Practical applications of implementing integrated mental health practices with primary care providers.

Community Health Advanced by Medical Practice Superstars is a 1-year, Health Resources and Services Administration (HRSA)-funded fellowship for early career physicians and physician assistants/associates to become primary care transformational leaders. Fellows implement practice-based health care transformation projects in one of the three HRSA priority areas: childhood obesity, mental health, and opioid use disorder. The purpose of these projects is to expand on integrated health in primary care settings where there is a shortage of mental health professionals. The fellows identified areas in which they were able to incorporate mental health care provision to improve diagnostic capacity and whole health delivery, facilitate appropriate behavioral health outcomes, and improve patient physical health outcomes. Project modalities included initiating or increasing behavioral health screenings, aligning screenings with patient outcomes, and coordinating behavioral health care with physical health care. This article describes six mental health-related health care practice transformation projects implemented across rural health care settings, including Federally Qualified Health Centers and academic medical centers. The topics included (a) depression in pregnant and postpartum mothers; (b) adverse childhood experiences screening; (c) depression and chronic disease outcomes, especially diabetes; (d) the use of automated enhancements in patients' electronic medical records for management of clinical depression; (e) improving health outcomes and medication adherence of patients with opioid use disorder; and (f) the (in)adequacy of the Patient Health Questionairre-2 (PHQ-2) for the assessment of depression among patients with diabetes. Clinical specialties included family medicine, pediatrics, and women's health. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Online High School Community Health Worker Curriculum: Key Strategies of Transforming, Engagement, and Implementation.

Background: Ample research evidence has demonstrated that Community Health Worker (CHW) programs are a cost-effective, culturally integrated, and impactful way to improve community health. Although most existing CHW programs recruit adults as CHWs, high school students, with their intellectual readiness and intimate community knowledge, also have great potential to be engaged as CHWs that impact community health. With this potential in mind, the High School Community Health Worker Curriculum (HSCHW), for face-to-face training, was created in 2016 at Morehouse School of Medicine (MSM) as an innovative solution to improve community health in underserved, urban neighborhoods. Sixteen Metro Atlanta high school students participated in the program's first cohort. The face-to-face HSCHW training program received very positive feedback from the students and community partners involved. Additionally, during the inaugural training, the program received more than 150 nationwide inquiries about an opportunity to either participate in the program or replicate its curriculum. Hence, in 2018, a corresponding online curriculum was created to meet these needs. The online HSCHW curriculum covers the roles and competencies described in the CHW Core Consensus (C3) Project and focuses on developing high school students' critical thinking, decision-making, and communication skills. As of February 2021, 346 high school community health workers have participated in this online curriculum. Purpose: This paper reports on the research study of the critical processes and strategies of transforming, engaging, and implementing the online HSCHW curriculum. Method: The project team conducted the research study to identify the key strategies to transform the face-to-face HSCHW curriculum, the engagement strategies embedded in the online curriculum's content development, and, ultimately, the curriculum's outcomes. Altogether, this mixed-method study analyzed and reported on the learning outcomes of 265 students', in tandem with 17 high school students' focused-group interviews and responses to online surveys. Results: The results showed that integrating instructional design processes is critical for the online curriculum's success. "Interestingness," the latent concept embedded in the online HSCHW curriculum, engages high school students in learning about complex CHW skills, through digital content and activities. Furthermore, the successful implementation of the program and its student learning outcomes was assured by integrating the online curriculum with local schools and community resources, training the local community and school "trainers" to facilitate the curriculum online, and providing ongoing coaching support from the program team. Impacts: This paper provides a research report on the key strategies and processes of creating and implementing an online CHW curriculum for high school students. Its findings will inform future endeavors to develop an online CHW curriculum for lifelong learners and increase training effectiveness. The online HSCHW curriculum increases the national capacity of community health workers, whose work will increase community engagement and health equity. The curriculum also empowers high school students to acquire health knowledge that can bridge the educational gap between health knowledge acquisition and health knowledge application. Additionally, the online HSCHW curriculum presents a concrete example of leveraging digital platforms to teach complex public health competencies to young adults who can positively impact community health.

A comparison of distal femoral physeal defect and fixation position between two different drilling techniques for transphyseal anterior cruciate ligament reconstruction.

The defect of the femoral tunnel at the level of the physeal scar during transtibial and anteromedial portal (AMP) drilling for transphyseal anterior cruciate ligament reconstruction was compared. Five matched pairs of knees (n=10) were drilled, and computed tomography was used to evaluate tunnel position and size at the level of the physeal scar. Significant radiographic changes were observed, including tunnel defect area at the physeal scar: 0.44 cm (1.2%) in the transtibial group versus 0.99 cm (2.7%) in the AMP group (P=0.008). AMP drilling creates a larger and more lateral tunnel defect at the level of the physeal scar.

Use of a midline anterior incision for isolated medial tibial plateau fractures.

A technique using an anterior midline incision with a medial parapatellar arthrotomy and a medial full-thickness skin flap for the open reduction and internal fixation of isolated medial tibial plateau fractures is presented. The approach is advocated as an alternative to a posteromedial approach when medial tibial plateau fractures are present alone. The anterior approach is simple and familiar for orthopaedic surgeons. It offers good visualization, simplifies reduction, and provides a functional scar if future procedures are necessary.