Teaching Public Health and Community Health Using a “COPC” Approach at the University of Utah By Marc E. Babitz, M.D., Professor Claire Clark, Ph.D., Assoc. Professor Bob Quinn, M.P.A., Course Administrator

Teaching Public Health and Community Health Using a “COPC” Approach Course Initiated in 1998 as a Primary Care Preceptorship (PCP) – 6 weeks Course Initiated in 1998 as a Primary Care Preceptorship (PCP) – 6 weeks Course changed in 2001 to current status Course changed in 2001 to current status 4 weeks, community project only 4 weeks, community project only Called Public/Community Project (PCP) Called Public/Community Project (PCP) Designated as a Service-Learning class Designated as a Service-Learning class

Teaching Public Health and Community Health Using a “COPC” Approach Vision – “To produce a skilled and socially responsible physician graduate who integrates the art and science of medicine in the care of individual patients and of populations.”

Teaching Public Health and Community Health Using a “COPC” Approach Mission – “To allow students to gain an appreciation for the public health/community health approach to the improvement of health for individuals and populations.”

Teaching Public Health and Community Health Using a “COPC” Approach Objectives - This required, four-week Public/Community Project is designed to acquaint medical students with the skills, knowledge, and attitudes basic to the Public Health/Community Health Model for addressing a community health problem or issue.

Teaching Public Health and Community Health Using a “COPC” Approach Activities - Complete and present a Public/Community Project (chosen by the student, a focus on a public health issue/problem present in the community setting); partner with a public or private agency that focuses on the topic chosen; use national, state and local public health resources, computer searches, and readings to complete their project.

Teaching Public Health and Community Health Using a “COPC” Approach Activities (con’t) – complete three computer guided programs: 1) an introduction to the basics of Public Health; 2) & 3) using a virtual community (rural and urban) computer game, conduct a community-based health need's assessment, intervention and evaluation (the full COPC process).

Teaching Public Health and Community Health Using a “COPC” Approach Project Types (COPC Model) Health Needs Assessment (which includes: defining the community, characterizing the community's health, and prioritizing their health concerns). Health Needs Assessment (which includes: defining the community, characterizing the community's health, and prioritizing their health concerns).

Teaching Public Health and Community Health Using a “COPC” Approach Project Types (COPC Model) Propose/Implement Targeted Interventions: Implementation of an action, activity, training, or educational program that is meant to alleviate a defined public health problem or issue. This should be measurable and address a specific group. Propose/Implement Targeted Interventions: Implementation of an action, activity, training, or educational program that is meant to alleviate a defined public health problem or issue. This should be measurable and address a specific group.

Teaching Public Health and Community Health Using a “COPC” Approach Project Types (COPC Model) Evaluate Outcomes: Review an ongoing/completed project to determine its effectiveness and make recommendations for changes or future actions. Evaluate Outcomes: Review an ongoing/completed project to determine its effectiveness and make recommendations for changes or future actions.

Teaching Public Health and Community Health Using a “COPC” Approach Course Evaluation/Grading Computer Programs: completed. Computer Programs: completed. Group “Reflection” session: completed. Group “Reflection” session: completed. Oral Project Presentation: graded (30%). Oral Project Presentation: graded (30%). Written Project Paper: graded (70%). Written Project Paper: graded (70%).

Walking Up Stream "It's not enough to pull drowning victims out of the river; we need to walk back upstream and find out who's throwing them in." Bishop V. Gene Robinson Bishop V. Gene Robinson

850+ Projects and Counting To date students have completed projects in 40 Utah communities, 11 different states and 8 countries. To date students have completed projects in 40 Utah communities, 11 different states and 8 countries. They have worked with hundreds of public and private agencies, clinics, hospitals and private groups. They have worked with hundreds of public and private agencies, clinics, hospitals and private groups. Of the three types of projects: Of the three types of projects: * 52% were Needs Assessments * 40% were Interventions * 8% Evaluations

