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Studies have shown that many low-income and disadvantaged Americans have a poor diet quality, which increases obesity and chronic disease risk. According to the Massachusetts Department of Public Health, education and income levels of Springfield residents are well below state averages, and racial diversity in Springfield has increased significantly over the past few decades. Springfield’s demographics increase the risk of health disparities in the community, and higher rates of diabetes, heart disease, and obesity are seen in Springfield. To promote healthy eating behaviors among Springfield residents, Mason Square Health Task Force (MSHTF), a Live Well Springfield (LWS) partner, created a 6-session nutrition curriculum, entitled The MENU Program. The goal was to increase overall health awareness and healthy eating behaviors among residents in communities that are being targeted by the LWS initiative. Topics of the The MENU Program included MyPlate guidelines and label reading, budget shopping and cooking, healthy restaurant choices, diet and chronic disease, and food justice. The objective of this study was to evaluate The MENU Program to assess its strengths, weaknesses, and effectiveness using both quantitative and qualitative data from surveys, process evaluation, and facilitator observations. There were two phases of this study: Phase 1 was the evaluation of the pilot program delivered to a group of senior women recruited through the Dunbar YMCA; Phase 2 evaluated the second offering of the curriculum to Mason Square residents enrolled in the Task Force Fit Challenge. All participants responded positively to The MENU Program sessions and positive changes were seen in knowledge, attitudes, and behaviors after both Phases. Participant-perceived useful material included handouts, group discussions, and hands-on activities. Observational data supports the usefulness of group discussion over lecture-based teaching methods. This study supports the use of The MENU Program as an effective community education program for Springfield, MA. It has the potential to positively influence residents’ diet quality and nutrition-related behaviors through improved nutrition knowledge and attitudes.

Abstract: Social Determinants of Health in Belize Free Clinic Introduction: To determine the most appropriate ways to serve patients in rural Belize through medical mission work, it is important to assess social determinants of health (SDOH). It has long been agreed that a variety of factors affect health, including environment, community and social context, access to healthcare, stress, income, mental health, education, and transportation. Many people in Roaring Creek, Belize, a village with a population of approximately 2,000, use Body and Soul Ministries, a nonprofit that invites medical teams from all over to deliver medical care, as their primary source of healthcare. During one of these trips, a medical team from East Tennessee State University (ETSU) provided medical care and employed the TeamCare survey, already used in several clinics in east Tennessee to assess the SDOH needs of the patient population in Roaring Creek. The purpose of this study was to use a survey that assesses several SDOH to determine better ways to address health needs in the community of Roaring Creek as well as connect patients with resources to meet those needs. Methods: A team of ETSU medical students, a resident, and five physicians served in a free clinic in Roaring Creek, Belize in October 2017. The team saw approximately 500 patients. Some patients were randomly selected to take the TeamCare survey to assess for six SDOH, including literacy, financial needs, drug use, abuse, transportation, and mental health. Based on the results of the survey, patients were connected with their local community health worker to assist in locating resources for patients. Using SPSS, results from the survey were arranged for frequencies and measures of central tendency. Results: Overall, a total of 106 patients responded to the TeamCare survey. Based on the survey results, 83.2% of patients responded “yes” to at least one question regarding needs related to SDOH. In fact, 7.9% of patients answered “yes” to five questions. Of note, 53.5% of patients responded positively for financial need, 46.5% positive for mental health needs, 37.6% positive for environmental alcohol or drug abuse, and 32.7% positive for transportation needs. More women stated positively for physical or verbal abuse compared to men (-1.48, p=0.001). Discussion and Conclusion: Roaring Creek, Belize is a rural community that illustrates how SDOH can impact health outcomes. There has been a recent effort for clinicians to address SDOH, especially in rural areas, but perhaps not enough globally. One way this can be done is by surveying for SDOH at clinic visits and then linking patients with relevant community resources. However, resources are not always readily available in Roaring Creek, Belize. Many patients are positive for SDOH, but with an overall lack of resources, it is important to do more research to determine how global health efforts can best serve these populations. Perhaps the best way for SDOH needs to be addressed is for Body and Soul to collaborate with community health workers and mission teams to establish ongoing programs and longstanding resources for the community.

