Increasing Reach of the Diabetes Prevention Program in African American Churches: Project FIT Lessons Learned in Using an Interprofessional Student Service-Learning Approach.

The Diabetes Prevention Program (DPP) is an evidence-based lifestyle intervention proven to reduce/delay diabetes onset with diet change, physical activity, and modest weight loss. However, access to the program is limited in low-resource communities. Having health profession students facilitate DPP groups as a service learning course-credit opportunity may benefit their interprofessional training while also expanding DPP access in underserved communities. We sought to use student reflections to identify themes to assist with program evaluation and to inform program refinements. Students (N=95) from the University of Missouri-Kansas City (UMKC) medical, physician assistant, and pharmacy programs led DPP groups in urban Kansas City African American churches alongside church health liaisons as part of an interprofessional service-learning course. Students reported creating satisfying, ongoing relationships with participants; developing a deeper understanding of obstacles to weight loss; and learning the role of other health professionals in the care of patients. They also identified obstacles to successful program implementation, such as needing less time in training and having equal participation from students across their interprofessional teams. Students learned important lessons by leading the DPP, but interprofessional service-learning courses have multiple obstacles to successful delivery. Still, this approach has great potential to increase access to the DPP in African American communities and promote skill development in health profession students.

A Web-Based Alcohol Screening and Brief Intervention Training Module Within Physician Assistant Programs in the Midwest to Increase Knowledge, Attitudes, and Confidence: Evaluation Study.

BACKGROUND: Preventing and reducing risky alcohol use and its side effects remains a public health priority. Discussing alcohol use with patients can be difficult; dedicated training for health care providers is needed to facilitate these conversations. A Web-based alcohol screening and brief intervention (SBI), comprising didactic and skills application training, was designed for physician assistant students. OBJECTIVE: This paper details experiences and outcomes in developing an alcohol SBI training curriculum and coordinating virtual encounters with standardized patients. We also explain challenges faced with developing an alcohol SBI training and a Web-based learning management site to fit the needs of 5 different physician assistant programs. METHODS: Training development comprised 3 phases-precourse, development, and implementation. The precourse phase included developing the initial training curriculum, building a website, and testing with a pilot group. The development phase refined the training curriculum based on user feedback and moved into a three-component module: didactic training module, guided interactive encounter with a simulated patient, and live encounter with a standardized patient. A learning management system website was also created. In the implementation phase, 5 physician assistant schools incorporated the Web-based training into curricula. Each school modified the implementation method to suit their organizational environment. Evaluation methods included pre- and postchange over time on trainee attitudes, knowledge, and skills (confidence) on talking to patients about alcohol use, trainee self-reported proficiency on the standardized patient encounter, standardized patient evaluation of the trainee proficiency during the alcohol use conversation, user evaluation of the type of technology mode for the standardized patient conversation, and overall trainee satisfaction with the Web-based training on alcohol SBI. RESULTS: Final evaluation outcomes indicated a significant (P<.01) change over time in trainee knowledge and skills (confidence) in the conduct of the alcohol SBI with a standardized patient, regardless of the program implementation method. Trainees were generally satisfied with the Web-based training experience and rated the use of the videoconference medium as most useful when conducting the alcohol SBI conversation with the standardized patient. Training that included a primer on the importance of screening, individual participation in the Web-based didactic alcohol SBI modules, and virtual encounters with standardized patients through a university-based simulation center was the most widely accepted. Successful implementation included program investment and curriculum planning. Implementation barriers involved technical challenges with standardized patient encounters and simulation center logistics, and varying physician assistant school characteristics. CONCLUSIONS: Development and implementation of Web-based educational modules to educate health care professionals on alcohol SBI is effective, easy to reproduce, and readily accessible. Identifying challenges affecting development, implementation, and utilization of learned techniques in practice, enhances facilitation of learning and training efficacy. As the value of technology-based learning becomes more apparent, reports detailing what has worked versus what has not may help guide the process.