Impact of an Academic–Community Partnership in Medical Education on Community Health: Evaluation of a Novel Student-Based Home Visitation Program

Rock, John A.; Acuña, Juan; Lozano, Juan Manuel; Martínez, Irene; Greer, Pedro; Brown, David R.; Brewster, Luther G.; Simpson, Joe Leigh

doi:10.1097/smj.0000000000000080

Cited by 24 publications

(11 citation statements)

References 28 publications

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“…NeighborhoodHELP challenges students to address complex real-world behavioral, environmental, ethical, medical, legal, and social issues through a household-centered approach in which teams visit medically underserved households in Miami-Dade County, Florida. 6 Household members receive services in exchange for helping to educate students. We define “household” as a group of individuals residing together within a dwelling, and we define “household-centered care” as identifying and helping to manage the social determinants that can improve the health outcomes of members of a household.…”

Section: Approachmentioning

confidence: 99%

Socially Accountable Medical Education: An Innovative Approach at Florida International University Herbert Wertheim College of Medicine

et al. 2018

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ProblemDespite medical advances, health disparities persist, resulting in medicine’s renewed emphasis on the social determinants of health and calls for reform in medical education.ApproachThe Green Family Foundation Neighborhood Health Education Learning Program (NeighborhoodHELP) at Herbert Wertheim College of Medicine provides a platform for the school’s community-focused mission. NeighborhoodHELP emphasizes social accountability and interprofessional education while providing evidence-based, patient- and household-centered care. NeighborhoodHELP is a required, longitudinal service–learning outreach program in which each medical student is assigned a household in a medically underserved community. Students, teamed with learners from other professional schools, provide social and clinical services to their household for three years. Here the authors describe the program’s engagement approach, logistics, and educational goals and structure.OutcomesDuring the first six years of NeighborhoodHELP (September 2010–August 2016), 1,470 interprofessional students conducted 7,452 visits to 848 households with, collectively, 2,252 members. From August 2012, when mobile health centers were added to the program, through August 2016, students saw a total of 1,021 household members through 7,207 mobile health center visits. Throughout this time, households received a variety of free health and social services (e.g., legal aid, tutoring). Compared with peers from other schools, graduating medical students reported more experience with clinical interprofessional education and health disparities. Surveyed residency program directors rated graduates highly for their cultural sensitivity, teamwork, and accountability.Next StepsFaculty and administrators are focusing on social accountability curriculum integration, systems for assessing and tracking relevant educational and household outcomes, and policy analysis.

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Section: Approachmentioning

confidence: 99%

Socially Accountable Medical Education: An Innovative Approach at Florida International University Herbert Wertheim College of Medicine

et al. 2018

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“…Medical students continue to be responsible for their assigned households until they graduate. The program resulted in a decrease in emergency room visits among student-visited households as well as an increase in preventive health screening (Breslin and Roller 2016;Rock et al 2014).…”

Section: Continuous Themesmentioning

confidence: 99%

“…Transformation in terminology to "communityengaged" is evidenced in the curriculum described above in the "Student Education" section. The anthropologist was instrumental in the conceptualization, development, and implementation of the Medicine and Society curricular strand as well as the focus on the participation of communitymembers in the oversight advisory board and collection of baseline data for the benchmark study for NHELP (Rock et al 2014). The language of cultural competence and working with multicultural populations, originally found in the 1996 plan, transformed into language focused on addressing the social determinants of disease and health disparities.…”

Section: Transforming Themesmentioning

confidence: 99%

Organizational Culture Theme Theory and Analysis of Strategic Planning for a New Medical School

Wiedman¹,

Martínez²

2017

Human Organization

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Acknowledgements go to FIU Past President Maidique whose strong leadership envisioned FIU as a research university. Provost James Mau and Tom Breslin encouraged anthropological research, while Wiedman was in an administrative role. Experience was gained by working with Hazel Weidman, a founder of the Society for Medical Anthropology, who demonstrated the effectiveness of community-based culturally sensitive health care. We'd also like to acknowledge the vision of the College of Medicine in hiring Iveris Martinez, an anthropologist, to engage in curriculum development and teaching.

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“…13 The Florida International University (FIU) Herbert Wertheim College of Medicine (HWCOM) has a strong foundation in the community and supports prevention efforts through its backbone community-based program, the Green Family Foundation Neighborhood HELP (described elsewhere). 14 Through the program, the HWCOM's Department of Medical and Population Health Sciences Research has developed intense and extensive coverage of underserved, underprotected areas in MDC and has conducted 3 population-based surveys that have provided knowledge and needs assessments for these 3 communities. The purpose of this study is to describe the population in 3 areas of interest in MDC for the community programs of the FIU HWCOM between 2009 and 2013, and to provide a profile of the older population living on these areas.…”

Section: Introductionmentioning

confidence: 99%

Profile of the Older Population Living in Miami-Dade County, Florida

Zevallos¹,

Wilcox²,

Jean

et al. 2016

Medicine

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Florida has the greatest proportion (19%) of older population (65 years or older) in the United States. The age distribution of its residents, in conjunction with a major shift in the leading cause of death within all age groups from acute illnesses to chronic disease, creates unprecedented health care challenges for the state. The objective of this study is to profile the older population living in Miami-Dade County (MDC) using 3 population-based, household-based surveys conducted over the past 5 years.This study examined cross-sectional data (demographics, health outcomes, risk factors, health assess, and utilization) collected from probability-sampled, household-based surveys conducted in 3 areas of MDC: north Miami-Dade, Little Haiti, and South Miami. The questionnaire was administered face-to-face by trained interviewers in English, Spanish, French, or Creole. Analyses were restricted to households containing at least 1 member aged 65 years or older (n = 935). One consenting adult answered the questionnaire on behalf of household members.The mean age of the respondent (60% females) was 60 years. Overall, respondents were predominantly African-Americans, Hispanics, and blacks of Haitian origin. One-third of all households fell below the US poverty thresholds. One-quarter of all households had at least 1 member who was uninsured within the year before the survey. Twenty percent of households had at least 1 member with an acute myocardial infarction or stroke during the year before the survey. Bone density tests and blood stool tests were strikingly underutilized. The health outcomes most prevalent within household members were cardiovascular diseases followed by cancer, anxiety/depression, obesity, asthma, and bone fractures. Twenty percent of households reported having at least 1 current smoker. Overall, emergency rooms were the most commonly used places of care after doctor's offices.Findings of 3 household-based surveys show a predominantly elderly, female, uninsured, and poor minority populations living in MDC, FL. The reported use of preventive services was constrained, and emergency room use was often reported as a main resource for health care. Cardiovascular disease, cancer, bone fractures, and related risk factors were the most prevalent health outcomes.

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Impact of an Academic–Community Partnership in Medical Education on Community Health: Evaluation of a Novel Student-Based Home Visitation Program

Cited by 24 publications

References 28 publications

Socially Accountable Medical Education: An Innovative Approach at Florida International University Herbert Wertheim College of Medicine

Socially Accountable Medical Education: An Innovative Approach at Florida International University Herbert Wertheim College of Medicine

Organizational Culture Theme Theory and Analysis of Strategic Planning for a New Medical School

Profile of the Older Population Living in Miami-Dade County, Florida

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