IntroductionThis paper presents work in the continuum of campus-community partnerships to train health science students to advance health equity. The authors share the development, implementation, and evaluation of “Interprofessional Approaches to Health Disparities” (IAHD), a course offered at the University of Illinois Chicago, a large, urban, public, academic institution.MethodsThe IAHD course focuses on selected vulnerable populations: Geriatrics, HIV/AIDS, Homelessness, Immigrant and Refugee Health, Incarcerated Populations, and Intimate Partner Violence. Health science students from medicine, nursing, pharmacy, dentistry, and public health learn in interprofessional teams, with didactic and experiential learning activities. Training includes addressing social determinants of health through interprofessional education and mentored community-based participatory research projects. The Kirkpatrick’s framework was used for program evaluation, with a retrospective pre-post design to measure self-efficacy for competence in interprofessional collaborative practice (IPC) using IPECC-SET, a validated instrument. The evaluation goal was to explore the impact of the learning experiences on attainment of learning objectives. Descriptive analysis of quantitative data explored the extent to which the learning objectives were met. Paired t-tests examined pre-post differences in self-efficacy for competence in IPC. Thematic analysis was conducted for open-ended qualitative data.ResultsSince its inception, 202 students have participated in the course. Program evaluation results indicate that students view the learning experiences positively; cumulatively, over 90% agreed that the course learning objectives were met. Analysis of the IPECC-SET data demonstrated statistically significant (p < 0.001) increases in self-efficacy for IPC across all 38 items, in all four domains. Qualitative data analysis yielded themes regarding the most effective aspects of the course and how learning experiences prepared students for their future work.DiscussionThus far, eleven cohorts of interprofessional health science students have been trained as a cadre of future health professionals, encouraged to continue practicing advocacy, leadership, scholarship, and interprofessional teamwork to advance health equity. The IAHD course is an exemplar of “Education in Action” and has led to meaningful contributions to the training of the future health professions workforce. It addresses workforce development needs, with a special focus on mitigating health disparities and advancing health equity to meet the challenges of the 21st century.

Purpose To investigate the impacts of The Patient-centered Medicine (PCM) Scholars Program – a longitudinal curriculum designed to inculcate attitudes, values, and competencies to practice patient-centered medicine, with a special focus on underserved populations, addressing social determinants of health and health disparities, and advancing health equity and social justice – on graduates’ career choices and practice behaviors. Methods Cross-sectional online survey of 2010–2017 program graduates (N=191) and analysis of residency placement data 2010–2024 from an institutional website. Sixty-three graduates responded to the survey, translating to a 33% response rate. Results Eighty-five percent of respondents reported that the program prepared them to provide patient-centered care for underserved and vulnerable patients. The most important PCM skills applied in practice included: building relationships with patients, communicating well with patients, and practicing collaborative decision-making. For residency training, 53% of graduates chose primary care settings, and 67% chose to work in underserved settings. The open-ended data revealed that students strongly valued the following aspects of the PCM Scholars Program: exposure to patient experience, dedication to serving the underserved, and building relationships with patients. Conclusions Our study provides evidence regarding the impacts of the PCM Scholars Program graduates’ career choices and their competencies to practice patient-centered care. The PCM Scholars Program has led to meaningful contributions to training the future healthcare workforce, to address the needs of our evolving patient populations with a special focus on advancing social justice and health equity. Long term, this work will continue to focus on bridging the gap between health professions education and practice and creating transformative educational innovations responsive to the need for a highly trained healthcare workforce that can meet the challenges of the 21st century.

