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Problem:
The numbers of children with chronic pulmonary disorders is steadily rising. As the number of children with chronic pulmonary disorders has increased, the number of health care providers trained to deal with their carried and complex needs has not kept in pace.
Goals and Objectives:
Goal 1: To recruit and train leaders to work with children with chronic respiratory illness and their families through a family-centered, culturally competent, ethically sound, interdisciplinary approach.
Objective 1: To recruit two pediatric pulmonary fellows during the granting period and at least one Masters level long-term trainee or two medium-term trainees who exhibit a high potential for leadership in the disciplines of nursing, nutrition and social work, respiratory care in each calendar year.
Objective 2: Provide interdisciplinary training in the causes, diagnosis, evaluation, treatment and prevention of chronic respiratory diseases in children and enhance the team approach and interdisciplinary skills of trainees to become leaders in the area of children’s respiratory diseases.
Objective 3: To provide interdisciplinary training to these trainees through the core curriculum and outreach clinics in working with culturally diverse populations, including how belief systems of the regional population (Native Americans, Hispanics, Pacific Islanders) affect health practices and outcomes.
Goal 2: To educate health care leaders and families in methods for reducing health care disparities among the region’s populations and for increasing community health promotion through advocacy.
Objective 1: To provide training in disease prevention and health promotion as it relates to respiratory diseases of childhood with emphasis on administration, management, and community needs assessment through a core curriculum and planned projects/presentations.
Objective 2: To provide training to trainees and fellows in working with minority populations of the region to decrease morbidity and increase wellness as it applies to respiratory diseases through outreach sites in White River, Yuma, Nogales, Sierra Vista, and Fort Defiance, Arizona.
Objective 3: To provide training to trainees and fellows in advocacy and the legislative process and in public and private systems of health care and public health policy through an interdisciplinary core curriculum and in exposure to the legislative process.
Goal 3: To provide research education and opportunities to familiarize the trainee with the generation, translation and integration of new knowledge into clinical care of CYSHCN.
Objective 1: Provide each fellow with formal training in research techniques, culminating in publication of a first-authored, peer reviewed, hypothesis driven research project.
Objective 2: Offer training to fellows and trainees on research techniques through the core curriculum and experience on research related activities (i.e. research proposal, projects).
Objective 3: Faculty will offer technical assistance to program/systems development to community agencies, with a focus on Title V agencies.
Goal 4: To offer continuing education to increase family and patient education, disease prevention and community health promotion programs in the area of children with special health care needs.
Objective 1: Provide one-day intensive seminars (with CME credit in Pediatric Asthma Management based on the NIH guidelines) titled Basic Asthma Management Skills (BAMS).
Objective 2: Offer training to area school personnel on caring for CYSHCN with chronic respiratory illnesses and to work with area school boards, schools, and school districts to increase education and understanding of these children in school settings.
Objective 3: Offer training and seminars for skill enhancement and the dissemination of new information to home health providers, case managers, community physician office personnel, WIC personnel, CRS (Title V) employees, and public health department personnel on caring for children with respiratory diseases.
Goal 5: To encourage/support rural health through outreach clinics, distance learning, and on-line information and lectures.
Objective 1: To provide subspecialty support to rural health providers serving diverse underserved populations, thereby reducing health care disparities, by conducting outreach clinics serving Native American (Navajo and Apache), Latino and rural Anglo populations.
Objective 2: To provide lectures and other educational services in conjunction with the outreach clinics held. To foster leadership skills, trainees will be expected to be active participants in the delivery of these services/activities under the supervision of the faculty member.
Objective 3: To make available to staff at the host facilities on-line information and to conduct distance learning activities such as audio teleconferences or other modalities.
Methodology:
Trainees will complete both a comprehensive core curriculum consisting of a seminar series and discipline-specific seminars to address detailed technical aspects of care. Trainees will also serve as active members of the care team, providing direct experience in interdisciplinary care of children with chronic lung disease. This will include participation in program development and collaborative efforts with other Title V agencies. Trainees will be required to complete projects in public policy/advocacy and outreach education to solidify the concepts learned in didactic sessions. An individual learning contract (ILC) will be developed jointly by the trainee and a faculty member to allow a focus on leadership activities most relevant to the trainee’s interest and discipline. Affiliations with a variety of community-based agencies and health care facilities will allow a broad range of experiences by which curricular and individual educational goals will be met through interdisciplinary clinical activities under PPC faculty supervision.
Coordination:
Collaborative relationships with local community agencies and health care facilities, many already in place, will provide a broad range of training sites to meet the needs of the individual trainee. These will include University Medical Center, Tucson Medical Center, Indian Health Service, Children’s Rehabilititative Services, Mariposa Health Clinic in Nogales, Arizona, University Physicians Incorporated Outreach Clinic in Sierra Vista, and Children’s Health Services Clinic in Yuma, Arizona.
Evaluation:
Trainees will be evaluated by faculty based on their participation in seminars and other educational activities, written and verbal presentations, and performance. Program effectiveness will be assessed using the following outcome measures: 1. Number of trainees completing the program per year by discipline; 2. Attainment of goal-specific objectives by year. 3. The success of trainees in developing leadership roles in their communities in the care of children with chronic pulmonary disorders.
Experience to Date:
The UAPPC trained a fellow, LT Nursing and LT Social Worker and four MT nutritionists and seven MT pediatricians. This year the PPC Curriculum included a Leadership Academy in collaboration with the College of Public Health. Projects that were completed were: Asthma in Day Care Settings, New Horizons: Issues Surrounding Transition from Adolescence to Adulthood for Cystic Fibrosis Patients, and Nutrition Lessons for Elementary Students. The UAPPC also conducted outreach clinics to Fort Defiance, Chinle, Yuma, White River, Arizona and Gallup, New Mexico. There were 106 educational programs delivered on various pediatric pulmonary illnesses. The staff and trainees delivered clinical service to 1,767 outpatient visits and to 264 inpatient visits. Our faculty has provided, mostly in an on-going manner, technical assistance to 48 other programs/agencies/boards. There are 33 lectures available on the UA PPC website. Highlights this year includes: The UA PPC has applied for a grant from NICHD/NIH to fund research that will develop, implement and assess the effectiveness of a culturally-specific asthma education program for Native American children. The UA PPC presented on an International Cystic Fibrosis Web cast on “Total Lung Care: Feel the Difference T.L.C. Makes.” The UAPPC was accepted as a Community Site for We Can! (Ways to Enhance Children's Activity & Nutrition).
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