- Email: [email protected]
Medical Students Leading a High School Health Education Program: Evaluation of Mihealth
Poster Abstracts / 60 (2017) S39eS82
an opportunity to discuss emergency contraception (EC) with adolescents in both primary care and acute care settings. The objective of this study was to examine training experiences in EC, and exposure to adolescent EC counseling during residency among providers who frequently see adolescents. Methods: Semi-structured individual interviews were conducted from June e October 2014 with 24 residents from four urban, academic institutions. Residents from family medicine, pediatrics, and emergency medicine where included in this study and were termed “frontline adolescent providers”. To recruit these residents, program administrators distributed a study informational email to residents and interested residents contacted the research team. Residents provided written consent and completed a brief demographic survey before the interview. Participants were recruited to meet an a priori recruitment goal of two residents from each specialty program at each hospital. The interview guide contained open-ended questions with set probes designed to explore residents’ educational and training experiences around adolescent sexual health and EC. Interviews were digitally recorded and transcribed. Using modified grounded theory, interviews were analyzed for salient themes. Results: Few residents had personally counseled adolescents about EC. Residents considered EC within their scope of practice but residents’ perception of their role in EC counseling depended on the way in which they viewed their own specialty. Those that viewed their specialty as preventative saw EC as different from, and even the opposite of, “maintenance contraception” and as an emergency intervention. As such, they believed EC counseling primarily should take place in an acute care setting. However, those who were engaged in emergent care saw EC as a primary care intervention, unless it was in the case of sexual assault, and believed this counseling should be occurring during a scheduled clinic visit before need of the method. Residents from different specialties expressed conflicting ideas around whose responsibility it was to start conversations around sexual health and contraception. Participants expressed they were nearly always the first to initiate conversations involving sexual health topics; when discussing EC, however, they reported not talking about it because adolescents never ask for it specifically. During the interviews, many residents reflected on their own framework and how they could incorporate EC into other situations or settings in the future. Conclusions: Frontline adolescent providers have a critical role in adolescent health care. Reframing EC for its diverse roles along the continuum of prevention and acute treatment may ensure that a wider variety of clinicians engage in EC counseling. It also important to highlight providers’ responsibility to initiate all adolescent sexual health and contraception conversations. This may lead to increased awareness of EC need. Sources of Support: Society of Family Planning Research Fund. 96. MEDICAL STUDENTS LEADING A HIGH SCHOOL HEALTH EDUCATION PROGRAM: EVALUATION OF MIHEALTH Kathryn S. Brown, BS 1, Margaret Riley, MD 2, Kaitlin A. Meixner, MAT 1, Christina DeBenedictus, BA 1. 1
University of Michigan Medical School; 2Department of Family Medicine, University of Michigan Medical School. Purpose: Recognizing the prevalence of health risk behaviors in the adolescent population and the reported inconsistency of high
S53
school health education, preclinical medical students designed a program, ‘MiHealth,’ in which medical students teach health lessons in the high school classroom. MiHealth aims to reduce adolescent health disparities while developing community-oriented physicians committed to providing exemplary medical communication and preventive health education in the clinic and in the communities they serve. Methods: MiHealth medical student leaders created a series of six interactive, sixty-minute lessons with the following themes: Smoking & Drugs (including e-cigarettes), Mental Health, Healthy Relationships, Sexual Health, Nutrition, and Fitness & Exercise. The lessons were delivered to two health classes at a local high school with a significant population of economically disadvantaged students. High school students receiving the MiHealth curriculum (n¼52) and a control group (n¼61) were surveyed on their knowledge, attitudes, and intentions relating to health and risk behaviors before and after the program. Medical students were surveyed on the impact of participating as program instructors. Results: Six weeks after program completion, high school students who received the MiHealth curriculum scored significantly higher on the health knowledge questionnaire (p¼0.007), and expressed significantly healthier attitudes and intentions toward risk behavior compared to the control group (p¼0.025). Participating medical students expressed greater commitment for future community involvement, work with underserved populations, and involvement in education while in medical school and in their careers. Conclusions: MiHealth is a high-yield, low input program that allows medical students to develop their teaching skills while working in the community to educate adolescents and decrease their risk behaviors. The program resulted in promising trends towards long-term knowledge retention and attitude change in adolescents, and may help mitigate the loss of drive for community service seen as medical students progress through medical school. Sources of Support: Not applicable. 97. DOES A RESIDENT EDUCATIONAL INTERVENTION INCREASE THE NUMBER OF REFERRALS FOR LONG-ACTING REVERSIBLE CONTRACEPTIVES (LARC) IN A RESIDENT-PREDOMINANT INNERCITY PEDIATRIC CLINIC? Laura Koenigs, MD, FSAHM, Shannon Fitzgerald, MD, Maayan Melamed, MD, Jennifer Friderici, MS. Baystate Medical Center.
