Statewide Outreach Research Articles

A Qualitative Evaluation of Health Professionals’ Perceptions State-wide Outreach Perinatal Mental Health Service

A Qualitative Evaluation of Health Professionals’ Perceptions State-wide Outreach Perinatal Mental Health Service

147 Creating a state-wide university network for translational science training

OBJECTIVES/GOALS: We have evaluated the primary factors behind successful expansion of the predoctoral TL1 training grant at OHSU to all research-intensive universities in the state, evaluating the precepts that were key to integration. We also evaluate inclusion of social and behavioral sciences in clinical and translational science training, METHODS/STUDY POPULATION: OHSU contains three professional schools (medicine, nursing, and dentistry) as well as graduate studies in science. There are also three research-intensive universities in Oregon: Portland State University (PSU); Oregon State University (OSU) in Corvallis; and the University of Oregon (UO). We report evaluation of our 7-year experience with a predoctoral TL1 program and the precepts behind successful implementation of statewide outreach. We have tracked applicants from each university and program, trainee feedback, and success of the applicants as measured by persistence in research, inclusion of translational methods, additional training acquired, and subsequent research funding. We also evaluate participation by behavioral and social scientists. RESULTS/ANTICIPATED RESULTS: The predoctoral TL1 has included 40 scholars over 7 years, with 65% PhD graduate students and 35% MD students who pursue an additional research degree (PhD, MCR). Of PhD graduate students, the distribution is similar among universities: OHSU 31%, PSU 19%, OSU 27%, UO 23%. 38% of all graduate student trainees are in behavioral or social science. Key precepts behind success include: concentration on specific graduate programs at each university; implementing a common curriculum based on the MCR curriculum; interinstitutional mentor teams; leadership team that spans universities; required core TL1 activities; and a competitive application process with an interinstitutional review committee. Applicants are required to identify how translational science education enhances their research career. DISCUSSION/SIGNIFICANCE: Creating a statewide resource for TL1 translational science training has increased opportunities to expand translational research throughout Oregon through providing new opportunities to enhance excellence through disseminating resources and training across the universities.

Opportunities to Improve Access to and Retention in the Child and Adult Care Food Program: Key Recommendations From Early Childcare Providers in Illinois, December 2020-July 2021.

Objectives. To identify recommendations to improve access to and retention in the Child and Adult Care Food Program (CACFP) as critical strategies to address health equity for low-income children. Methods. We conducted a qualitative key informant study of early childcare center and home providers (n = 35) in low-income urban and rural census tracts in Illinois between December 2020 and July 2021. Interviews with providers were organized and analyzed by the study team in MAXQDA Qualitative Data Analysis software. Themes were refined and finalized via member checking with an expert panel of providers and advocates. Results. Overall, providers spoke positively of the benefits of CACFP participation. Themes that centered around strategies to improve awareness of and access to CACFP included (1) conducting systematic statewide outreach, (2) improving technical assistance for enrollment, and (3) supporting positive sponsor-provider relationships. Themes related to retention included (1) alleviating procurement burdens, (2) extending reimbursement rates, and (3) expanding flexibilities. Conclusions. Policymakers looking to increase access to and retention in CACFP could consider state-level strategies such as systematic outreach and more targeted technical assistance. (Am J Public Health. 2024;113(S3):S231-S239. https://doi.org/10.2105/AJPH.2023.307433).

A mixed-methods evaluation of a state-wide outreach perinatal mental health service

BackgroundAccess to perinatal mental health services in rural and remote areas is scarce, particularly perinatal psychiatry services. Telehealth, together with psychiatry consultation-liaison services are one way to improve access to areas of need. The New South Wales State-wide Outreach Perinatal Services – Mental Health (SwOPS) program is a Sydney-based program, offering specialist perinatal consultation-liaison services to rural and remote community mental health clinicians caring for perinatal women with significant mental health problems. This study aimed to evaluate healthcare practitioners’ perceptions of the SwOPS program.MethodHealthcare practitioners (N = 31) were purposely recruited to participate in the study. Data were analysed using a mixed-methods cross-sectional design.ResultsMost participants reported being familiar with and satisfied with the service. As a result of accessing the service, participants reported an increase in knowledge and confidence regarding caring for women with moderate-to-severe or complex mental health conditions. Qualitative comments highlight the participant’s perceptions of the program.ConclusionThis study provides useful insights about a state-wide telehealth psychiatry consultation-liaison service from the perspective of practitioners. It highlights the benefits, facilitators, and barriers associated with implementing such services.

