Establishing a disability-inclusive agenda for sustainable development in 2015 and beyond.

Disability was omitted from the Millennium Declaration and eight Millennium Development Goals. As a result, individuals with disabilities and their advocates, health-related agencies and major United Nations (UN) groups collaborated to explicate the rights and needs of persons with disabilities. A community empowerment approach was guided by the Convention on the Rights of Persons with Disabilities, input from expert groups, public meetings held across the globe, questionnaires sent to civil society representatives, and rich online conversation. Persons with disabilities have the right to health, education, gainful employment, social protection, and participation in political and public life. Selected results from The World We Want consultation for the topic of 'Inequalities and a disability-inclusive agenda' illustrate the potential of reaching consensus among a broad array of constituents, informing decisions about policy and practice.

Preparing students to practice evidence-based dentistry: a mixed methods conceptual framework for curriculum enhancement.

This article describes a mixed methods conceptual framework for evidence-based dentistry to enhance the curriculum at the University of Alabama at Birmingham School of Dentistry. A focus of recent curriculum reform has been to prepare students to integrate evidence-based dentistry into clinical practice. The authors developed a framework consisting of four conceptual phases to introduce curriculum innovation: 1) exploration of the phenomenon; 2) development of two new instruments; 3) data collection, analysis, outcomes, and evaluation; and 4) application to curricular reform. Eight sequential procedural steps (literature review; focus group discussions; development of themes; survey design; internal review; data collection, analysis, and evaluation; development of recommendations with external review; and implementation of recommendations for curricular enhancement) guided the curricular enhancement. Faculty members supported the concept of teaching evidence-based dentistry to facilitate major curriculum reform, and course directors incorporated evidence-based teaching to prepare scientist-practitioners who meet dental performance standards. The new curriculum implemented following completion of the study is in its third year. Much of its structure is based on evidence-based teaching methodologies, and approximately one-third of the content consists of small groups researching clinical problems with applied science and discussing the findings. The framework described in this article proved useful to guide revision of predoctoral clinical education at one dental school and may be useful in other settings.

Implementation of school policies to prevent youth tobacco use in Alabama.

BACKGROUND: Public health professionals must monitor the effectiveness of school policies and programs to prevent youth initiation, promote quitting, and eliminate secondhand smoke. This analysis of school tobacco policies was preliminary to release of a state tobacco prevention and control plan for 2010-2015. METHODS: University health educators collaborated with the state health agency to review policies of 33 school systems in 5 Metropolitan Statistical Areas and 9 public health areas. Authors developed a systematic approach of 8 steps useful to rate implementation of school tobacco control and prevention policies and discuss implications for health education program planning. RESULTS: Thirty school policies prohibited possession and use of tobacco by students, faculty and campus visitors, and 26 of 33 specified disciplinary measures following violations. Only 4 public education agencies included 3 of the 6 elements of a model tobacco prevention and control policy as suggested by the state public health agency. None featured all 6 elements. None specified establishing school-community partnerships for tobacco prevention and control. CONCLUSIONS: Preparing smoke-free youth requires implementing and evaluating tobacco education in grades K-12 including use of model guidelines from federal agencies and professional organizations. Determining the focus of existing school tobacco policies is an initial step to encourage adoption of comprehensive policies to reduce youth use of tobacco. Youth health advocates may act together with school administrators and legislators to strengthen policies to be consistent with model guidelines for tobacco prevention and control.

HealthyME HealthyU(©2010UCPGB): a collaborative project to enhance access to health information and services for individuals with disabilities.

