Benjamin McIntire, Susan Greni, Stephanie Radil, M. Menning
Background: The University of Nebraska Medical Center (UNMC) is the host of a student-run free clinic (SRFC) called SHARING (Student Health Alliance Reaching Indigent Needy Groups) which has been serving uninsured patients in the Omaha metro area since 1997. Interprofessional student volunteers from medicine, pharmacy, nursing, medical laboratory science, physical therapy, and physician assis-tant programs operate under the supervision of an attending physician at each clinic. As a quality improvement project regarding volunteer recruitment, a survey of students was undertaken to de-termine the motivations and barriers to participation at SHARING. Methods: An anonymous, web-based survey hosted on Microsoft Forms was sent once to current UNMC students using their institutional email addresses. The survey included Likert scale as well as open- and closed-ended questions. Themes were identified in the responses to the open-ended ques-tions and tallied. Results: Out of 1,310 students surveyed, 137 participated for a response rate of 10.5%. Of those who responded, 65% had previously volunteered at SHARING, and their top motivators included gaining clinical experience and helping people in need of free healthcare. Likert scale questions indicated that volunteers were satisfied with their experiences and improved their empathy, clinical reasoning, and interprofessional skills. Of those who had not participated at SHARING, the top barriers were reported to be lack of time for volunteering and feeling inadequately prepared to offer medical care. Conclusion: Decreasing barriers to participation is important for a successful SRFC to be staffed by busy student volunteers. Suggestions for improved participation included a more detailed training program, more flexibility in clinic scheduling, academic incentives such as awards/recognition, and prioritization of advertising efforts. Due to the limited number of respondents to this survey, a wider study may give more detailed feedback that could lead to further quality improvement measures.
{"title":"A Look into Motivations and Barriers to Student Involvement at the SHARING Clinic, a Student-Run Free Clinic","authors":"Benjamin McIntire, Susan Greni, Stephanie Radil, M. Menning","doi":"10.59586/jsrc.v8i1.313","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.313","url":null,"abstract":"Background: The University of Nebraska Medical Center (UNMC) is the host of a student-run free clinic (SRFC) called SHARING (Student Health Alliance Reaching Indigent Needy Groups) which has been serving uninsured patients in the Omaha metro area since 1997. Interprofessional student volunteers from medicine, pharmacy, nursing, medical laboratory science, physical therapy, and physician assis-tant programs operate under the supervision of an attending physician at each clinic. As a quality improvement project regarding volunteer recruitment, a survey of students was undertaken to de-termine the motivations and barriers to participation at SHARING. \u0000Methods: An anonymous, web-based survey hosted on Microsoft Forms was sent once to current UNMC students using their institutional email addresses. The survey included Likert scale as well as open- and closed-ended questions. Themes were identified in the responses to the open-ended ques-tions and tallied. \u0000Results: Out of 1,310 students surveyed, 137 participated for a response rate of 10.5%. Of those who responded, 65% had previously volunteered at SHARING, and their top motivators included gaining clinical experience and helping people in need of free healthcare. Likert scale questions indicated that volunteers were satisfied with their experiences and improved their empathy, clinical reasoning, and interprofessional skills. Of those who had not participated at SHARING, the top barriers were reported to be lack of time for volunteering and feeling inadequately prepared to offer medical care. \u0000Conclusion: Decreasing barriers to participation is important for a successful SRFC to be staffed by busy student volunteers. Suggestions for improved participation included a more detailed training program, more flexibility in clinic scheduling, academic incentives such as awards/recognition, and prioritization of advertising efforts. Due to the limited number of respondents to this survey, a wider study may give more detailed feedback that could lead to further quality improvement measures.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46940861","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Students and faculty at the University of Texas Medical Branch (UTMB) embarked on the novel undertaking of establishing a comprehensive, interprofessional clinic treating underserved, uninsured residents of Galveston County, Texas, and the surrounding area, modeled after the patient-centered medical home (PCMH). The need for such a community clinic is evident in relevant literature and patients’ suggestions, in addition to local demographic data. The comprehensive nature of this approach to clinic design is apparent in the intricate planning and documents produced by the steering committee, which outline a unique operational structure that optimizes clinic flow. This paper describes the planning, implementation, and future directions of an interprofessional, student-led free clinic operating under the PCMH model that offers a framework for other clinics.
