, credit-based off-campus internship courses are arranged for students' final years at school.Social implicationsThrough on-site trainings, students accumulate work experience and explore into a related career field. The accumulation of experience and gaining of insights mirror the philosophy of learning by doing, which involves students' reflective thinking.Originality/valueIt is hoped that the analysis can serve as reference for internship courses planning in the future.

The role of organizational context in the implementation of a statewide initiative to integrate mental health services into pediatric primary care.

Although there is evidence that mental health services can be delivered in pediatric primary care with good outcomes, few changes in service delivery have been seen over the past decade. Practices face a number of barriers, making interventions that address determinants of change at multiple levels a promising solution. However, these interventions may need appropriate organizational contexts in place to be successfully implemented. The objective of this study was to test whether organizational context (culture, climate, structures/processes, and technologies) influenced uptake of a complex intervention to implement mental health services in pediatric primary care. We incorporated our research into the implementation and evaluation of Ohio Building Mental Wellness Wave 3, a learning collaborative with on-site trainings and technical assistance supporting key drivers of mental health care implementation. Simple linear regression was used to test the effects of organizational context and external or fixed organizational characteristics on program uptake. Culture, structure/processes, and technologies scores indicating a more positive organizational context for mental health at the project's start, as well as general cultural values that were more group/developmental, were positively associated with uptake. Patient-centered medical home certification and use of electronic medical records were also associated with greater uptake. Changes in context over the course of Building Mental Wellness did not influence uptake. Organizational culture, structures/processes, and technologies are important determinants of the uptake of activities to implement mental health services in pediatric primary care. Interventions may be able to change these aspects of context to make them more favorable to integration, but baseline characteristics more heavily influence the more proximal uptake of program activities. Pediatric primary care practices would benefit from assessing their organizational context and taking steps to address it prior to or in a phased approach with mental health service implementation.

The RHINO Community of Practice: Building a Space for Data Users and Enthusiasts in Washington State

ObjectiveTo grow and facilitate a community of syndromic surveillance data users in Washington State, improving and expanding local syndromic practice.IntroductionPrior to June 2016, there were 45 registered users of syndromic surveillance data in Washington State, with 29 (64.4%) representing 5 of Washington’s 35 local health jurisdictions and 16 (35.6%) at the state level. Of those registered users, 9 (8.8%) had logged into ESSENCE at least once in the 6 months before October 2016.In June 2016, the Washington State syndromic surveillance program began accepting Meaningful Use data and sought to increase its user base. To accomplish this, the Washington State Department of Health (WA DOH) designated a staff member to oversee outreach efforts to increase the visibility of syndromic data in the state, including the establishment of a Community of Practice.MethodsThe Washington State syndromic surveillance program—the Rapid Health Information NetwOrk (RHINO)—began the process of stakeholder engagement by delivering a needs assessment to 15 current and potential users of the Electronic Surveillance System for the Early Notification of Community-based Epidemics (ESSENCE) platform. The survey assessed interest in participation in a Community of Practice for Washington State syndromic data users, the timing and format for meetings, needs for technical assistance, and topic areas of interest. RHINO then used the survey results to create a bank of topics for Community of Practice calls and develop a strategy for long-term outreach and engagement.In April of 2017, the RHINO team developed a new strategic plan and outlined metrics for evaluating growth and challenges in the program’s outreach efforts, including plans for outreach to novel disciplines like emergency preparedness. These metrics included counts of invitations for speaking engagements, ESSENCE users, onsite ESSENCE trainings and attendees at those trainings, organizations and disciplines represented in the Community of Practice, Community members, and webinars facilitated for the Community. RHINO staff compiled monthly tabulations of these metrics to track progress over the course of the year and aid in adjustments to outreach efforts as necessary.ResultsRHINO received 10 responses to the survey, with 9 respondents from local health jurisdictions and 1 from WA DOH. Respondents indicated particularly strong interest in regular webinars, a database of resources, and live trainings to support syndromic practice in their work. They also expressed concerns about the distance which would be required for in-person meetings.RHINO established that meetings would occur via webinar every other month and held 6 webinars between October 2016 and October 2017 on a broad range of topics including developing syndrome definitions, basic ESSENCE functions, using ESSENCE’s Report Manager tool, monitoring influenza-like-illness in ESSENCE, and using syndromic data for situational surveillance. In addition to the Community of Practice webinars, RHINO staff developed technical guides for both the Washington and National Surveillance Program’s (NSSP) ESSENCE platforms, a handbook for using syndromic surveillance data in Washington State, and a curriculum for onsite ESSENCE training.Between October 2016 and October 2017, RHINO offered 8 onsite ESSENCE trainings for groups of users at the Washington State Department of Health and local health jurisdictions, serving a total of 36 attendees. Over the course of the year, ESSENCE users in Washington State increased to 75, with 40 (53.3%) of them logging into the system at least once over the previous 6 months and 20 (26.7%) listed as “new users” who have not yet activated their accounts. The Community of Practice itself has 86 members representing 16 agencies and 19 disciplines.As RHINO’s profile increased and more potential users became aware of the availability of syndromic data, RHINO began receiving invitations to present for external partners. Between March 2016 and October 2017, RHINO received 8 invitations to present to audiences of potential syndromic data users. These audiences included leadership at the Washington State Department of Health and emergency preparedness and response organizations.In the next year, the program will continue offering data trainings and partner meetings to better serve the needs of both current and potential data users in Washington State. As more jurisdictions begin to have production-quality data, RHINO will continue offering onsite training. RHINO has also built a relationship with the Northwest Tribal Epidemiology Center in Portland, Oregon to begin the process of exploring data sharing with the Tribal Nations and Organizations located within Washington.ConclusionsThrough the development and implementation of a detailed outreach plan, RHINO increased the user base and profile of syndromic surveillance data in Washington State. This work was made possible through the careful construction of strong relationships with new and potential partners and the decision to diversify RHINO’s staff to include members with backgrounds beyond epidemiology.

