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Background: Formative assessment of the rollout process of the California Oral Health Literacy (OHL) toolkit uses a mixed-methods approach. The OHL toolkit is an educational resource for dental professionals to improve communication with patients. This study was intended to obtain user feedback and suggestions for improvement. Methods: This mixed-methods assessment of the OHL toolkit rollout included anonymous post-training surveys distributed at regional dental societies in California and 1:1 interviews with dental champions who would work with the research team on toolkit rollout. Anonymous and deidentified data were analyzed using R and Dedoose. Results: From surveys (n = 37), the OHL toolkit components of highest interest to respondents were teach-back, increasing health literacy awareness among staff and learning to use plain language communication. Perceived implementation barriers were time constraints, insufficient staffing and a need for more training on communication techniques. Impressions, implementation prospects and recommendations for the OHL toolkit were obtained from qualitative interviews (n = 6). Overall, participants had positive impressions of the training presentation, OHL toolkit and implementation prospects. Conclusion: This study identified interest areas and implementation barriers, data that can be used to further improve the OHL toolkit and reduce barriers faced by practitioners. Further assessments at clinician and patient levels will be helpful for outcomes evaluation. Practical implications: The OHL toolkit is perceived positively by dental practitioners in California. Facilitators and barriers identified by dental providers and champions can be addressed through changes to the OHL toolkit and training. Rollout at the national level is being considered. [ABSTRACT FROM AUTHOR]

Problem: Medical educators, clinicians, and health policy experts widely acknowledge the need to increase the diversity of our healthcare workforce and build our capacity to care for medically underserved populations and reduce health disparities.Intervention: The Program in Medical Education for the Urban Underserved (PRIME-US) is part of a family of programs across the University of California (UC) medical schools aiming to recruit and train physicians to care for underserved populations, expand the healthcare workforce to serve diverse populations, and promote health equity. PRIME-US selects medical students from diverse backgrounds who are committed to caring for underserved populations and provides a 5-year curriculum including a summer orientation, a longitudinal seminar series with community engagement and leadership-development activities, preclerkship clinical immersion in an underserved setting, a master's degree, and a capstone rotation in the final year of medical school.Context: This is a mixed-methods evaluation of the first 4 years of the PRIME-US at the UC Berkeley–UC San Francisco Joint Medical Program (JMP). From 2006 to 2010, focus groups were conducted each year with classes of JMP PRIME-US students, for a total of 11 focus groups; major themes were identified using content analysis. In addition, 4 yearly anonymous, online surveys of all JMP students, faculty and staff were conducted and analyzed.Outcome: Most PRIME-US students came from socioeconomically disadvantaged backgrounds and ethnic backgrounds underrepresented in medicine, and all were committed to caring for underserved populations. The PRIME-US students experienced many program benefits including peer support, professional role models and mentorship, and curricular enrichment activities that developed their knowledge, skills, and sustained commitment to care for underserved populations. Non-PRIME students, faculty, and staff also benefited from participating in PRIME-sponsored seminars and community-based activities. Challenges noted by PRIME-US students and non-PRIME students, faculty, and staff included the stress of additional workload, perceived inequities in student educational opportunities, and some negative comments from physicians in other specialties regarding primary care careers.Lessons Learned: Over the first 4 years of the program, PRIME-US students and non-PRIME students, faculty, and staff experienced educational benefits consistent with the intended program goals. Long-term evaluation is needed to examine the participants' medical careers and impacts on California's healthcare workforce and patient outcomes. Attention should also be paid to the challenges of implementing new medical education enrichment programs. [ABSTRACT FROM AUTHOR]

Cancer self-efficacy (CSE) and spiritual well-being (SWB) have been associated with better self-rated health (SRH) among breast cancer survivors (BCS), but have not been well studied among Latina BCS (LBCS). Multivariate logistic regression analyses of secondary data from a cross-sectional population-based telephone survey of 330 LBCS explored relationships of language acculturation, CSE, and SWB subdomains of inner peace and faith with SRH. English proficiency was associated with SRH, independent of other covariates (OR=2.26, 95% CI 1.15, 4.45). Cancer self-efficacy attenuated this effect and was positively associated with SRH (OR=2.24, 95% CI 1.22, 4.10). Adding inner peace (a SWB subscale) attenuated the association of CSE and SRH (OR=1.67, 95% CI 0.88, 3.18). Inner peace remained associated with SRH (OR= 2.44, 95% CI 1.30, 4.56), controlling for covariates. Findings support the importance of a sense of inner peace and control over breast cancer to LBCS' perceived health. [ABSTRACT FROM AUTHOR]

Objectives. There is a critical need for effective, large-scale health communication programs to support parents of children aged 0-5 years. We evaluated the effectiveness of the Kit for New Parents, a multimedia health and parenting resource now distributed annually to 500000 parents in California. Methods. In this quasi-experimental study, 462 mothers in the intervention group and 1011 mothers in the comparison group, recruited from prenatal and postnatal programs, completed a baseline interview about health-relevant parenting knowledge, and mothers in the intervention group received the kit. Both groups were reinterviewed 2 months later. At 14-months postbaseline, 350 mothers in the intervention group and a sample of 414 mothers who had equivalent demographic characteristics (comparison group) were interviewed about parenting knowledge and practices. Results. Of the mothers in the intervention group, 87% reported using the kit within 2 months after receiving it, and 53% had shared it with their partner. At both follow-ups, mothers in the intervention group showed greater gains in knowledge and reported better practices at 14 months than did mothers in the comparison group. Gains were greater for prenatal recipients and for Spanish speakers. Providers considered the kit a valuable resource for their parenting programs. Conclusions. The kit is an effective, low-cost, statewide health intervention for parents. (Am J Public Health. 2007;97:1813-1819. doi:10.2105/AJPH.2006.089532) [ABSTRACT FROM AUTHOR]