Substance use behavior and suicide indicators among rural middle school students.

BACKGROUND: This study provides a descriptive profile of substance use behavior and the prevalence of suicide indicators (thought about, considered, and planned) among rural middle school students and examines the association between substance use and suicidal indicators among middle school students participating in the Coordinated School Health Program in a rural state. METHODS: During April and May 2004, 10,273 middle school students completed the middle school Youth Risk Behavior Survey. RESULTS: This study found that a large percentage of students had initiated substance use behavior, with the greatest number of students having tried cigarettes (40.9% females and 42.7% males), followed by alcohol use (37.2% females and 41.3% males). Additionally, suicidal ideation and behavior were prevalent. Significant associations were found between substance use and suicidal ideation and behavior among middle school students. CONCLUSIONS: Prevention programs for adolescent suicide should be implemented during the middle school years and should focus on preventing substance use given its relationship to suicide.

Rural health professions education at East Tennessee State University: survey of graduates from the first decade of the community partnership program.

CONTEXT: To help meet rural Appalachian needs, and with initial support from the W.K. Kellogg Foundation, East Tennessee State University partnered with 2 counties to implement a health curriculum for nursing, public health, and medical students in a rural setting. The Community Partnerships Program 3-year longitudinal curriculum included theoretical, conceptual, and practice elements of the 3 disciplines incorporated into an experiential, inquiry-based, service-learning program. Interdisciplinary learning, problem solving, and reinforcement of career choices in medically underserved rural communities were emphasized. PURPOSE: To compare career choices, attitudes, and practice locations of Community Partnerships Program graduates with traditional graduates. METHODS: Surveys were mailed to Community Partnerships Program and traditional program graduates matriculating from 1992 to 2002 (response rates 58/84 and 72/168, respectively). FINDINGS: Community Partnerships Program graduates indicated a significantly greater interest in rural primary care, care for the underserved and interdisciplinary group collaboration, and were more likely to practice in rural locations than did their traditionally educated peers. Family, personal factors, and the availability of employment were major influences in determining the decision to choose a career in a rural location. Community Partnerships Program graduates indicated they were better prepared to work in interdisciplinary teams and were more likely to work in community-based programs and activities than did the traditional graduates. CONCLUSION: A program that enrolls students interested in rural health care and provides training in rural communities produces graduates who will practice in rural areas.

An application of multidisciplinary education to a campus-community partnership to reduce motor vehicle accidents.

OBJECTIVE: A collaborative campus-community partnership program provided the framework for an intervention to reduce motor vehicle accident fatalities along a rural Appalachian highway. Students from public health, nursing and medicine worked with community members to identify the problem and plan the strategy to address it. METHODS: An inquiry-based learning model proved to be an appropriate approach to engage student teams with community leaders in identifying and resolving health needs. Inquiry-based strategies place students in guided learning situations where their investigations lead to working solutions. The inquiry-based model matched the curricular objectives of the Community Partnership Program (CPP) more closely than the classroom oriented problem-based learning approach. IMPLEMENTATION: In the spring of 1994, students, along with citizens and officials of a rural Appalachian county, initiated a community-based prevention project focused on reducing deaths from motor vehicle accidents employing the principles of an inquiry-based learning model. DISCUSSION: This project effectively demonstrates the role that students can play in mobilizing diverse elements of the community to address identified health and safety concerns. It provides an illustration that a longitudinal, community-based, service-learning approach to health professions education is beneficial to both student learners and communities. CONCLUSIONS: Through the use of inquiry-based learning methods, students gained real life experience in applied principles of health statistics, epidemiology, community organization, health risk communication, health education planning and program implementation. Outcomes of the project included a measurable reduction in automobile-related fatalities and the initiation by the state department of transportation of a series of investigations expected to pave the way for physical improvements to the roadway.

Graduate health professions education: an interdisciplinary university - community partnership model 1996 - 2001.

INTRODUCTION: In 1996, East Tennessee State University (ETSU) reinforced its historical commitment to multidisciplinary community engagement by developing a graduate level community partnerships program in the Division of Health Sciences. While the university's earlier health partnership efforts relied primarily on curricular innovation, the approach to graduate health professions education was to seed a series of curricular enhancements and interdisciplinary, community-based learning experiences and service into traditional curricula. This paper presents the experience of one school in crafting a regional network that became the basis of a division-wide graduate level teaching and learning initiative. INNOVATIONS AND EVALUATION: Carefully selected planning and implementation techniques enabled multidisciplinary practitioners and community members from across a 20-county region to participate with university faculty in training ETSU learners in community-based medical care. By year four of the project, curricular "enhancements" were institutionalized in over five departments across the Division and engaged 1160 medical residents and graduate learners in a give - get model of health education. Programme evaluation methodology was collaboratively defined and documentation of programme effort and outcomes regularly reported and strategically reviewed. CONCLUSIONS: Programme evaluation demonstrates mutual benefit to community and university. Faculty involvement in programme activity increased fourfold and community involvement in training of health professions graduate learners increased threefold by year four. Educational innovations were adopted into traditional curricula, thousands of hours of clinical services were provided to underserved communities and the university-community team forged by network links continues to promote multidisciplinary interests through joint public policy endeavors.

A Model Rural Health Orientation Course Using Interdisciplinary, Community Oriented, Inquiry Based Strategies.

Introduction to Rural Health was developed as the introductory course for the Community Partnerships in Health Education - a new curriculum educating students using interdisciplinary, community oriented, and inquiry based strategies. Medical students, nursing students, and public health students participated in an elective curriculum designed to teach interdisciplinary groups of students to deliver primary health care in under-served communities. The curriculum began with an intensive one-week course designed to introduce students to the community, its people, their health care needs, and the process of working in interdisciplinary groups. The course was taught using a variety of community based activities. Student evaluations indicated that students strongly agreed that the course objectives were met using this nontraditional methodology. Qualitative analysis indicated that students regarded the team-building aspects of the course as the most influential. Community members indicated a high level of satisfaction with their input in the developmental process and with the extent to which community resources and interests were included.