BACKGROUND AND SIGNIFICANCE. Various studies have identified physical risk factors for musculoskeletal disorders (MSDs) associated with hand harvesting of crops, due to repetitive motions, lifting or carrying of heavy loads, and working in flexed trunk postures. A paucity of research exists on ergonomic risks to tomato farmworkers. The available studies have estimated risk based on self-reports of injury and semi-quantitative measures. METHODS. A partnership between East Tennessee State University (ETSU) and a migrant health center (Rural Medical Services) has identified some of the occupational health needs of this population. With the aid of surface electromyography (sEMG), an objective-quantitative tool, a more refined understanding of ergonomic health risks for this population will be developed. The purpose of this study is to evaluate the muscle load and fatigue induced on the anterior deltoid and upper trapezius muscles during three tasks: driving stakes into the ground, tying of tomatoes to stakes, and hoisting of a 35-pound bucket full of tomatoes. Space for a mock test plot, where the study will be conducted, is available at the ETSU’s Valleybrook facility. Muscle activity recordings will be obtained from 15 tomato farmworkers. Spectral analysis and the amplitude probability distribution function (APDF) will be used to assess fatigue and muscle load respectively. A repeated measures ANOVA will be employed in the study. ANTICIPATED RESULTS. Findings of this study should show that localized muscle loading increases muscle fatigue. Neuromuscular demand should vary, depending on the type of task performed. Stake pounding may show a higher neuromuscular demand than the other tasks. AIM 1. Evaluate the magnitude of muscle activity during three simulated tomato-field tasks and measure the intensity of movement during the stake pounding task. AIM 2. Compare estimates of muscle fatigue and muscle load induced on the anterior deltoid and upper trapezius muscles during three simulated tomato-field tasks.

Interprofessional collaboration in healthcare is vital to the nation’s health and interprofessional education is of significant interest in the current academic climate and practice environment. Remote Area Medical is a non-profit healthcare organization that partners with community hosts to provide dental, vision, and medical services to medically underserved patients in remote areas of the United States and abroad. RAM mobile clinics have served over 785,000 people since their founding in 1985, providing vital healthcare services free of charge through the volunteer services of healthcare professionals. RAM mobile clinics provide an excellent opportunity for interprofessional collaboration and interprofessional education as learners partner with volunteer professionals to serve the community. The RAM mobile clinic in Gray, Tennessee was first established in 2017 and implemented the innovate utilization of undergraduate and graduate health professional students from the East Tennessee State University Academic Health Sciences Center in student teams. Interprofessional student teams along with precepting faculty are flexible in location and services offered to best serve the needs of the mobile clinic at any given time. Interprofessional student teams work to improve patient utilization of services offered at the event and assist with medication histories and health screens while growing student interprofessional patient care skills in the process. The objective of this research is to describe the impact of interprofessional student teams on patient care at the Gray, Tennessee RAM mobile clinic during the first two years. Data was collected from the years 2017 and 2018 by the student volunteer coordinator then analyzed by student researchers. The interprofessional student teams consisted of 87 student volunteers that were training in Clinical and Rehabilitative Sciences, Medicine, Nursing, Public Health, or Pharmacy over the course of the three-day mobile clinic in 2017 and 109 different student volunteers in 2018. Student teams were precepted by interprofessional faculty and logged 2,332 interventions in 2017 and 1,130 interventions in 2018. The top two interventions in 2017 were Medication Histories and Blood Glucose Screens while the top two interventions in 2018 were Medication Histories and Health Screens. Variation in number of interventions logged and type of interventions logged can be explained by event characteristics that differed between the two years. Student participants commented positively on their engagement with one another and discussions they had to better understand each other’s professions between patient encounters. This research attempts to demonstrate that the impact of interprofessional student teams at a RAM mobile clinic is worth the investment of faculty resources in planning and execution to engage student learning while benefitting the patient population being served. This research also provided a hypothesis for additional research to be conducted around the 2019 Gray, Tennessee RAM mobile clinic.

