Characteristics of the Commission on Accreditation of Allied Health Education Programs or National Athletic Trainers' Association -accredited athletic training programs associated with first -attempt passing rates on the NATABOC examination

Athletic training is an allied health profession recognized by the American Medical Association requiring certification by examination. There are two routes towards certification as an athletic trainer: attending a university with an accredited athletic training program or with an internship program By 2004, the only route towards certification will be by attending a Commission on Accreditation of Allied Health Education Programs (CAAHEP) or National Athletic Trainers' Association (NATA) accredited athletic training program. CAAHEP looks at passing rates on the NATA Board of Certification (NATABOC) examination when granting accreditation. This study examined characteristics of programs associated with first time passing rates. ^ Directors from 39 CAAHEP or NATA accredited athletic training programs completed a descriptive 17-question survey regarding academic characteristics, faculty characteristics, and program characteristics. Analysis used Spearman's rho correlation coefficient, with significance of p = <.05. Four program directors were interviewed to gather additional insight. ^ There were three program characteristics that showed a significant positive association with first attempt passing rates: the number of full-time and part-time approved clinical instructors (ACIs), and the number of students in the program. Further investigation found a statistically significant association between a low ratio of ACIs to athletic training students and first time passing rates. ACIs are certified athletic trainers (ATCs) who have received special training in order to supervise athletic training students. CAAHEP mandates a 1:8 ratio of ATCs to athletic training student. This study showed that a smaller ratio of ATC to student in combination with ACI training was significantly associated with higher first time passing rates. The number of courses above the required 13 delineated by the Education Council showed a significant negative association with first attempt passing rates. ^ Universities seeking or maintaining accreditation should incorporate characteristics associated with a higher passing rate on the NATABOC examination. Characteristics include utilizing a large number of full-time and part-time ACIs, admitting a large number of students into the program while maintaining a low ACI to athletic training student ratio, and offering curricula that focuses on the 13 courses that have been deemed relevant to the athletic training curriculum by the Education Council. ^

Reducing Health Disparities: Medical advice and health behavior of minorities with diabetes

OBJECTIVE: to examine the relationships among reported medical advice, diabetes education, health insurance and health behavior of individuals with diabetes by race/ethnicity and gender. METHOD: Secondary analysis of data (N = 654) for adults ages > or = 21 years with diabetes acquired through the National Health and Nutrition Examination Survey (NHANES) for the years 2007-2008 comparing Black, non-Hispanics (BNH) and Mexican-Americans (MA) with White, non-Hispanics (WNH). The NHANES survey design is a stratified, multistage probability sample of the civilian noninstitutionalized U.S. population. Sample weights were applied in accordance with NHANES specifications using the complex sample module of IBM SPSS version 18. RESULTS: The findings revealed statistical significant differences in reported medical advice given. BNH [OR = 1.83 (1.16, 2.88), p = 0.013] were more likely than WNH to report being told to reduce fat or calories. Similarly, BNH [OR = 2.84 (1.45, 5.59), p = 0.005] were more likely than WNH to report that they were told to increase their physical activity. Mexican-Americans were less likely to self-monitor their blood glucose than WNH [OR = 2.70 (1.66, 4.38), p < 0.001]. There were differences by race/ethnicity for reporting receiving recent diabetes education. Black, non-Hispanics were twice as likely to report receiving diabetes education than WNH [OR = 2.29 (1.36, 3.85), p = 0.004]. Having recent diabetes education increased the likelihood of performing several diabetes self-management behaviors independent of race. CONCLUSIONS: There were significant differences in reported medical advice received for diabetes care by race/ethnicity. The results suggest ethnic variations in patient-provider communication and may be a consequence of their health beliefs, patient-provider communication as well as length of visit and access to healthcare. These findings clearly demonstrate the need for government sponsored programs, with a patient-centered approach, augmenting usual medical care for diabetes. Moreover, the results suggest that public policy is needed to require the provision of diabetes education at least every two years by public health insurance programs and recommend this provision for all private insurance companies