{"title":"Designing an Interprofessional, Student-Led Clinic with the Patient-Centered Medical Home (PCMH) Model","authors":"Claire Leighton, Grayson Jackson, Tanner Israel, Joanna Chyu, Dayoung Jeon, C. Garcia","doi":"10.59586/jsrc.v8i1.354","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.354","url":null,"abstract":"Students and faculty at the University of Texas Medical Branch (UTMB) embarked on the novel undertaking of establishing a comprehensive, interprofessional clinic treating underserved, uninsured residents of Galveston County, Texas, and the surrounding area, modeled after the patient-centered medical home (PCMH). The need for such a community clinic is evident in relevant literature and patients’ suggestions, in addition to local demographic data. The comprehensive nature of this approach to clinic design is apparent in the intricate planning and documents produced by the steering committee, which outline a unique operational structure that optimizes clinic flow. This paper describes the planning, implementation, and future directions of an interprofessional, student-led free clinic operating under the PCMH model that offers a framework for other clinics.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43674150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Benton G Chuter, Alexander Lieu, John Kevin O Dayao, Jennifer J Bu, Kevin Chen, Taiki Nishihara, Sally L. Baxter
Background Diabetic retinopathy is the leading cause of blindness among working-age adults in the United States and requires timely screening and management. This study evaluates the impact of the coronavirus disease 2019 (COVID-19) pandemic on diabetic retinopathy screening (DRS) for uninsured, predominantly Latino patients at the University of California San Diego Student-Run Free Clinic Project (SRFCP). Methods A retrospective chart review was conducted of all living diabetic patients at SRFCP who were seen in 2019 (n=196), 2020 (n=183), and 2021 (n=178). Ophthalmology clinic referrals, scheduled patient visits, and visit outcomes were analyzed longitudinally to determine the impact of the pandemic on screening patterns. Results The study population was 92.1% Latino, 69.5% female, with a mean age of 58.7 years. The distribution of patients seen (p<0.001), referred (p=0.012), and scheduled (p<0.001) in 2020 and 2021 significantly differed from 2019. In 2019, 50.5% of 196 patients eligible for DRS were referred, 49.5% were scheduled, and 45.4% were seen. In 2020, 41.5% of 183 eligible patients were referred, but only 20.2% were scheduled and 11.4% were seen. In 2021, there was a rebound: 63.5% of 178 patients were referred, 56.2% scheduled and 46.1% seen. No shows and cancellations represented 12.4% and 6.2% of the 97 encounters scheduled in 2019, but were markedly higher (10.8% and 40.5% respectively) for the 37 encounters scheduled in 2020. Conclusions The COVID-19 pandemic significantly impacted the delivery of eye care at SRFCP. The need for annual DRS exceeded the capacity of the ophthalmology clinic in all years studied, but the difference was especially pronounced with more stringent COVID-19 restrictions in 2020. SRFCP patients could benefit from telemedicine DRS programs to improve screening capacity.