In response to the limited information about health information and training needs among persons with disabilities, a collaborative group of Alabama researchers, educators, and clinicians was formed to implement a statewide needs assessment with support provided by the Alabama Council for Developmental Disabilities and the National Network of Libraries of Medicine. Educational and assessment activities were guided by the Systems Model of Clinical Preventive Care and Health Information National Trends Survey (HINTS) methodology. Four constructs from the 2007 HINTS Annotated Version were identified as relevant to the concepts of local interest. Results of printed and online surveys administered to 251 family and other caregivers, 87 individuals with disabilities, 110 clinical service providers, and 570 health professions students revealed outstanding health communication needs to improve access to reliable consumer information and clinical services. HealthyME HealthyU(©2010UCPGB) developed new educational materials that address issues identified from the needs assessment, specifically (a) accessibility of health care facilities; (b) patient-provider communication; (c) personal health management by consumers and families/caregivers; and (d) sources of trustworthy electronic health information. Six brief digital video training modules were developed for consumers, families, and professionals featuring as speakers health care providers, health professions students, and individuals with cognitive disabilities. Following field testing, video modules were revised and then widely distributed to consumers, family caregivers, and service providers. Preliminary evaluation indicates content is relevant and comprehensible to individuals with disabilities.

Responding to Health Information and Training Needs of Individuals with Disabilities.

The role of a medical librarian includes guiding consumers to search for information related to specific health needs and interpret information for personal use. Little is known about barriers to accessing health information and clinical services for those with cognitive and physical disabilities. The purpose of this paper is to describe a statewide needs assessment of the health information and services needs of individuals with disabilities and their caregivers.Data from the needs assessment conducted by the Health Services Training Project of more than 1,000 respondents indicate unmet needs for outreach to increase effective use of library and information resources. Fewer consumers and their caregivers utilized the Internet to search for health information as compared to clinical service providers and students in health professions. A majority of consumers reported difficulty obtaining and understanding online health information. Service providers and students shared concerns about information quality. Consumers and caregivers expressed highest levels of trust in information provided by service providers, nonprofit health agencies, reference books, and libraries.

Validation of the Drinking Context Scale (DCS-9) for use with non-adjudicated first-year college students.

The Drinking Context Scale (DCS-9) has been used to measure the impact of drinking during social, emotional, and situational contexts. Psychometric properties remain unevaluated in a population of non-adjudicated first-year college students in the southeast. Liseral 8.8 was used to test the factorial validity of the DCS, using Confirmatory Factor Analysis. The original three factor model for the DCS represented acceptable fit to the data (chi(2)=36.72, df=24, p=0.047, CFI=0.991, SRMR=.0406) supporting its use with first-year college students. Invariance between gender, ethnic group, and geographical regions should be examined by future researchers.

A method for standardizing procedures in rehabilitation: use in the extremity constraint induced therapy evaluation multisite randomized controlled trial.

OBJECTIVE: An enduring problem in the field of rehabilitation has been the lack of standardization in the protocols of treatments and tests. To develop a process evaluation method to standardize the administration of rehabilitation procedures used in the Extremity Constraint Induced Therapy Evaluation (EXCITE) Trial, a randomized controlled trial of upper-extremity constraint-induced therapy implemented across 7 sites. DESIGN: Process evaluation. SETTING: Research laboratory. PARTICIPANTS: Convenience sample or research personnel. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Checklist scoring sheets were developed to rate videotapes using systematic application of prescribed steps for each of 5 procedures across 3 time periods. Time periods were immediately after training, and 1 and 2 years later. A performance score of at least 90% was required before individual research personnel were allowed to participate in the trial. RESULTS: Overall performance scores ranged from 85.8% to 95% of performance items correctly executed. There was a significant improvement in standard performance of procedures between the first time period (immediately after training) and each of the subsequent time periods for all but 1 procedure. The scoring of standardized performance when carried out with routine participant testing and training did not differ significantly from scoring from videotaped sessions submitted for standardization rating for 2 of the procedures, suggesting adequate validity of scoring from videotape. CONCLUSIONS: The present method was successful in assessing protocol fidelity for the EXCITE research personnel and represents 1 means of addressing the longstanding problem in rehabilitation of the lack of standardization in administering different treatments and tests.

Validation of the College Alcohol Problem Scale-revised (CAPS-r) for use with non-adjudicated first-year students.