This pilot study explored the relationship between self-reported trauma exposure, psychopathology, and coping strategies and preventive health behaviors (PHBs) and self-rated health (SRH) in a sample of clinic patients in a large, urban health system. Results indicated that trauma exposure explained only a small portion of the variance in PHBs and SRH. Higher trauma exposure was not associated with lower PHB engagement, suggesting that trauma’s impact on health behaviors may be more nuanced. Specifically, current self-reported psychopathology, including depression, anxiety, and PTSD, was negatively correlated with PHB engagement, and coping strategies accounted for additional variance in PHBs beyond trauma and psychopathology. SRH was significantly influenced by trauma exposure, especially in the presence of psychological distress, but no significant relationship was found between SRH and coping strategies. These results underscore the importance of screening for current psychopathology and coping strategies in healthcare settings, rather than solely focusing on trauma history. Although trauma informed healthcare interventions may focus on screening for trauma, our results suggest that programs should prioritize mental health screening and coping assessment to better address individuals’ health risks and promote resilience. Future research should investigate how various types of trauma may differentially impact patients’ health behaviors and coping.

Increasing the number of students who have learned to provide competent HIV care and prevention services is expected to reduce future HIV workforce shortages. To achieve this goal, the Midwest AIDS Training Education Center (MATEC) at the University of Illinois Chicago embarked on a project to integrate the existing National HIV Curriculum (NHC) into the curricula of accredited graduate programs in medicine, nursing, and pharmacy to enhance the quality of HIV education at 23 health profession programs (HPPs) in the midwestern part of the United States between 2019 and 2022. This article describes the curriculum integration process and presents outcomes at the student level. HPPs completed faculty pre- and post-integration surveys for each course in which they integrated content from the NHC. The data from these surveys were used to describe the integration process. After studying material from the NHC, students completed a retrospective endpoint assessment designed to measure changes in knowledge of HIV prevention and care and intent to provide care to people with HIV and those at high risk of HIV in their future careers. All the surveys were created in Qualtrics and administered online. Paired t-tests were performed using SAS v. 9.4 to assess changes in knowledge and intent to work with people with HIV. The NHC was integrated into 211 courses with an enrollment of 12,822 students. Integration strategies varied by profession discipline, with nursing programs preferring to use online self-study, medicine programs incorporating the NHC in lectures, and pharmacy programs creating learning groups on the NHC’s e-learning platform. Students across all three health disciplines reported statistically significant increases in knowledge of HIV prevention and care services and intent to provide care to people with and at high risk of HIV. The NHC can be successfully integrated into the curricula of HPPs with positive outcomes for students. Given the current shortage of HIV clinicians, this intervention can have a positive impact on expanding the HIV workforce and provide a model for integrating national curricula at the preprofessional graduate level.

The Clinician Scholars Program (CSP) was designed to expand the HIV care workforce by improving the clinical capacity of clinicians in underserved areas. This evaluation assessed program participants' long-term practice changes and system changes. The year-long program combined mentoring, training, and on-site clinical observation. Qualitative interviews (N = 46) were conducted with Scholars at least 2 years following CSP, supplemented by a 2023 survey. Multiple coders analyzed transcripts using open coding. Thematic analysis explored practice changes and efforts to move patients along the HIV care continuum. Findings indicate positive long-term impacts of CSP regarding the HIV care continuum and care system engagement. Over 90% of Scholars remained working in HIV care, with 75% maintaining or increasing patient loads and 72% making changes to their clinical practice. This training model appears to enhance care along the HIV care continuum and may be adaptable to other contexts that address complex chronic conditions.

The value of health care delivered via effective interprofessional teams has created an imperative for interprofessional education (IPE) and interprofessional collaborative practice (ICP). To inform IPE strategies, we investigated differences in perceived self-efficacy (SE) for competence in ICP among health professions students. The study data were collected between 2015 and 2019 from students from 13 different health professions programmes (N = 3,497) before an annual institutional interprofessional programme. Students completed the IPECC-SET-27, a validated instrument evaluating perceived SE for competence in ICP, and rated their 1) amount of previous contact with, and 2) perceived understanding of, the role of different health professions. Students in different health professions education programmes were compared using parametric statistics. Regression analyses explored factors influencing SE for competence in ICP. Findings revealed significant differences in perceived SE for competence in ICP between programmes (p < .05). Specifically, health information management/health informatics, dentistry, medicine, and nursing students expressed relatively higher SE, whereas physical therapy and occupational therapy students expressed relatively lower SE. Perceived understanding of the role of health professions (p < .01) and gender (p < .01) contributed significantly to predicting perceived SE for competence in ICP, while the amount of previous contact with other health professions did not (p = .42). The findings highlight the value of designing IPE with consideration of specific learner needs.

