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Biomedical subjects

Erica Frank

Publications and source records attributed to Erica Frank.

At least 19 recordsLinked to original sources
PubMed2007

Personal and professional correlates of US medical students' vegetarianism.

OBJECTIVE: To determine prevalence and correlates of US medical students' self-identification as vegetarians. DESIGN: Medical students were anonymously surveyed via questionnaire three times: at freshmen orientation, orientation to wards, and during senior year. SUBJECTS: Medical students in the Class of 2003 (n=1,849) at 15 US medical schools (response rate 80%). OUTCOME MEASURES: We examined self-reported vegetarianism, abstinence from meat items on a food frequency questionnaire, and associations between students' vegetarianism and their health-related outcomes. STATISTICAL ANALYSES: Bivariate associations were tested with chi(2) tests. RESULTS: During medical school, 7.2% of students self-identified as vegetarians; this percentage declined over time. Those who were vegetarians for health reasons (66% of vegetarians) ate more fruits and vegetables than those who were vegetarians for nonhealth reasons (P=0.02). Vegetarians were more likely (P<0.01) than nonvegetarians to eat more fruits and vegetables (P=0.002); be women (P=0.009); be Hindu, Buddhist, or Seventh Day Adventist (P< or =0.0004); be politically liberal (P=0.007); have a body mass index < or =25 (P=0.008); or, as freshmen, to perceive nutrition counseling as highly relevant to their intended practices (P=0.007). Vegetarian students were no more likely to counsel patients about nutrition than were nonvegetarians. CONCLUSIONS: Prevalence of vegetarianism was higher among US medical students than among other US adults, although the prevalence declined during medical school. Medical students and physicians with healthful personal practices are more likely to encourage such behaviors in their patients, although the specific nutrition habit of vegetarianism among medical students was unassociated with their nutrition counseling practices.

Adolescent↗
PubMed2006

Predictors of US medical students' prevention counseling practices.

OBJECTIVE: To understand predictors of medical students' prevention counseling practices. METHODS: We surveyed medical students (n=2316 individuals) in the Class of 2003 at freshman orientation, and again at entrance to wards and senior year in a nationally representative sample of 16 US medical schools (response rate=80.3%). MAIN OUTCOME MEASURES: Perceived relevance of prevention counseling and seniors' frequency of prevention counseling. RESULTS: Healthier personal practices (p<0.0001), intention to become a primary care practitioner (p=0.0007), and attending a medical school that encouraged healthy personal practices (p=0.002) significantly predicted the frequency with which seniors reported currently counseling patients about preventive interventions (using a validated measure). Perceived counseling relevance was also significantly predicted by intention to become a primary care practitioner (p<0.0001), attending a school that encouraged healthy personal practices (p=0.0007), being earlier in one's training (p<0.0001), more interested in prevention (p<0.0001), female (p<0.0001), non-White (p=0.007), and by having healthy personal practices (p=0.008). CONCLUSIONS: Several of the variables predicting physician counseling also predict US medical students' reporting counseling (especially personal health practices and specialty type). In addition, the avidity with which medical schools encourage students to be healthy significantly influences their reported patient counseling. These findings can give a fresh, evidence-based direction to help create physicians who counsel patients about prevention.

Adult↗
PubMed2006

Experiences of belittlement and harassment and their correlates among medical students in the United States: longitudinal survey.