The knowledge and use of critical thinking teaching strategies of faculty in associate degree nursing education programs

The purpose of this study was to determine the knowledge and use of critical thinking teaching strategies by full-time and part-time faculty in Associate Degree Nursing (ADN) programs. ^ Sanders CTI (1992) instrument was adapted for this study and pilot-tested prior to the general administration to ADN faculty in Southeast Florida. This modified instrument, now termed the Burroughs Teaching Strategy Inventory (BTSI), returned reliability estimates (Cronbach alphas of .71, .74, and .82 for the three constructs) comparable to the original instrument. The BTSI was administered to 113 full-time and part-time nursing faculty in three community college nursing programs. The response rate was 92% for full-time faculty (n = 58) and 61% for part-time faculty (n = 55). ^ The majority of participants supported a combined definition of critical thinking in nursing which represented a composite of thinking skills that included reflective thinking, assessing alternative viewpoints, and the use of problem-solving. Full-time and part-time faculty used different teaching strategies. Full-time faculty most often used multiple-choice exams and lecture while part-time faculty most frequently used discussion within their classes. One possible explanation for specific strategy choices and differences might be that full-time faculty taught predominately in theory classes where certain strategies would be more appropriate and part-time faculty taught predominately clinical classes. Both faculty types selected written nursing care plans as the second most effective critical thinking strategy. ^ Faculty identified several strategies as being effective in teaching critical thinking. These strategies included discussion, case studies, higher order questioning, and concept analysis. These however, were not always the strategies that were used in either the classroom or clinical setting. ^ Based on this study, the author recommends that if the profession continues to stress critical thinking as a vital component of practice, nursing faculty should receive education in appropriate critical teaching strategies. Both in-service seminars and workshops could be used to further the knowledge and use of critical thinking strategies by faculty. Qualitative research should be done to determine why nursing faculty use self-selected teaching strategies. ^

Tobacco use prevention education (TUPE) programs in the state of Florida: Teachers' perceptions of program structure and effectiveness

This study described teacher perceptions of TUPE program effectiveness in Florida in an attempt to improve programs by identifying factors that might influence teacher motivation and performance. Very little work has been done to examine how teachers' perceptions are related to the effectiveness of TUPE programs. A statewide survey provided information about how teachers' perceptions of program effectiveness are affected by variables such as: program structure, barriers, tobacco use norms, and training variables. Data were obtained from a telephone survey conducted in Florida as part of the Tobacco Pilot Project (TPP). The sample included 296 middle school teachers and 282 high school teachers as well as 193 middle school principals and 190 high school principals. Correlational and hierarchical regression analyses identified correlates and predictors of teachers' ratings of effectiveness. Results suggest that use of peer leaders, more frequent evaluations, a higher degree of parent involvement, fewer barriers, greater student interest, and lower tolerance for tobacco use were correlated with higher ratings of program effectiveness. Furthermore, student interest, peer, staff, and community tolerance norms, peer leaders, program evaluation, and parent involvement predicted middle school teachers' perceptions. Parent tolerance, student interest, number of barriers, and more frequent program evaluation predicted high school teachers' perceptions. In addition, middle school teachers who reported a lower number of factors negatively associated with teacher receptivity were more likely to view TUPE programs more favorably than teachers who reported a greater number of these risk factors. This relationship was not as robust among the high school teacher sample. Differences between the middle and high school sample were found in the magnitude and number of significant correlations, the proportion of variance accounted for by predictor variables, and the strength of the relationship between the number of factors negatively associated with teacher receptivity and teachers' perceptions of TUPE effectiveness. These findings highlighted the importance of the timing, program features, and the external environment for enhancing or minimizing teachers' ratings of TUPE program effectiveness. In conclusion, significant increases in TUPE teachers' self-efficacy will occur through the participation of peers, parents, staff, and community leaders in different aspects of TUPE programs. ^