Implementation of Integrated Disease Surveillance and Response (IDSR) in Swaziland

Objective: To strengthen public health surveillance and monitor implementation of Integrated Disease Surveillance and Response in the Kingdom of Swaziland.Introduction: Swaziland adopted the Integrated Disease Surveillance and Response (IDSR) strategy in 2010 to strengthen Public Health Surveillance (PHS) that fulfills International Health Regulations (2005) and the Global Health Security Agenda (GHSA). This strategy allows the Ministry of Health (MoH), Epidemiology and Disease Control Unit (EDCU) to monitor, prevent and control priority diseases in the country. We used a health systems strengthening approach to pilot an intervention model for IDSR implementation at five hospitals in Swaziland over a pilot phase of three months.Methods: Our intervention included cross-country IDSR trainings, sensitizations and onsite trainings targeting national and regional health teams for over 250 health workers. The EDCU developed and disseminated standardized case definitions for health facilities (HFs) to detect, confirm and report priority conditions. Trained health care workers were tasked to cascade knowledge sharing and sensitization about IDSR with their HFs during in-service trainings. The facilities were to use IDSR standard case definition as guidelines for diagnosing and reporting cases; submit monthly reports on all priority conditions to Health Management Information System (HMIS) and intensify reporting through immediate disease notification system (IDNS) for all notifiable conditions. Indicators and monitoring tools for disease surveillance and response as recommended by the technical guidelines for IDSR in the African region were developed. The intervention was evaluated at five purposively selected high-volume referral hospitals (attending to ≥1500 to 15000 outpatient visits per month), which also have maternity services.Structured questionnaires in the form of a monitoring tool, checklists and observations were used to collect data. Quantitatively, monthly reports submitted by the five facilities to HMIS were reviewed and analyzed for completeness and timeliness. Clinic supervisors were identified from outpatient, inpatient, maternity and laboratory departments as key informants to explore successes and challenges of IDSR implementation. Additionally, IDSR officers visited health facilities and observed the registers and reporting forms used to report IDSR priority conditions and the availability of IDSR guidelines.Results: The five HFs submitted monthly reports from June to August 2017 with a calculated completeness of 80% in June 2017, 60% in July and 40% in August. Timeliness was calculated was at 20% in June, 20% in July and 40% in August. IDSR officers observed that all five HFs document cases of priority diseases in registers during consultations and use daily tally sheets. However, it was observed that diseases reported through the immediate diseases notification system were not all documented in the morbidity registers and vice versa. Health workers reported to be unaware about all diseases that require immediate notification to trigger investigation, hence some disease like perinatal deaths were never notified through the IDNS system during the period of evaluation. All five hospitals reported not utilizing the standard cases definitions provided to identify and report IDSR priority diseases.Conclusions: The proportion of completeness and timeliness from the five HFs during the evaluation period was low compared to WHO recommended standards of >= 80% from all HFs. This therefore, poses challenges in monitoring and responding to the priority conditions as per IDSR standards and recommendations. All five hospitals reported not utilizing the standard cases definitions to identify and report IDSR priority diseases and this poses challenges in comparison of data across sites, monitoring priority diseases, conditions and events and also identifying the alert or epidemic thresholds. There is need to capacitate more health workers on IDSR for Swaziland to strengthen PHS and be able to prevent and control public health threats timely.