OBJECTIVE: To determine medical students' perceptions of having been harassed or belittled and their correlates, for the purposes of reducing such abuses. DESIGN: Longitudinal survey. SETTING: 16 nationally representative US medical schools. PARTICIPANTS: 2884 students from class of 2003. MAIN OUTCOME MEASURES: Experiences of harassment and belittlement at freshman orientation, at entry to wards, and in senior year by other students, by residents or fellows, by preclinical professors, by clinical professors or attendings, or by patients. RESULTS: 2316 students provided data (response rate 80.3%). Among seniors, 42% (581/1387) reported having experienced harassment and 84% (1166/1393) belittlement during medical school. These types of abuse were caused by other students (11% (158/1389) and 32% (443/1390) of students experienced such harassment or belittlement, respectively). Harassment and belittlement was also caused by residents (27% (374/1387) and 71% (993/1393)), preclinical professors (9% (131/1386) and 29% (398/1385)), clinical professors (21% (285/1386) and 63% (878/1390)), and patients (25% (352/1387) and 43% (592/1388)). Only 13% (181/1385) of students classified any of these experiences as severe. Medical students who reported having been harassed or belittled did not differ significantly from those not reporting such experiences by sex, ethnicity, political orientation, or religion. They did differ significantly by chosen specialty and were significantly more likely to be stressed, depressed, and suicidal, to drink alcohol or to binge drink, and to state that their faculty did not care about medical students. They were also significantly less likely to be glad they trained to become a doctor. CONCLUSION: Most medical students in the United States report having been harassed or belittled during their training. Although few students characterised the harassment or belittlement as severe, poor mental health and low career satisfaction were significantly correlated with these experiences.

Aggression↗
PubMed2006

Basic demographics, health practices, and health status of U.S. medical students.

BACKGROUND: There has never been a nationally representative survey of medical students' personal health-related practices, although they are inherently of interest and may affect students' patient-counseling practices. METHODS: To determine basic health practices and status, a survey was conducted of medical students (n =2316 individuals responding to > or =1 survey) in the Class of 2003 at freshman orientation, entrance to wards, and senior year in a nationally representative sample of 16 medical schools (response rate=80.3%). RESULTS: Most medical students (84%) reported never having smoked cigarettes, and both genders typically drank two drinks per drinking episode (with bingeing more common among men). Students exercised a median of at least 4 hours per week, and preferred strenuous exercise. Medical students across all years and both genders reported a median of 7 hours of sleep per night. Nearly all (97%) reported their health to be at least good, typically with 1 or fewer days of poor physical or mental health in the past month. Both genders (particularly women) were unlikely to be overweight or obese. Reported rates of any chronic condition were < or =2% except for hypertension among men, and obesity, dyslipidemia, and depression in both genders. Unlike their other relatively positive behaviors compared with their peers, medical students had variable rates of preventive screening. CONCLUSIONS: Medical students in the United States were healthy, and reported many good health behaviors when compared with other young U.S. adults. However, for some, health behaviors and personal health practices either did not meet national goals or placed students at risk.

Alcohol Drinking↗
PubMed2006

Vitamin and mineral supplement use among US medical students: A longitudinal study.

OBJECTIVE: To provide data on medical students' multivitamin and calcium supplement use during medical school. DESIGN: Medical students were anonymously surveyed at three time points: freshman orientation, orientation to wards, and during senior year. SUBJECTS: Medical students (n = 2,316) at 16 US medical schools (response rate = 80.3%). OUTCOME MEASURES: Prevalence and correlates of multivitamin and calcium supplement use throughout medical school. STATISTICAL ANALYSES: Chi2 tests with associated P values, and logistic regression with associated odds ratios and confidence intervals. RESULTS: Half of medical students surveyed used multivitamins, and 19% used calcium supplements, at least once per week as freshmen. Consumption of calcium, but not multivitamin, supplements increased during subsequent years (P = 0.0001) and both supplements were more commonly used by women (P < 0.0003). Of 970 students tracked across all three time points, 14% of women, compared with only 2% of men (P < 0.0001), took calcium at all three time points. Using multivariate models, we found that medical students were more likely to use multivitamins if they exercised regularly, had children, were underweight, or were women who were not heavy users of alcohol (P < 0.0001 to P < 0.05). Similarly, students who were women, underweight, exercised regularly, or had a personal or family history of osteoporosis were more likely to consume supplemental calcium (P < 0.0001 to P = 0.04). CONCLUSIONS: Medical students of all types used supplements at moderate rates, and women used supplements more commonly and consistently than did men. Medical students, especially nonunderweight and nonexercising students, may be particularly important targets for messages regarding appropriate and adequate vitamin/mineral use.