{"title":"Impact of COVID-19 on the Delivery of Eye Care to Uninsured Diabetic Patients at a Student-Run Free Clinic: A Comprehensive Evaluation of Eye Clinic Performance.","authors":"Benton G Chuter, Alexander Lieu, John Kevin O Dayao, Jennifer J Bu, Kevin Chen, Taiki Nishihara, Sally L. Baxter","doi":"10.59586/jsrc.v8i1.358","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.358","url":null,"abstract":"Background\u0000Diabetic retinopathy is the leading cause of blindness among working-age adults in the United States and requires timely screening and management. This study evaluates the impact of the coronavirus disease 2019 (COVID-19) pandemic on diabetic retinopathy screening (DRS) for uninsured, predominantly Latino patients at the University of California San Diego Student-Run Free Clinic Project (SRFCP).\u0000\u0000\u0000Methods\u0000A retrospective chart review was conducted of all living diabetic patients at SRFCP who were seen in 2019 (n=196), 2020 (n=183), and 2021 (n=178). Ophthalmology clinic referrals, scheduled patient visits, and visit outcomes were analyzed longitudinally to determine the impact of the pandemic on screening patterns.\u0000\u0000\u0000Results\u0000The study population was 92.1% Latino, 69.5% female, with a mean age of 58.7 years. The distribution of patients seen (p<0.001), referred (p=0.012), and scheduled (p<0.001) in 2020 and 2021 significantly differed from 2019. In 2019, 50.5% of 196 patients eligible for DRS were referred, 49.5% were scheduled, and 45.4% were seen. In 2020, 41.5% of 183 eligible patients were referred, but only 20.2% were scheduled and 11.4% were seen. In 2021, there was a rebound: 63.5% of 178 patients were referred, 56.2% scheduled and 46.1% seen. No shows and cancellations represented 12.4% and 6.2% of the 97 encounters scheduled in 2019, but were markedly higher (10.8% and 40.5% respectively) for the 37 encounters scheduled in 2020.\u0000\u0000\u0000Conclusions\u0000The COVID-19 pandemic significantly impacted the delivery of eye care at SRFCP. The need for annual DRS exceeded the capacity of the ophthalmology clinic in all years studied, but the difference was especially pronounced with more stringent COVID-19 restrictions in 2020. SRFCP patients could benefit from telemedicine DRS programs to improve screening capacity.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":"8 1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49101419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shambhawi Thakur, Christian Schmidt, Rohan Sharma, Lydia Sa, Brynn E. Sheehan, Shannon McCole, A. Leader
Background: Uninsured patients (8.6% of the United States population) are more likely to have poorly controlled diabetes and hypertension, which can lead to altered vision or even blindness. Checking vital signs regularly is important in monitoring chronic diseases to prevent poorer health outcomes, especially in populations with limited access to care. HOPES (Health Outreach Partnership of Eastern Virginia Medical School Students) and CCE (Clínica Comunitaria Esperanza) are student-run free clinics that serve the uninsured population of Hampton Roads, Virginia. This study describes the services offered and examines trends in measuring vital signs at HOPES and CCE Ophthalmology Clinics to evaluate clinical operations and areas for improvement. Methods: A retrospective chart review of 347 HOPES and CCE Ophthalmology appointments from January 2015 to June 2021 explored patient demographics, vital sign measurement, reason for visit, diagnoses, and services provided. Chi-square tests were utilized to compare the measurement of vital signs between the two clinics. Results: 179 appointments met inclusion criteria. Of the 39 different reasons for visit, the most common were blurry vision, diabetic eye exams, floaters, and systemic hypertension. Of the 63 distinct diagnoses made, the most common were cataracts, diabetes with or without retinopathy, and presbyopia. A total of 175 services were provided, including 61 custom frames and glasses, 48 prescriptions for glasses, 54 medications, and 26 referrals to other providers. Vital signs were obtained during 113 appointments (63.10%) and the frequency of vital sign measurement differed significantly between the two clinics (68.80% at HOPES and 50.00% at CCE), p = 0.02. Conclusion: Vital signs were not consistently obtained at the HOPES and CCE Ophthalmology clinics despite diabetes and hypertension, diseases with known ophthalmologic sequelae, representing primary reasons for visit. Findings are a call to action for quality improvement measures in clinics to enforce vital sign measurement during every encounter.