Scaling Up and Tailoring the "Putting Public Health in Action" Training Curriculum.

Despite access to a growing menu of evidence-based interventions, public health practitioners continue to underuse them, in part because practitioners may require new knowledge, skills, and resources to do so. Numerous foundations, universities, governmental agencies, and consultants are providing trainings to address the gaps in practitioners' capacity. To most significantly affect population health, these trainings need to reach practitioners who may have limited access to on-site trainings. Despite the number of organizations offering trainings, little is known about how to scale up trainings to efficiently extend their reach or how to tailor trainings to the needs of different intervention. The Cancer Prevention and Control Research Network and its collaborating centers have developed a training curriculum and delivered it in both in-person and distance formats to a range of audiences. The purpose of this article is to describe the training curriculum and findings from the Network's evaluation of approaches used to scale up delivery of the "Putting Public Health Evidence in Action" curriculum and tailor content for specific evidence-based interventions.

An educational initiative in response to identified PrEP prescribing needs among PCPs in the Southern U.S.

ABSTRACTPre-exposure prophylaxis (PrEP) is an effective HIV prevention method, but many primary care physicians (PCPs) have not incorporated PrEP into practice. While PrEP may be a key strategy to reducing high HIV transmission rates in the southern US, knowledge about PrEP prescribing patterns among PCPs in this region is lacking. An online survey was sent to a large network of PCPs at an academic medical center in North Carolina in October 2015. The survey was repeated in September 2016, after an educational intervention that included on-site trainings at 14 PCP offices. Chi-square tests were used to compare PrEP prescribing patterns among providers. The initial survey was sent to 389 PCPs, with 115 (30%) responding. Of these, 78% reported seeing men who have sex with men (MSM). Only 17% had prescribed PrEP. The most frequently identified barrier was lack of knowledge (60%). When the survey was repeated after the educational initiative, 79 PCPs (20%) responded. Of these, 90% reported seeing MSM, and 35% had prescribed PrEP. PCPs who had attended a training were more likely to have prescribed PrEP (OR 4.84, CI 1.77–13.21). In conclusion, PrEP prescribing among PCPs in the southern US is low. A survey among PCPs identified lack of knowledge as a barrier to prescribing, motivating an institutional-wide educational campaign in response. Further efforts are needed to continue to raise awareness and educate PCPs in the South about PrEP.

Access to Interprofessional Continuing Education in Integrated Care Through Digital Instructional Technology

ABSTRACTIn preparing the workforce for integrated care, continuing professional education serves a critical role. Within a rapidly changing health care landscape, matriculated students now benefit from pedagogical innovations supporting integrated care, particularly interprofessional education, and working professionals must not be excluded from this transformation. University-based digital instructional programs can support the learning needs of working professionals, providing an alternative and complement to brick-and-mortar classrooms and ad hoc onsite trainings. This paper describes the structure, content, digital approach, and outcomes of a continuing education program in integrated behavioral health and primary care, housed in a school of social work at a major university. The challenges of interprofessional digital education are described and future directions are suggested.

The role of academician Korzh A. A. in the development of pediatric orthopedics in Yevpatoriya central children's clinical sanatorium of the ministry of defense of Ukraine

The paper analyzed an orthopedic and scientific assistance that was provided by Academician Korzh A. A. and scientists of the Kharkov Research Institute of Orthopedics and Traumatology named after prof. M. I. Sytenko to the specialists of Yevpatoriya Central Children’s Clinical Resort of the Ministry of Defense of Ukraine. Close cooperation between the two hospitals was aimed to the implementation of scientific research results and the achievements of the Institute specialists into the therapeutic and diagnostic work of sanatorium. This fact allowed doctors to master the technique of spinal and large joints surgery, bone grafting and surgical repair after poliomymyelitis and skeletal injuries, etc. All mentioned above improved the quality of medical and rehabilitative care for children with diseases of the musculoskeletal system. In addition, scientists of the Institute provided scientific-technical and advisory assistance in the organization of research, they also led the dissertation research managing by Yevpatoria colleagues. At the initiative of Korzh A. A. and with his direct participation the on-site thematic trainings in pediatric orthopedics were organized for doctors at the sanatorium using specialists from department of traumatology and orthopedics of the Ukrainian Institute of Advanced Medical. 18 scientific conferences were conducted at the sanatorium. The doctors of sanatorium prepared 442 reports in scientific medical journals; published 576 papers and defended 6PhD theses. International recognition of sanatorium as an effective orthopedic-surgical treating and rehabilitation institutions for children with diseases of the musculoskeletal system was one of the achievements of a fruitful collaboration.