Adult↗
PubMed2006

Clinical and personal intimate partner violence training experiences of U.S. medical students.

OBJECTIVE: To learn about U.S. medical students' attitudes, experiences, and practices regarding intimate partner violence (IPV). METHODS: In a sample reflective of all U.S. medical schools, we surveyed the class of 2003 in 16 U.S. medical schools at three different times in their training. RESULTS: A total of 2316 medical students responded, for a response rate of 80%. By senior year, although 91% of medical students reported receiving at least some training in discussing IPV, only one fifth reported extensive training. Although 73% of students entering wards thought IPV was highly important for physicians to discuss with patients, only 55% of students entering wards, decreasing to 35% of seniors, thought IPV would be highly relevant to their own practice. Only 55% of seniors reported talking with general medicine patients at least sometimes about IPV. Greater frequency of discussing IPV for seniors was associated with being a woman (60% vs. 50% for men, p = 0.006), self-designating as politically moderate or liberal (p = 0.0008), and thinking (on entering wards) that it was highly important for physicians to talk to patients about IPV (p = 0.0002). Perceived relevance of discussing domestic violence to intended practice was substantially higher among women, underrepresented minorities, those having a personal or family history of domestic violence, and those categorizing themselves as politically liberal or very liberal. Among seniors, the prevalence of reporting a personal history of IPV was 3% for women and 1% for men; 12% of women and 7% of men reported a family or personal IPV history. CONCLUSIONS: Despite national interest in IPV issues, efforts in U.S. medical schools to increase IPV screening and prevention have not achieved saturation. These gaps in IPV instruction in medical schools are a concern because studies have reported that physicians who receive IPV education training are significantly more likely to screen for it.

Adult↗
PubMed2006

Predictors of nutrition counseling behaviors and attitudes in US medical students.

BACKGROUND: Nutrition counseling by physicians can improve patients' dietary behaviors and is affected by physicians' nutrition practices and attitudes, such as the perceived relevance of nutrition counseling. OBJECTIVE: The objective was to provide data on medical students' perceived relevance of nutrition counseling, reported frequency of nutrition counseling, and frequency of fruit and vegetable intakes. DESIGN: Students (n = 2316) at 16 US medical schools were surveyed and tracked at freshmen orientation, at the time of orientation to wards, and in their senior year. RESULTS: Freshmen students were more likely (72%) to find nutrition counseling highly relevant than were students at the time of ward orientation (61%) or during their senior year (46%; P for trend = 0.0003). Those intending to subspecialize had lower and declining perceptions of counseling relevance (P for trend = 0.0009), whereas the perceived relevance of counseling by primary care specialists remained high (P for trend = 0.5). Students were significantly more likely to find nutrition counseling highly relevant if they were female, consumed more fruit and vegetables, believed in primary prevention, had personal physicians who encouraged disease prevention, or intended to specialize in primary care. Only 19% of students believed that they had been extensively trained in nutrition counseling, and 17% of seniors reported that they frequently counseled their patients about nutrition. Students who consumed more fruit and vegetables, believed that they would be more credible if they ate a healthy diet, were not Asian or white, or intended to specialize in primary care counseled patients about nutrition more frequently. Medical students consumed an average of 3.0 fruit and vegetable servings/d, which declined over time. CONCLUSIONS: The perceived relevance of nutrition counseling by US medical students declined throughout medical school, and students infrequently counseled their patients about nutrition. Interventions may be warranted to improve the professional nutritional practices of medical students.

Adolescent↗
PubMed2006

Firearm-related personal and clinical characteristics of US medical students.