{"title":"Program Evaluation and Assessment of Vital Sign Measurement at Student-Run Free Ophthalmology Clinics","authors":"Shambhawi Thakur, Christian Schmidt, Rohan Sharma, Lydia Sa, Brynn E. Sheehan, Shannon McCole, A. Leader","doi":"10.59586/jsrc.v8i1.332","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.332","url":null,"abstract":"Background: Uninsured patients (8.6% of the United States population) are more likely to have poorly controlled diabetes and hypertension, which can lead to altered vision or even blindness. Checking vital signs regularly is important in monitoring chronic diseases to prevent poorer health outcomes, especially in populations with limited access to care. HOPES (Health Outreach Partnership of Eastern Virginia Medical School Students) and CCE (Clínica Comunitaria Esperanza) are student-run free clinics that serve the uninsured population of Hampton Roads, Virginia. This study describes the services offered and examines trends in measuring vital signs at HOPES and CCE Ophthalmology Clinics to evaluate clinical operations and areas for improvement. \u0000Methods: A retrospective chart review of 347 HOPES and CCE Ophthalmology appointments from January 2015 to June 2021 explored patient demographics, vital sign measurement, reason for visit, diagnoses, and services provided. Chi-square tests were utilized to compare the measurement of vital signs between the two clinics. \u0000Results: 179 appointments met inclusion criteria. Of the 39 different reasons for visit, the most common were blurry vision, diabetic eye exams, floaters, and systemic hypertension. Of the 63 distinct diagnoses made, the most common were cataracts, diabetes with or without retinopathy, and presbyopia. A total of 175 services were provided, including 61 custom frames and glasses, 48 prescriptions for glasses, 54 medications, and 26 referrals to other providers. Vital signs were obtained during 113 appointments (63.10%) and the frequency of vital sign measurement differed significantly between the two clinics (68.80% at HOPES and 50.00% at CCE), p = 0.02. \u0000Conclusion: Vital signs were not consistently obtained at the HOPES and CCE Ophthalmology clinics despite diabetes and hypertension, diseases with known ophthalmologic sequelae, representing primary reasons for visit. Findings are a call to action for quality improvement measures in clinics to enforce vital sign measurement during every encounter.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41725500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Alex Im, Amanda Tosi, Jonathan S. Taylor-Fishwick, Brynn E. Sheehan, N. Sriraman, A. Leader
The uninsured Hispanic pediatric population in the United States faces significant challenges in accessing medical care due to language barriers, citizenship status, and limited access to health insurance. Clínica Comunitaria Esperanza Pediátrica (CCE-P) is a bilingual student-run free clinic created to provide healthcare to the underserved population in southeastern Virginia. This study further details the creation, implementation, and early outcomes of CCE-P as well as barriers encountered throughout the process. It describes four critical steps in establishing CCE-P, including leveraging existing institutional partnerships, ensuring high standards of care, prioritizing community outreach, and implementing a quality improvement program. Study outcomes include a demographic characterization of the 46 pediatric patients served by CCE-P, a description of clinic services, and an analysis of gaps in care and strategies to provide more comprehensive health services. This publication serves as an outline to an adaptable model that other organizations may use to establish similar clinics in their own communities.
{"title":"Clínica Comunitaria Esperanza Pediátrica: The Development and Early Outcomes of a Bilingual Medical Home for Uninsured Hispanic Children","authors":"Alex Im, Amanda Tosi, Jonathan S. Taylor-Fishwick, Brynn E. Sheehan, N. Sriraman, A. Leader","doi":"10.59586/jsrc.v8i1.306","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.306","url":null,"abstract":"The uninsured Hispanic pediatric population in the United States faces significant challenges in accessing medical care due to language barriers, citizenship status, and limited access to health insurance. Clínica Comunitaria Esperanza Pediátrica (CCE-P) is a bilingual student-run free clinic created to provide healthcare to the underserved population in southeastern Virginia. This study further details the creation, implementation, and early outcomes of CCE-P as well as barriers encountered throughout the process. It describes four critical steps in establishing CCE-P, including leveraging existing institutional partnerships, ensuring high standards of care, prioritizing community outreach, and implementing a quality improvement program. Study outcomes include a demographic characterization of the 46 pediatric patients served by CCE-P, a description of clinic services, and an analysis of gaps in care and strategies to provide more comprehensive health services. This publication serves as an outline to an adaptable model that other organizations may use to establish similar clinics in their own communities. \u0000 \u0000 ","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46229522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
In 2018, the behavioral health clinic within the Interprofessional Community Clinic, a student-led free clinic in Lake County, Illinois, expanded its mental health services by implementing health behavior change consultations (HBCCs) during primary care appointments. HBCCs are conducted by psychology graduate students and are designed to help patients implement behavior and lifestyle changes to improve overall health. Consults are requested by the medical team to assist patients with developing strategies for reasons such as weight management, increasing physical activity, and medication adherence. An HBCC consultant discusses current lifestyle behaviors, identifies motivations and barriers to making change, and assists the patient with goal-setting. Follow-up with patients often occurs during their subsequent medical appointments to monitor progress, reassess goals, and troubleshoot barriers. Since 2018, the utilization of HBCCs increased to an average of one out of six patients receiving an HBCC per clinic day. This descriptive report describes the implementation of HBCCs, a patient case example of an HBCC, and strategies to help student-led clinics implement similar services. Integrating behavior change appointments in student-led clinics through the use of HBCC can help reduce some of the burden on primary care providers and help patients better manage their health conditions.