A rising tide: California's ongoing commitment to monitoring, managing and enforcing its marine protected areas

In 2012, California completed its marine protected area (MPA) planning and designation process, yielding a network of 124 MPAs from the Mexican border to Oregon. The management effort that has followed is comprehensive and strategic, with a focus on scientific monitoring, interagency coordination, public education and outreach, and enforcement. Initial monitoring results show more and bigger fish, especially in older MPAs where the benefits of limiting fishing have had longer to accrue. Today, California state agencies increasingly acknowledge and contemplate MPA protections in their permitting decisions, as regional and statewide outreach and education efforts enhance public awareness, social capital and stewardship. While enforcement remains challenging in a marine region as large and populous as California, the state has taken important steps to promote compliance with new MPA regulations and—with the support of the state legislature—has strengthened laws to address poaching. As new MPAs are established throughout the world in accordance with global targets, California's post-designation efforts provide a valuable and educational case study for local, national and international MPA managers.

The Medi-Cal Incentives to Quit Smoking Project: Impact of Statewide Outreach Through Health Channels

Little is known about how incentives may encourage low income smokers to call for quitline services. This study evaluates the impact of outreach through health channels on California Medicaid (Medi-Cal) quitline caller characteristics, trends, and reach. Longitudinal study. Medi-Cal quitline callers. Statewide outreach was conducted with health providers, Medi-Cal plans (all-household mailings with tracking codes), and public health organizations (March 2012-July 2015). For incentives, Medi-Cal callers could ask for a $20 gift card; in September 2013, callers were offered free nicotine patches. Caller characteristics were compared with chi-square analyses, joinpoint analysis of call trends was performed accounting for Medi-Cal population growth, referral source among Medi-Cal and non-Medi-Cal callers was documented, and the annual percentage of the population reached who called the Helpline was calculated. Analyses were conducted 2016-2018. Total Medi-Cal callers were 92,900, a 70% increase from prior annual averages: 12.4% asked for the financial incentive, 17.3% reported the mailing code, and 73.3% received nicotine patches while offered. Among the two thirds of callers who completed counseling, 15.5% asked for the financial incentive, and 13.6% reported the mailing code. A joinpoint analysis showed call trends increased 23% above expected for the Medi-Cal population growth after mailings to providers and members began, and decreased after outreach ended. Annual reach increased from 2.3% (95% CI=2.1, 2.6) in 2011 to peak at 4.5% (95% CI=3.6, 5.3) in 2014. Among subgroups with higher reach rates, some also had higher rates of asking for the financial incentive (African Americans, American Indian), reporting the tracking code (whites), or both (aged 45-64 years). Medi-Cal callers were more likely than non-Medi-Cal callers to report providers (32.3% vs 23.8%) and plans (19.7% vs 1.4%) as their referral source, and less likely to cite media (20.2% vs 44.4%, p<0.001). Statewide outreach through health channels incentivizing Medi-Cal members increased the utilization and reach of quitline services. This article is part of a supplement entitled Advancing Smoking Cessation in California's Medicaid Population, which is sponsored by the California Department of Public Health.

Development of carrier testing for common inborn errors of metabolism in the Wisconsin Plain population.

This community project is an initiative through the University of Wisconsin Biochemical Genetics Clinic and the Wisconsin Newborn Screening Program to identify members of the Plain population who are at risk for having children with maple syrup urine disease (MSUD) or propionic acidemia (PA) or who have PA. Because of the high prevalence of metabolic conditions in the Plain population and the importance of early intervention, a statewide outreach project was developed to provide targeted variant analysis of the common MSUD and PA pathogenic variants in this population through health-care provider distribution of blood spot testing kits. Awareness was achieved through outreach efforts with the state midwives guild and Plain population meetings. Eighty individuals were tested; diagnosis was confirmed for three adults with PA and one couple was identified as being at risk for having a child with PA. Genetic counseling was provided to those identified. Follow-up diagnostic testing was completed for the at-risk couple's children; none were found to be affected. This initiative successfully provided accessible clinical testing for MSUD and PA for a high-risk population. Early identification of at-risk couples sets the foundation for early care of at-risk neonates, thereby improving future clinical outcomes.Genet Med 19 3, 352-356.

