Enterprise Evaluation: A New Opportunity for Public Health Policy.

Standard evaluation practice in public health remains limited to evaluative measures linked to individual projects, even if multiple interrelated projects are working toward a common impact. Enterprise evaluation seeks to fill this policy gap by focusing on cross-sector coordination and ongoing reflection in evaluation. We provide an overview of the enterprise evaluation framework and its 3 stages: collective creation, individual data collection, and collective analysis. We illustrate the application of enterprise evaluation to the Gulf Region Health Outreach Program, 4 integrated projects that aimed to strengthen health care in Louisiana, Mississippi, Alabama, and the Florida Panhandle after the Deepwater Horizon oil spill. Shared commitment to sustainability and strong leadership were critical to Gulf Region Health Outreach Program's success in enterprise evaluation. Enterprise evaluation provides an important opportunity for funding agencies and public health initiatives to evaluate the impact of interrelated projects in a more holistic and multiscalar manner than traditional siloed approaches to evaluation.

An intersectoral, international policy fellowship experience as a framework for faculty development: the marshall memorial fellowship.

This paper describes the experience of a faculty physician at a historically Black medical school who participated in the Marshall Memorial Fellowship, an intersectoral, international experience in which emerging leaders explore political, economic, social, and cultural institutions. The fellowship facilitates collaboration and sharing these experiences within academia and the community.

Post-disaster Gulf Coast recovery using telehealth.

OBJECTIVE: The Gulf Coast continues to struggle with service need far outpacing available resources. Since 2005, the Regional Coordinating Center for Hurricane Response (RCC) at Morehouse School of Medicine, Atlanta, GA, has supported telehealth solutions designed to meet high service needs (e.g., psychiatry) within primary care and other healthcare organizations. The overall RCC vision is to support autonomous, useful, and sustainable telehealth programs towards mitigating unmet disaster-related needs. SUBJECTS AND METHODS: To assess Gulf Coast telehealth experiences, we conducted semistructured interviews with both regional key informants and national organizations with Gulf Coast recovery interests. Using qualitative-descriptive analysis, interview transcripts were analyzed to identify shared development themes. RESULTS: Thirty-eight key informants were interviewed, representing a 77.6% participation rate among organizations engaged by the RCC. Seven elements critical to telehealth success were identified: Funding, Regulatory, Workflow, Attitudes, Personnel, Technology, and Evaluation. These key informant accounts reveal shared insights with telehealth regarding successes, challenges, and recommendations. CONCLUSIONS: The seven elements critical to telehealth success both confirm and organize development principles from a diverse collective of healthcare stakeholders. The structured nature of these insights suggests a generalizable framework upon which other organizations might develop telehealth strategies toward addressing high service needs with limited resources.

Using mini-grants and service-learning projects to prepare students to serve underserved populations.

This article discusses a short term service-learning initiative developed by the Center for Community Health and Service Learning (CCHSL) at Morehouse School of Medicine, exploring how extramural mini-grant opportunities can be used to teach students and residents about community health assessment, health communication, and health promotion.

Training residents to address cancer health disparities.

INTRODUCTION: Cancer is the source of significant morbidity and mortality in the United States, and eliminating cancer-related racial and ethnic disparities has become an ever-increasing focus of public health efforts. Increasing workforce diversity plays a major role in the reduction of health disparities, and a well-trained professional workforce is essential for the prevention, control, and ultimate elimination of this disease. METHODS: To help address this need, the Public Health/General Preventive Medicine residency program at Morehouse School of Medicine (MSM) developed an innovative Cancer Prevention and Control Track (CPCT). We describe the structure of the track, funding, examples of resident activities, and program successes. RESULTS: Since the development of the track in 2007, there have been 3 graduates, and 2 residents are currently enrolled. Residents have conducted research projects and have engaged in longitudinal community-based activities, cancer-focused academic experiences, and practicum rotations. There have been 3 presentations at national meetings, 1 research grant submitted, and 1 research award. CONCLUSION: The CPCT provides residents with comprehensive cancer prevention and control training with emphasis in community engagement, service, and research. It builds on the strengths of the diversity training already offered at MSM and combines resources from academia, the private sector, and the community at large.

Assessing the role of spirituality in coping among African Americans diagnosed with cancer.

Spirituality plays an important role in cancer coping among African Americans. The purpose of this study was to report on the initial psychometric properties of instruments specific to the cancer context, assessing the role of spirituality in coping. Items were developed based on a theoretical model of spirituality and qualitative patient interviews. The instruments reflected connections to self, others, God, and the world. One hundred African American cancer survivors completed the instruments by telephone. The instruments showed adequate internal reliability, mixed convergent validity, discriminant validity, and interpretable factor structures.

Faith-based partnerships in graduate medical education: the experience of the Morehouse School of Medicine Public Health/Preventive Medicine Residency Program.