<p>Since teachers’ referrals involve evaluation of students through sustained observation, comprehensive features of giftedness can be identified. In 2007, a project called Having Opportunities Promotes Excellence (HOPE) was launched at Purdue University with funds from the Jack Kent Cooke Foundation (Gentry et al., 2015). This 3-year project aimed to help identify giftedness among low-income and ethnically diverse students and serve these students in advanced programs. To do so, the project team created the <i>HOPE Scale</i> (Gentry et al., 2015), an instrument used by teachers to assess the academic and socioemotional characteristics of gifted students. Previous results from Project HOPE served as the foundation for the current studies. This dissertation is comprised of three related research papers investigating the <i>HOPE Scale</i> as an equitable measure for identifying underrepresented students for the gifted services. Following are the purpose and research questions for each of these related studies.</p><p></p><h3><a></a><a>Study 1: Validity Evidence for the <i>HOPE Scale</i> to Identify Gifted Students from Low-Income and Multicultural Families in Korea</a> </h3><div><a></a></div><p></p><h3><a></a><a>Study 2: Exploring Individual and Classroom Characteristics on Students’ Outcome Scores from the <i>HOPE</i> Teacher Rating Scale</a></h3><div><a></a><h3><a></a><a></a><a>Study 3: The Relationship between Students’ Academic Achievement and the <i>HOPE</i> Teacher-rating Scale: Exploration to Equitably Identify Underrepresented Gifted Students</a></h3><br></div>

Human papillomavirus is the most frequently occurring sexually transmitted infection and has been recognized as the necessary cause of cervical cancer. Understanding the shift in public awareness caused by recent changes to cervical prevention is critical to addressing cervical cancer disparities in Appalachia. Since the human papillomavirus vaccine was approved for prevention, little data have been collected regarding human papillomavirus risk assessment and vaccine perceptions among Appalachian women. The purpose of the authors in this study was to investigate communication and cultural issues via a social scripting framework that could influence human papillomavirus vaccine uptake among southern Appalachian women; and explore participants' perceptions of human papillomavirus, cervical cancer, and the vaccine. A qualitative, descriptive design was employed to examine these issues in eight counties in northeast Tennessee and southwest Virginia. Thirty-nine women aged 18-49 years participated in a single individual interview or focus group session from October 2007 through August 2008. Interview and focus group data were audio-taped and transcribed verbatim. Two major themes emerged from the data: the human papillomavirus vaccine protection dilemma and spheres of silence surrounding the human papillomavirus vaccine protection dilemma. Study findings suggested areas for future research and may assist healthcare professionals in approaching southern Appalachian women as they make decisions regarding cervical cancer prevention.

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Librarians can be major contributors at multihealth profession community outreach efforts. East Tennessee State University Quillen College of Medicine Library (ETSU QCOML) partnered with the Remote Area Medical Group (RAM) at two health "expeditions" in northeastern Tennessee to provide consumer health information to the people who came to the event for medical, dental, and vision care. A booth staffed by library workers that utilized MedlinePlus.gov was set up at each event. Preselected handouts were used along with online searching. The library booth was able to provide consumer health information to 1,310 people. By participating in this event, it allowed not only the library workers to assist the public with consumer health questions but also exposed other health care professionals to what medical librarians can do to directly help patients.

Based on previous studies and the author's observations pre-service teachers do not typically consider teaching in underserved areas as their preferred option (Aragon et al., 2014). My goal for this study was to provide PSTs with a different perspective on teaching in urban areas by developing a compendium of evidenced-based practices based on the five major patterns found in effective teaching in underserved elementary schools. A qualitative content analysis of research on teacher effectiveness in underserved, underfunded, and under-resourced elementary schools allowed me to gather data from previous studies to identify evidenced-based best practices for this particular setting. Based on the review of literature, I found the following five major patterns when discussing teacher effectiveness in underserved, underfunded, and under-resourced elementary schools: Student-Teacher Relationships, Safe and Supportive, Learning Environment, Real-world Connections, Collaborative Learning, and Differentiation. Pre-service teachers considering working in an urban environment and veteran teachers can benefit from learning about these five commonalities found in effective instruction when serving underserved populations. A comprehensive website was created to provide educators with a resource that concisely explains evidence-based practices in the urban education setting.