The study of genetic syndromes in a rural setting.

The syndromal and genetic biology reported and reviewed herein can be studied, analyzed and reported by any "GP" with the required gifts, enthusiasm, drive, and ability to work with collaborators of goodwill at University centers near or far; and most importantly, to continue lifelong education and retraining. Beginning individually in rural Boulder, MT in 1947 it was possible to train in phenotype analysis with methods available to any GP, somewhat later to enlist collaborators at the Universities of Wisconsin and Washington, and finally to establish a genetic services program at a regional medical center (Shodair Children's Hospital in Helena) with fiscal support from the State Legislature amending and extending the prior Newborn Screening Act of Montana. With such financial stability it was possible to attract another physician, genetic counselors and a cytogeneticist to the Shodair Program. This genetic center now has expanded to a staff of 22 with advanced capabilities in cytogenetics, biochemistry and molecular biology (q.v. Elias in this issue). In these past 50 years then I have seen the Montana Genetics Program grow from humble rural beginnings to the amazing center it is now providing statewide outreach services, genetic education and the most advanced diagnostics and research. Now, it may not be inappropriate for me to recommend the Montana model for implementation in other genetically underserved regions throughout the United States.

Statewide Initiative to Embed Consumer Health Librarians in Public Libraries: A Case Study

In 2004 a collaborative, statewide outreach project in Delaware was undertaken where consumer health librarians were embedded in public libraries. In order to explore the effect of the embedded librarians on the quality of health information provision, unobtrusive reference visits were made to half of the public libraries in the state. The query “Do vaccines cause autism?” was posed to library staff; resources provided were recorded. In 67 percent of visits, public library staff provided authoritative health information resources. It appears the embedded librarians had a positive residual effect on the provision of authoritative health resources for addressing an ambiguous query.

Sharing Tails®: A State-Wide Public Outreach Program Teaching Children About Native Arizona Fish

Limited public outreach programs about Arizona native fish exist and those that do are passive, fee-based, or Web-oriented, while others limit their geographic range. The program this article addresses sought to improve this situation with development of a state-wide outreach program with a goal to educate Arizona's children about native fish with an objective to generate excitement about these fish in elementary school children. Through on-site school visits using multimedia, interactive play, and hands-on activities, the Sharing Tails ® program educated 33,285 students about native fish from January 2009 through May 2011.

Existing and Proposed Child Find Initiatives in One State's Part C Program

Despite a Child Find mandate in IDEA, early detection and screening of infants and toddlers with special needs continues to remain an area in need of improvement. The authors sought to better understand existing and proposed outreach initiatives in one state's Part C Early Intervention (EI) program that ranks among the lowest nationally in the area of Child Find. Undergraduate students (n = 17) completed a Child Find reflection as part of an EI Methods course. Parents (n = 10) whose child had received EI and were currently employed in an information-sharing role supporting EI families and staff participated in a semi-structured focus group. Thematic analyses revealed promising district-specific efforts, perceived roadblocks hindering statewide outreach, and recommended strategies that can be used across states in urban and rural areas. Implications for informing state initiatives, supporting brainstorming efforts in other state Part C programs, and conducting targeted studies to strengthen the evidence-base for Child Find initiatives are discussed.

Reaching the Hard to Reach: Lessons Learned from a Statewide Outreach Initiative

Despite high levels of need, many federal assistance programs are underutilized, with differential participation rates among demographic subpopulations. Outreach efforts seek to address challenges facing potentially eligible program recipients. This article examines a statewide initiative to address barriers to participation in the Supplemental Nutrition Assistance Program (SNAP), focusing on the elderly and people with disabilities, eligible immigrants, and low-income working households. We describe a dynamic approach that relies on community partnerships and utilizes media messaging, information dissemination, and direct client assistance to reach our target populations. The data illustrate how continuous evaluation allows for systematic adaptation of strategies, highlighting lessons learned for future outreach efforts.1 1The name of the Food Stamp Program was officially changed as a result of the 2008 Farm Bill to the Supplemental Nutrition Assistance Program. Work reported on here began with the Food Stamp Program and transitioned to SNAP. For purposes of consistency, the program will be referred to as SNAP.