Introduction:Childhood experiences affect health across the lifespan. Evidence-based strategies targeting early-life stress are emerging. Nevertheless, faculty physicians' preparation to incorporate this science into practice has not been well studied. This study explores medical faculty knowledge and beliefs, timing and route of knowledge acquisition, perceived relevance and application of study topics, and characteristics associated with concept mastery.Methods:The authors developed and administered an exploratory survey to faculty from six departments at two medical schools. The team analyzed responses using quantitative and qualitative methods.Results:Eighty-one (8.8%) eligible faculty completed the survey. Of respondents, 53 (65.4%) achieved high knowledge, 34 (42.0%) high beliefs, and 42 (59.1%) high concept exposure question scores, but only 6 (7.4%) through a formal route. Although 78 (96.8%) respondents indicated that survey concepts are relevant, only 18 (22.2%) reported fully incorporating them in their work, and 48 (59.2%) identified the need for additional coaching. Respondents reporting full incorporation were significantly more likely to attain high concept exposure scores (17 respondents, 94.4%, versus 25 respondents, 39.7%,P< .001). Quantitative and qualitative analysis highlighted limited respondent awareness of trauma prevalence among health care workers, lack of familiarity with interventions, and time and resource challenges addressing childhood adversity.Discussion:Although survey respondents had some familiarity with study concepts and perceived their relevance, most are not fully applying them. Results suggest that exposure to study concepts is associated with full incorporation. Therefore, intentional faculty development is essential to prepare faculty to include this science in practice.

This integrative review identified challenges for interprofessional home care and provided recommendations for improving geriatric home care. A search of six databases identified 982 articles; 11 of them met the review's eligibility criteria and were included in the review. Quality appraisal of the included studies was performed using two tools (Critical Appraisal Skills Program for Qualitative Research and Mixed Methods Appraisal Tool), and their overall methodological quality was found to be satisfactory. After applying D'Amour et al.'s framework, four "challenge" themes emerged: (1) lack of sharing, (2) lack of partnership, (3) limited resources and interdependency, and (4) power issues. Recommendations included providing practical multidisciplinary training guided by a standardized model, establishing streamlined communication protocols and a communication platform reflecting the actual needs of users by involving them in its design, and asking interprofessional team members to commit to home care planning and to cultivate a collaborative culture and organizational support.

BACKGROUND:Despite advances in knowledge and science, evidence indicates that health care disparities and inequities continue to exist across diverse populations. Educating and training the next generation of health professionals to focus on addressing social determinants of health (SDOH) and advancing health equity is a key priority. This aim requires educational institutions, communities, and educators to strive for change in health professions education, to attain the goal of creating transformative educational systems that better meet the public health needs of the 21st Century.PURPOSE AND OUTCOMES:Communities of practice (CoPs) are groups of people who share a concern or a passion for something they do and learn how to do it better as they interact regularly. The National Collaborative for Education to Address Social Determinants of Health (NCEAS) CoP is focused on integrating SDOH into the formal education of health professionals. The NCEAS CoP is one model to replicate how health professions educators can work together for transformative health workforce education and development. The NCEAS CoP will continue to advance health equity by sharing evidence-based models of education and practice that address SDOH and help build and sustain a culture of health and well-being through sharing models for transformative health professions education.CONCLUSIONS:Our work is an example that shows we can build partnerships across communities and professions, thereby freely sharing ideas and curricular innovations that address the systemic inequities that continue to fuel persistent health disparities and inequities, and contribute to moral distress and burnout of our health professionals.