Assessment of training and technical assistance needs of Colorectal Cancer Control Program Grantees in the U.S.

BackgroundPractitioners often require training and technical assistance to build their capacity to select, adapt, and implement evidence-based interventions (EBIs). The CDC Colorectal Cancer Control Program (CRCCP) aims to promote CRC screening to increase population-level screening. This study identified the training and technical assistance (TA) needs and preferences for training related to the implementation of EBIs among CRCCP grantees.MethodsTwenty-nine CRCCP grantees completed an online survey about their screening activities, training and technical assistance in 2012. They rated desire for training on various evidence-based strategies to increase cancer screening, evidence-based competencies, and program management topics. They also reported preferences for training formats and facilitators and barriers to trainings.ResultsMany CRCCP grantees expressed the need for training with regards to specific EBIs, especially system-level and provider-directed EBIs to promote CRC screening. Grantees rated these EBIs as more difficult to implement than client-oriented EBIs. Grantees also reported a moderate need for training regarding finding EBIs, assessing organizational capacity, implementing selected EBIs, and conducting process and outcome evaluations. Other desired training topics reported with higher frequency were partnership development and data collection/evaluation. Grantees preferred training formats that were interactive such as on-site trainings, webinars or expert consultants.ConclusionsPublic health organizations need greater supports for adopting evidence-based interventions, working with organizational-level change, partnership development and data management. Future capacity building efforts for the adoption of EBIs should focus on systems or provider level interventions and key processes for health promotion and should be delivered in a variety of ways to assist local organizations in cancer prevention and control.Electronic supplementary materialThe online version of this article (doi:10.1186/s12889-015-1386-1) contains supplementary material, which is available to authorized users.

An Evaluation of Service-Learning Activities: Dietetic Students’ On-Site Food Safety Trainings on Critical Violations at Restaurants in Springfield-Greene County, Missouri

An Evaluation of Service-Learning Activities: Dietetic Students’ On-Site Food Safety Trainings on Critical Violations at Restaurants in Springfield-Greene County, Missouri

The Kid Fitness™ School Program: Effects on Daily Physical Activity

INTRODUCTION: To address the need for increased physical activity (PA) among school-aged children, Kid Fitness Inc. developed the Kid Fitness™ Television and School Program. The School Program is a classroom-based, PA and healthy eating promotion program that integrates activity into the elementary school academic curriculum. Seven-minute PA sessions integrated throughout the class day substitute for seated activity and provide content-specific fun routines. PURPOSE: An evaluation of the program was conducted to assess daily PA level using pedometry among first and second grade students. METHODS: A total of nine (9) classrooms were recruited (3 intervention and 6 control). The length of the intervention period was 8 weeks. The Kid Fitness™ modules consisted of DVD activity sessions and lesson plans. All teachers participated in onsite trainings prior to the intervention period. The final sample of participants with complete pre-post data consisted of students from the control classrooms (n = 78) and students from the intervention classrooms (n = 57). The pre-post intervention data were analyzed using SPSS, v17. Descriptive statistics, independent t-tests, and ANCOVA were performed. RESULTS: Independent t-test results showed a significant difference in the baseline average number of steps between the two groups (t[133] = 3.631; p =.001). ANCOVA was used to control baseline scores and to provide unbiased estimates of the program effects. After controlling for differences in baseline scores, there was a significant difference in post-program average number of steps (F[1,132] = 46.07, p <.001). The Kid Fitness™ exposed group students walked more steps (3077 steps) than control classroom students (2320 steps). CONCLUSION: The results of this evaluation suggest that incorporating a fun activity break such as Kid Fitness™ in a lower elementary grade classroom setting demonstrates an increase in children's in-school PA levels. The structured components of this program with focused PA, health context messages, and activities provide a positive environment where students are more likely to engage in greater amounts of PA compared to students exposed to a more traditional curriculum.