2018年，伊利诺伊州莱克县由学生领导的免费诊所跨专业社区诊所(Interprofessional Community clinic)的行为健康诊所通过在初级保健预约期间实施健康行为改变咨询(HBCCs)，扩大了其心理健康服务。hbcc由心理学研究生进行，旨在帮助患者实施行为和生活方式的改变，以改善整体健康状况。医疗团队要求咨询以帮助患者制定诸如体重管理、增加体育活动和药物依从性等原因的策略。HBCC咨询师讨论当前的生活方式行为，确定做出改变的动机和障碍，并帮助患者设定目标。对患者的随访通常发生在他们随后的医疗预约中，以监测进展、重新评估目标和排除障碍。自2018年以来，HBCC的使用率增加到平均每六个接受HBCC治疗的患者中就有一个。本描述性报告描述了HBCC的实施，一个HBCC的患者案例，以及帮助学生主导的诊所实施类似服务的策略。通过使用HBCC，在学生主导的诊所中整合行为改变预约可以帮助减轻初级保健提供者的一些负担，并帮助患者更好地管理自己的健康状况。
{"title":"Implementing Health Behavior Change Consultations for Adult Patients in a Free Student-Led Interprofessional Community Clinic","authors":"Esha Kumar, Madeline Konsor, Jessica Sampson, Kristin Schneider","doi":"10.59586/jsrc.v8i1.299","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.299","url":null,"abstract":"In 2018, the behavioral health clinic within the Interprofessional Community Clinic, a student-led free clinic in Lake County, Illinois, expanded its mental health services by implementing health behavior change consultations (HBCCs) during primary care appointments. HBCCs are conducted by psychology graduate students and are designed to help patients implement behavior and lifestyle changes to improve overall health. Consults are requested by the medical team to assist patients with developing strategies for reasons such as weight management, increasing physical activity, and medication adherence. An HBCC consultant discusses current lifestyle behaviors, identifies motivations and barriers to making change, and assists the patient with goal-setting. Follow-up with patients often occurs during their subsequent medical appointments to monitor progress, reassess goals, and troubleshoot barriers. Since 2018, the utilization of HBCCs increased to an average of one out of six patients receiving an HBCC per clinic day. This descriptive report describes the implementation of HBCCs, a patient case example of an HBCC, and strategies to help student-led clinics implement similar services. Integrating behavior change appointments in student-led clinics through the use of HBCC can help reduce some of the burden on primary care providers and help patients better manage their health conditions. ","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46517433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Phillip Yang, J. Tsai, Barbara Robles-Ramamurthy, N. Emko
Background: The COVID-19 pandemic has worsened the health and mental health of individuals experiencing homelessness. However, little research has investigated the pandemic’s impact on families experiencing homelessness, who likely experienced greater stressors due to the additional responsibilities of managing the needs of children. Student-run free clinics (SRFCs) can provide important needs assessment investigations and mental health interventions in underserved communities. This study examined the effect of the pandemic on the mental health of one sample of families experiencing homelessness associated with an SRFC. Methods: Between November and December 2020, families experiencing homelessness at a homeless shelter in San Antonio, Texas were surveyed. Twenty-one parent and 20 child questionnaire responses on the pandemic’s effect on health, depression, and anxiety were analyzed. One-sample t-test with Bonferroni correction was used for statistical analysis. Results: Parents experiencing homelessness reported statistically significant worsening of coping ability, stress levels, family situation, financial situation, physical health, mental health, depression, and anxiety symptoms at the time of the survey compared to prior to the pandemic. Adults reported more worsening of anxiety symptoms than depression symptoms. Loneliness was the only general health measure that was not significantly worsened. In their young children (mean age = 6.7 years), parents reported no worsening of any outcomes. Conclusions: Our sample of families experiencing homelessness reported significant life and mental health challenges due to the COVID-19 pandemic. People experiencing homelessness who live in a communal housing facility may protect against characteristic pandemic-related loneliness. Young children may require developmentally focused clinical assessments to adequately capture mental health challenges. SRFCs should be equipped to provide specialized mental health services and other community health services, such as vaccinations, to reduce pandemic-related morbidity and mortality.
