Genetic counseling and testing (GCT) inform cancer management for persons at risk for hereditary breast and ovarian cancer (HBOC). Community‐based organizations (CBOs) may play a role in identifying at‐risk Latinx individuals to connect them to GCT but data are lacking. Two academic centers and their four CBO partners planned to implement a validated questionnaire for HBOC risk screening (“HBOC risk screening tool”). This study aimed to assess CBO's preferences for HBOC risk screening tools, as well as the barriers and facilitators anticipated for future implementation. Pre‐implementation focus groups were conducted with CBO's staff. Discussions centered on current practices to identify and refer at‐risk patients. During the discussion, staff were asked to select one out of five validated HBOC risk screening tools to implement and to discuss anticipated barriers/facilitators for implementation. The four focus groups were coded and qualitative analyzed following the Consolidated Framework for Implementation Research (CFIR) and Health Equity domains. All CBOs chose the Family History Screen 7 (FHS‐7). Participants (N = 35) highlighted how the FHS‐7 was easy to adapt to better fit the target population and changing guidelines. They had positive attitudes toward implementing the screening tool, stressed how the culture of the organization positioned them to reach the target population, and noted barriers in different CFIR domains (e.g., low knowledge about HBOC and GCT referrals; scarce available resources). Participants pointed to barriers related to health equity domains including limited access to GCT and follow‐up care for uninsured and underinsured populations, challenges obtaining accurate family history, and immigration‐related barriers. CBOs highlighted the importance of partnering with other stakeholders to overcome barriers. Findings emphasize the need to develop multi‐level implementation strategies to overcome barriers and leverage facilitators. This study can inform the development of implementation toolkits for CBOs to implement HBOC screening tools to advance health equity.
Aim: To assess the impact of international surgical observership, the level of satisfaction of past participants and obtain their feedback on their experience. Since 2011, the international observership program (IOP) is offered in partnership with the Panamerican Trauma Society (PTS) and the Virginia Commonwealth University (VCU), Division of Acute Care Surgery Services. The IOP has facilitated knowledge exchange opportunities on trauma care and emergency medical systems (EMSs) for physicians in training from Latin America countries. Materials and methods: An online survey using REDCap was conducted among past participants (n = 36). The 14-question survey had a combination of dichotomous, multiple-choice, open-ended, and Likert scale questions. To keep the survey anonymous, participant identifiers were not used. Descriptive analysis was carried out. Results: The response rate was 53% (n = 19). The overall effect of IOP should be considered as positive, as 17 (89%) respondent alumni consider the IOP exceeded or met their expectations and 18 (95%) would recommend it to a friend and colleague. Similarly, 89% of the IOP's alumni believe that the observership helped them with their career growth. Most of the observers commented that the experience was inspiring, opened their minds, and broadened their horizons. Conclusion:The present survey adds further evidence of the positive impact that international observerships offer to physicians in training coming from low-and middle-income countries. The IOP introduces students to new knowledge for comprehensive care of trauma patients that would be advantageous to their future professional roles.
Background: Increasing access to safe, timely, and affordable acute care in low- and middle-income countries is a worldwide priority. Longitudinal curricula on systems of acute care have not been previously described. Objectives: The authors aimed to develop a novel four-year longitudinal curriculum for medical students addressing systems development across multiple acute care specialties. Methods: The authors followed Kern’s six-step framework for curriculum design. After review of literature, a group of medical students and school of medicine faculty conducted a targeted needs assessment. Foundational goals and objectives were adapted from the 39 interprofessional global health competencies by the Consortium of Universities for Global Health. Educational strategies include didactic sessions, workshops, journal clubs, preceptorships, and community outreach. Clinical years include specialty-specific emphases, guided junior-level discussions, and a capstone project. Yearly SWOT and Kirkpatrick model analyses served as program evaluation. Findings: The Curriculum Council approved the program in July 2019. During the first cycle, the program matriculated 30 students from classes of 2023 (14) and 2022 (16). The first year produced 11 interactive sessions, 6 journal clubs, and 10 seminars led by 31 faculty and guest speakers; 29/30 students completed requirements; 87 evaluations reflected 4.57/5 content satisfaction and 4.73/5 instructor satisfaction. The 2023 cohort reported improved understanding of session objectives (3.13/5 vs. 3.82/5, p = 0.03). Free-text feedback led to implementation of pre-reading standardization and activity outlines. Conclusion: The Program was well-received and successfully implemented. It meets the needs of graduating medical students interested in leading global health work. This novel student-faculty collaborative model could be applied at other institutions seeking to provide students with a foundation in global acute care.
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