Purpose: Long-acting reversible contraception (LARC) is composed of single-rod contraceptive implants and copper and levonorgestrel intrauterine devices (IUDs). These are associated with the highest rates of satisfaction and lowest rates of failure among reversible contraceptives. Possibly due to provider misconceptions, LARC is underutilized in many populations, particularly adolescents. To address this gap, we developed a resident-led workshop to improve Pediatric and Med-Peds residents’ knowledge about LARC’s indications, safety and efficacy. Our study asked the question “Does providing educational sessions regarding LARC change Resident Physicians’ knowledge and beliefs about LARC?” A secondary question was, “Does providing educational sessions regarding LARC to pediatric residents increase the number of referrals of adolescent patients in the resident clinic for LARC?”
an opportunity to discuss emergency contraception (EC) with adolescents in both primary care and acute care settings. The objective of this study was to examine training experiences in EC, and exposure to adolescent EC counseling during residency among providers who frequently see adolescents. Methods: Semi-structured individual interviews were conducted from June e October 2014 with 24 residents from four urban, academic institutions. Residents from family medicine, pediatrics, and emergency medicine where included in this study and were termed “frontline adolescent providers”. To recruit these residents, program administrators distributed a study informational email to residents and interested residents contacted the research team. Residents provided written consent and completed a brief demographic survey before the interview. Participants were recruited to meet an a priori recruitment goal of two residents from each specialty program at each hospital. The interview guide contained open-ended questions with set probes designed to explore residents’ educational and training experiences around adolescent sexual health and EC. Interviews were digitally recorded and transcribed. Using modified grounded theory, interviews were analyzed for salient themes. Results: Few residents had personally counseled adolescents about EC. Residents considered EC within their scope of practice but residents’ perception of their role in EC counseling depended on the way in which they viewed their own specialty. Those that viewed their specialty as preventative saw EC as different from, and even the opposite of, “maintenance contraception” and as an emergency intervention. As such, they believed EC counseling primarily should take place in an acute care setting. However, those who were engaged in emergent care saw EC as a primary care intervention, unless it was in the case of sexual assault, and believed this counseling should be occurring during a scheduled clinic visit before need of the method. Residents from different specialties expressed conflicting ideas around whose responsibility it was to start conversations around sexual health and contraception. Participants expressed they were nearly always the first to initiate conversations involving sexual health topics; when discussing EC, however, they reported not talking about it because adolescents never ask for it specifically. During the interviews, many residents reflected on their own framework and how they could incorporate EC into other situations or settings in the future. Conclusions: Frontline adolescent providers have a critical role in adolescent health care. Reframing EC for its diverse roles along the continuum of prevention and acute treatment may ensure that a wider variety of clinicians engage in EC counseling. It also important to highlight providers’ responsibility to initiate all adolescent sexual health and contraception conversations. This may lead to increased awareness of EC need. Sources of Support: Society of Family Planning Research Fund. 96. MEDICAL STUDENTS LEADING A HIGH SCHOOL HEALTH EDUCATION PROGRAM: EVALUATION OF MIHEALTH Kathryn S. Brown, BS 1, Margaret Riley, MD 2, Kaitlin A. Meixner, MAT 1, Christina DeBenedictus, BA 1. 1
University of Michigan Medical School; 2Department of Family Medicine, University of Michigan Medical School. Purpose: Recognizing the prevalence of health risk behaviors in the adolescent population and the reported inconsistency of high
S53
school health education, preclinical medical students designed a program, ‘MiHealth,’ in which medical students teach health lessons in the high school classroom. MiHealth aims to reduce adolescent health disparities while developing community-oriented physicians committed to providing exemplary medical communication and preventive health education in the clinic and in the communities they serve. Methods: MiHealth medical student leaders created a series of six interactive, sixty-minute lessons with the following themes: Smoking & Drugs (including e-cigarettes), Mental Health, Healthy Relationships, Sexual Health, Nutrition, and Fitness & Exercise. The lessons were delivered to two health classes at a local high school with a significant population of economically disadvantaged students. High school students receiving the MiHealth curriculum (n¼52) and a control group (n¼61) were surveyed on their knowledge, attitudes, and intentions relating to health and risk behaviors before and after the program. Medical students were surveyed on the impact of participating as program instructors. Results: Six weeks after program completion, high school students who received the MiHealth curriculum scored significantly higher on the health knowledge questionnaire (p¼0.007), and expressed significantly healthier attitudes and intentions toward risk behavior compared to the control group (p¼0.025). Participating medical students expressed greater commitment for future community involvement, work with underserved populations, and involvement in education while in medical school and in their careers. Conclusions: MiHealth is a high-yield, low input program that allows medical students to develop their teaching skills while working in the community to educate adolescents and decrease their risk behaviors. The program resulted in promising trends towards long-term knowledge retention and attitude change in adolescents, and may help mitigate the loss of drive for community service seen as medical students progress through medical school. Sources of Support: Not applicable. 97. DOES A RESIDENT EDUCATIONAL INTERVENTION INCREASE THE NUMBER OF REFERRALS FOR LONG-ACTING REVERSIBLE CONTRACEPTIVES (LARC) IN A RESIDENT-PREDOMINANT INNERCITY PEDIATRIC CLINIC? Laura Koenigs, MD, FSAHM, Shannon Fitzgerald, MD, Maayan Melamed, MD, Jennifer Friderici, MS. Baystate Medical Center.
Purpose: Long-acting reversible contraception (LARC) is composed of single-rod contraceptive implants and copper and levonorgestrel intrauterine devices (IUDs). These are associated with the highest rates of satisfaction and lowest rates of failure among reversible contraceptives. Possibly due to provider misconceptions, LARC is underutilized in many populations, particularly adolescents. To address this gap, we developed a resident-led workshop to improve Pediatric and Med-Peds residents’ knowledge about LARC’s indications, safety and efficacy. Our study asked the question “Does providing educational sessions regarding LARC change Resident Physicians’ knowledge and beliefs about LARC?” A secondary question was, “Does providing educational sessions regarding LARC to pediatric residents increase the number of referrals of adolescent patients in the resident clinic for LARC?”