Biomedical subjects

Suzanne Cashman

Publications and source records attributed to Suzanne Cashman.

6 recordsLinked to original sources

PubMed2004

Clinical prevention and population health: curriculum framework for health professions.

The Clinical Prevention and Population Health Curriculum Framework is the initial product of the Healthy People Curriculum Task Force convened by the Association of Teachers of Preventive Medicine and the Association of Academic Health Centers. The Task Force includes representatives of allopathic and osteopathic medicine, nursing and nurse practitioners, dentistry, pharmacy, and physician assistants. The Task Force aims to accomplish the Healthy People 2010 goal of increasing the prevention content of clinical health professional education. The Curriculum Framework provides a structure for organizing curriculum, monitoring curriculum, and communicating within and among professions. The Framework contains four components: evidence base for practice, clinical preventive services-health promotion, health systems and health policy, and community aspects of practice. The full Framework includes 19 domains. The title "Clinical Prevention and Population Health" has been carefully chosen to include both individual- and population-oriented prevention efforts. It is recommended that all participating clinical health professions use this title when referring to this area of curriculum. The Task Force recommends that each profession systematically determine whether appropriate items in the Curriculum Framework are included in its standardized examinations for licensure and certification and for program accreditation.

Advisory Committees↗

PubMed2004

Developing and measuring progress toward collaborative, integrated, interdisciplinary health care teams.

In this article we report the results of a longitudinal study of an intervention to enhance interdisciplinary team functioning in a primary care setting. Components of the team development intervention are outlined. Team members' assessments of progress towards expressing values consistent with an effective team--as measured through the System for the Multiple Level Observation of Groups (SYMLOG)--are presented and discussed. Institutional, organizational, and team related supports and barriers that affect the development of collaborative, integrated teams are identified and discussed; implications for ensuring teams' success are presented.

Cooperative Behavior↗

PubMed2004

Applying service-learning through a community-academic partnership: depression screening at a federally funded community health center.

CONTEXT: Increasingly, health care facilities worldwide, particularly those that comprise the safety-net, are finding themselves understaffed and challenged to meet patients' needs. Identifying additional sources of support and resources is critical for facilities to be able to sustain current and develop new initiatives to improve patients' health. APPROACH: We present one community health center's reliance on a partnership with an academic medical/nursing institution to develop and initiate a depression screening and treatment project. Incorporating students to help implement or pilot a needed clinical service for a high prevalence condition presents significant rewards as well as challenges. Nevertheless, an academic-community partnership has the potential to initiate systems change at the clinical level. RESULTS: Using a service-learning modality, medical and nursing students worked with health center providers to initiate a pilot depression screening and treatment program based on the chronic disease model. Implementation of this initiative succeeded in poising the health center for participation in a large, federally supported collaborative on depression in primary care. While students gained insight into some of the challenges faced by safety net providers and their patients, discontinuity in student availability led to uneven pacing in project implementation. CONCLUSION: Curricula that employ a service-learning framework can enable health care facilities world-wide to gain additional resources for needed initiatives. Students' learning experiences can provide an excellent mutually beneficial opportunity as a "jumpstart" for new evidence-based clinical initiatives and demonstration projects. Such programs can help meet the needs of patients while enhancing students' education. However, students can neither make up for staffing shortages nor be expected to maintain programs. In order to be successful for the long term, service-learning projects must skirt the pitfalls of the inherent logistical incompatibilities e.g. schedules and length of commitment, between academic institutions and health care facilities.

Academic Medical Centers↗

PubMed2004

Characteristics of patients at three free clinics.

This study examined factors associated with the use of three free clinics located in Central Massachusetts. A total of 248 patients completed a questionnaire during the 2-month study period. Descriptive results showed a majority of free clinic patients are low-income, uninsured, and female. Many patients (62%) do not have a usual source of care, nor do they know where to go if the clinic is not open (61%). Most (82%) report using free clinics because they lack insurance. Patients who had been using the free clinics longer than 1 year are more likely to use the clinic because of inadequate insurance (p = 0.002) and as a way to obtain prescription drugs (p < 0.001). Although they serve an important need, free clinics cannot provide comprehensive, continuous care. Efforts to provide health care to the medically underserved must take these findings into consideration if they are to be successful.

Adolescent↗

PubMedDate not supplied

Health status of a low-income vulnerable population in a community health center.

Healthcare safety net providers are under increasing pressure to meet the physical and mental health--as well as the range of social service-needs of traditionally vulnerable and hard-to-reach populations. The extent to which health center patients are less well and in poorer health than is the rest of society, thus requiring greater depth and breadth of service, has not generally been the focus of systematic assessment. This case study uses the 12-Item Short-Form Health Survey (SF-12) and selected years of healthy life questions from the National Health Interview Survey to assess the self-perceived health status of patients at one Section 330 community health center in central Massachusetts. Five hundred thirteen patients completed all questions on the SF-12; 619 completed each of the years of healthy life questions. Respondents' physical and mental component summary scores were significantly lower than national norms for all age groups (P < .001). Respondents were also significantly more likely than the civilian noninstitutionalized population to be unable to perform major activities (P < .0001) and to be in fair or poor health (P < .0001). Analyses give an indication of the magnitude of difference in self-perceived health status between this poor, vulnerable population and the citizenry at large and suggest implications for policy related to safety net healthcare facilities.

Adult↗

PubMedDate not supplied

Underdiagnosis of obesity at a community health center.

BACKGROUND: Obesity is at epidemic proportions. This study examined the extent to which obesity is being diagnosed at a community health center residency-training site. Results were examined by provider type. Characteristics of patients with obesity diagnosed by primary care providers were compared with characteristics of patients determined to be obese by body mass index (BMI) calculation exclusively. METHODS: A cross-sectional design was used. Medical records of 465 adult patients were audited. Data collected included diagnosis of obesity, height and weight, demographics, and comorbidity. RESULTS: Of the 465 patients' charts audited, 83 contained a provider diagnosis of obesity, and 74 additional patients were determined to be obese by BMI calculation exclusively. Significant underdiagnosis occurred among all provider types (P = .036). Patients with a diagnosis of obesity had significantly higher BMI scores (38.4 vs 34.4, P = .002). Obesity was more likely to be diagnosed in female than in male patients (P = .001). Differences related to age, insurance coverage, and comorbidity were not significant. CONCLUSIONS: Obesity was found to be an underdiagnosed condition among all provider types. As evidenced by significantly higher BMI scores for provider-diagnosed obesity, the data suggest that the obesity diagnosis is made by appearance. The importance of teaching and modeling the use of BMI to diagnose obesity is underscored.

Adolescent↗