ABSTRACT
Issue Female genital mutilation (FGM) comprises all procedures that injury female genital organs for non-medical reasons, with several health impacts. Due to global migration, FGM has been increasingly recognised as a healthcare issue in Europe, affecting nearly 1 million women. In Portugal it is estimated that 5483 migrant women have undergone FGM in the Lisbon region. Intervention is required to tackle this issue. Description Portugal launched the “Healthy Practices: End of FGM”, a multiagency project targeting Lisbon and Tagus Valley region. Project implementation started in Nov 2018 at 5 local public health units (PHU) and was scaled-up to 5 more in Feb 2020. Project comprises 3 main axes: 1) inclusion in public policy instruments;2) professionals’ education and awareness;and 3) community intervention. We describe inclusion of FGM in public policy, professionals training and changes in FGM recording before and after intervention. Results Between 2018-2022, inclusion of FGM in municipalities’ migration policies doubled. Between 2019-2021, 110 training sessions (n = 1722 professionals) were promoted. During pandemic years, only 344 (2020) and 202 (2021) were trained. Raising awareness and empowerment to risk communities happened mainly through local/online open sessions, workshops, flyer distribution, video projections. These occurred in all 10 PHU, mostly through partnerships with Non-Governmental Organizations and municipalities. According to the Portuguese Health Records, until 2018 there were only 300 women registered with FGM. Between 2019-2021, 363 more were added. Lessons The multisectoral approach allowed PHU professionals to collaborate directly with external organizations from different society sectors. COVID-19 pandemic posed a challenge to implementation, especially in the community intervention axis. Notification numbers increased after interventions, though causality could not be established and impact evaluation is yet to be performed. Key messages • Multisectoral projects for FGM intervention have specific implementation challenges, including how to justify and evaluate them, that must be considered in each setting. • Training health professionals might increase identification and notification of FGM, but the impact in preventing FGM in the Portuguese reality is still largely unknown.
ABSTRACT
BACKGROUND: In-person clinic visits can be challenging for underserved populations due to social determinants of health such as transportation, time off work, and childcare responsibilities. These challenges were further compounded during the COVID-19 pandemic, which propelled primary care physicians to rapidly incorporate telehealth into their practice. The aim for this project was to assess our internal medicine residents' views on, preparation for, and comfort with telehealth. METHODS: With technical support from our local Area Health Education Center (AHEC) chapter, we created a telehealth training module specific to our residency continuity clinics. Upper-level Internal Medicine residents were surveyed regarding their experience and comfort level with the use of telehealth in their continuity clinics. First-year residents were excluded, as they were assigned to in-person clinic visits during the peak of the pandemic. Survey results were analyzed using descriptive statistics. Themes, areas of improvement, and next steps were identified. RESULTS: Approximately 57 percent of Wake Forest Internal Medicine residents (n=38) completed the newly developed telehealth online training module and associated survey assessing resident experience and comfort level with telehealth. Many respondents (71.9%) stated that they had not received prior training in telehealth. However, 65.7% of residents surveyed stated they felt comfortable managing patients through telehealth. Many of those surveyed believed telehealth benefits the health of patients (84.4%,) is an important learning opportunity during residency (93.8%,) and expect to use telehealth in their future career (97.1%.) A majority of residents felt telehealth could be a suitable alternative for routine follow-up and chronic disease management, but mentioned the lack of patient connectivity to video and need for access to objective data like vital signs and physical exam. CONCLUSIONS: Internal Medicine residents were eager to incorporate telehealth into their current training and future careers, despite most not having received prior telehealth training. Residents recognized the limitations of telehealth and frequently suggested home measurements of vital signs to improve management decisions. Thus, “Know Your Numbers” pilot project was created, which targets patients with poorly controlled diabetes and hypertension, was designed to provide residents with greater exposure to telehealth, as well as equip patients with the remote monitoring tools necessary to better inform treatment recommendations. Patients are scheduled for interval telehealth visits between their regularly scheduled in-person visits with their resident primary care physician. Residents will be surveyed again in July 2022 to assess changes in comfort level and experience with telehealth.
ABSTRACT
In recent years, the use of mobile learning (M-learning) has significantly increased in educational and academic settings with the growth of mobile technology (MT) and many studies have been realized in this field. But the literature reveals that most of the previous researches presented in the field of MT acceptance in high school and university. On the other hand, lack of sufficient research is clearly seen on the acceptance of MT and the use of the M-learning in primary school due to the corona pandemic and its negative effects e.g. the absence of learners in educational settings. Hence, this lack has motivated us to present an extended technology acceptance model (TAM) in the context of M-learning for primary school students. This quantitative non-experimental research has investigated the possibility of using TAM for identifying effective factors on M-learning acceptance by primary school students as a user acceptance model for academic intentions and determined these factors through testing TAM in the school setting. Experimental findings prove that perceived ease of use (PEOU), perceived enjoyment (PE), perceived convenience (PC), and perceived usefulness (PU) had effect on attitude toward using MT by primary school students. Also, continuance intention to use (CI) was directly influenced by perceived usefulness and attitude toward using (AT) constructs. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.