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To utilise a community-based participatory approach in the design and implementation of an intervention targeting diet-related health problems on Navajo Nation.
A dual strategy approach of community needs/assets assessment and engagement of cross-sectorial partners in programme design with systematic cyclical feedback for programme modifications.
Navajo Nation, USA.
Navajo families with individuals meeting criteria for programme enrolment. Participant enrolment increased with iterative cycles.
The Navajo Fruit and Vegetable Prescription (FVRx) Programme.
A broad, community-driven and culturally relevant programme design has resulted in a programme able to maintain core programmatic principles, while also allowing for flexible adaptation to changing needs.
OBJECTIVES/SPECIFIC AIMS: The objective of this study was to prospectively assess caregiver-perceived barriers to accessing post-acute care for their injured child and determine if caregivers report ongoing, unmet health needs for their children after trauma. METHODS/STUDY POPULATION: This was a prospective cohort study that followed 50 participants for 6 months and administered surveys to parents of children who are admitted to a pediatric level 1 trauma center for injury. Surveys were given bi-weekly regarding care children received after hospital discharge. At 3 months, parents were surveyed over the phone on whether they were able to access all needed health services and if there were any perceived barriers to obtaining or providing at-home care. At 6 months, parents were given the Child & Family Follow-up Survey to assess ongoing physical, mental, social, and scholastic needs. Free responses and transcribed interviews were analyzed using thematic content analysis and frequencies are reported for discrete data. RESULTS/ANTICIPATED RESULTS: Out of 50 families recruited, 47 completed follow-up assessments. At 3 months, common themes regarding challenges after hospital discharge included difficulty scheduling specialist care; uncertainty in managing their child’s pain; transitioning home without enough knowledge to meet their child’s medical needs; lack of communication between multiple providers; distress at having providers release children to full activities before caregivers were comfortable. At 6 months, approximately 24% of parents reported children had ongoing cognitive limitations, 29% reported emotional problems, 19% reported physical limitations, 33.3% reported difficulty in school, and 15% reported play/social difficulties. DISCUSSION/SIGNIFICANCE OF IMPACT: Evidence suggests families face significant barriers in accessing follow-up care, despite nearly universal health insurance coverage for children. Further, a large percentage of parents report ongoing health needs, despite the majority of the cohort having only mild or moderate severity injuries. Making follow-up care more patient-centered for families of traumatically injured children may improve compliance with medical regiments and reduce the likelihood of future disability. Examples of this may be coordinating care among multiple specialty providers, so that patients with multiple injuries can schedule multiple follow-up appointments on the same day. Additionally, more caregiver education on administering pain medication, caring for wounds, and safe practices for returning to full activities would be beneficial for families.
Acute Care and Emergency Gynecology covers almost 100 common and uncommon gynecologic problems encountered in urgent and emergency settings. Problems are presented in a case-based approach, integrating relevant evidence-based major Society recommendations where available, and supplementing with carefully researched expert opinion for many common situations for which no guidelines apply. The emphasis in on management. Discussions are designed to be detailed enough to guide practice, but focused to where they can be read in the time available prior to seeing a patient. The book serves two goals: first, it is designed for the many providers who prefer case-based learning, particularly for continuing professional development purposes; secondly, it is designed for rapid reference for someone seeing a similar case in this setting. Essential reading for physicians, midwives, nurse practitioners, and physician assistants in the areas of gynecology, family medicine, and primary care who provide gynecologic care in the urgent and emergency setting.
Introduction: With evidence to support the use of text messaging for smoking cessation, some quitlines in North America have incorporated text messaging into their service offerings.
Aims: This study sought to evaluate whether integrated phone counselling and text messaging services are acceptable to quitline callers, and to identify strategies for improving text messaging services in the context of a quitline.
Methods: Thirty-five adult callers of the New Mexico state quitline who had enrolled in multi-call phone counselling and Text2Quit, a text messaging programme, were interviewed by phone. Interviews assessed use and acceptability of the phone counselling and text messaging interventions.
Results: Use of phone counselling and text messaging was generally high among participants. While most participants reported that they would highly recommend Text2Quit (75.8%) or phone counselling (78.8%) individually, a relatively higher proportion indicated they would highly recommend the combined services (93.9%). Suggestions for improvement focused on increased customisation and personalisation.
Conclusions: This study provides preliminary evidence for the acceptability of integrated phone counselling and text messaging services. Research is needed that explores the impact of these widely-used integrated services on smoking cessation.
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