Planning a Medical School to Serve an Educationally and Medically Underserved Area: Florida International University in Miami, FL

This paper provides the historic background of the Florida International University College of Medicine planning process.

Reaching an Underserved Wine Customer: Connecting with the African American Wine Consumer

Marketing strategies addressing underserved African American wine customers’ needs that also positively impact producers’ and retailers’ clientele was the impetus for this exploratory, qualitative paper. African Americans demonstrate a thirst to elevate their education about and be more involved in the wine industry as evidenced by the proliferation of African American wine-tasting groups designed to help educate and expose their membership to a variety of wines. Moreover, compared to the average adult, African-American wine drinkers are 241% more likely to have spent $20 or more on a bottle of store bought wine (Arbitron, 2005). Despite African Americans’ representation as one of the fastest growing ethnic minority segments in the U.S., wine industry strategies don't appear to connect with this market segment. Like Alice in Wonderland, we characterize this phenomenon by suggesting this market segment is ‘peering through the looking glass’. Three focus groups were conducted to specify possible targeted media strategies as well as to identify attitudes and opinions that influence this segment's wine purchasing and consumption behaviors. Industry strategies were suggested that would appear to benefit producers, retailers, and this customer segment. The results of the research will be used to inform a quantitative instrument in order to generalize findings beyond the context of the exploratory setting.

The effect of osteoporosis education on calcium intake and physical activity in a group of community-dwelling Black older adults

The unprecedented increase in the number of older adults is expected to increase the burden of osteoporosis on the individual and society. Blacks have been understudied in osteoporosis prevention education research. Although the risk of osteoporosis is low in this population, its consequences are significant. This study employs a two-group experimental design (experimental and wait-list control groups) to evaluate the effect of an osteoporosis education on two osteoporosis prevention behaviors (OPBs)—calcium intake (CI) and physical activity (PA), in a group of community-dwelling Black older adults, 50 years and older resident in South Florida. A final sample of 110 (mean age 70.15 years), 90% female and 10% male completed a battery of questionnaires at two assessment periods. The experimental group participated in six weekly education program sessions immediately following baseline assessment, and the wait-list control group received the education following end of program assessment by all participants. The weekly educational sessions were conducted in social settings (church or senior center) employing constructs of the Revised Health Belief Model. The sessions focused on improving CI; osteoporosis knowledge (OKT), self-efficacy (SE), health beliefs (HB) and PA. Findings revealed significantly greater increase in reported CI ( M = 556 mg, Wilks’ λ = .47, F (1,108)=122.97, p< .001, η2=.53), OKT (p< .001), and SE (p< .001) among participants in the experimental compared to the wait-list control group. There was no significant difference between the two groups for PA and most of the HB subscales. OKT and SE were the best predictors of CI, while perceived barrier was a predominant factor predicting PA. Over the study period, a change in SE was the only variable related to changes in both OPBs. Attrition rate was lower than expected, which can be attributed to the settings utilized for the study. These findings support the importance of utilizing a familiar social setting. These results suggested the effectiveness of a program offered in multiple short sessions among this underserved minority population to improve OKT and SE resulting in a change in OPBs (increase in CI). However, there is need to explore alternative strategies to improve PA in this population group.

The relationship between educational placement, instructional practices, and achievement gains of Black students with specific learning disabilities in secondary urban school settings