Healthy Lungs: Cancer Education for Middle School Teachers Using a “Train and Equip” Method

Prevention of the initiation of tobacco use, which is associated with increased risk of developing cancer of the lung, the oral cavity, larynx, and emphysema, should target middle school-age children because that is where experimentation with tobacco use usually begins. Millions of children attending school do not receive proper education regarding the biological science of the human respiratory system coupled with the impact that tobacco use has at the cell, tissue, and organ levels of biological organization because their teachers are ill-prepared and ill-equipped to teach this normal and cancer-related content. The University of Arkansas for Medical Sciences has a statewide outreach program that provides middle school teachers training in a "Healthy Lungs" curriculum that covers the normal functional anatomy of the respiratory system as a basis for adding the effect of tobacco use and its associated cancers and emphysema. This training also provides each participant a resource kit of supplies, materials, and items of equipment. A long-term implementation survey identified a high degree of transference of content and use of the resource kit items into new classroom learning activities for the trainee's students for both the normal functional anatomy of the human respiratory system and associated general and cell/tissue/organ-specific cancer biology.

Impact of a community‐based walking program on fruit and vegetable consumption

The purpose of this study was to assess the impact of Walk Across Arizona, a 16 week, statewide outreach walking program, on self‐reported fruit and vegetable (F&amp;V) consumption in adult participants (18–100 yrs). F&amp;V consumption was assessed in pre‐ and post‐program self‐administered surveys that asked amount and what kinds of F&amp;V eaten in the previous day. Changes in F&amp;V consumption were assessed using Wilcoxon matched‐pairs signed‐rank tests. Potential impact of age, body mass index (BMI), and prior physical activity were assessed using multivariate regression. Of the 2,454 adult participants registered for the program, 1,170 (70% female, mean age 50.0 years) reported F&amp;V consumption at both registration and wrap‐up surveys. These participants significantly increased their reported consumption of F&amp;V (p&lt;0.05), while increasing their physical activity level and decreasing their BMI. The change in F&amp;V consumption during the program was associated with baseline F&amp;V consumption, gender, ethnicity, and the average miles reported per week. These findings suggest that a program aimed at increasing physical activity can have an impact on other areas of healthy living in the form of increased F&amp;V consumption. The integration of nutrition messages into the walking program may further increase the consumption of F&amp;V amongst program participants.

Use of the Published Lance Armstrong Cancer Story to Teach Health Science Content to High School Students

Lance Armstrong (2000) authored a book titled It's Not About the Bike--My Journey Back to Life, regarding his battle with testicular cancer. It became a New York Times Bestseller and was selected by the School Library Journal as one of the Best Adult Books for High School Students for 2001. The goal of this project was to determine if this published medical story, along with Mr. Armstrong's status as a world-renowned athlete, could foster interested learning about biology and relevant normal human biology for teachers and their students. A professional development workshop was designed and offered on two occasions to different groups of K-14 teachers (N = 52), and a tele-teaching program was offered multiple times to different groups of Grade 7-12 students (N = 117). A professional evaluator external to the project evaluated both arms of this study. These sessions were part of a statewide outreach program called the Partners in Health Sciences (PIHS) program at the University of Arkansas for Medical Sciences (UAMS). PIHS began in 1991 (Burns, 2002) and as of August 1, 2006 has recorded 66,482 hours of training consumed by 17,004 participants (9,596 of which were Grades 712 students). The PIHS program has included a large amount of cancer-related content (Burns & Lindsey, 2004). Protocol Used Quotes related to the medical and biological aspects of Mr. Armstrong's story were taken from the book (with permission from the publisher) and used as interest hooks/gateways to engage the audience in learning the relevant health science content. The normal and/or cell biology pertaining to each quotation became the workshop syllabus. The title of the workshop and the ITV sessions was: Testicular Cancer and Other Tumors of the Germ Cells: Male and Female - A Detailed Look at the Lance Armstrong Cancer Story. What follows are abbreviated versions of the content presented/discussed in the teacher workshop. The workshop syllabus is at available online at: http://k12education.uams.edu. Sample Syllabus Content I Have Cancer. I'm 25. Why Should I Have Cancer? A neoplasm is a new growth/formation in the body originating in one's own cells, probably as an event in a single cell. Neoplasms exist in two major forms: benign or malignant. All malignant neoplasms are called cancers. Although actually means a swelling, the word tumor is commonly used in place of cancer or neoplasm. In general, the incidence of increases as age increases, but there are certain types of cancers that have a peak incidence in the decades of life. Although a rare disease, testicular has its peak incidence in young men age 18-30. Thus the importance of TSE (testicular self-examination) in this age range (TSE cards were obtained from the Lance Armstrong Foundation and given to all participants). Cancer, unlike an inflammatory process such as an infected hair follicle, abscessed tooth, ingrown toenail, etc., is not usually associated with pain in its stages. Without pain as a warning sign, an stage can be present, but completely un-noticed by the host and the doctor, i.e., it is clinically silent. This is why BSE (breast self examination), TSE, mammography, colonoscopy, digital rectal exam of the prostate, stool guaiac, blood and urine tests, chest X-ray, etc. are so important. They are designed to detect the presence of when the person does not know that is present because nothing hurts and nothing is wrong with any bodily function. It requires a mass containing one billion tumor cells to become morphologically/clinically observable as a very small lesion. It can take several years and 20-30 doublings to produce the one billion cells from the single cell beginning. Consequently, a tumor mass that is diagnosed early by current technological means actually contains at least one billion cells and probably has been silently present for months to years. …

