Published Articles
The Shoulder to Shoulder Model — Channeling Medical Volunteerism Toward Sustainable Health Change
By Jeffery E. Heck, MD; Andrew Bazemore, MD, MPH; Phil Diller, MD, PhD
Background: Rapid growth in medical volunteerism in resource-poor countries presents an oppor tunity for improving global health. The challenge is to ensure that the good intentions of volunteers are channeled effectively into endeavors that generate locally acceptable, sustainable changes in health. Methods: Started in Honduras in 1990, Shoulder to Shoulder is a network of partnerships between family medicine training programs and communities in Honduras and other resource-poor countries. The program involves short-term volunteering by US health professionals collaborating with community health boards in the host countries. The program has been implemented in seven US family medicine training programs and is supported by a small international staff. Results: During the 16 years of program operation, more than 1,400 volunteers have made visits to host countries, which include Honduras, Ecuador, and Tanzania. Clinics have been established, school-based food programs and community-based water filtration programs developed, and cancer screening and pregnancy-care programs put in place. These and other programs have been implemented on a budget of less than $400,000, raised through donations and small grants. Conclusions: The Shoulder to Shoulder model allows health care professionals to channel short-term medical volunteerism into sustainable health partnerships with resource-poor communities. The resulting network of partner ships offers a powerful resource available to governments and foundations, poised to provide in novative interventions and cost-effective services directly to poor communities.
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Family Medicine, the NIH, and the Medical-Research Roadmap: Perspectives From Inside the NIH
By Sean C. Lucan, MD, MPH; Frances K. Barg, PhD, MEd; Andrew W. Bazemore, MD, MPH; Robert L. Phillips, Jr, MD, MSPH
Background and Objectives: Family medicine has had little engagement with the National Institutes of Health (NIH), and it is unclear what NIH officials think about this.
Methods: Purposive sampling identified 13 key informants at NIH for open-ended, semi-structured interviews. Evaluation was by content analysis.
Results: NIH officials expressed the perception that family physicians have strong relationships with patients and communities and focus on interdisciplinary collaboration but that they do limited research and have weak research infrastructure. They also indicated that NIH has repackaged its stated focus, to include areas of research that might be applicable to family medicine, but whether this represents real change is questionable; NIH still emphasizes basic science and exclusionary trials. While NIH officials suggested that family physicians still have no obvious NIH home, they also suggest that family physicians are well-poised to recruit patients and inform questions, if not lead research. Family physicians have opportunity with Clinical and Translational Science Awards (CTSAs) but need areas of expertise and additional formal research training to succeed with greater research participation.
Conclusions: NIH key informants generally appreciated family medicine clinically but viewed family medicine research as underdeveloped. Some identified opportunities for family medicine to lead, particularly CTSAs. Greater self-advocacy, research training, and developing areas of expertise may improve family medicine’s engagement with NIH.
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Cervical Cancer Articles
Cervical Cancer Screening Power Point Presentation shown above, (7 megabytes)
Cost Effectiveness in Cervical Screening (pdf)
(NEJM) Spanish Medical Terms for Cervical Screening (.doc)
Protocol for Cervical Cancer Screening Shoulder to Shoulder (.doc)
Single Visit Approach to Cervical Cancer Prevention (Lancet) (pdf)