Background: Hypertension (HTN) accounts for one in five deaths of American women. Major societies worldwide aim to make evidence-based recommendations for HTN management. Sex- or gender-based differences exist in epidemiology and management of HTN; in this study, we aimed to assess sex- and genderbased language in major society guidelines. Materials and Methods: We reviewed HTN guidelines from four societies: the American College of Cardiology (ACC), the American College of Emergency Physicians (ACEP), the European Society of Cardiology (ESC), and the Eighth Joint National Committee ( JNC8). We quantified the sex- and gender-based medicine (SGBM) content by word count in each guideline as well as identified the gender of guideline authors. Results: Two of the four HTN guidelines (ACC, ESC) included SGBM content. Of these two guidelines, there were variations in the quantity and depth of content coverage. Pregnancy had the highest word count found in both guidelines (422 words in ACC and 1,523 words in ESC), which represented 2.45% and 3.04% of the total words in each guideline, respectively. There was minimal coverage, if any, of any other life periods. The number of women authors did not impact the SGBM content within a given guideline. Conclusions: Current HTN management guidelines do not provide optimal guidance on sex- and gender-based differences. Inclusion of sex, gender identity, hormone therapy, pregnancy and lactation status, menopause, and advanced age in future research will be critical to bridge the current evidence gap. Guideline writing committees should include diverse perspectives, including cisgender and transgender persons from diverse racial and ethnic backgrounds.

The number of older Americans, ages 65 years and above, is projected to more than double from 46 million in 2014 to 98 million by 2060.1 Despite these projections, the number of health professionals trained to address the needs of this population is declining and a shortage has been projected across the country by 2025.2-4 To address this health workforce gap, the Institute of Medicine report, Retooling for an Aging America5 calls for enhanced geriatric training across health professions, and a growing body of evidence supports the value of interprofessional education (IPE) and collaborative practice.

Purpose In Egypt, the main challenges to interprofessional education (IPE) implementation are complexity of the required curricular design, the attitudinal barriers between professions, and the needed resources. Action research work was planned and implemented to identify alternative solutions to overcome barriers to IPE in the local Egyptian context. Methods -An 8-week e-learning elective course was developed, implemented, and evaluated. A mixed group of 30 nursing and medical students was enrolled voluntarily in the course. Female to male ratio was 3:2. Four faculty members were assigned to manage the course. Based on the EMRO-WHO guidelines, ethics content was selected and organized. A closed Facebook group was created and utilized as the e-learning platform. Facilitated large-group and case-based discussions were the main instructional methods. Scoring of mixed small group assignments was the main assessment tool. Course evaluation was conducted using the Interprofessional Socialization and Valuing Scale (ISVS) and an Online-Course Evaluation Questionnaire (OCEQ). Results ISVS results revealed that students’ perception of ability, comfort and value in working with others, were all positive. The OCEQ provided additional evidence regarding the satisfaction of students with the Facebook group as a learning platform. Assignment submission rate was 90%. Success rate of small group assignments (scores ≥ 60%) was 100%. Response rate to the open online discussions was 63%. Through peer evaluation as well as direct observation of online discussions, there was evidence of distinct contributions by females and by medical students compared to nursing students. Conclusion As evidenced by the students’ perception and performance, our IPE distance learning experience was valuable. Motivation of medical students as well as females was evident. IPE is a challenging process. The elective approach and using DL can offer solutions. Conducting relevant practical sessions as well as sustainability of this IPE e-learning experience remain key challenges.