Needs Assessments Bottled Water Use Among Hispanic Patients at a Community Health Center Bottled Water Use Among Hispanic Patients at a Community Health Center Emergency Response on St. George Golf Courses Emergency Response on St. George Golf Courses Muslim Women in Salt Lake County: Health Needs and Barriers Muslim Women in Salt Lake County: Health Needs and Barriers Living Wills and the Homeless Population of Salt Lake City Living Wills and the Homeless Population of Salt Lake City An Analysis and Assessment of a Free Medical Clinic in Vietnam An Analysis and Assessment of a Free Medical Clinic in Vietnam

Interventions Promotion of Cancer Screening Program in Wasatch County, Utah Promotion of Cancer Screening Program in Wasatch County, Utah A ‘30 Second’ Breast Cancer PBS A ‘30 Second’ Breast Cancer PBS Video Spot Pretest HIV Counseling at Moi Teaching and Referral Hospital, Kenya, Africa Pretest HIV Counseling at Moi Teaching and Referral Hospital, Kenya, Africa Skin Cancer and Shingles in Utah’s Elderly Population: An Intervention Skin Cancer and Shingles in Utah’s Elderly Population: An Intervention

Evaluations Lead Poisoning Screening Process in a Rural Clinic Lead Poisoning Screening Process in a Rural Clinic Health Access Project: How Successful Has It Been? Health Access Project: How Successful Has It Been? Impact and Use of the Impact and Use of the Staywell Fitness Center at IPSC Staywell Fitness Center at IPSC

Student Ownership and Partnership On their Own: Interest and Ownership On their Own: Interest and Ownership *Broad Spectrum of Projects *Broad Spectrum of Projects *Innovative and Unique (Surprise!) With Suggested Partners With Suggested Partners *Added Follow-up and Completeness *Larger Efforts *Continuity

IRB vs. Educational Worked closely with Institutional Review Board to assure projects meet their exempt guidelines Worked closely with Institutional Review Board to assure projects meet their exempt guidelines Student Guidelines and Faculty Oversight Student Guidelines and Faculty Oversight Forming a partnership with a group or agency where students help them with an effort that address their issues and needs. Forming a partnership with a group or agency where students help them with an effort that address their issues and needs.

Student Evaluations of Us Learning Value (3.4 of 5) Learning Value (3.4 of 5) Use of Technology (4.2) Use of Technology (4.2) Support and Organization (4.5) Support and Organization (4.5) Overall Satisfaction (3.8) Overall Satisfaction (3.8) Too long, too Short, Another Time Too long, too Short, Another Time Life Altering or Why do you make us do this? Life Altering or Why do you make us do this?

Service-Learning Introduction Adult-Learning Adult-Learning Project in the Community Project in the Community The “Three Parts” The “Three Parts” Service Impact on the Community Service Impact on the Community Reciprocity & Partnership Reciprocity & Partnership

Service-Learning Definition A 3-Way Partnership among A 3-Way Partnership among Students Students Communities Communities School of Medicine School of Medicine Service and learning occur in a mutually beneficial exchange

Service-Learning: Four Basic Goals 1. Meaningful Service to the Community 1. Meaningful Service to the Community 2. Student Experience Relevant to Course Material 2. Student Experience Relevant to Course Material 3. “Engagement in the Community” Perspective 3. “Engagement in the Community” Perspective 4. Structured Self-Reflection 4. Structured Self-Reflection

Reflection: The ABCD’s “Pick an event or experience and describe it from the following 4 areas: “Pick an event or experience and describe it from the following 4 areas: A—How were you AFFECTED (feelings)? B—Did you perform a new BEHAVIOR during this project? C—Did you learn new knowledge (COGNITION) while engaged in your project?

ABCD’s of Reflection (continued) D—Describe the DIVERSITY of the people, for example: D—Describe the DIVERSITY of the people, for example: Health Beliefs Health Beliefs Cultural/Ethnic View Cultural/Ethnic View Physical/Mental Challenges Physical/Mental Challenges Ages/Gender Ages/Gender Languages Spoken Languages Spoken Education Education Socioeconomic Status, etc. Socioeconomic Status, etc.

Conclusions Value-Added Component to Students/Community/University/Courses Value-Added Component to Students/Community/University/Courses Funding Potential for Courses Funding Potential for Courses Impact on Student Willingness to Engage in their Communities—Now and Future Impact on Student Willingness to Engage in their Communities—Now and Future

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