Black students, in general, are underserved academically (Darling-Hammond, 2000; Townsend, 2002) and overrepresented in special education (Donovan & Cross, 2002). Black students with disabilities are further overrepresented in more restrictive educational environments (Skiba, Poloni-Staudinger, Gallini, Simmons & Feggins-Azziz, 2006). Although the National Longitudinal Transition Study 2 (NLTS2) revealed that the academic performance of students with learning disabilities is positively related to the percentage of courses taken in the general education setting (Newman, 2006), the research specifically on placement of Black students with disabilities, particularly at the secondary level, as it relates to academic achievement is lacking. While previous studies have sought to determine which placement is better for students with disabilities, no study was found that specifically examined the impact of placement specific to Black students with specific learning disabilities (SLD) in urban settings (Fore, III, Hagan-Burke, Burke, Boon & Smith, 2008; Rea, McLaughlin & Walther-Thomas, 2002). This study examined educational placement, instructional best practices, and achievement gains of Black students with SLD in urban secondary settings using an ex post facto research design. Achievement, placement, and demographic data were collected and analyzed on approximately 314 Black eighth grade students with SLD. The Teacher Instructional Practices Survey was developed and used to collect and analyze data from the teachers of 78 of these students as it relates to instructional best practices. Results indicate no significant difference in reading but a significant difference in math gains of students served in inclusive settings as compared to resource settings with a small effect size. Also, no significant relationship was found between achievement gains and the reported use of instructional best practices. However, there was a relationship between educational placement and the use of instructional best practices. The results implied that there is a need for training with both general and special education teachers on instructional best practices for SWD and that there should be certain IEP team considerations when making placement decisions for this population of students with disabilities. It is recommended that future research in this area include classroom observations and factors other than test scores to measure growth in achievement.

Forging professional public health nursing in a southern state: Florida's public health nurses, 1889-1934

From 1889 to 1934, Florida's nurses belonging to a new group of professional women ushered in a pioneering phase of public health nursing in Florida. During this era, the nurses' ability to confront health and professional issues varied a great deal but in quiet and forceful ways they tackled cultural and environmental problems to assist people who were ill or help prevent people from becoming ill. This dissertation places the development of professional public health nursing in its social context by uncovering the relationships public health nurses formed with clubwomen, the medical profession, city leaders, midwives, and others. In 1888, there were few graduate nurses in the state, no state board of health and no organized nursing service to respond to Jacksonville's great yellow fever epidemic. By 1934, national and state leaders of public health nursing had built up the profession to become an essential part of the State Board of Health's service to the community. Between these milestones, in the era of white supremacy and Jim Crow, public health nurses combined their professional training with a pioneer spirit of innovation and risk-taking. In the predominately rural state, the public health nurses' resolve to overcome environmental hazards and cultural obstacles stands out as they attempted to reach those who were unserved or underserved by modern medicine.

The Impact of the Internet in Six Latin American Countries

Access to the Internet has grown exponentially in Latin America over the past decade. The International Telecommunications Union (ITU) estimates that in 2009 there were 144.5 million Internet users in South America, 6.4 million in Central America, and 8.2 million in the Caribbean, or a total 159.2 million users in all of Latin America.1 At that time, ITU reported an estimated 31 million Internet users in Mexico, which would bring the overall number of users in Latin America to 190.2 million people. More recent estimates published by Internet World Stats place Internet access currently at an estimated 204.6 million out of a total population of 592.5 million in the region (this figure includes Mexico).2 According to those figures, 34.5 per cent of the Latin American population now enjoys Internet access. In recent years, universal access policies contributed to the vast increase in digital literacy and Internet use in Argentina, Brazil, Chile, Colombia, and Costa Rica. Whereas the latter was the first country in the region to adopt a policy of universal access, the most expansive and successful digital inclusion programs in the region have taken hold in Brazil and Chile. These two countries have allocated considerable resources to the promotion of digital literacy and Internet access among low income and poor populations; in both cases, civil society groups significantly assisted in the promotion of inclusion at the grassroots level. Digital literacy and Internet access have come to represent, particularly in the area of education, a welcome complementary resource for populations chronically underserved in nations with a long-standing record of inadequate public social services. Digital inclusion is vastly expanding throughout the region, thanks to stabilizing economies, increasingly affordable technology, and the rapid growth in the supply of cellular mobile telephony. A recent study by the global advertising agency Razorfish revealed significant shifts in the demographics of digital inclusion in the major economies of South America, where Web access is rapidly increasing amid the lower middle class and the working poor.3 Several researchers have suggested that Internet access will bring about greater civic participation and engagement, although skeptics remain unsure this could happen in Latin America. Yet, there have been some recent instances of political mobilization facilitated through the use of the Web and social media applications, starting in Chile when “smart mobs” nationwide demonstrated against former Chilean President Michelle Bachelet when she failed to enact education reforms in May 2006. The Internet has also been used by marginalized groups and by guerrillas groups to highlight their stories. In sum, Internet access in Latin is no longer a medium restricted to the elite. It is rather a public sphere upon which civil society has staked its claim. Some of the examples noted in this study point toward a developing trend whereby civil society, through online grassroots movements, is able to effectively pressure public officials, instill transparency and demand accountability in government. Access to the Internet has also made it possible for voices on the margins to participate in the conversation in a way that was never previously feasible. 1 International Telecommunications Union [ITU], “Information Technology Public & Report,” accessed May 15, 2011, http://www.itu.int/. 2 Internet World Stats, “Internet Usage Statistics for the Americas,” accessed March 24, 2011, http://www.internetworldstats.com/stats2.htm 3 J. Crump, “The finch and the fox,” London, UK (2010), http://www.slideshare.net/razorfishmarketing/the-finch-and-the-fox.