{"title":"COVID-19 Related Mental Health Among a Sample of Families Transitioning from Homelessness Living in a Communal Housing Facility","authors":"Phillip Yang, J. Tsai, Barbara Robles-Ramamurthy, N. Emko","doi":"10.59586/jsrc.v8i1.347","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.347","url":null,"abstract":"Background: The COVID-19 pandemic has worsened the health and mental health of individuals experiencing homelessness. However, little research has investigated the pandemic’s impact on families experiencing homelessness, who likely experienced greater stressors due to the additional responsibilities of managing the needs of children. Student-run free clinics (SRFCs) can provide important needs assessment investigations and mental health interventions in underserved communities. This study examined the effect of the pandemic on the mental health of one sample of families experiencing homelessness associated with an SRFC. \u0000Methods: Between November and December 2020, families experiencing homelessness at a homeless shelter in San Antonio, Texas were surveyed. Twenty-one parent and 20 child questionnaire responses on the pandemic’s effect on health, depression, and anxiety were analyzed. One-sample t-test with Bonferroni correction was used for statistical analysis. \u0000Results: Parents experiencing homelessness reported statistically significant worsening of coping ability, stress levels, family situation, financial situation, physical health, mental health, depression, and anxiety symptoms at the time of the survey compared to prior to the pandemic. Adults reported more worsening of anxiety symptoms than depression symptoms. Loneliness was the only general health measure that was not significantly worsened. In their young children (mean age = 6.7 years), parents reported no worsening of any outcomes. \u0000Conclusions: Our sample of families experiencing homelessness reported significant life and mental health challenges due to the COVID-19 pandemic. People experiencing homelessness who live in a communal housing facility may protect against characteristic pandemic-related loneliness. Young children may require developmentally focused clinical assessments to adequately capture mental health challenges. SRFCs should be equipped to provide specialized mental health services and other community health services, such as vaccinations, to reduce pandemic-related morbidity and mortality.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49206527","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The Student Health Alliance Reaching Indigent Needy Groups (SHARING) clinics are student run freeclinics (SRFCs) at the University of Nebraska Medical Center that serve low income, uninsured adultsin Omaha, Nebraska. Like many other SRFCs, they face multiple barriers to providing high quality care.To address this, the SHARING Quality Improvement (QI) Database was created. QI has many definitions,but, overall, it is a method of analyzing clinic performance and the changes made to improvethe clinic. Before this database, there was no way of continuously tracking clinic metrics over time, soprevious QI projects required timely data abstraction that often only evaluated retrospective outcomeswith limited real-time data to track clinical outcomes as changes were implemented therebylimiting our ability to implement further changes to improve patient health. A review of SRFC literaturereveals a lack of a model or guide on how to assess quality of care in SRFCs and track patient dataover time. This study seeks to fill this gap. Our database consists of a patient list of electronic medicalrecords that were compiled in the charting system Epic. The patient data is exported into a MicrosoftExcel document each month and clinic metrics are analyzed, thus providing a real-time dashboard ofquality metrics for the clinic. This database will be utilized to inform decisions regarding the reform ofclinic processes. This database model can be used at other SRFCs to monitor quality of care providedat their clinics and implement QI measures accordingly.
