Participant observation elicits unique observation data from both an insider's and an outsider's perspectives. Despite the growing tendency to adopt participant observation strategies in health care research regarding health-related beliefs and types of behavior, the use of participant observation in current research is mostly limited to structured clinical settings rather than community settings. In this paper, we describe how we use participant observation in a community health research study with Chinese-born immigrant women. We document discrepancies between these women's beliefs and types of behavior regarding health and health promotion. We further discuss the ethnical, time, and setting challenges in community health research using participant observation. Possible solutions are also discussed.

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My dissertation is composed of two essays that investigate the interrelationship between consumers' health, education, behavioral choices, and perceptions. The first essay evaluates the impact of teenage smoking on schooling and estimates the lifetime income loss due to lower educational achievement and attainment caused by youth smoking. Using unusually rich data from China, the study shows that youth smoking can biologically reduce learning productivity and discourage motivation to go to school (where smoking is forbidden), resulting in lower educational outcomes and, consequently, reduced lifetime income. The second essay empirically analyzes the effect of a doctor diagnosis of hypertension (high blood pressure) on food demand and nutrient intake. The study shows that three quarters of the hypertensive population in China are unaware of their condition. A doctor's diagnosis can lead consumers to update their perceptions about their health and, therefore, make better decisions for their food choices. The study finds that, after a diagnosis of hypertension, consumers significantly reduce their daily fat intake, especially the consumption of animal oil and pork. The effect is stronger for 2004 data, compared to the 1997 and 2000 data. This suggests that consumers have become more health conscious in recent years. Comments

The aim of this quality improvement (QI) project was to assess a shadowing experience with a certified WOC nurse (CWOCN) on 4 interprofessional collaborative practice domains: interprofessional communication, role awareness and responsibilities, teams and teamwork, and values and ethics for interprofessional practice. PARTICIPANTS AND SETTING: Forty-nine physician residents in Family and Internal Medicine participated in this project set at a health system in Chicago, Illinois. APPROACH: Residents spent 16 hours shadowing a CWOCN and completed the Interprofessional Education Collaborative Competency Self-Assessment Tool (IPESAT) pre-and postshadowing that measured 4 interprofessional education (IPE) domains: interprofessional communication, role awareness and responsibilities, teams and teamwork, and values and ethics for interprofessional practice. Paired t tests were performed to determine differences in IPESAT scores before and after the shadowing experience. OUTCOMES: Residents demonstrated significant improvement in their overall knowledge of IPE (P = .000) as well as knowledge within each of the 4 domains (P = .000). After the shadowing experience, the overall ranking improved by 7.5%; the greatest gain (10.8%) occurred in the teamwork domain. IMPLICATIONS FOR PRACTICE:We found that even a comparatively brief shadowing experience with a CWOCN improved knowledge in IPE competencies. The shadowing experience is now permanently part of the Internal Medicine Residency program, and based on these IPE outcomes, other residency programs in our setting, such as the Rehabilitation and Family Medicine program, have increased their requests to shadow with the CWOCN.