BACKGROUND: Firearm injuries are the second leading cause of fatal injury in the US, and several medical specialty societies encourage patient counseling about firearm injury prevention. Because personal choices. influence physicians' willingness to counsel, it would be valuable to know how frequently guns are kept in the homes of physicians-in-training, as well as their perceptions and current rates of counseling about firearm injury prevention. METHODS: At a nationally representative sample of 16 medical schools, we surveyed the class of 2003 at freshman orientation, entrance to wards, and during senior year. RESULTS: A total of 2,316 students provided data (response rate = 80.3%). Among freshmen, 16% reported living in a home with a firearm, 13% did so at entry to wards, as did 14% of seniors (14% overall, women = 9%, men = 19%). Only 34% of seniors reported counseling their patients more often than "never/rarely" about firearm possession and storage. CONCLUSIONS: US medical students reported substantially lower rates of household gun ownership than the general population, but their participation in firearm-related counseling is also low.

Adult↗
PubMed2005

A description and qualitative assessment of a 4-year intervention to improve patient counseling by improving medical student health.

BACKGROUND: To test whether promoting medical student health could efficiently improve patient counseling, we developed and implemented a 4-year-long curricular and extracurricular intervention to promote healthy behaviors among students in the Class of 2003 at Emory University School of Medicine, Atlanta, Georgia. METHODS: We asked students: (1) "What did you think about these [listed intervention components]"; (2) "did any of these interventions influence your personal health habits/attitudes toward your personal health"; and (3) "did any of these interventions influence your behavior or attitudes regarding current or future clinical practices, including history taking or counseling? If so, how? If not, why not?" Students evaluated the effectiveness of these formats and proposed changes in our intervention. The focus groups were transcribed and analyzed with QSR N5. RESULTS: Several major themes emerged from the focus groups: Listen to the students early, often, substantively, and noticeably; Incorporate many faculty and student leaders; Quietly integrate the curricular activities into the regular curriculum; Provide a strong, science-based, pragmatic prevention curriculum to complement the personal health promotion; Don't just use lectures to teach; Offer plentiful, nonrequired, fun extracurriculars; Don't nag; Have achievable interventions and recommendations; Provide collective data, but don't overexpose the students to it, and don't assume that collective data apply to every student, especially if it's unpleasant news; Provide personalized data where possible; and Uncouple evaluations from the intervention, and keep evaluations brief. CONCLUSIONS: Some students seemed pleased to have their medical school be attentive to their health, and believed that the project positively influenced their personal health practices and clinical practices (which was our goal). The students enjoyed many components of the intervention, especially the extracurricular activities, and recognized that they and their classmates were at risk for unhealthy behaviors that had personal and clinical implications. However, many also felt resentful and that they were nagged. Although we had anticipated these responses, and had therefore taken pains to avoid the things that the students most resented, we were insufficiently sensitive to how strong those responses would be.

Attitude of Health Personnel↗
PubMed2005

Potential effects of the next 100 billion hamburgers sold by McDonald's.

BACKGROUND: McDonald's has sold >100 billion beef-based hamburgers worldwide with a potentially considerable health impact. This paper explores whether there would be any advantages if the next 100 billion burgers were instead plant-based burgers. METHODS: Nutrient composition of the beef hamburger patty and the McVeggie burger patty were obtained from the McDonald's website; sales data were obtained from the McDonald's customer service. RESULTS: Consuming 100 billion McDonald's beef burgers versus the same company's McVeggie burgers would provide, approximately, on average, an additional 550 million pounds of saturated fat and 1.2 billion total pounds of fat, as well as 1 billion fewer pounds of fiber, 660 million fewer pounds of protein, and no difference in calories. CONCLUSIONS: These data suggest that the McDonald's new McVeggie burger represents a less harmful fast-food choice than the beef burger.

Animals↗
PubMed2005

Interpretation of the BBT chart: using the "Gap" technique compared to the Coverline technique.