{"title":"Employing a Quality Improvement Database to Observe the Gaps in Care at a Student-Run Free Clinic","authors":"Jess Grimmond, M. Menning","doi":"10.59586/jsrc.v8i1.266","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.266","url":null,"abstract":"The Student Health Alliance Reaching Indigent Needy Groups (SHARING) clinics are student run freeclinics (SRFCs) at the University of Nebraska Medical Center that serve low income, uninsured adultsin Omaha, Nebraska. Like many other SRFCs, they face multiple barriers to providing high quality care.To address this, the SHARING Quality Improvement (QI) Database was created. QI has many definitions,but, overall, it is a method of analyzing clinic performance and the changes made to improvethe clinic. Before this database, there was no way of continuously tracking clinic metrics over time, soprevious QI projects required timely data abstraction that often only evaluated retrospective outcomeswith limited real-time data to track clinical outcomes as changes were implemented therebylimiting our ability to implement further changes to improve patient health. A review of SRFC literaturereveals a lack of a model or guide on how to assess quality of care in SRFCs and track patient dataover time. This study seeks to fill this gap. Our database consists of a patient list of electronic medicalrecords that were compiled in the charting system Epic. The patient data is exported into a MicrosoftExcel document each month and clinic metrics are analyzed, thus providing a real-time dashboard ofquality metrics for the clinic. This database will be utilized to inform decisions regarding the reform ofclinic processes. This database model can be used at other SRFCs to monitor quality of care providedat their clinics and implement QI measures accordingly.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47629941","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Cynthia Tang, George Win, S. Unangst, Tricia Haynes, Brittany Pendergraft, Kaystin Weisenberger, Adrienne Ohler, Natalie Long, Laine Young-Walker
Background: The MedZou Community Health Clinic at the University of Missouri School of Medicine is a student-run free clinic (SRFC) providing primary care and specialty services to uninsured patients of Missouri. Little is published about the relationship of volunteerism in SRFCs and residency match results. This study evaluated the association of SRFC volunteering on residency placement. We hy-pothesized that there would be an increased likelihood of medical students matching into specialties correlating with specialty clinics they volunteered with as students. Methods: We analyzed data on volunteers who graduated from the University of Missouri School of Medicine between 2010-2019 in this retrospective study. Selection criteria included students who per-mitted publishing their residency match results publicly and actively volunteered for MedZou (at least five volunteer shifts). Odds ratios (OR) were calculated with Fisher exact tests using a confidence in-terval (CI) of 95% to assess whether volunteering in a specialty clinic was associated with matching in that specialty. Clinics with at least five volunteers during the study period were analyzed (Dermatol-ogy, Musculoskeletal [MSK], and Neurology). Results: Twenty-nine percent of the MedZou volunteers that fit the inclusion criteria volunteered for the Dermatology, MSK, or Neurology Clinic. We found significant associations between those who volunteered in a specialty clinic and those who matched in a related specialty for Dermatology (OR = 4.25, 95% CI = 1.37, 12.13), Musculoskeletal (OR = 3.49, 95% CI = 1.45, 7.98), and Neurology Clinics (OR = 10.89, CI = 1.71, 50.39). Additionally, 51% of MedZou volunteers that fit inclusion criteria volunteered for Primary Care Clinic. These students were also found to have a significant association with matching into a related primary care specialty (OR= 2.01, CI= 1.14, 3.62). Conclusions: The results of this study indicated that clinical exposure at a SRFC specialty clinic was associated with residency match into related specialties.
