Search

This scoping review provides an overview of cancer interventions implemented with Arab Americans across the cancer control continuum, including an examination of outcomes and implementation processes. The search strategy included database searching and reviewing reference lists and forward citations to identify articles describing interventions with Arab adults living in the US, with no restrictions on date of publication or research methodology. The review included 23 papers describing 12 unique cancer interventions. Most interventions focused on individual-level determinants of breast and cervical cancer screening; used non-quasi-experimental research designs to evaluate intervention effectiveness; and demonstrated improvements in short-term cancer screening knowledge. Implementation processes were less commonly described. Most interventions were culturally and linguistically tailored to communities of focus; were delivered in educational sessions in community settings; engaged with the community mostly for recruitment and implementation; and were funded by foundation grants. Suggestions for research and intervention development are discussed. [ABSTRACT FROM AUTHOR]

The impact of adverse childhood experiences (ACEs) is well documented and poses challenges for all those living and working with children who have experienced early adversity. The need to be trauma-informed when working with children in all educational settings is now recognised as essential if healing and learning are to take place. There are an increasing number of trauma-informed approaches available, but empirical evidence that supports their efficacy, particularly in the early years of education, is currently scarce. This paper presents the findings of a small-scale study which explored early childhood professionals' perceptions of the effectiveness and sustainability of one trauma-informed approach, Trust Based Relational Intervention (TBRI®). Used widely across the US and Europe, TBRI® is relatively new to Australia and was trialled for the first time in this Tasmanian study. Substance Abuse and Mental Health Services Administration's (SAMHSA, 2014) concept of trauma and guidance for a trauma-informed approach was used to provide a theoretical framework. Online surveys were used to gather data after each professional learning workshop and three and six-months later. Participants reported several positives of TBRI®, including self-development and improved outcomes for children. Whilst challenges/barriers to using the approach were noted, many related to contextual issues rather than to TBRI® specifically. Findings also showed that equipping families with a similar skill set would be advantageous and integral to effecting sustainable change. [ABSTRACT FROM AUTHOR]

Mental health challenges have been recognized as one of the most prevalent issues impacting children and families within the United States. Children and families of color are disproportionately affected by this due to lack of access to preventative and ongoing supports, and programs that can help address their overall well-being. These issues are even more severe for those that are at risk or interact with the child welfare system. Social workers use various clinical modalities to assess and support them. In the recent years, child welfare agencies have turned to Evidence based programs (EBPs) as a best practice to meet the needs of children and families. The Title IV-E Prevention Services Clearinghouse, established by the Administration of Children and Families is a landmark effort to review and promote such EBP's that prevents foster care placements, including mental health programs. While the Clearinghouse has reviewed 141 programs and services, out of which 71 have been rated as promising, supported, or well-supported, there is a dearth of culturally responsive programs that have met the Clearinghouse criteria. Given the overrepresentation of African American and Native American Families in the child welfare system, and the critical role of the Clearinghouse in reviewing and promoting EBPs, this paper highlights the philosophical, administrative, cultural and logistical barriers for culturally relevant programs to be accepted into the Clearinghouse. It also provides specific recommendations on how the Clearinghouse and researchers can build EBPs that account for the intersection between mental health, social location and cultural identities of the children and families that social workers serve. [ABSTRACT FROM AUTHOR]

In the United States, adults from marginalized communities experience disproportionate barriers to healthcare which can have a profound impact on overall health and well-being. This phenomenon is especially true for those within the African American, Latinx, and Native American communities. These barriers include Social Determinants of Health (SDOH) which refer to environmental conditions including economic stability, access to quality education, access to quality healthcare, access to quality housing, and community resources that profoundly impact health. One way to address healthcare barriers is to provide Home-Based Primary Care (HBPC) which brings care to individuals with complex healthcare needs where they are most comfortable. Despite the importance, many HBPC teams do not include social work services. Patients may benefit when these services are offered because social workers are experts in social care and work with adults with complex healthcare needs to address SDOH. In this paper, we discuss RUSH@Home which is one HBPC program where social work plays a critical role in patient care. [ABSTRACT FROM AUTHOR]

