Interprofessional perspectives on faculty-to-faculty incivility from nursing and social work.

Healthcare delivery systems frequently require interprofessional collaboration between members of several health and social care professions. In the United States, two of the largest are nursing and social work. How these two professions address incivility between faculty members is not well understood. This paper describes the results of an examination of Faculty-to-Faculty Incivility (FFI) by both social work and nursing educators. National surveys of U.S. social work faculty (n = 216) and nursing faculty (n = 588) indicate common concerns between the two groups. Nursing and social work educators experience similar rates of behaviors that may be considered FFI, but social workers are more likely to identify these behaviors as uncivil. Data suggest that there are differences between nursing and social work faculty in their beliefs about the causes of FFI, and also in their reported barriers to addressing FFI in the workplace. The discussion highlights concerns that are common between the groups, contextual aspects that differ between the two professions, and ways in which interprofessional collaboration between nurses and social workers in academia and healthcare can help to address this problem among both groups.

A Community-Wide Collaboration to Reduce Cardiovascular Disease Risk: The Hearts of Sonoma County Initiative.

PURPOSE AND OBJECTIVES: Collaboration across multiple sectors is needed to bring about health system transformation, but creating effective and sustainable collaboratives is challenging. We describe outcomes and lessons learned from the Hearts of Sonoma County (HSC) initiative, a successful multi-sector collaborative effort to reduce cardiovascular disease (CVD) risk in Sonoma County, California. INTERVENTION APPROACH: HSC works in both clinical systems and communities to reduce CVD risk. The initiative grew out of a longer-term county-wide collaborative effort known as Health Action. The clinical component involves activating primary care providers around management of CVD risk factors; community activities include community health workers conducting blood pressure screenings and a local heart disease prevention campaign. EVALUATION METHODS: The impact of the clinical improvement efforts was tracked using blood pressure data from the 4 health systems participating in HSC. Descriptive information on the community-engagement efforts was obtained from program records. Lessons learned in developing and maintaining the collaborative were gathered through document review and interviews with key informants. RESULTS: Favorable trends were seen in blood pressure control among patients with hypertension in the participating health systems: patients with controlled blood pressure increased from 58% in 2014 to 67% in 2016 (P < .001). Between 2017 and 2019, the community engagement effort conducted 99 outreach events, reaching 1,751 individuals, and conducted 1,729 blood pressure screenings, with 441 individuals referred to clinical providers for follow-up care. HSC scored highly on 6 essential elements of an effective coalition and achieved a degree of sustainability that has eluded many other collaboratives. IMPLICATIONS FOR PUBLIC HEALTH: Factors contributing to the success of HSC include 1) starting small and focused to build trust among participants and demonstrate value, 2) working within the framework of a larger effort, and 3) providing long-term, open-ended backbone support.

Student perspectives on diversity and the cultural climate at a U.S. medical school.

PURPOSE: To obtain the perspectives of medical students at one school on racial/ethnic campus diversity and cultural competence and to gain their perceptions of the institutional climate around diversity at their university and of reasons for minority underrepresentation at their medical school. METHOD: A student-driven survey of all medical students (N = 398) at a single medical school in the spring of 2003, supplemented by four focus groups from all racial and ethnic groups on the campus. RESULTS: A large majority of the responding students (n = 216; 54%) endorsed the value of campus diversity and the importance of cultural competence to the process of becoming a clinician. Most students felt their university had achieved a positive cultural climate, characterized by openness to diverse perspectives and attention to equity. Most students also felt that the university's programs and policies reflected a commitment to diversity, but fewer students--those from underrepresented minorities (URMs) in particular--felt that the university truly valued having a diverse student body and faculty. Most students felt that the lack of diversity on campus was a barrier to recruiting and retaining minority candidates. Some minority students also blamed the medical school's limited social, academic, and financial support, as well as inadequate efforts to recruit minority students. CONCLUSIONS: Medical students generally place a high value on campus diversity and cultural competence. URM students in particular felt that their university could do more to implement its commitment to diversity, including making greater efforts to recruit and retain URM students. These views constitute a barometer for medical schools to gauge and track their efforts to enhance campus diversity, incorporate cultural competence education, and create an inclusive and welcoming climate for students of all backgrounds.

Living with severe mental illness--what families and friends must know: evaluation of a one-day psychoeducation workshop.

One-day "family survival" psychoeducation workshops are a promising, convenient method of disseminating basic information to families with a relative who is diagnosed with a serious mental illness such as schizophrenia, major depression, or other affective disorders. At five separate psychoeducation workshops, 83 participating families completed the self-report North-Sachar Family Life Questionnaire and open-ended "problem lists" of issues facing the families both before and after the workshops. Outcomes consistently demonstrated positive change pre- to post-workshop. Issues reported by workshop participants included desire for education about illness, identification of resources, coping with the illness, and family relationships. The workshop model demonstrated consistent achievement of the outcomes measured, meeting short-term goals. Although models such as the family responsive approach reported in this article are not designed to create long-term gains for the family, they appear to benefit families and may help connect families with more intensive services to facilitate long-term change.

Certification and program regulations for inpatient services to youth with addiction: a state-level analysis.

Recent evidence has indicated that the prevalence of addiction in youth is far higher than previously expected. High demand for services to this population require attention to programs providing interventions, in particular to the regulations and structures that assure youth receive quality services. Thus, the current research examines state-level certification and program requirements for inpatient youth facilities. Current data (from August 2002 through July 2003) on state-level regulations was collected from a variety of sources. Wherever possible, confirmation was sought from multiple sources. Multiple authors interpreted information. Youth with addictions are currently being treated across a wide variety of governmental agencies. Level of detail and clarity of information varied widely, as did distinctness of youth requirements from adult ones. Adequate regulatory attention was evident in a minority of states, while a handful of states did little or nothing to distinguish youth from adult services. While it is undoubtedly the case that providers within each state offer outstanding services, there is often little or no available protection for these youth through governmental regulations. Attention is needed in almost all states to providing additional regulations and program requirements that assure youth consistency in service quality. Recommendations are made for standards of certification requirements.