Assessing the Variability in Interpretation of the Catholic Directives Pertaining to Reproductive Health Services: An Exploratory Qualitative Study of Two Hospitals on the American East Coast.

The ethics in Catholic hospitals are guided by the Ethical and Religious Directives for Catholic Health Care Services, which provide direction on many topics, including family planning. Previous research has demonstrated there is variability in the availability of prohibited family planning services at Catholic hospitals. This study aims to research a potential source of variability in interpretation and application of the directives through interviewing ethics committee members. Participants were recruited from two different hospitals on the east coast with a total sample size of eight. Ethics committee members were asked questions regarding their personal approach to ethics, their hospital's approach to ethics, and the permissibility of specific family planning methods at their hospital. Most ethics committee members stated that the Catholic faith and/or directives were important in their hospitals' approach to ethics. Most participants stated that they had instances in which their personal approach to ethics conflicted with their hospital's approach, citing women's health and end-of-life care as common causes of conflict. All but one ethics committee member stated that hormonal contraception was forbidden under the directives; however, many members stated that this was either a gray area or permissible under certain circumstances. Reproductive health issues rarely came before the ethics committee at either site with one participant referring to them as "black and white issues." This research suggests that ethics committee members did not see the directives governing family planning services to be ambiguous. However, given the low frequency in which these issues come to the attention of the ethics committee, it is difficult to determine whether the opinions expressed by our participants contribute to the variability between Catholic hospitals when it comes to reproductive healthcare provision. An interesting topic for future research would be interviewing executives at Catholic hospitals to determine where this variability arises.

Promoting Affirmative Transgender Health Care Practice Within Hospitals: An IPE Standardized Patient Simulation for Graduate Health Care Learners.

Introduction: Transgender patients frequently experience discrimination within health care settings due to provider lack of knowledge and bias resulting in poor service delivery. Team-based interprofessional collaboration is becoming a best practice for health professionals to improve patient-centered care and address these health disparities. Methods: A team-based interprofessional education simulation activity was developed as a teaching activity at a university for graduate health care learners in medicine, nursing, occupational therapy, physical therapy, physician assistant, social work, and health care administration programs over 2 years (N = 494). The simulation focused on a transgender patient brought to the emergency department (ED) after a workplace assault. Students were placed in interprofessional teams and asked to critique the initial ED interaction with the patient and then complete a team huddle and discharge planning meeting with a standardized patient. Student preparedness to engage in the Interprofessional Education Collaborative (IPEC) competencies was assessed through a posttest measure. Results: Student learners reacted overwhelmingly positively to the activities of the workshop. The averaging of 2 years of data yielded students responses of strongly agree and agree at 90% or higher for all IPEC core competencies, as well as for educational objectives of the workshop. Discussion: Reducing the structural, interpersonal, and individual stigma experienced by transgender patients requires institutions to offer experiential learning opportunities for future health care providers. This interprofessional education simulation experience focusing on transgender patients calls attention to the negative impact of stigma while also promoting competency in interprofessional practice.

Sexual health behaviors in a random sample of students at a Mid-Atlantic university: 2010-2011.

College students represent a unique population of interest to researchers, college health clinic and wellness program directors, as well as policy makers who are interested in promoting sexual health and well-being in young adults. In order to better understand the needs of this population, a large public, Land-grant University in the Mid-Atlantic region participated in the National College Health Assessment survey during 2010 and 2011. A stratified random sample of full-time undergraduate and graduate students was invited to participate in an online survey. The final sample included 2,304 students. Descriptive statistics using Chi-square highlight the relationships between student sexual practices, sexual health screening and prevention practices, and receipt of sexual health education at the university. Regression analysis was conducted to examine the factors associated with receipt of sexual health education. Implications for college health and wellness stakeholders are discussed.

Influential factors in HPV vaccination uptake among providers in four states.

To examine health providers' perceived barriers, supports, and vaccination actions in delivering the HPV vaccine to females ages 9-17 in four states. Differences in providers' HPV vaccination of pre-adolescents compared with older adolescents were explored. A random sample of 1,500 pediatricians, family physicians, gynecologists, nurse practitioners, and physician assistants from four states were asked to complete a mail survey. Providers were recruited through state medical and nursing boards. The final sample included 227 respondents. Among those participants, health providers vaccinated older females (ages 13-17) at significantly higher rates than pre-adolescents (ages 9-12) in all four states. Providers who reported increased barriers to HPV vaccination were significantly less likely to vaccinate girls in either age group. The most frequent barriers reported by providers included the financial burden of the HPV vaccine and encountering patients (more often patients' parents) who have negative perceptions of vaccine. Most common supports included a personal belief in the positive impact of the HPV vaccine, followed by providers feeling comfortable talking with parents about the sexual nature of the vaccine, and the importance of adhering to the CDC's recommendations on HPV vaccination. Age of patient will likely influence providers' HPV vaccination behaviors, particularly if parents have concerns about vaccinating their pre-adolescents. Providers can best serve their patients when they are aware of the potential barriers and supports that may influence their HPV vaccination behaviors.