The effect of a breakfast program on nutritional status, quality of life, and health care use among frail homebound older adults

The population of older adults is rapidly increasing, creating a need for community services that assist vulnerable older adults in maintaining independence and quality of life. Recent evidence confirms the importance of food and nutrition in reaching this objective. The Elderly Nutrition Program (ENP) is part of a system of federally funded community based programs, authorized through the Older Americans Act. ENP services include the home-delivered meals program, which targets frail homebound older adults at nutritional risk. Traditionally, ENP services provide a noon meal 5 days/week. This study evaluated the impact of expanding the home-delivered meals service to include breakfast + lunch, on the nutritional status, quality of life and health care utilization of program participants. ^ This cross-sectional study compared 2 groups. The Breakfast group (n = 167) received a home-delivered breakfast + lunch, 5 days/week. The Comparison group (n = 214) received lunch 5 days/week. Participants, recruited from 5 ENP programs, formed a geographically, racially/ethnically diverse sample. Participants ranged in age from 60–100 years, they were functionally limited, at high nutritional risk, low income, and they lived alone and had difficulty shopping or preparing food. Participant data were collected through in-home interviews and program records. A 24-hour food recall and information on participant demographics, malnutrition risk, functional status, health care use, and applicable quality of life factors were obtained. Service and cost data were collected from program administrators. ^ Breakfast group participants had greater energy/nutrient intakes (p < .05), fewer health care contacts (p < .05), and greater quality of life measured as food security (p < .05) and fewer depressive symptoms (p < .05), than comparison group participants. These benefits were achieved for $1.30/person/day. ^ The study identified links from improvements in nutritional status to enhanced quality of life to diminished health care utilization and expenditures. A model of health, loneliness, food enjoyment, food insecurity, and depression as factors contributing to quality of life for this population, was proposed and tested (p < .01). ^ The breakfast service is an inexpensive addition to traditional home-delivered meals services and can improve the lives of frail homebound older adults. Agencies should be encouraged to expand meals programs to include a breakfast service. ^

Examination of the impact of personality, social, and cognitive factors on the co-occurrence of health risk behaviors among multi-problem youth: The utility of an integrative framework

Research has identified a number of putative risk factors that places adolescents at incrementally higher risk for involvement in alcohol and other drug (AOD) use and sexual risk behaviors (SRBs). Such factors include personality characteristics such as sensation-seeking, cognitive factors such as positive expectancies and inhibition conflict as well as peer norm processes. The current study was guided by a conceptual perspective that support the notion that an integrative framework that includes multi-level factors has significant explanatory value for understanding processes associated with the co-occurrence of AOD use and sexual risk behavior outcomes. This study evaluated simultaneously the mediating role of AOD-sex related expectancies and inhibition conflict on antecedents of AOD use and SRBs including sexual sensation-seeking and peer norms for condom use.^ The sample was drawn from the Enhancing My Personal Options While Evaluating Risk (EMPOWER: Jonathan Tubman, PI), data set (N = 396; aged 12-18 years). Measures used in the study included Sexual Sensation-Seeking Scale, Inhibition Conflict for Condom Use, Risky Sex Scale. All relevant measures had well-documented psychometric properties. A global assessment of alcohol, drug use and sexual risk behaviors was used.^ Results demonstrated that AOD-sex related expectancies mediated the influence of sexual sensation-seeking on the co-occurrence of alcohol and other drug use and sexual risk behaviors. The evaluation of the integrative model also revealed that sexual sensation-seeking was positively associated with peer norms for condom use. Also, peer norms predicted inhibition conflict among this sample of multi-problem youth. ^ This dissertation research identified mechanisms of risk and protection associated with the co-occurrence of AOD use and SRBs among a multi-problem sample of adolescents receiving treatment for alcohol or drug use and related problems. This study is informative for adolescent-serving programs that address those individual and contextual characteristics that enhance treatment efficacy and effectiveness among adolescents receiving substance use and related problems services.^