Progress towards Elimination of HIV Mother-to-Child Transmission in the Dominican Republic from 1999 to 2011

In 1999, prevention of mother-to-child transmission (pMTCT) using antiretrovirals was introduced in the Dominican Republic (DR). Highly active antiretroviral therapy (HAART) was introduced for immunosuppressed persons in 2004 and for pMTCT in 2008. To assess progress towards MTCT elimination, data from requisitions for HIV nucleic acid amplification tests for diagnosis of HIV infection in perinatally exposed infants born in the DR from 1999 to 2011 were analyzed. The MTCT rate was 142/1,274 (11.1%) in 1999–2008 and 12/302 (4.0%) in 2009–2011 (), with a rate of 154/1,576 (9.8%) for both periods combined. This decline was associated with significant increases in the proportions of women who received prenatal HAART (from 12.3% to 67.9%) and infants who received exclusive formula feeding (from 76.3% to 86.1%) and declines in proportions of women who received no prenatal antiretrovirals (from 31.9% to 12.2%) or received only single-dose nevirapine (from 39.5% to 19.5%). In 2007, over 95% of DR pregnant women received prenatal care, HIV testing, and professionally attended delivery. However, only 58% of women in underserved sugarcane plantation communities (2007) and 76% in HIV sentinel surveillance hospitals (2003–2005) received their HIV test results. HIV-MTCT elimination is feasible but persistent lack of access to critical pMTCT measures must be addressed.

The Effect of Osteoporosis Education on Calcium Intake and Physical Activity in a Group of Community-Dwelling Black Older Adults

The unprecedented increase in the number of older adults is expected to increase the burden of osteoporosis on the individual and society. Blacks have been understudied in osteoporosis prevention education research. Although the risk of osteoporosis is low in this population, its consequences are significant. This study employs a two-group experimental design (experimental and wait-list control groups) to evaluate the effect of an osteoporosis education on two osteoporosis prevention behaviors (OPBs) – calcium intake (CI) and physical activity (PA), in a group of community-dwelling Black older adults, 50 years and older resident in South Florida. A final sample of 110 (mean age 70.15 years), 90% female and 10% male completed a battery of questionnaires at two assessment periods. The experimental group participated in six weekly education program sessions immediately following baseline assessment, and the wait-list control group received the education following end of program assessment by all participants. The weekly educational sessions were conducted in social settings (church or senior center) employing constructs of the Revised Health Belief Model. The sessions focused on improving CI; osteoporosis knowledge (OKT), self-efficacy (SE), health beliefs (HB) and PA. Findings revealed significantly greater increase in reported CI (M = 556 mg, Wilks’ λ = .47, F(1,108)=122.97, p< .001, η2=.53), OKT (p< .001), and SE (p< .001) among participants in the experimental compared to the wait-list control group. There was no significant difference between the two groups for PA and most of the HB subscales. OKT and SE were the best predictors of CI, while perceived barrier was a predominant factor predicting PA. Over the study period, a change in SE was the only variable related to changes in both OPBs. Attrition rate was lower than expected, which can be attributed to the settings utilized for the study. These findings support the importance of utilizing a familiar social setting. These results suggested the effectiveness of a program offered in multiple short sessions among this underserved minority population to improve OKT and SE resulting in a change in OPBs (increase in CI). However, there is need to explore alternative strategies to improve PA in this population group.