Family-centered care (FCC) is widely established as the standard professional practice model in pediatric hospital settings (Arabiat, D., Whitehead, L., Foster, M., Shields, L., & Harris, L. (2018). Parents' experiences of family centred care practices. Journal of Pediatric Nursing, 42, 39–44. https://doi.org/10.1016/j.pedn.2018.06.012; Espe-Sherwindt, M. (2008). Family-centred practice: Collaboration, competency and evidence. Support for Learning, 23(3), 136–143. https://doi.org/10.1111/j.1467-9604.2008.00384.x). It embraces social work values that promote self-determination and family empowerment by positioning family members as partners in healthcare treatment, delivery, and decision-making (Kuo, D. Z., Houtrow, A. J., Arango, P., Kuhlthau, K. A., Simmons, J. M., & Neff, J. M. (2012). Family-centered care: Current applica?tions and future directions in pediatric health care. Maternal and Child Health Journal, 16(2), 297–305. https://doi.org/10.1007/s10995-011-0751-7). To promote and advance FCC principles, healthcare organizations collaborate with patients and families as lived experience volunteers, or family leaders, to ensure program design and education reflect users' perspectives and experiences. Despite evidence for its efficacy and uptake (Arabiat, D., Whitehead, L., Foster, M., Shields, L., & Harris, L. (2018). Parents' experiences of family centred care practices. Journal of Pediatric Nursing, 42, 39–44. https://doi.org/10.1016/j.pedn.2018.06.012), translating FCC principles into practice can be challenging (McCarthy, E., & Guerin, S. (2022). Family-centred care in early intervention: A systematic review of the processes and out?comes of family-centred care and impacting factors. Child: Care Health and Development, 48(1), 1–32. https://doi.org/10.1111/cch.12901). In this paper, we introduce an innovative training program for family leaders that embodies the core principles of FCC. The training program was developed in collaboration with families, healthcare and higher education stakeholders, and engagement specialists by a social worker in a pediatric rehabilitation setting in Toronto, Ontario. The program prepares family leaders to engage in teaching and facilitation roles in healthcare education. The Teaching and Facilitation Course for Family as Faculty is the first program of its kind in Canada and was recently recognized by the Health Standards Organization of Canada as a leading practice in healthcare. Since launching in 2019, over 50 participants connected with healthcare organizations across Ontario have completed the course. Graduates have partnered with educators in designing and facilitating over 85 initiatives and workshops across healthcare and academic institutions. The outcomes of a utilization-focused program evaluation, including the strengths and lessons learned are discussed. [ABSTRACT FROM AUTHOR]

Objectives: To describe how the UNC Horizons program, a comprehensive women-centered program for pregnant and parenting women with substance use disorders, and its patient population have changed over time and summarize basic neonatal outcomes for infants born to women in treatment at Horizons. Methods: Yearly Annual Reports from fiscal years of 1994 to 2017 were abstracted. Patient characteristics and infant outcomes compared to normative North Carolina data were examined. Results: Highlights of findings include: The percentage of women for whom opioids were the primary substance of use increased from 0% in 1995–1996 to 62% in 2016–17, while cocaine decreased from 66 to 12%. Intravenous substance use history increased from 7% in 1994–1995 to 41% in 2016–2017. The number of women reporting a history of incarceration rose from 10–20% in the early years to 40%-50% beginning in 2007–2008. The proportion of women reporting a desire to hurt themselves rose from 20% in 2004–2005 to 40% in 2016–2017. Self-reported suicide attempt history remained consistent at 32% across years. While reporting of childhood physical abuse remained at 38% across years, reporting of sexual abuse and domestic violence trended upward. Horizons did not differ from North Carolina in the likelihood of patients giving birth prematurely [χ2(13) = 20.6,p =.082], or the likelihood of a patient giving birth to a low birthweight infant [χ2(13) = 14.7,p =.333]. Conclusions for Practice: Breaking the cycle of addiction for women and children must focus on helping women with substance use problems develop a sense of hope that their lives can improve, and a sense of feeling safe and nurtured. Significance: Systematic examinations of programs that provide treatment services to pregnant and parenting women with substance use disorders have typically been focused on a limited set of outcomes and have been cross-sectional in nature. The current paper presents a detailed examination of the patient populations over a 23-year period, with particular attention to the changes over time in the women served. The birth weight and prematurity of infants born to the women in this program were likewise examined over time, and in comparison to state-level data. [ABSTRACT FROM AUTHOR]

The United States (US) Food and Drug Administration (FDA) Investigational New Drug (IND) Final Rule (US FDA, Final rule: Investigational new drug safety reporting requirements for human drug and biological products and safety reporting requirements for bioavailability and bioequivalence studies in humans, 2010) applies to all human drugs and biological products being studied under an IND. The Final Rule specifies that a sponsor must file an IND safety report for any Suspected Unexpected Serious Adverse Reaction (SUSAR) of a medicinal product being investigated. To make a proper SUSAR classification, sponsors need to go beyond conventional Data Monitoring Committees (DMCs) with an interdisciplinary effort, using all relevant data (including data outside clinical trials), to make judgments on the possibility of serious adverse events being caused by the study drug—rather than the underlying condition of the patient or a concomitant therapy. Ball et al. (Ball et al. in Ther Innov Regul Sci 55:705–716, 2021) have reported on how the Final Rule has been implemented by large pharmaceutical companies. This paper explores the experiences of small sponsor companies regarding the Final Rule, to understand the current challenges that they have been facing to meet aggregate IND safety reporting requirements. [ABSTRACT FROM AUTHOR]