Evaluation of Social Marketing Efforts Designed to Increase Enrollment in the Children's Health Insurance Program (CHIP)

ABSTRACT Expanded eligibility criteria for children in the federally funded Child Health Insurance Program (CHIP) has created unique social marketing challenges because of the need to engage families that historically have not received public support. The purpose of this article is to evaluate statewide outreach strategies to increase CHIP enrollment. Quantitative research identified the outreach strategies used by Ohio counties and determined the counties that demonstrated the greatest increases in child health insurance enrollment. Qualitative research explored consumer and outreach staff perceptions of which marketing strategies led to success. Findings, implications, and application to social marketing theory are discussed.

PATH (Project For Active Teaching Of History): A History Education Community Partnership

The Project for Active Teaching of History (PATH) is designed as a history education community collaborative to enhance the teaching and learning of American history. This paper will provide research findings, critical analysis, and application ideas and issues regarding PATH. The research perspectives focus on achievement of project goals and objectives in the areas of “powerful” teaching and learning and professional development and will focus on case studies regarding the project’s success in improving American history teaching and learning. PATH integrates summer seminars, colloquia, online support, project development, and various outreach projects. A second component, ePATH (electronic Project for the Active Teaching of History), has been established to provide statewide outreach through videoconferencing and additional online support.

A New School's Perspective on Clinical Curriculum

The new predoctoral dental education program at the University of Nevada, Las Vegas, officially began on August 26, 2002. Key concepts identified as foundations for the UNLV clinical curriculum model include Student Active Integrated Learning (SAIL), the need to actively link oral health to systemic health, a sophisticated practice management model, a focus on culturally sensitive statewide outreach, establishing a strong biomedical research base, and development of future faculty. The predoctoral program will be comprised of five general practices. Students from each of the four academic years will be assigned to a practice group; each student will be expected to provide patient care within the scope of his or her current training.

The Alabama Science in Motion Program

DURING the past 30 years, many educators, especially those in secondary science, have become frustrated with traditional teaching methods. Too often, science becomes rote and pedantic; the vitality of scientific inquiry is difficult to incorporate into the formal classroom. To rectify this situation, current educational theory, as reflected in The National Science Education Standards, emphasizes hands-on, inquiry-based learning, typically in a laboratory environment. Unfortunately, lab exercises often require more teacher preparation and classroom resources than more traditional methods. Many schools do not have the resources necessary to support hands-on, inquiry-based learning in the science laboratory. The purpose of this article is to describe the Alabama Science in Motion Program (hereafter abbreviated ASIM), a statewide outreach program supporting science education. The mission of the program is to provide hands-on lab exercises to high school classrooms. ASIM provides equipment, training and expertise. In addition, ASIM delivers lab exercises directly to the schools and works closely with teachers in their own classrooms.

Outreach. The resource of state schools for the deaf.

Sixty-five state supported schools for the deaf were surveyed to obtain basic data on the provision of statewide outreach services. Fifty schools (77%) responded, 41 (82%) of which were engaged in statewide outreach. Twelve states are authorized by statute, 13 by interagency or memorandum of agreement with SEAs (State Education Agency) or LEAs (Local Education Agency). Sixteen states have undertaken these efforts independently or under less formal arrangements. Funding varies--some receive state or federal funds, others include such services as part of their regular budgets. The data contained herein should be valuable to schools and states wishing to become "partners" in the education of deaf children.