Children who begin school with less developed early literacy skills often have a difficult time catching up to their peers, and children who are poor readers in the first few years of school continue struggling with reading when compared with their peers at later grades. Before school entry, schools may be limited in their regular access to…

Introduction: Immigrant physicians are a valued resource for physician workforces in many countries. Few studies have explored the education and training needs of immigrant physicians and ways to facilitate their integration into the health care system in which they work. Using an educational program developed for immigrant civilian physicians…

The Geriatric Scholar Program (GSP) is a Department of Veterans Affairs' (VA) workforce development program to infuse geriatrics competencies in primary care. This multimodal educational program is targeted to primary care providers and ancillary staff who work in VA's rural clinics. GSP consists of didactic education and training in geriatrics…

Purpose: We describe and evaluate a project designed to pilot test an evidence-based clinical intervention for assessing and treating depression in older adults in rural primary care clinics. Project ADAPT--Assuring Depression Assessment and Proactive Treatment--utilized existing primary care resources to overcome barriers to sustainability…

Context: Founded in 1971 with state funding to increase the number of primary care physicians in rural Minnesota, the Rural Physician Associate Program (RPAP) has graduated 1,175 students. Third-year medical students are assigned to primary care physicians in rural communities for 9 months where they experience the realities of rural practice with…

The Healthy Steps for Young Children program is a national initiative developed by pediatricians from Boston University in collaboration with professionals from the Commonwealth Fund. This program for families with young children (birth to 3 years of age) provides developmentally--oriented services within pediatric primary care through addition of…

A study of Dalhousie University (Nova Scotia) medical school primary care residency graduates (n=200) and other specialty graduates (n=371) suggests that the institution's policy of requiring first-year residencies in small community health services may cause more graduates, both primary care and specialists, to choose rural practice locations.…

Pediatricians can play a role in promoting family literacy. Boston City Hospital has developed a model program that integrates family literacy into pediatric primary care, and has designed a program of research to evaluate its effects. The program has three components. In the waiting room, volunteers model for parents how to listen, question,…

A community-based, drop-in, self-help wellness center representing an empowerment approach to developing culturally appropriate health promotion for black women is described. The program, affiliated services, and jointly sponsored programs are reviewed. Relationships with supporting organizations, strengths and pitfalls of the model, and program…

A study evaluated the impact of the reorganization of the academic Sepulveda (California) Veterans' Administration medical center toward primary and ambulatory care. Surveys of several thousand patients were linked to computerized utilization and mortality data and related to the center's strategic plan and goals. Substantial improvement in…

The process of change at the academic Sepulveda (California) Veterans' Administration hospital during implementation of a new ambulatory primary care program was examined through individual or focus group interviews with 63 managers, house officers, and patients. Major problems included administrative integration of in- and outpatient services;…

This report outlines the national and state environmental context for the SECCS Initiative in supporting MCH strategic planning in early childhood systems building. This strategic context has implications for roles, relationships, and activities within a planning process and ultimately an implementation process. It summarizes the opportunities and…