Cambria L. Garell

Background: The American Medical Association’s Declaration of Professional Responsibility is an important covenant obligating present-day physicians to transcend personal beliefs and affiliations to advocate for changes that alleviate suffering and promote human health. Despite this recognition of advocacy as a pillar of physician duty, advocacy training in undergraduate medical education remains variable across institutions, elective in nature, and often insufficient in developing trainees’ professional identities and competence as health advocates. Methods: Educators at the UCLA David Geffen School of Medicine designed and delivered a novel half-day session required for all first-year medical students to nurture their professional identities as health advocates and empower them with knowledge, skills, and attitudes (KSA) needed to give voice to issues impacting the patients and communities they serve. Students attended a shared didactic followed by two focused workshops. The session was conducted annually from 2023–2025. Pre- and post-session data was collected after each iteration to evaluate changes in KSA. Results: A total of 509 first-year medical students participated in the session from 2023–2025 with 477 (94%) partaking in the session synchronously. All 509 participants (100%) completed at least one survey, and 361 (71%) completed both pre- and post-surveys. Pooled data showed that participation led to statistically significant improvement on a 7-point Likert scale at similar rates in all three cohorts in each of the measured domains: knowledge (Δ1.45, p < 0.001), skills (Δ1.37, p < 0.001), and attitudes (Δ0.44, p < 0.001). Conclusions: A required half-day advocacy session supported trainees in developing their professional identities and acquiring foundational KSA needed to fulfill their roles as health advocates. Implementing this session across institutions can broaden its impact. Longitudinal data collection can clarify its long-term influence on physician engagement in advocacy and on health outcomes of patients and communities.

Background/Objectives: Pediatric obesity is a public health epidemic in the United States and in many countries worldwide. Due to the interrelatedness of obesity and toxic stress, mindfulness is a promising practice to support healthful eating behaviors and combat stress in the management of this condition. In this pilot study we evaluated the acceptability and feasibility of implementing a brief mindfulness-based program for pediatric patients seeking treatment for overweight and obesity, with an assessment of exploratory outcomes. Methods: Nineteen children (ages 8–17 with body mass indices (BMIs) ≥ the 85th percentile) and caregiver dyads (n = 19) were recruited from a multidisciplinary pediatric weight management clinic. Four thirty-minute psychoeducational mindfulness-based sessions were provided via telehealth. Qualitative feedback was sought during and after program completion. Child and caregiver mindful eating and general mindfulness measures were collected from participant dyads at baseline, and one month and three months after program completion. Results: Qualitative program feedback from participants was generally positive. Session attendance rates were high (89%), with most participants highly engaged during sessions and the follow-up clinic visits. An analysis of exploratory measures data revealed no significant changes in child or caregiver dyad mindful eating or general mindfulness scores at one month (n = 9) or three months (n = 7) post-program completion compared to baseline (n = 10). Conclusions: This pilot, mindfulness-based program was feasible and acceptable to implement as a scalable behavioral intervention in long-term pediatric obesity treatment. Study of a larger, controlled sample is needed to determine the impact of program participation on mindful eating and general mindfulness, along with clinical obesity-related outcomes, in the management of pediatric obesity.

Background/Objectives: This study aims to fill gaps in the existing literature through a qualitative evaluation of stakeholders involved in Food Is Medicine (FIM) programs. The primary objective was to examine the structural components, implementation process, and perceived impact of the University of California Los Angeles (UCLA) and Venice Family Clinic (VFC) Emergency Prepared Meal Program (UCLA-VFC Food Program), developed as a collaboration between a university and Federally Qualified Health Center (FQHC) during a period of community crisis. A secondary objective was to compare this program with three other FIM initiatives, identifying convergences and divergences in design and effectiveness. Methods: The methodology involved semi-structured interviews conducted with stakeholders across all four programs. Participants were recruited based on their direct involvement with program ideation, design, or implementation. Interviews were conducted online between July and September 2022, with 11 stakeholders. A thematic analysis was applied to the transcribed responses using an inductive thematic analysis. Results: Key findings highlighted four recurrent themes: (1) the critical role of leadership and a collaborative culture; (2) the importance of community partnerships and health education; (3) challenges related to logistics, funding, and sustainability; and (4) the need for assessment and evaluation. These findings provide valuable insight into the design of future FIM interventions, particularly those embedded in healthcare settings. Conclusions: In conclusion, this study offers preliminary evidence supporting the unique potential of university–community partnerships to address food insecurity. Unlike previous research that emphasized clinical outcomes, our findings provide a contextualized understanding of programmatic implementation. While further quantitative evaluation is necessary, this work lays the groundwork for a collaborative model between various entities including universities, healthcare systems, clinics, and community health/food services aimed at addressing social determinants of health.

(1) Background/Objective: California has one of the highest rates of pediatric dental caries in the nation. One way to combat this problem is through non-dental provider training programs that focus on prevention. However, there are limited data on healthcare provider training program integration and evaluation of oral health curricula focused on prevention of early childhood caries. This study will assess the change in healthcare providers’ attitudes, knowledge, and skills by implementing an interprofessional educational (IPE) oral health curriculum in medicine and nurse practitioner programs at one university in Southern California. (2) Methods: A mixed method design was employed using a pre- and post-educational survey, and end-of-program focus group interviews. Descriptive statistics and paired t-tests were used to assess group differences and thematic analyses for the focus groups. (3) Results: A total of 81 students (14 pediatric medicine residents, 18 pediatric, and 49 family nurse practitioners) completed the curriculum and surveys. Attitudes related to oral hygiene remained unchanged, with the nurse practitioner group showing improved clinical skills (all questions; p < 0.021). Knowledge scores significantly improved across all groups (paired t-test; p < 0.001). All focus groups expressed the helpfulness of the educational modules, the usefulness of the skills learned, and the benefits of IPE activities. (4) Conclusion: Healthcare providers showed improved oral health knowledge and clinical skills acquired through the oral health program and can serve as a model to educate across disciplines on the prevention of early childhood caries.

Nutrition knowledge, confidence, and skills are thought to be important elements in the role of healthcare professionals in obesity prevention and management. The Upstream Obesity Solutions curriculum goes upstream with a multidisciplinary approach to supplement nutrition education among health professional trainees. Educational strategies of didactics, teaching kitchens, and service-based learning were employed for medical, dental, and nursing students and resident physicians. Pre/post participation surveys assessed knowledge, attitude, and practices; lifestyle habits; and culinary skills among 75 trainees in this cross-sectional descriptive study. There was variability in statistically significant improvement in knowledge, attitudes, and practices about obesity management and nutrition education, lifestyle habits, and culinary skills among learner groups.