Factors Associated With Urban Youth and Parent Perceptions of the Preventability of Assault Injury: An Emergency Department Sample.

OBJECTIVES: This study aimed to identify factors associated with urban youth and parent's perception of the preventability of medically attended youth assault injuries to guide future violence prevention strategies. METHODS: Assault-injured youth (n = 188; ages, 10-15 years; 60% male; 96% black) and their parents were recruited from 2 pediatric emergency departments in 2 cities. Mental health, injury severity, circumstances of injury, and family composition were some of the factors explored as cross-sectional predictors of the perception of the preventability of youth assault injury. Separate models were developed using stepwise regression for youth and parents. RESULTS: Sixty-eight (38%) youth and 123 parents (68%) reported that the injury was definitely preventable (χ2 = 9.6250, P < 0.05). For youth, identifying themselves as the aggressor (odds ratio [OR], 0.23, 95% confidence interval [CI], 0.07-0.70) or having been hospitalized for psychiatric illness (OR, 0.21; 95% CI, 0.05-0.85) was associated with lower odds of perceiving their injury as preventable, while being under the care of a mental health professional (OR, 3.87; 95% CI, 1.21-12.39) was associated with higher odds. For parents, being in a household with grandparents (OR, 0.21; 95% CI, 0.04-0.99) or having a child with a learning disability (OR, 0.16; 95% CI, 0.05-0.57) was associated with lower odds of perceiving the injury as preventable. CONCLUSIONS: Several factors in youth and parents were identified as being associated with perception of preventability of injuries in this high-risk population of youth. Youth and parents identified different factors. In addition, although most parents reported that the assault injury sustained by their child was preventable, the opposite was true for youth perceptions. Future violence prevention programs should consider youth and parent perspectives and develop unique strategies to address both their needs.

Pre-departure Training for Healthcare Students Going Abroad: Impact on Preparedness.

BACKGROUND: Many medical and nursing schools offer opportunities for students to participate in global health experiences abroad, but little is known about the efficacy of pre-departure training in preparing students for these experiences. OBJECTIVES: The primary aim was to identify characteristics of pre-departure training associated with participants' reporting a high level of preparedness for their global health experiences. Secondary objectives included identifying students' preferred subjects of study and teaching modalities for pre-departure training. METHODS: A questionnaire was distributed to all medical and nursing students at our institution from 2013 to 2015. Questions addressed prior global health experiences and pre-departure training, preferences for pre-departure training, and demographic information. Findings: Of 517 respondents, 55% reported having a prior global health experience abroad, 77% of whom felt prepared for their experience. Fifty-three percent received pre-departure training. Simply receiving pre-departure training was not associated with perceived preparedness, but pre-departure training in the following learning domains was: travel safety, personal health, clinical skills, cultural awareness, and leadership. Perceiving pre-departure training as useful was also independently associated with self-reported preparedness. Students' preferred instruction methods included discussion, lecture, and simulation, and their most desired subjects of study were travel safety (81%), cultural skills (87%), and personal health (82%). CONCLUSIONS: Incorporating travel safety, personal health, clinical skills, cultural awareness, and/or leadership into pre-departure training may increase students' preparedness for global health experiences. Student perceptions of the usefulness of pre-departure training is also associated with self-reported preparedness, suggesting a possible "buy-in" effect.

Global Health Career Interest among Medical and Nursing Students: Survey and Analysis.

BACKGROUND: Global health experiences undertaken in international settings (GHEs) are becoming an increasingly prevalent aspect of health professions education and, as such, merit comprehensive analysis of the impact they have on students and host communities. OBJECTIVE: To assess the associations between demographic/experiential factors and the interest of health professions students in careers involving global health. METHODS: A cross-sectional survey was administered online to a convenience sample of medical and nursing students at Johns Hopkins University. Questions addressed level of interest in a global health career, prior GHEs, and demographic information. Items were either Likert scale or multiple choice. Various regression analyses were performed. FINDINGS: Of 510 respondents, 312 (61.2%) expressed interest in a global health career and 285 (55.9%) had prior GHEs. Multivariate logistic regression found female sex, age ≥27 years, household income <$100,000/y, and a prior research-related GHE independently associated with higher interest in global health careers. On subset analysis of participants with one or more prior GHEs: age ≥27 years, household income <$100,000/y, a prior research-related GHE, and having multiple GHEs were each independently associated with increased interest in a global health career. CONCLUSIONS: Simply participating in a global health experience abroad is not significantly associated with interest in a global health career. However, sex, age, household income, and research-related GHEs are significantly associated with global health career interest. These findings may inform the development of global health programs at medical and nursing schools and can guide efforts to increase the number of health care professionals entering global health careers.

Awareness of racial/ethnic disparities in surgical outcomes and care: factors affecting acknowledgment and action.

BACKGROUND: Studies have demonstrated racial/ethnic disparities in surgical outcomes and care. Surgeon awareness and its association with institutional action remain unclear. The study sought to assess surgeons' awareness of racial/ethnic disparities, ascertain whether demographic and practice factors influence acknowledgement of disparities, and determine whether surgeons are seeking to mitigate disparities. METHODS: Anonymous online survey was administered to a random sample of American College of Surgeons (ACS) general surgeons (July 2013 to March 2014). Responses were weighted for nonresponse and risk-adjusted using logistic regression. RESULTS: 172 surgeons completed the survey. Levels of acknowledged disparities were low. Less than one half reported institutional efforts to address disparities, and less than one fourth had taken efforts to investigate disparities in their personal practice. Several respondent factors including Academic Medical Center affiliation, awareness of the ACS statement on optimal access, and year of medical school graduation significantly associated with expressed acknowledgment of disparities. CONCLUSIONS: Such associations speak to the need for continued efforts to promote enhanced provider awareness and participation. As the field of surgical disparities moves from understanding to action, we must acknowledge the contributing role that providers play.