Grace M. Drnach-Bonaventura

Social determinants of health (SDOH) greatly impact an individual’s health, yet health care professionals are undereducated on addressing SDOH when identified. While many factors influence and drive educational practices, there is a lack of guidance in understanding best practices in teaching SDOH in online undergraduate health programs. This study examines the use of discussion board posts and peer to peer learning to increase knowledge of SDOH in an online, undergraduate course. Specific aims were to (1) examine students’ perceptions and understanding of SDOH and associated health outcomes in their communities, and (2) assess peer to peer discussions as one method for teaching SDOH in online, undergraduate programs. Discussion board posts and reflections were qualitatively reviewed using thematic analyses. Overall, students expressed positive and negative perceptions of certain SDOH domains. Discussion board posts with peer responses can provide valuable insight into how students perceive and engage with SDOH in relation to community health issues. Students demonstrated learning and understanding of the complex ways SDOH both support and hinder health outcomes, and the intricacies of the relationship between health and SDOH, such as hierarchies or the role of culture. Integrating SDOH activities in curriculum through discussion board posts is one effective teaching strategy to build knowledge in online, undergraduate health courses.

As undergraduate public health programs continue to grow across the United States, it is important to tailor public health pedagogy in large classroom settings to meet the learning styles of diverse Generation Z students. Generation Z students are unique as they have grown up in an uncertain economic and political environment, tend to be more open minded and open to engagement and feedback, and have a unique set of technology skills and expectations for in classroom learning. We present a case study of a three-pronged approach to effectively scale up introductory public health courses in large classroom settings to meet the learning styles for Generation Z through: (1) Integrating Technology, (2) Emphasizing Real World Skills, and (3) Providing Clear and Defined Rubrics. This combination of student digital prowess and connectedness presents unique opportunities for instructors to adopt unique teaching tools and assessment modalities to appeal to a diverse student population.

Background: Evidence-based early intervention practices, such as screening, brief intervention, and referral to treatment (SBIRT), are recommended to identify unhealthy use and provide linkages to treatment to prevent substance use disorder. However, there is a lack of screening frequency recommendations. Pennsylvania (PA) SBIRT was a five-year initiative to implement SBIRT in primary care sites. This study evaluated the effects of screening policies in PA SBIRT on changes in substance use risk category over time. Methods: Quantitative data were obtained from seven primary care sites implementing SBIRT, with patients who were screened twice using the Drug Abuse Screening Test, US Alcohol Use Disorders Identification Test, or the Alcohol, Smoking, and Substance Involvement Screening Test and experienced any risk category change (n = 1,364). Patients were 49% male, 51% female, 81% White, and 14% Black. An intercept-only generalized estimating equation model tested whether category changes between screen one and screen two were statistically significant. Results: The average number of months between screenings for those experiencing a risk category change was 9.01 with a range of 0 to 46 months. There was a statistically significant change between screening one and screening two ( P > 0.001), with 44% undergoing a decrease in risk category and 56% undergoing an increase in risk category. Of those undergoing an increase in risk category, 91% moved from a negative/low risk category to a positive/higher risk category. Conclusions: Results suggest that frequent screening policies may improve identification of substance use risk category changes. The results act as a catalyst to further evaluate recommended screening intervals for detecting unhealthy substance use to increase identification and patient connection.