OBJECTIVE: The aim of the study was to compare the accuracy of the Gap and Coverline techniques of interpreting the basal body temperature chart. METHODS: We compared the proportion of menstrual cycles for which the Gap and Coverline techniques accurately identified the post-ovulatory final fertile phase (FFP) and the initial infertile phase (IIP) and the median number of days each overestimated the fertile period, using urinary LH testing as the gold standard. RESULTS: The Gap and Coverline techniques identified the FFP within +/-1 day of that identified by LH testing in 13/33 (39%) and 10/33 (30%) cycles (chi2=0.6; p=.44), respectively, and the IIP within +1 day of that of LH testing in 13/33 (55%) and 4/33 (12%) cycles, respectively (chi2=13.4; p<.001). The Gap and Coverline techniques overestimated the fertile period by 1 and 4 days, respectively (p=.0002). CONCLUSION: Based on this small study, the Gap technique appears to be more accurate than the Coverline technique in identifying the post-ovulatory IIP.

Adult↗
PubMed2005

Validation of a brief diet survey instrument among medical students.

Our objective was to assess the reproducibility and accuracy of fat and of fruit and vegetable items on a 43-item food frequency questionnaire (FFQ) previously self-administered by students at 16 US medical schools. Five in-person, 24-hour recalls were administered between two FFQ administrations to 88 medical students. Reported fat intake decreased from the first (34.7%) to the second (33.1%) FFQ administration ( P <.001); the reproducibility correlation was r =0.63. Fat intake from recalls (28.4%) was lower than that from the FFQ (33.8%, P <.001). The Pearson correlation was r =0.36. Fruit and vegetable servings per day were 3.9 and 3.7 from the first and second FFQ, respectively ( P =.5); the reproducibility correlation was r =0.77. Fruit and vegetable servings were marginally higher from recalls (4.3) than from the FFQ (3.8, P =.06). The Pearson correlation for fruit and vegetable servings was r =0.50. This brief FFQ provides acceptably reproducible and valid estimates of fruit and vegetable servings per day among most groups of medical students, but overestimates fat as a percentage of energy intake.

Adult↗
PubMed2004

Personal health promotion at US medical schools: a quantitative study and qualitative description of deans' and students' perceptions.

BACKGROUND: Prior literature has shown that physicians with healthy personal habits are more likely to encourage patients to adopt similar habits. However, despite the possibility that promoting medical student health might therefore efficiently improve patient outcomes, no one has studied whether such promotion happens in medical school. We therefore wished to describe both typical and outstanding personal health promotion environments experienced by students in U.S. medical schools. METHODS: We collected information through four different modalities: a literature review, written surveys of medical school deans and students, student and dean focus groups, and site visits at and interviews with medical schools with reportedly outstanding student health promotion programs. RESULTS: We found strong correlations between deans' and students' perceptions of their schools' health promotion environments, including consistent support of the idea of schools' encouraging healthy student behaviors, with less consistent follow-through by schools on this concept. Though students seemed to have thought little about the relationships between their own personal and clinical health promotion practices, deans felt strongly that faculty members should model healthy behaviors. CONCLUSIONS: Deans' support of the relationship between physicians' personal and clinical health practices, and concern about their institutions' acting on this relationship augurs well for the role of student health promotion in the future of medical education. Deans seem to understand their students' health environment, and believe it could and should be improved; if this is acted on, it could create important positive changes in medical education and in disease prevention.

Adult↗
PubMed2004

Personal and clinical exercise-related attitudes and behaviors of freshmen U.S. medical students.

To determine personal and clinical exercise-related attitudes and behaviors of freshmen U.S. medical students, we surveyed 1,906 entering freshman medical students (response rate = 87%; average age = 24 years) in 17 U.S. medical schools. Students reported a median of 45 min/day of exercise, 80 min/week each of mild and moderate exercise, and 100 min/week of strenuous exercise. Nearly all students (97.6%) engaged in some moderate or vigorous exercise in a typical week. Sixty-four percent complied with U.S. Department of Health and Human Services exercise recommendations. Most freshmen (79%) believed it would be highly relevant to their future practices to counsel patients about exercise; predictors included intention to provide primary care, excellent health, prevention emphasis by their personal physician, and performing more strenuous exercise.

Adult↗