{"title":"A Retrospective Study on the Influence of Participation at a Student-Run Free Clinic on Medical Specialty Choice","authors":"Cynthia Tang, George Win, S. Unangst, Tricia Haynes, Brittany Pendergraft, Kaystin Weisenberger, Adrienne Ohler, Natalie Long, Laine Young-Walker","doi":"10.59586/jsrc.v8i1.287","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.287","url":null,"abstract":" \u0000 Background: The MedZou Community Health Clinic at the University of Missouri School of Medicine is a student-run free clinic (SRFC) providing primary care and specialty services to uninsured patients of Missouri. Little is published about the relationship of volunteerism in SRFCs and residency match results. This study evaluated the association of SRFC volunteering on residency placement. We hy-pothesized that there would be an increased likelihood of medical students matching into specialties correlating with specialty clinics they volunteered with as students. \u0000Methods: We analyzed data on volunteers who graduated from the University of Missouri School of Medicine between 2010-2019 in this retrospective study. Selection criteria included students who per-mitted publishing their residency match results publicly and actively volunteered for MedZou (at least five volunteer shifts). Odds ratios (OR) were calculated with Fisher exact tests using a confidence in-terval (CI) of 95% to assess whether volunteering in a specialty clinic was associated with matching in that specialty. Clinics with at least five volunteers during the study period were analyzed (Dermatol-ogy, Musculoskeletal [MSK], and Neurology). \u0000Results: Twenty-nine percent of the MedZou volunteers that fit the inclusion criteria volunteered for the Dermatology, MSK, or Neurology Clinic. We found significant associations between those who volunteered in a specialty clinic and those who matched in a related specialty for Dermatology (OR = 4.25, 95% CI = 1.37, 12.13), Musculoskeletal (OR = 3.49, 95% CI = 1.45, 7.98), and Neurology Clinics (OR = 10.89, CI = 1.71, 50.39). Additionally, 51% of MedZou volunteers that fit inclusion criteria volunteered for Primary Care Clinic. These students were also found to have a significant association with matching into a related primary care specialty (OR= 2.01, CI= 1.14, 3.62). \u0000Conclusions: The results of this study indicated that clinical exposure at a SRFC specialty clinic was associated with residency match into related specialties. ","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49535665","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Zumana Miyfa, Lisa Ho, V. Khristov, M. Palisoc, Hannah Bennett, Siddhartha Roy, T. Mcgarrity, Megan Mendez-Miller
Colonoscopy screening starting at age 50 is key for the early detection and prevention of colorectal cancer (CRC). Barriers to care, such as lack of insurance, transportation, and healthcare literacy, can deter a patient from completing a screening colonoscopy. Delayed CRC screening results in missed opportunities for detecting disease at an earlier stage, ultimately leading to increased healthcare costs and morbidity. We implemented a pilot program that combines student-led patient navigation with ride-share services to promote colonoscopy screening among at-risk populations in Harrisburg, Pennsylvania, United States, at no cost to patients. During the first year of the program, the rate of adequate colonoscopy preparation was 77% (10 out of 13 patients), and the attendance rate was 100% for all scheduled appointments. While this study analyzed a small cohort of participants, it demonstrates how a colonoscopy screening program can be organized and conducted successfully through collaboration among multiple stakeholders. Future aims include expanding the program and assessing its receptiveness via post-procedure surveys for patients, patient navigators, and healthcare providers.
{"title":"Utilization of a Ride-Share Application and Patient Navigation Program for Promoting Colonoscopy Among High-Risk Adults","authors":"Zumana Miyfa, Lisa Ho, V. Khristov, M. Palisoc, Hannah Bennett, Siddhartha Roy, T. Mcgarrity, Megan Mendez-Miller","doi":"10.59586/jsrc.v8i1.268","DOIUrl":"https://doi.org/10.59586/jsrc.v8i1.268","url":null,"abstract":"Colonoscopy screening starting at age 50 is key for the early detection and prevention of colorectal cancer (CRC). Barriers to care, such as lack of insurance, transportation, and healthcare literacy, can deter a patient from completing a screening colonoscopy. Delayed CRC screening results in missed opportunities for detecting disease at an earlier stage, ultimately leading to increased healthcare costs and morbidity. We implemented a pilot program that combines student-led patient navigation with ride-share services to promote colonoscopy screening among at-risk populations in Harrisburg, Pennsylvania, United States, at no cost to patients. During the first year of the program, the rate of adequate colonoscopy preparation was 77% (10 out of 13 patients), and the attendance rate was 100% for all scheduled appointments. While this study analyzed a small cohort of participants, it demonstrates how a colonoscopy screening program can be organized and conducted successfully through collaboration among multiple stakeholders. Future aims include expanding the program and assessing its receptiveness via post-procedure surveys for patients, patient navigators, and healthcare providers.","PeriodicalId":73958,"journal":{"name":"Journal of student-run clinics","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48702249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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