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Problem:
Chronic respiratory conditions, including asthma, are the most common disabling coditions in childhood. Many underserved children with these conditions do not have adequate medical homes. Trained clinical leaders are needed to address the systems and policies and impact these children nationwide.
Goals and Objectives:
Goal 1: Provide interdisciplinary clinical training to health care professionals about comprehensive, culturally competent community-based family-centered care for children with chronic respiratory disease.
Objective 1: Objective 1: Recruit, orient, and develop an Individual Training Plan for 5 long-term and recruit, orient, and train 20 medium trainees representing the five health care disciplines (medicine, nursing, nutrition, social work, and respiratory care) annually.
Objective 2: Each long-term trainee co-manages 5 children with special respiratory health care needs (CSRHCN) such as asthma or cystic fibrosis whose families are underserved because of poverty, rural location, and/or cultural differences as part of an interdisciplinary health care team during their training.
Objective 3: Each medium and long-term trainee completes a self-assessment to measure their knowledge of family-centered and culturally competent care. Long term trainees will demonstrate application of these principles in clinical activities during their MCHB training.
Goal 2: Provide leadership training to assure and improve health care and systems of care for children with special health care needs, and reduce disparities in care for underserved populations.
Objective 1: Long and medium-term trainees each learn the history, vision, strategic goals of the Maternal Child Health Bureau, the pertinent Healthy People 2010 objectives, and the objectives of Bright Futures and identify how this information applies to their career as leaders.
Objective 2: Long-term trainees complete a Leadership Capstone Project consistent with their Individualized Training Plan developed at matriculation which demonstrates 6 of the 11 MCHB Leadership Competencies developed in 2004.
Objective 3: Long-term trainees each identify a health care disparity within an underserved population of children and develop a strategy to resolve the disparity while completing the PPC Core Curriculum, the UW MCHB Consortium’s Leadership Workshop series, and conducting clinical care.
Goal 3: Maintain an exemplary clinical and leadership training program with MCH values that serves children with chronic respiratory conditions with input and evaluation from families, trainees, and leaders.
Objective 1: Hire faculty and annually recruit medium and long-term trainees that bring diversity in gender, ethnicity, and cultures to the training program.
Objective 2: Involve parents, trainees, and community leaders in evaluation, development, and implementation of PPC clinical and leadership training curricula and experiences at least twice each year and use parents as regular consultants and teachers.
Objective 3: Faculty complete annual self-assessments in leadership strengths, family-centeredness, and cultural competency and participate in >2 activities that assure further career development based on a written Faculty 5-Year Development Plan.
Goal 4: Increase capacity of the MCHB infrastructure to assure quality and accessible healthcare for children through partnerships in continuing education, technical assistance, and advocacy activities.
Objective 1: Serve local, regional, and national health audiences and agencies annually by providing 50 continuing education activities, including use of distance learning methods, by both faculty and trainees.
Objective 2: Faculty and trainees collaborate with Title V agencies and organizations in Region X and nationally to improve systems of care and reduce disparities in care through 25 technical assistance activities annually.
Objective 3: Faculty and long-term trainees jointly conduct >1 advocacy activities annually using components of the PPC Advocacy curriculum with agencies and organizations that address health status and heath care services for CSRHCN.
Goal 5: Develop and disseminate new knowledge through interdisciplinary research about leadership training, health promotion and disease prevention, family resilience, and health care to CSRHCN.
Objective 1: Each faculty member annually completes >1 project that creates new knowledge, guidelines, curricula, educational products, or policies pertaining to children with special respiratory health care needs.
Objective 2: Long-term trainees and faculty collaborate annually with other MCHB funded programs, including other PPCs, to generate and/or disseminate >3 new products or publications pertinent to CSRHCN during the grant cycle.
Objective 3: The PPC conducts 1 interdisciplinary research project assessing the effectiveness of a leadership training methodology in conjunction with the three other MCHB training programs at the University of Washington.
Methodology:
Methods to achieve the program’s goal and objectives include orientation, serial self-assessments, reflective journaling, unidisciplinary courses for graduate degrees, interdisciplinary seminars about MCHB history, vision, and MCHB Training Strategic Plan, Healthy People 2010 objectives, Bright Futures clinical standards; a Core PPC lecture series, interdisciplinary clinical practicums in inpatient units, outpatient, telehealth and outreach clinics, identification of disparities in clinical care and strategies to improve them, participation in research, leadership field experiences to learn advocacy and coalition building, the UW MCHB Leadership Training Consortium workshops, identifying disparities in care, and a Leadership Capstone Project addressing >6 leadership competencies. Program methods include maintaining faculty in all 5 disciplines, annual faculty self-assessments regarding cultural competency, family centered care, and leadership development; recruiting diverse trainees and faculty, clinical service to underserved children in four states, parent involvement with teaching and program evaluation, regional continuing education, distance learning, technical assistance and collaboration with Title V agencies in Region X states, interdisciplinary research on systems of care and pulmonary conditions, faculty development, and collaboration with the national network of PPCs.
Coordination:
Partners include 3 UW MCHB Leadership training programs for joint leadership training; public health clinics as clinical training sites serving diverse underserved groups; Title V agencies in Washington, and Idaho, telehealth services, and technical assistance; state Lung Associations for joint research and advocacy opportunities; national research networks, UW WWAMI sites for continuing education; and national professional organizations and MCHB programs for joint initiatives.
Evaluation:
Evaluations of training include tests, faculty oversight of clinical practice, patient logs, journaling, attendance at workshops, oral presentations, use of electronic information systems, serial self-assessments, and completion of a Leadership Capstone project. Program evaluation includes Advisory Committee and family input, trainee diversity, children served; continuing education, technical assistance, and advocacy activities; joint Title V agency and MCHB projects, and research publications.
Experience to Date:
a) Six long-term and 29 medium term trainees were trained. b) Continuing education included 53 training sessions to 1,643 individuals. c) PPC Staff provided clinical services to 123 infants ages <1 of which 54% received funding from Title XIX and services to 991 children between ages 1 and 24 of which 41% received funding from Title XIX. d) PPC Faculty provided technical assistance to 67 recipients (Title V agencies, local providers, professional organizations, and state agencies) regionally and nationally. e) PPC faculty published 13 articles/abstracts, 1 book chapter and contributed to 3 electrronic learning modules/websites. f) Other program accomplishments include: Assistance with state asthma plan development and implementation in Washington and Idaho, development of a research program in pediatric sleep medicine, updating the national Asthma Educator certification examination, developing new non-invasive measures of airway inflammation, re-classification of pediatric interstitial lung disease, international management strategies for bronchiectasis in indigenous populations, a regional referral center for spine and chest wall disorders affecting lung function, identifying risk factors for chronic lung disease in Alaskan native children, developing an MCHB strategic plan for training, and developing leadership competency definitions for MCHB trainees.
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