Maternal and Child Health Training Program
Grant Title: Pediatric Pulmonary Centers
Wynton Hoover, MD
University of Alabama at Birmingham
1600 7th Avenue South, ACC-620
Birmingham, AL 35233
Children with chronic respiratory conditions comprise a large portion of children with special health care needs. This training project addresses the training needs of pediatric pulmonary subspecialists, nurses, social workers, nutritionists, and respiratory therapists to care for these children.
Goal 1: To refine, execute, and evaluate an interdisciplinary leadership training curriculum at the graduate and post-graduate levels, based on the MCH Leadership Competencies. Objective 1: To provide interdisciplinary leadership training in clinical practice, teaching, and research to pediatric pulmonary fellows as evidenced by programmatic evaluations that reflect fellows with growing MCH leadership and discipline-specific competencies (annually, faculty). Objective 2: To provide an interdisciplinary traineeship, which includes didactic, leadership and clinical practicum, for trainees for graduate course credit as evidenced by programmatic evaluations that reflect trainees with growing MCH leadership and discipline-specific competencies (annually, faculty). Objective 3: To provide interdisciplinary training through customized didactic, leadership, and/or clinical experiences for medium- and short-term trainees as evidenced by post-training evaluations that reflect MCH leadership and discipline-specific competencies (annually, faculty. Goal 2: To ensure clinical and community-based training for fellows/trainees that is structured on exemplary, comprehensive, interdisciplinary, family-centered, culturally competent service models. Objective 1: To ensure the provision of a clinical practicum for fellows/trainees in a tertiary care setting that advances discipline-specific and interdisciplinary skills in providing comprehensive, family-centered, culturally-competent care for CSHCN and their families (annually, faculty). Objective 2: To ensure the provision of a community-based practicum for fellows/trainees that emphasizes service to underserved MCH populations (annually, faculty). Objective 3: To ensure the provision of a clinical practicum for medium- and short-term trainees in tertiary or community-based care settings that advances discipline-specific and interdisciplinary skills in providing comprehensive care to CSHCN and their families (annually, faculty). Goal 3: To recruit, select, support, and retain culturally, racially, and ethnically diverse PPC pediatric pulmonary fellows and long-, medium-, and short-term interdisciplinary trainees. Objective 1: To recruit/select =1 physicians annually for the 3-year pediatric pulmonary fellowship; =5 graduate/post-graduate nurses, nutritionists, respiratory therapists, and social workers for the long-term interdisciplinary traineeship; and >30 medium- and short-term trainees (annually, faculty). Objective 2: To support/ retain =1 1st yr fellows, =1 2nd yr fellows, =1 3rd yr fellows for the 3-year post-doctoral pediatric pulmonary fellowship, and =5 graduate/ post-graduate trainees for the long-term interdisciplinary traineeship (3 to 12 months) (annually, faculty). Objective 3: To increase cultural, racial, and ethnic diversity among MCH providers by ensuring that >25% of PPC fellows/trainees are from under-represented groups (annually, faculty). Goal 4: For faculty, fellows, and trainees to provide CE based on identified needs to health and related care providers at national, regional, and state levels. Objective 1: To provide =100 national, regional, and state CE activities, based on identified needs of groups served (annually, faculty). Objective 2: To provide =1 substantive PPC-developed CE event per year using distance learning technology based on identified needs of groups served (annually, faculty). Goal 5: For faculty, fellows, and trainees to provide TA/Consultation and Collaboration with State Title V/MCH Agencies and related programs, geared to identified needs, at national/regional/state levels. Objective 1: To provide TA/Consultation and Collaboration on =15 projects with State Title V/MCH agencies and other related programs, geared to identified needs, at the national/international level (annually, faculty). Objective 2: To provide TA/Consultation and Collaboration on =45 projects with State Title V/MCH agencies and other related programs, geared to identified needs, at the regional and state levels (annually, faculty).
A carefully planned interdisciplinary leadership training curriculum for fellows/trainees in the core disciplines of pediatric pulmonary medicine, nursing, nutrition, respiratory care, and social work will be implemented and evaluated. The curriculum is based on the MCH Leadership Competencies and consists of a didactic component, a leadership practicum, and a clinical practicum. The curriculum addresses leadership, public health, community based systems of care for CSHCN, MCH/Title V and related legislation, interdisciplinary training and practice, cultural/linguistic competence, family-centered care, emerging issues, research, and technology. The fellows'/trainees' clinical preparation occurs in the inpatient setting as well as outpatient sub-specialty clinics at Children's Hospital. Trainees choose from a variety of community sites for their community-based training. Recruitment of fellows/trainees is accomplished through collaboration with affiliated discipline-specific programs at institutions of higher learning. Special efforts are made to recruit fellows/trainees from under-represented groups. Faculty, fellows, and trainees participate in continuing education activities regionally and nationally. The UAB PPC will collaborate annually with the Alabama Department of Public Health to produce and evaluate an internationally broadcast teleconference on a pediatric pulmonary topic. Faculty, fellows, and trainees will provide technical assistance on a variety of topics.
The 6 MCHB-funded training programs in AL have formed a MCH Leadership Network, the mission of which is to provide interdisciplinary MCH leadership education to fellows/trainees, CE to MCH providers, and advocacy through partnerships with the MCH community. The Network was selected to participate in MCHB's first Diversity Peer Collaborative. The PPC enjoys a strong relationship with the State Title V MCH and CSHCN programs in AL and has established ties with the Mississippi Department of Health.
Evaluation tools include both process and outcome data measures. The Family Partner, fellows/trainees, PPC Advisory Committee, Parent Consultants, and a former fellow/trainee focus group, and CE/TA recipients are involved in evaluation using multiple methods and tools. PPC data is entered into the National Information Reporting System (NIRS). All MCHB-required administrative forms and performance measures will be reported. Program evaluation is the direct responsibility of the Co-Director.
In Y1 the UAB PPC gained a new project director, respiratory care and nursing faculty, and Family Partner. 1 fellow and 4 trainees (1 nutrition, 1 respiratory care, 1 SW and 1 SW-PH) completed training and 1 fellow completed Y1/3. 50% of the Y1long-term trainees were from underrepresented groups. Additions to the curriculum included 2 video-linked classes with the University of Florida PPC. Training was provided for 42 medium-term (medicine and nutrition) and 16 short-term (nursing, nutrition, biological sciences) trainees. The trainee poster, "Racial Disparities in the Presence of Medical Home for Children with Asthma in Alabama" won an award at the Simpson-Ramsey poster competition. 32 CE activities reached 5525 recipients, with 59% of activities being regional, national, or international in scope. The trainees planned and implemented a CE event for the JCBE school nurses. A nationally broadcast teleconference "Children with Chronic Respiratory Complaints: When Does Normal Become Abnormal?" was viewed by >1800 participants. TA activities included planning and hosting the annual PPC meeting in Washington DC in Feb. 2011. Collaboration with the 5 other MCH-funded training projects as part of the Alabama MCH Leadership Network and the work of the MCH Diversity Peer Collaborative remain ongoing. A total of 1107 individuals received TA, with 129 activities and 68 projects (14% regional, 13% national, 14% international). In Y1, a total of 5687 CYSHCN were served by the UAB PPC.