Background and Objectives: Schools of medicine in the United States may overstate the placement of their graduates in primary care. The purpose of this project was to determine the magnitude by which primary care output is overestimated by commonly used metrics and identify a more accurate method for predicting actual primary care output. Methods: We used a retrospective cohort study with a convenience sample of graduates from US medical schools granting the MD degree. We determined the actual practicing specialty of those graduates considered primary care based on the Residency Match Method by using a variety of online sources. Analyses compared the percentage of graduates actually practicing primary care between the Residency Match Method and the Intent to Practice Primary Care Method. Results: The final study population included 17,509 graduates from 20 campuses across 14 university systems widely distributed across the United States and widely varying in published ranking for producing primary care graduates. The commonly used Residency Match Method predicted a 41.2% primary care output rate. The actual primary care output rate was 22.3%. The proposed new method, the Intent to Practice Primary Care Method, predicted a 17.1% primary care output rate, which was closer to the actual primary care rate. Conclusions: A valid, reliable method of predicting primary care output is essential for workforce training and planning. Medical schools, administrators, policy makers, and popular press should adopt this new, more reliable primary care reporting method.

Background: Though the prevalence of Alzheimer's disease and related dementias (ADRD) continues to rise, the majority of people feel uninformed and fearful of the disease.Mobile apps are a platform that can offer easy access to comprehensive information, advice, and resources.No apps are available that provide a coordinated, centralized source of information on ADRD, including practical advice to support persons with dementia and help them confront daily challenges throughout the disease continuum.Objective: We examined the utility of a mobile app as a new approach to educating older adults with and without dementia, caregivers, and clinicians on how to navigate the challenging ADRD experience from diagnosis to end of life.Methods: We developed a mobile app, Dementia Guide Expert, to deliver evidencebased and practical information about ADRD.We conducted initial usability testing of the app in older-age adults and practicing clinicians.Results: Beta testing among older adults (n=53) found that the content was engaging and useful but could be reorganized to improve access.Among clinicians (n=20), 50% strongly agreed and 50% agreed that the app provided valuable information and practical advice and would be useful for people with ADRD and their caregivers.The app was launched in December 2017.As of March 2019, the app had been downloaded/viewed 24,353 times in 12 countries and it was recently translated into Spanish.Conclusion: Using a mobile app to disseminate evidence-based information about ADRD is feasible and was well received by both older adults and clinicians.Plans are underway to translate the app into additional languages, which will help in global adoption, increase dementia awareness, and provide the world population with knowledge and skills to better understand and manage the challenges of ADRD.

Background: Worldwide, nearly 570,000 women are diagnosed with cervical cancer each year, with 85% of new cases in low- and middle-income countries. The African continent is home to 35 of 40 countries with the highest cervical cancer mortality rates. In 2014, a partnership involving a rural region of Senegal, West Africa, was facing cervical cancer screening service sustainability barriers and began adapting regional-level policy to address implementation challenges. Objective: This manuscript reports the findings of a systematic literature review describing the implementation of decentralized cervical cancer prevention services in Africa, relevant in context to the Senegal partnership. We report barriers and policy-relevant recommendations through Levesque's Patient-Centered Access to Healthcare Framework and discuss the impact of this information on the partnership's approach to shaping Senegal's regional cervical cancer screening policy. Methods: The systematic review search strategy comprised two complementary sub-searches. We conducted an initial search identifying 4272 articles, then applied inclusion criteria, and ultimately 19 studies were included. Data abstraction focused on implementation barriers categorized with the Levesque framework and by policy relevance. Results: Our findings identified specific demand-side (clients and community) and supply-side (health service-level) barriers to implementation of cervical cancer screening services. We identify the most commonly reported demand- and supply-side barriers and summarize salient policy recommendations discussed within the reviewed literature. Conclusions: Overall, there is a paucity of published literature regarding barriers to and best practices in implementation of cervical cancer screening services in rural Africa. Many articles in this literature review did describe findings with notable policy implications. The Senegal partnership has consulted this literature when faced with various similar barriers and has developed two principal initiatives to address contextual challenges. Other initiatives implementing cervical cancer visual screening services in decentralized areas may find this contextual reporting of a literature review helpful as a construct for identifying evidence for the purpose of guiding ongoing health service policy adaptation.