The impact of training future optometrists in community health centers

Community health centers are a rewarding and rich career choice for future optometrists. As primary eye care providers, optometrists in these multi-disciplinary settings have the potential to make significant and lasting impacts on patients of underserved populations, to increase awareness surrounding cultural diversity and impact on healthcare, and to advocate for healthcare equity. This article discusses why community health centers can be a career destination for current and prospective optometry students, and provides examples of making an impact as a health center optometrist.

How to Support Student Academic Success

21st-century medical education is focused on healthcare equity by creating opportunities for students who are from underrepresented minority groups and non-traditional backgrounds to pursue medicine. Institutions that have spearheaded this movement have found a wide variation in the baseline knowledge, skills, and attitudes of their incoming medical students. Ensuring that these students meaningfully transition into and progress through medical school without negatively impacting their performance or wellness is a challenge that needs to be strategically addressed. This chapter will outline the challenges associated with the transition of matriculating medical students, the importance of a curriculum that promotes equity, the role of a developmental learning environment in supporting student academic success, and guidelines to use coaching to enhance student engagement.

Health Care Equity in the Use of Advanced Analytics and Artificial Intelligence Technologies in Primary Care

The integration of advanced analytics and artificial intelligence (AI) technologies into the practice of medicine holds much promise. Yet, the opportunity to leverage these tools carries with it an equal responsibility to ensure that principles of equity are incorporated into their implementation and use. Without such efforts, tools will potentially reflect the myriad of ways in which data, algorithmic, and analytic biases can be produced, with the potential to widen inequities by race, ethnicity, gender, and other sociodemographic factors implicated in disparate health outcomes. We propose a set of strategic assertions to examine before, during, and after adoption of these technologies in order to facilitate healthcare equity across all patient population groups. The purpose is to enable generalists to promote engagement with technology companies and co-create, promote, or support innovation and insights that can potentially inform decision-making and health care equity.

Tailoring interventions for social isolation among older persons during the COVID-19 pandemic: challenges and pathways to healthcare equity

Background Social isolation among older adults raises major issues for equity in healthcare in the context of the COVID-19 pandemic. Main text This commentary describes current challenges in preventing social isolation among older adults and proposes pathways to develop inclusive approaches to intervention in this vulnerable population. Building interventions that take account of structural inequities among older persons, as well as their subjective experiences, expectations and perspectives, appears fundamental to improve their health and quality of life in pandemic and post-pandemic contexts. Conclusions We argue that equity-based and person-centered approaches are critical to counter the negative outcomes of social isolation in the vulnerable older population.

Meaningful patient and public involvement to advance healthcare equity, quality and accessibility

Background A large part of public health is promoting healthcare equity, quality and accessibility. Patient and public involvement (PPI) is a powerful tool to support this goal. It can lead to a richer understanding of public health research topics, improve data quality and analysis, increase trust in and dissemination of research findings, and ultimately achieve health services that are useful, useable and desirable. However, this all relies on PPI being conducted in a meaningful, respectful and inclusive way. Guidance is available on how to conduct, report and evaluate PPI activities. However, evaluative data are often brief, narrative descriptions, which reflects the lack of robust tools specifically developed to assess PPI. The purpose of this study was to develop and pilot tools to objectively assess PPI in the context of research project meetings. Methods PPI and group dynamics literature was used to guide the construction of an observation protocol and questionnaire. The research tools were piloted within a randomised trial of a community intervention for refugee children reporting symptoms of posttraumatic stress. Results The Active Involvement of Users in Research Observation Schedule is a semi-structured observation protocol, which consists of 12 observable behaviours relating to the interpersonal relations between researchers and PPI advisors; the nature of advisor contributions; and how the advisors guide research development. Each category consists of positive and negative behaviours. There is an accompanying paper-based assessment form that allows attendees to independently and anonymously grade the meeting on a list of items that correspond to those on the observation pro-forma. Preliminary inter-rater reliability for the observation protocol is good (ICC=0.833; 95% CI: 0.569-0.947). Conclusions Although the research tools require further refinement and validation, the methodological approach offers a promising, rigorous way to evaluate PPI. Key messages A large part of public health is promoting healthcare equity, quality and accessibility. Patient and public involvement (PPI) is a powerful tool to support this goal. The Active Involvement of Users in Research Observation Schedule and Questionnaire offer a promising, rigorous way to evaluate PPI and promote meaningful involvement to advance public health research.