BackgroundFor families with autistic children living in rural areas, limited access to services partly results from a shortage of providers and extensive travel time. Telehealth brings the possibility of implementing alternative delivery modalities of Parent Mediated Interventions (PMIs) with the potential to decrease barriers to accessing services. This study aimed to evaluate the feasibility and acceptability of implementing the World Health Organization-Caregivers Skills Training program (WHO-CST) via an online, synchronous group format in rural Missouri.MethodsWe used a mixed methods design to collect qualitative and quantitative data from caregivers and program facilitators at baseline and the end of the program, following the last home visit. Caregivers of 14 autistic children (3–7 years), residents of rural Missouri, completed nine virtual sessions and four virtual home visits.ResultsFour main themes emerged from the focus groups: changes resulting from the WHO-CST, beneficial aspects of the program, advantages and disadvantages of the online format, and challenges to implementing the WHO-CST via telehealth. The most liked activity was the demonstration (36%), and the least liked was the practice with other caregivers. From baseline to week 12, communication skills improved in both frequency (p < 0.05) and impact (p < 0.01), while atypical behaviors decreased (p < 0.01). For caregivers' outcomes, only confidence in skills (p < 0.05) and parental sense of competence (p < 0.05) showed a positive change.ConclusionOur results support the feasibility of implementing the WHO-CST program via telehealth in a US rural setting. Caregivers found strategies easy to follow, incorporated the program into their family routines, and valued the group meetings that allowed them to connect with other families. A PMI such as the WHO-CST, with cultural and linguistic adaptations and greater accessibility via telehealth-plays an essential role in closing the treatment gap and empowering caregivers of autistic children.

This study analyzed patients' perspectives about a measure of current, usual, and extreme pain and a measure of activity-related pain. Thirty-one patients with osteoarthritis participated in focus groups. Researchers completed thematic analysis of transcripts using coding software and an inductive approach. Three emerging themes were that many factors affected patients' perceptions and ratings of pain intensity, patients used different approaches to construct pain ratings, and patients interpreted maximal response anchors differently. Particularly, novel findings were that patients evaluated pain fluctuation, location, duration, and quality when constructing pain intensity ratings. Also, activity items helped patients to remember pain and provided a valued context for communicating pain experiences. However, the activities needed to be sufficiently described and personally relevant. These findings further clarify the challenges patients face and the workarounds they use when rating pain intensity. The patients' suggestions for improved administration methods and items warrant future investigation.

No abstract

Little is known about the experiences that influence entering medical students’ internal concepts of themselves as future physicians. During orientation to medical school, students were asked to write stories in response to the cue, “Tell a story about a person or experience that inspired you to consider a career of service in medicine.” Qualitative methodology was employed to analyze 190 student stories. Thematic analysis identified descriptive details about content and allowed comparison between the students’ and School’s expectations. Inspirational settings, contexts, and individuals were identified. Nine different inspirational events were described. Student and School expectations for the kinds of physicians they hoped to become were generally consistent. The study demonstrates that students do indeed bring to medical school visions of the kinds of physicians they hope to become. Linking that vision with medical school activities including the White Coat Ceremony provides a bridge between medical school and students’ earlier lives, thus explicitly linking orientation to professional formation.

Community-academic partnerships have demonstrated how collaboration can provide academic healthcare workers and non-medical community providers such as educators and social services with a comprehensive view of issues affecting refugee populations. The ICIH (Interagency Council on Immigrant Health) is a physician-community partnership consisting of healthcare professionals, non-medical educators, social workers, early childhood services and other community agencies. It was formed to address the well-being of a local immigrant population, strengthen bonds between the community and healthcare system, and educate and empower pediatricians to provide culturally aware services. The collaboration has been very successful as demonstrated by the production of multiple collaborative products in a very short time period with minimal funding. This article explores the experiences of community and physician members in order to share insights and recommendations for others working in small cities who wish to start such a collaborative. We collected data from 17 of 30 ICIH members through focus groups, interviews, and a survey and conducted a qualitative analysis using transcripts from these sessions. From our analysis, the following themes emerged: 1) increased awareness of challenges faced by refugee families, 2) making connections and collaborating with a diverse group of agencies, 3) improvement of care for the population using knowledge learned through the ICIH, 4) expanding perspectives through the sharing of information between agencies, 5) the importance of education for providers and community members about the refugee population, and 6) relational support gained through interaction with other service providers struggling to overcome similar obstacles. Results support the ideals of a productive community-academic partnership. With this information, we present recommendations for others working to establish similar community-academic collaboration efforts.

No abstract

No abstract

No abstract