American journal of preventive medicine
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Randomized Controlled Trial
Telephone counseling and attendance in a national mammography-screening program a randomized controlled trial.
In Germany, a mammography-screening program (MSP) was implemented on a national level. It complies with all criteria of the European guidelines for quality assurance in screening mammography; however, the attendance rate is 54%, falling short of the target attendance rate of 70%. The aim of this study was to investigate whether additional telephone counseling improves attendance among nonresponders and the level of satisfaction with telephone counseling. ⋯ Individual telephone counseling for nonresponders to a national program for breast cancer screening was well accepted by participants and effective.
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Public health situations faced by family physicians and other primary care practitioners, such as severe acute respiratory syndrome (SARS) and more recently H1N1, have resulted in an increased interest to identify the public health competencies relevant to family medicine. At present there is no agreed-on set of public health competencies delineating the knowledge and skills that family physicians should possess to effectively face diverse public health challenges. ⋯ These competencies will also be used to guide the development of a family medicine-public health primer and faculty development sessions to support family medicine faculty facilitating residents to achieve these competencies. Once more fully implemented, an evaluation will be initiated to determine the degree to which these public health competencies are being achieved by family medicine graduates, especially whether they attained the knowledge, skills, and confidence necessary to effectively face diverse public health situations-from common to emergent.
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This is one of six short papers that describe additional innovations to help integrate public health into medical education; these were featured in the "Patients and Populations: Public Health in Medical Education" conference. They represent relatively new endeavors or curricular components that had not been explored in prior publications. Although evaluation data are lacking, it was felt that sharing a description of a longitudinal curriculum focused on the development of basic advocacy skills through practical activities in community assessment and engagement combined with legislative advocacy at the University of New Mexico would be of value to medical educators.
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In 1999, Determinants of Community Health was introduced at the Faculty of Medicine, University of Toronto. The course spanned all 4 years of the undergraduate curriculum and focused on addressing individual patient and community needs, prevention and population health, and diverse learning contexts. ⋯ For the same amount of curricular time, an integrated spiral curriculum for teaching public health appears to be more effective than traditional approaches.
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In an era of substantial reform to the nation's health system, there has never been a greater need for physicians to understand public health. One way to foster public health in medical education is to utilize the resources within General Preventive Medicine and Public Health (PM) residency programs. Trained in public health and clinical medicine, PM physicians are uniquely positioned to bridge these disciplines. ⋯ These results suggest that PM residency programs are an underutilized resource in fostering public health in medical education, especially on engagement at the level of graduate medical education. Strategies to improve engagement should consider the nine criteria outlined in this study, as well as common barriers.