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A systematic review of topic-specific faith-based health programs determined that health outcomes can be improved though faith-based health interventions. A university research team, in partnership with the Kansas United Methodist Church and a United Methodist philanthropy, facilitated planning and development of a statewide initiative to increase the capacity of laity-led health ministry teams. The purpose of this paper is to describe the processes utilized to design and implement an initiative to increase capacity for laity-led comprehensive health ministry among Kansas United Methodist Church congregations and to share the key elements of the initiative. [ABSTRACT FROM AUTHOR]

Background: Secondary triage protocols have been described in the literature as physiologic (first-tier) criteria and mechanism-related (second-tier) criteria to determine the level of trauma activation. There is debate as to the efficiency of triage decisions based on mechanism of injury which may result in overtriage and overuse of limited trauma resources. Our institution developed and implemented an advanced three-tier trauma alert system in which stable patients presenting with blunt traumatic mechanism of injury would be evaluated by the emergency department (ED) physician rather than the trauma surgeon. The American College of Surgeons Committee on Trauma (ACSCOT) requires that operational changes be monitored and evaluated for patient safety and performance. The primary aim of this study was to evaluate the process, as well as outcomes, of patient care pre and post implementation of the new triage protocol. The secondary aim was to determine predictor variables that were associated with ED dismissal. Methods: A retrospective blinded pre/post process change implementation explicit chart review was conducted to compare process and outcomes of minimally injured trauma patients who were field triaged by mechanism of injury. Generalized linear modeling was performed to determine which predictor variables were associated with ED dismissal. Results: There were no significant differences in minutes to physician evaluation, CT scan, OR/ICU disposition, readmission rates, safety or quality. Significant differences only occurred in time to chest x-ray, length of stay in ED, and ED dismissal rates. Trauma surgeon and ED physician patient groups did not differ on ISS, age, or sex. The only significant predictor for ED dismissal was treatment provider, with ED physicians 3.6 times more likely to dismiss the patient from the emergency department. Conclusions: ED physicians provided comparable care as measured by safety, timeliness, and quality in minimally-injured patients triaged to our trauma center based only on mechanism of injury. Moreover, ED physicians were more likely to dismiss patients from the ED. A three-tiered internal triaging protocol can redirect resource usage to reduce the burden on the trauma service. This may be increasingly beneficial in trauma models in which the trauma surgeons also serve as critical care intensivists. [ABSTRACT FROM AUTHOR]

Due to their access to medically underserved and vulnerable populations, community health centers (CHCs) can play an essential role in emergency response. CHCs often fill this role in partnership with other local health resources, such as local health departments (LHD). Little research has been done to understand the success of these partnerships as it relates to emergency planning and emergency response. This study compares CHC and LHD personnel regarding past, present, and future collaborative preparedness and response activities. Surveys were distributed electronically to 1,265 clinical and clerical staff at LHDs and CHCs in 23 states who met the study criteria. Of the 522 respondents, 287 (55%) reported having engaged in collaborative preparedness activities in general, with CHCs more likely to report partnering than LHDs. LHDs were more likely than CHCs to report taking part in specific preparedness activities, such as planning activities (91, 79%), (χ2(1, N = 280) = 7.395, P < 0.05), mass dispensing drill/exercises (65, 42%), (χ2(1, N = 279) = 14.019, P < 0.001), and communication drill/exercises (69, 47%), (χ2(1, N = 280) = 13.059, P < 0.001). This study suggests that collaborations between CHCs and LHDs in general are occurring, but these general collaboration are not being translated into participation in functional drills or exercises. Additional efforts to ensure a more comprehensive partnership between CHCs and LHDs in emergency preparedness are warranted. [ABSTRACT FROM AUTHOR]

Community health centers (CHCs) provide care to a large number of medically under served Americans. As primary care providers and trusted members of their communities, CHCs need to be prepared to respond to emergency and disaster situations, as they may be relied upon for medical care and other support services. Focus groups were conducted with CHC medical directors and administrators from New York City. Participants discussed previous emergency preparedness training, future training needs, applicability of competencies, and usefulness of two training programs. Participants indicated that they had more experience with preparedness training than many of their colleagues, although participants still reported further training needs. In particular, emergency roles and responsibilities, decontamination and containment, and personal preparedness were given as needed training topics for staff. The training resources were reported to be useful and beneficial. Participants also reported that most of the competencies were appropriate for CHC clinicians. During an emergency, people want to receive care from their normal provider, and for many, that provider is a CHC. This and other research suggests that the emergency preparedness needs facing CHCs are significant and should be addressed. [ABSTRACT FROM AUTHOR]

The 2006 Centers for Disease Control recommendations for routine HIV screening in all health care settings could include dental clinics an important testing venue. However, little is known about patients' attitudes regarding the routine use of rapid oral HIV screening at an urban free dental clinic. This pilot study seeks to evaluate the patient perspective on rapid HIV screening in this setting. In June 2007, patients at a free dental clinic in Kansas City, Missouri, were provided an attitude assessment survey prior to their dental visit. This dental clinic serves a diverse patient population consisting of approximately 37 white, 47 black, 6 Hispanic, 4 Asian, and 1 Native American uninsured patients. Results were analyzed for acceptance of testing and potential barriers. Of the 150 respondents, 73 reported they would be willing to take a free rapid HIV screening test during their dental visit. Overall, 91 of Hispanics, 79 of Caucasians, and 73 of African American patients reported they would be willing to be screened. Patients with a history of multiple prior screening tests for HIV were more likely to agree to oral rapid HIV screening in the dental clinic. The majority (62) reported that it did not matter who provided them with the screening result, although some (37) preferred their dentist above any other provider. Low self-perception of risk (37) and having already received screening elsewhere (24) were the main reasons for not accepting a free, rapid HIV screening. Overall, dental clinic patients widely accepted the offer of rapid oral HIV screening. Rapid HIV screening in the dental clinic setting is a viable option to increase the number of individuals who know their HIV status. [ABSTRACT FROM AUTHOR]

Despite increasing attention to academic–practice partnerships for health practice and workforce development, guidelines for how to implement such partnerships are few. The Kansas Public Health Workforce and Leadership Development (WALD) Center provides a successful example of such a partnership. The WALD Center implements public health education and training projects through a collaborative process of health needs identification, program conceptualization, research, and program evaluation. Such coordination allows for continuous practitioner-oriented program development and the sharing of a rural state's scarce resources between interconnected projects. The WALD Center's methods provide a model for academic–practice partnerships for community health practice and workforce development, even in environments with scarce health resources. [ABSTRACT FROM AUTHOR]

Discusses a study on how low-income, uninsured patients in the U.S. use emergency departments, and how it affects nursing practice. Barriers to medical care access; Barriers to obtaining insurance; Perceptions of primary care services.