Community-Academic Partnerships: Teaching Medical Students Public Health

1. Community-Academic Partnerships: Teaching Medical Students Public Health American Public Health Association, November 2004 Jan K Carney MD MPH University of Vermont College of Medicine

4. Why Public Health Projects? • All physicians will face public health issues • Multiple determinants of health • Population/community context of individual patients • Increasing need for disease prevention • Partnerships essential

5. Multiple Determinants of Health

6. Why public health projects? • Physicians face a growing list of public health issues in clinical practice today: examples: • Preventing childhood obesity • Emerging infectious diseases • Preventing and caring for chronic conditions in an aging population • IOM recommends that “all medical students receive basic public health training in the population-based prevention approaches to health.”

7. Vermont Integrated Curriculum (VIC) • Implemented at the UVM College of Medicine fall 2003 • Integrates sciences and clinical medicine • Develops skills for life-long learning • Public health competencies

8. Public Health Projectsin the Vermont Integrated Curriculum • MSLG I = first year • Student groups of 8 • May 2004 = project ranking • MSLG II = Public Health Projects • September through December • Second year students • Begin September 2004 • 13 projects per year

9. Themes and Competencies • Professional development • Learning • Leadership and Collaboration • Research and Discovery

10. Goals and Objectives

11. Public Health Projects:Educational Goals • Understand the breadth and scope of public health • Understand current and emerging public health issues • Understand how public health interfaces with clinical medicine • Understand and apply public health research methods

12. Public Health ProjectsEducational Goals • Understand the role of the community in improving individuals’ health • Learn practical ways to improve the health of both individuals and populations • Be creative and have fun!

13. For each Public Health Project: • 1. must address a public health issue • 2. must ask and answer a scientific question • 3. must show a public health benefit

14. Public Health Framework

15. Healthy People 2010Overarching goals • 1. increase quality and years of healthy life • 2. eliminate health disparities

16. Access to quality health services Arthritis Cancer Chronic Kidney Disease Diabetes Disability Educational programs Environmental health Family planning Food Safety Health Communication Heart Disease and Stroke HIV Immunization and Infectious Diseases Injury and violence prevention Maternal, infant and child health Medical Product Safety Mental health Nutrition and overweight Occupational health Oral health Physical activity Public Health Infrastructure Respiratory Diseases Substance abuse Tobacco Vision and Hearing Healthy People 2010Focus Areas

17. Community-Academic Partnerships • Students asked for better way to make a difference • Previous project design reversed: • “Community First”! • Community agencies asked to identify public health needs • Projects designed to meet community-identified needs

18. Community-Academic Partnerships • Link with community agencies • United Way of Chittenden County • Invited proposals – January 2004 • Protocols developed to match HP2010 focus areas and educational goals • May 2004 – student rank and match • IRB process/IRB tutorial

21. Evaluation • Field notes – for peers (COMET) • Written report – • About 10 pages • Background, Methods, Results, Conclusions • For mentors and agencies • Poster presentation – • Visually appealing summary • Professional quality • Suitable for submission to national meeting • January poster presentation at COM

22. Evaluation (cont’) • Grading = Pass/Fail • Student self-assessment • Agency assessment • Faculty mentor assessment • Midpoint and final • Individual contribution and group work • Competency based

23. Project Examples: 2004

25. Public Health Project Titles: 2004 • 1. Navigating a 15 minute doctor visit: Helping patients communicate with their physicians • 2. Public Health for Refugees in Vermont: Public Health in the Home • 3. Healthy Choice for Teens: the path to well-being through diet and exercise (Woodside) • 4. The Built Environment and Health: Promoting healthy and active Vermont communities (VDH)

26. Projects – 2004 (cont’) • 5. Helping patients to help themselves: educational methods to improve access to health care – Lund family center • 6. Teaching young children about nutrition and physical activity: Improving nutrition and physical fitness in YMCA families • 7. Improving health care quality and reducing errors (VNA) • 8. Assessing psychiatry needs at a community mental health center (Howard)

27. Projects 2004- (cont’) • 9. Immunizations are for adults, too: reducing the risk of influenza and pneumococcal disease in a nursing home • 10. Diabetic-friendly food donations: nutritional options for the homebound senior (CCEFS) • 11. Improving the health of the community: educational strategies at the Community Health Center

28. Projects – 2004 (cont’) • 12. Improving the health of Puerto Cabezas, Nicaragua, Burlington’s Sister City • 13. Complementary and Alternative Medicine: Physician beliefs and patient/doctor communication

32. Public Health Projects – Healthy People 2010 areas • Access to Quality Health Services • Health Communication • Environmental Health • Diabetes • Immunizations and infectious disease • Nutrition/Physical Activity • Mental Health

34. Jan K Carney, MD MPH,Associate Dean for Public Health, University of Vermont College of Medicine 371 Pearl St, Burlington VT 05401 (802) 847-8268 Jan.Carney@uvm.edu