1. JeffSTARS: One Student, One Resident, One Step Toward Change Columbia Physician Advocacy Fellows Meeting November 18-19, 2010 Esther K. Chung, MD, MPH Associate Professor of Pediatrics Jefferson Medical College, Thomas Jefferson University A.I. DuPont Hosp for Children/Nemours

2. JeffSTARS Overview Req. Outpt Rotation (Year-Round) Journal Club (monthly) Advocacy Café (weekly) Reflective writings Community Site visits and reports Pre- and post- assessments Intensive Elective (1-3x/Year) Seminar series 50% time with a community partner Mutually agreeable project Legislative Advocacy Day Presentation Paper Cafés and Journal Club Continuity Clinics (Yearly) JeffSTARS paper/talk

3. Year 1 Progress: July 09 – Sept 10 IMPACT 3 rd year students: 138 4 th year students: 15 Pediatric residents: 52 Family and community medicine residents: 18 Cafés: 58 Community site visits: approx. 90 Community partners Advocacy opportunities for faculty Expansion to Wilmington Clinic Website completion Community partners Campus partners

4. Community Site Visit - Examples WIC orientation and visit to neighborhood offices Home visits with the MOMobile Trips to Harrisburg – Child Death Review EPA Hearing PSR Peaceful Posse groups PA AAP Advocacy Initiatives Child with Special Health Care Needs workgroup

5. Mike Campbell, Esq., with two 3rd-year medical students in front of Kendra Klein, MDs poster on child abuse prevention at the Community Partners Appreciation Lunch

6. Advocacy Cafés & Reflective Writings Topics – examples Childhood obesity Media violence Child abuse Teen pregnancy Infant mortality Access to care Access to dental care Car safety Breastfeeding Qualitative analysis of writings Tone (detached, engaged, passionate) Broadening perspective (barriers, personal experience, self- reflection) Empowerment (passive/active; generating ideas/actions, attitudes)

7. Advocacy Café, Fridays, 1230 – 2 pm Kurt Yusi, MS III, Why dont all clinical rotations have small group discussions where we talk about advocacy?

8. Language Barriers in Clinical Care: Reflections from A.M., 3rd-Yr Pediatrics Resident Advocating for ways to provide medical care in a language the patient can understand is important for all…involved: patients, families, and physicians. The inefficiency that comes from everyone hoping the patient speaks English could be avoided. This is a problem that needs to be dealt with head- on, not when its just too obvious to ignore.

9. Refugee Clinic (Clinical Care) at Jeff. Peds – Reflections from A.B., 3 rd Yr Pediatrics Resident The refugee clinic is…amazing…, and Im so proud that our residents will be a part of it. I dont know that I would have ever come home from a regular clinic day and read multiple articles about refugee camps and international policy; the experience undoubtedly leads to reflection.

10. Community Site Visit to Harrisburg with PA AAP – Resident Reflections This experience was significant in unveiling the mystery of the legislative process. I now realize how achievable it is to identify a problem you feel passionate about, and work towards a solution with the help of your state legislators. As a young resident, I feel energized and empowered to work towards change for the members of my community.

11. Pre- and Post-Assessments Rise in subjective and mean objective knowledge scores (17 vs. 23, p < 0.0001) for residents and medical students, independent of anticipated specialty Rise in self-reported, comfort and ability to advocate for children (mean score 24 vs. 28, p < 0.0001) Residents when compared to medical students were more likely to vote in the past year (97% vs. 81%, p < 0.01) Higher advocacy activity scores were associated with higher baseline mean objective knowledge scores (0-3: 15; 4-6: 17; 7+: 19, p < 0.01)

12. Elective Projects Launching a Refugee Clinic at Jeff Peds Developing a Toolkit for Teachers for Prevent Child Abuse PA Developing Guidelines for the Transition of Medically Complex Foster Care Children Developing Web Resources for Health Professionals for Planned Parenthood Contributing to Reproductive Health Guidelines with the Womens Law Project JeffREP: Jefferson Refugee Education Partners

13. Recent meeting with Cheryl Bullock, Senior Advisor and Southeast Regional Director for U.S. Senator Bob Casey (Risa Yavorsky, MS III; Cheryl Bullock; Vicki Mui, MS III)

16. Goals for Year 2 Expand community partners Delaware expansion Change to the JeffSTARS longitudinal component Continue to take advantage of community events Reassess volume of data collected

17. Thank you! Happy Thanksgiving!