Building capacity in child welfare to screen for mental health challenges: lessons learned.

BACKGROUND: Children involved in child welfare services are at high risk for emotional and behavioral problems that are not adequately identified and treated. As part of a federal review, Youth and Family Services (YFS), child protective services in Charlotte, North Carolina, was informed that they must improve their response to youth needs, particularly regarding mental health, or face losing millions of dollars in federal funding. OBJECTIVES: We have described herein an effort to build agency capacity for identifying mental health needs through a community-university partnership and share lessons learned about implementing the new process. METHODS: Community and university partners came together to develop a mental health screening pilot for one Youth and Family Services (YFS) district. LESSONS LEARNED: Community-university partners across all levels of a hierarchically structured agency must work together to align implementation of partner activities with system-level goals. Recommendations for collaboration, from a stakeholder perspective, are also described.

A comparison of African American and Latina social networks as indicators for culturally tailoring a breast and cervical cancer education intervention.

As similar cancer health disparities have been documented for African American (AA) women and Latinas, it would be important to determine whether comparable interventions could be used to increase screening among these 2 culturally different populations. This paper reports research findings comparing cultural dimensions of breast and cervical cancer as they impact Latino and AA social networks and explore the feasibility of creating outreach models that may serve both groups. An existing intervention that integrates the social roles and relationships of AA women, The Witness Project(R), is used as a framework for tailoring an intervention for Latino communities. Findings and data from focus groups and key informant interviews were collected from more than 120 Latinos in Arkansas and New York City. These findings are analyzed using the Pen-3 Model, categorized, and compared with previous social role and network information from AA women as reflected in the Witness Project(R) intervention model. The findings from this study demonstrated variations between AA women and Latinas with regard to roles and gender relationships while demonstrating similarities with regard to spiritual beliefs and attitudes toward cancer. We applied our results to culturally tailor and develop a breast and cervical cancer intervention, Esperanza y Vidatrade mark (Hope and Life), that incorporates Latino values and social relationships. This study demonstrates that a proven education and outreach model for AA women may provide a framework for creating a culturally appropriate intervention for Latinas. Further research is needed to study the efficacy of the new model. Cancer 2007. (c) 2006 American Cancer Society.

The POD: a new model for mentoring underrepresented minority faculty.

Mentoring, long recognized as a catalyst for successful careers, is particularly important to the career development of underrepresented minority (URM) faculty. In academic medicine, mentor-protégé relationships are seriously threatened by increased clinical, research, and administrative demands and an emphasis on scholarship over citizenship. New mentoring models are needed, and they should be adaptable to a medical school's unique structure and mission. The Peer-Onsite-Distance (POD) model, developed in 2002 by the authors and introduced at the College of Medicine at the University of Arkansas for Medical Sciences, is a targeted, multilevel mentoring prototype that is built on a solid research foundation and tailored to the unique needs of URM medical school faculty. The mentee's individual needs for guidance related to career goals, resources, and the content and interaction skills that are known to be critical to successful academic careers are targeted for development. The multilevel approach provides a unique network of peer and faculty mentors who provide site-specific career guidance. Also in the network are leaders in their fields who can provide access to accurate information, cautions, predictions, and announcements of future resources or potential restrictions in academic medicine. Mentor commitments are clearly defined and time contributions are maximized. The POD model aims to promote retention and advance the careers of URM faculty by wrapping them in a protective cushion of interpersonal and intrapersonal support. The flexibility of the design allows for adaptation to any institution's unique structure and mission.

Incorporating cultural constructs and demographic diversity in the research and development of a Latina breast and cervical cancer education program.

BACKGROUND: Latino immigrants are at higher risk of death from breast and cervical cancer, necessitating effective cancer education interventions. METHODS: Qualitative and quantitative information was obtained from Latinos from Arkansas and New York City through focus groups and questionnaires. Findings were analyzed using the PEN-3 model. RESULTS: The results demonstrate a mechanism for creating a culturally competent program, Esperanza y Vida, through progressively analyzing the findings to define the key perceptions, enablers, and nurturers, then applying this information to construct program components to address appropriate health behavior and cultural components that address the specific needs of a diverse Latino population. CONCLUSION: Finding a systematic approach to incorporating and embracing sociocultural perspectives and constructs may effectively appeal to diverse Latino immigrants in the development of a cancer education intervention.

Evaluating immediate and long-range effect of a geriatric clerkship using reflections and ratings from participants as students and as residents.

This article describes a longitudinal study developed to assess perceived usefulness of a mandatory geriatric clerkship from the perspective of junior students completing the newly initiated program in 1998-1999 and 1999-2000 and these same students as second- or third-year residents. End-of-clerkship student evaluations were compared with follow-up resident surveys of those same students to identify the utility of information provided and strengths and weaknesses of the initial course experience. Students participated in hospice, outpatient clinics, nursing homes, and transitional care venues during their clerkship experience at the Donald W. Reynolds Department of Geriatrics, College of Medicine, University of Arkansas for Medical Sciences. Two hundred eighty-five student evaluations were collected, and 143 resident surveys were returned. Quantitative and qualitative data from students and residents corroborated each other in identifying strengths and weaknesses of the clerkship. Hospice information was successfully incorporated into residency practice. In contrast, outpatient clinic, nursing home, and transitional care segments of the clerkship were perceived as inadequate. Survey responses validated faculty changes that were initiated in the following years. These changes use settings and patients that more accurately mirror those seen in typical resident encounters.