First-year students in transition to college are at increased risk for consuming greater amounts of alcohol and are subject to subsequent alcohol-related problems. The 8-item College Alcohol Problem Scale-revised (CAPS-r) has been used to measure alcohol-related problems in adjudicated undergraduates and psychology majors. However, structural validity of the CAPS-r has not been examined in a general first-year student population. Confirmatory factor analysis (CFA) was used to test the structural validity of this two-factor model using LISREL 8.5. The original two-factor measurement model for the 8-item CAPS-r represented acceptable fit to the data (chi(2)=37.52, df=19, p=.007, CFI=.968, SRMR=.0449), supporting its use with first-year college students. Future studies need to examine invariance across ethnic, gender, and geographical groups.

Responses of health and physical educators to overweight children in Alabama.

The purpose of this article is to provide an overview of the increasing problem of overweight children in Alabama including clinical definition, risk factors, and prevalence data. Health and physical educators should become familiar with guidelines released by national organizations, such as the Centers for Disease Control and Prevention, the Institute of Medicine, and state departments of education and public health. These guidelines provide direction to health promotion program activities in schools, community, and recreational settings aimed at modifying predisposing, reinforcing, and enabling factors. Four examples are presented in the narrative to illustrate collaborative partnerships among health care organizations, a health insurer, public schools, an academic research university, and state agencies to enhance youth health. The final section provides practical recommendations for professional health and physical educators regarding obesity risk reduction.

Ecological strategies to promote healthy body image among children.

BACKGROUND: Personal habits of children and adolescents related to healthy body image (BI) are influenced by various determinants in the micro- and macroenvironment. These include attitudes and behaviors about eating; exercise and physical appearance modeled by parents, teachers, and peers; as well as opportunities to learn new habits and social praise for healthy choices. The coordinated school health program (CSHP) is compatible with the 5 levels of an ecological approach to developing new health behaviors. METHODS: Authors systematically applied the ecological model to all 8 components of coordinated school health. Next, strategies for each of the components were developed using the professional literature as well as author expertise in the areas of health education, exercise science, and dietetics. RESULTS: For each strategy, applicable health and physical education standards, as well as goals for each strategy and additional Web resources, were provided to assist educators and administrators in supporting healthy BI among students. CONCLUSIONS: Educators may effectively use a coordinated approach to guide multiple intervention activities aimed at increasing healthy habits among adolescents and their families. The strength of the CSHP is its collaborative nature with active participation by students, faculty members, family caregivers, agency professionals, community residents, and health care providers.

Drinking likelihood, alcohol problems, and peer influence among first-year college students.

Excessive alcohol consumption is a predominant health concern on college campuses in the United States. A stepwise multiple regression analysis was used to examine the predictive values of demographic factors in relation to alcohol subscales (Drinking Context Scale, College Alcohol Problems Scale-revised, and Social Modeling Scale) with the outcome of number of drinking days in the past 30 days among a sample (n = 224) of first-year college students. The final model predicted 37.5% of the variability in drinking days in the past month. All variables, except for race, were significantly associated with the outcome (p < .05).

Using technology to teach health: a collaborative pilot project in Alabama.

The Centers for Disease Control and Prevention (CDC) identified six adolescent risk behaviors that contribute to chronic diseases and disorders, including poor dietary habits, sedentary lifestyle, and abuse of alcohol, tabacco, and other drugs. This project pilot-tested a "train-the-trainer" model to diffuse an interactive health education software program into Alabama middle schools during a school year. Developmentally appropriate content included nutrition, physical activity, and prevention of substance use. Twenty-four site facilitators selected from 18 public school systems trained 364 colleagues and 2,249 students to use the software. During a school year, facilitators created 150 student assignments; they reported increased interest among students in health instruction. An essential feature of the project involved an active partnership among the funder, state department of education, university, and public schools. Planners provided technical assistance through face-to-face interaction, distance learning, telephone and e-mail communications, and a Web site. Planners and facilitators worked together to overcome barriers to the use of technology for health instruction.