Faith-based organizations can be strategic partners in addressing the needs of low-income and underserved individuals and communities. The Morehouse School of Medicine (MSM) Public Health/Preventive Medicine Residency Program (PH/PMR) collaborates with faith-based organizations for the purpose of resident education, community engagement, and service. These partners provide guidance for the program's community initiatives and health promotion activities designed to address health inequities. Residents complete a longitudinal community practicum experience with a faith-based organization over the 2-year training period. Residents conduct a community health needs assessment at the organization and design a health intervention that addresses the identified needs. The faith-based community practicum also serves as a vehicle for achieving skills in all eight domains of the Public Health Competencies developed by the Council on Linkages and all six Accreditation Council for Graduate Medical Education (ACGME) Core Competencies. The MSM PH/PMR Program has engaged in faith-based partnerships for 7 years. This article discusses the structure of these partnerships, how partners are identified, funding sources for supporting resident projects, and examples of resident health needs assessment and intervention activities. The MSM PH/PMR Program may serve as a model to other residency and fellowship programs that may have an interest in developing partnerships with faith-based organizations.

Using service-learning to teach community health: the Morehouse School of Medicine Community Health Course.

Medical education is evolving to include more community-based training opportunities. Most frequently, third- and fourth-year medical students have access to these opportunities. However, introducing community-based learning to medical students earlier in their training may provide a more formative experience that guides their perspectives as they enter clinical clerkships. Few known courses of this type exist for first-year medical students. Since 1998, the Morehouse School of Medicine (MSM) has required first-year students to take a yearlong Community Health Course (CHC) that entails conducting a community health needs assessment and developing, implementing, and evaluating a community health promotion intervention. In teams, students conduct health needs assessments in the fall, and in the spring they develop interventions in response to the problems they identified through the needs assessments. At the end of each semester, students present their findings, outcomes, and policy recommendations at a session attended by other students, course faculty, and community stakeholders.The authors describe the course and offer data from the course's past 11 years. Data include the types of collaborating community sites, the community health issues addressed, and the interventions implemented and evaluated. The MSM CHC has provided students with an opportunity to obtain hands-on experience in collaborating with diverse communities to address community health. Students gain insight into how health promotion interventions and community partnerships can improve health disparities. The MSM CHC is a model that other medical schools across the country can use to train students.

Role of religion in cancer coping among African Americans: a qualitative examination.

The present study used qualitative methods to examine if and how African Americans with cancer use religiosity in coping. Patients (N = 23) were recruited from physician offices and completed 1-1(1/2) hour interviews. Themes that emerged included but were not limited to control over one's illness, emotional response, importance of social support, role of God as a healer, relying on God, importance of faith for recovery, prayer and scripture study, and making sense of the illness. Participants had a great deal to say about the role of religion in coping. These themes may have utility for development of support interventions if they can be operationalized and intervened upon.

Development and validation of measures of religious involvement and the cancer experience among African Americans.

Research indicates that African Americans diagnosed with cancer tend to use religion in coping. However less is known about the specific role that religion plays in the coping process. Based on previous qualitative work, five instruments were developed to assess the role of religious involvement in cancer coping: God as helper, God as healer, Faith in healing, Control over cancer and New perspective. The instruments were administered to 100 African Americans with cancer. Each exhibited high internal reliability, and concurrent and discriminant validity. These instruments may have applied value for the development of church-based cancer support/survivorship interventions.

Role of spirituality in cancer coping among African Americans: a qualitative examination.

INTRODUCTION: This study used qualitative methods to examine whether, and if so how, African American cancer survivors use spirituality in coping with the disease. Spirituality was defined using a model involving connectedness to self, others, a higher power, and the world. METHODS: Twenty-three African American patients with various forms of cancer were recruited from physician offices and completed 1-1.5 h interviews. Data were coded by multiple coders using an inductive process and open-coding. RESULTS: Themes that emerged included, but were not limited to the aforementioned types of connectedness, one theme being connections to God. Given the important role of social support in the cancer experience, participants also emphasized their connectedness to others, which is in support of the spirituality model. Participants also articulated the notion that connections with others were not always positive, indicating that some perceived certain connections as having a detrimental impact on their well-being. Participants also expressed the desire to share their cancer story with others, often gained a new perspective on life, and obtained new self-understanding as a result of their illness experience. DISCUSSION/CONCLUSIONS: Findings indicate that African Americans perceive that spirituality plays a strong role in their cancer coping and survivorship. Spirituality may address a human need for certitude in crisis. Further research is warranted for model testing, and to examine the role of spirituality in cancer coping among those of different backgrounds and cancer types/stages. IMPLICATIONS FOR CANCER SURVIVORS: These themes may have utility for the development of support interventions for cancer survivors.