Overweight in school-aged children associated with emotional and behavioral difficulties: results from a national sample.

OBJECTIVE: To determine whether there is an association between perceived pediatric overweight and emotional/behavioral difficulties among children ages 4 to 17 years in the United States. DESIGN: A cross-sectional study SETTING: Interview of an adult knowledgeable about a child's emotional and physical health. All statistical analyses were completed using SPSS 17.0. PARTICIPANTS: A total of 7096 noninstitutionalized children aged 4 to 17 years identified in the 2007 National Health Interview Survey. OUTCOME MEASURES: Included in the 2007 National Health Interview Survey were 7096 noninstitutionalized children aged 4 to 17 years. After controlling for age, gender, race, poverty status, education of mother, family structure, and health status, this study found that 7.4% of the children appeared to be overweight and 5.2% had emotional/behavioral difficulties. It also found that caregivers who indicated that their child had a problem with being overweight were more likely to report that the child experienced emotional/behavioral difficulties compared to caregivers who did not report perceived overweight in their child. Characteristics of the children most frequently reported to be overweight included Hispanic race, older children (ages 15-17 years), and those with higher poverty rates and poorer health status. CONCLUSION: The continual increase in pediatric overweight and associated emotional/behavioral difficulties suggests a need for replicable interventions that teach child caregivers to recognize and prevent overweight among vulnerable populations.

Diversity in academic medicine no. 6 successful programs in minority faculty development: ingredients of success.

This article describes the ingredients of successful programs for the development of minority faculty in academic medicine. Although stung by recent cuts in federal funding, minority faculty development programs now stand as models for medical schools that are eager to join the 140-year-old quest for diversity in academic medicine. In this article, the ingredients of these successful faculty development programs are discussed by experts in minority faculty development and illustrated by institutional examples. Included are descriptions of program goals and content, mentoring and coaching, selecting participants, providing a conducive environment, managing the program, and sustaining support. This article is a companion to another article, "Successful Programs in Minority Faculty Development: Overview," in this issue of the Mount Sinai Journal of Medicine.

Diversity in academic medicine no. 1 case for minority faculty development today.

For the past 20 years, the percentage of the American population consisting of nonwhite minorities has been steadily increasing. By 2050, these nonwhite minorities, taken together, are expected to become the majority. Meanwhile, despite almost 50 years of efforts to increase the representation of minorities in the healthcare professions, such representation remains grossly deficient. Among the underrepresented minorities are African and Hispanic Americans; Native Americans, Alaskans, and Pacific Islanders (including Hawaiians); and certain Asians (including Hmong, Vietnamese, and Cambodians). The underrepresentation of underrepresented minorities in the healthcare professions has a profoundly negative effect on public health, including serious racial and ethnic health disparities. These can be reduced only by increased recruitment and development of both underrepresented minority medical students and underrepresented minority medical school administrators and faculty. Underrepresented minority faculty development is deterred by barriers resulting from years of systematic segregation, discrimination, tradition, culture, and elitism in academic medicine. If these barriers can be overcome, the rewards will be great: improvements in public health, an expansion of the contemporary medical research agenda, and improvements in the teaching of both underrepresented minority and non-underrepresented minority students.

Diversity in academic medicine no. 3 struggle for survival among leading diversity programs.

Since efforts to increase the diversity of academic medicine began shortly after the Civil War, the efforts have been characterized by a ceaseless struggle of old and new programs to survive. In the 40 years after the Civil War, the number of minority-serving institutions grew from 2 to 9, and then the number fell again to 2 in response to an adverse evaluation by the Carnegie Foundation for the Advancement of Teaching. For 50 years, the programs grew slowly, picking up speed only after the passage of landmark civil rights legislation in the 1960s. From 1987 through 2005, they expanded rapidly, fueled by such new federal programs as the Centers of Excellence and Health Careers Opportunity Programs. Encompassing majority-white institutions as well as minority-serving institutions, the number of Centers of Excellence grew to 34, and the number of Health Careers Opportunity Programs grew to 74. Then, in 2006, the federal government cut its funding abruptly and drastically, reducing the number of Centers of Excellence and Health Careers Opportunity Programs to 4 each. Several advocacy groups, supported by think tanks, have striven to restore federal funding to previous levels, so far to no avail. Meanwhile, the struggle to increase the representation of underrepresented minorities in the health professions is carried on by the surviving programs, including the remaining Centers of Excellence and Health Careers Opportunity Programs and new programs that, funded by state, local, and private agencies, have arisen from the ashes.

Diversity in academic medicine no. 5 successful programs in minority faculty development: overview.

Despite recent drastic cutbacks in federal funding for programs to diversify academic medicine, many such programs survive and continue to set examples for others of how to successfully increase the participation of minorities underrepresented in the healthcare professions and, in particular, how to increase physician and nonphysician minority medical faculty. This article provides an overview of such programs, including those in historically black colleges and universities, minority-serving institutions, research-intensive private and public medical schools, and more primary care-oriented public medical schools. Although the models for faculty development developed by these successful schools overlap, each has unique features worthy of consideration by other schools seeking to develop programs of their own. The ingredients of success are discussed in detail in another article in this theme issue of the Mount Sinai Journal of Medicine, "Successful Programs in Minority Faculty Development: Ingredients of Success."

The Morehouse Faculty Development Program: evolving methods and 10-year outcomes.

BACKGROUND AND OBJECTIVES: African American physicians remain underrepresented among all medical school faculty, including faculty in departments of family medicine. This paper reports on a faculty development effort aimed at increasing the number and academic skills of underrepresented minority faculty. METHODS: In 1992, Morehouse School of Medicine began a faculty development program. The program trains faculty and community-based preceptors in teaching, scientific writing, grant writing, research, and minority career issues. Formats now include a 1-year longitudinal program, 4-6-week stand-alone modules, and an executive faculty development program for physicians from across the nation. Evaluation measures include participant enrollment, completion rate, participant feedback, and self-reported academic competencies before and after the program. RESULTS: A total of 113 participants completed the program from 1992-2003. Only seven enrollees failed to complete the program. Of 113 graduates, 104 (92.0%) were ethnically African American, Afro Caribbean, or African, while only two were white, non-Hispanic. More than four out of five (81%) now spend at least some time teaching on a regular basis, and 71% spend more than 25% time in teaching roles. Self-reported before-after competencies in specific academic skills such as teaching, writing, research, and grant writing rose from 2.7 to 4.1 on a 5-point scale. CONCLUSIONS: Faculty development is a potentially effective strategy for increasing diversity in academic primary care. Historically black and Hispanicserving institutions can make contributions to training minority faculty. More-rigorous study could elucidate which program elements have the greatest effect on minority faculty academic career choice, scholarly productivity, and career trajectory and the extent to which these programs could be adapted to majority institutions.