The increasing need for mental health support and a shortage of therapists have led to the development of the eXtended-reality Artificial Intelligence Assistant (XAIA). This platform combines spatial computing, virtual reality (VR), and artificial intelligence (AI) to provide immersive mental health support. Utilizing GPT-4 for AI-driven therapy, XAIA engaged participants with mild-to-moderate anxiety or depression in biophilic VR environments. Speaking with an AI therapy avatar in VR was considered acceptable, helpful, and safe, with participants observed to engage genuinely with the program. However, some still favored human interaction and identified shortcomings with using a digital VR therapist. The study provides initial evidence of the acceptability and safety of AI psychotherapy via spatial computing, warranting further research on technical enhancements and clinical impact. [ABSTRACT FROM AUTHOR]

Background: Coronary artery disease (CAD) confers increased risks of premature mortality, non-fatal morbidity, and significant impairment in functional status and health-related quality of life. Routine administration of electronic patient-reported outcome measures (PROMs) and its real time delivery to care providers is known to have the potential to inform routine cardiac care and to improve quality of care and patient outcomes. This study describes a user-centered development and evaluation of the Alberta Provincial Project for Outcomes Assessment (APPROACH) electronic Patient Reported Outcomes Measurement (e-PROM) system. This e-PROM system is an electronic system for the administration of PROMs to patients with CAD and the delivery of the summarized information to their care providers to facilitate patient-physician communication and shared decision-making. This electronic platform was designed to be accessible via web-based and hand-held devices. Heuristic and user acceptance evaluation were conducted with patients and attending care providers. Results: The APPROACH e-PROM system was co-developed with patients and care providers, research investigators, informaticians and information technology experts. Five PROMs were selected for inclusion in the online platform after consultations with patient partners, care providers, and PROMs experts: the Seattle Angina Questionnaire, Patient Health Questionnaire, EuroQOL, and Medical Outcomes Study Social Support Survey, and Self-Care of Coronary Heart Disease Inventory. The heuristic evaluation was completed by four design experts who examined the usability of the prototype interfaces. User acceptance testing was completed with 13 patients and 10 cardiologists who evaluated prototype user interfaces of the e-PROM system. Conclusion: Both patients and physicians found the APPROACH e-PROM system to be easy to use, understandable, and acceptable. The APPROACH e-PROM system provides a user-informed electronic platform designed to incorporate PROMs into the delivery of individualized cardiac care for persons with CAD. [ABSTRACT FROM AUTHOR]

Research shows many positive effects from physical exercise. The present study examined the impact of a structured physical exercise program compared to treatment as usual on the gross motor skills of children diagnosed with autism spectrum disorder (ASD). Participants included 20 children, from 4 to 7 years old, who were assigned to two groups; an experimental group (n = 10) who received a structured physical exercise program for 60-min sessions, three times a week for eight weeks, and a control group (n = 10) who received conventional physiotherapy. Gross motor skills were assessed with the Abbreviated Development Scale -3 before and after the physical exercise program. The experimental group exhibited significant improvements in gross motor skills compared to the control group. This study suggests that structured physical exercise programs can improve gross motor skills in children with ASD. [ABSTRACT FROM AUTHOR]

Background: The Good Life with osteoArthritis: Denmark (GLA:D™), an evidence-based education and exercise program designed for conservative management of knee and hip osteoarthritis (OA), has been shown to benefit participants by reducing pain, improving function, and quality of life. Standardized reporting in the GLA:D databases enabled the measurement of self-reported and performance-based outcomes. There is a paucity of qualitative research on the participants' perceptions of this program, and it is important to understand whether participants' perceptions of the benefits of the program align with reported quantitative findings. Methods: We conducted semi-structured telephone interviews with individuals who participated in the GLA:D program from January 2017 to December 2018 in Alberta, Canada. Data were analyzed using an interpretive description approach and thematic analysis to identify emergent themes and sub-themes associated with participants perceived benefits of the GLA:D program. We analyzed the data using NVivo Pro software. Member checking and bracketing were used to ensure the rigour of the analysis. Results: 30 participants were interviewed (70% female, 57% rural, 73% knee OA). Most participants felt the program positively benefited them. Two themes emerged from the analysis: wellness and self-efficacy. Participants felt the program benefited their wellness, particularly with regard to pain relief, and improvements in mobility, strength, and overall well-being. Participants felt the program benefited them by promoting a sense of self-efficacy through improving the confidence to perform exercise and routine activities, as well as awareness, and motivation to manage their OA symptoms. Twenty percent of participants felt no benefits from the program due to experiencing increased pain and feeling their OA was too severe to participate. Discussion: The GLA:D program was viewed as beneficial to most participants, this study also identified factors (e.g., severe OA, extreme pain) as to why some participants did not experience meaningful improvements. Early intervention with the GLA:D program prior to individuals experiencing severe OA could help increase the number of participants who experience benefits from their participation. Conclusion: As the GLA:D program expands across jurisdictions, providers of the program may consider recruitment earlier in disease progression and targeting those with mild and moderate OA. [ABSTRACT FROM AUTHOR]

Individuals with autism spectrum disorder (ASD) engage in less physical activity than typically-developing peers. This can result in serious negative consequences for individual well-being and may contribute to the physical, behavioral, and emotional challenges associated with ASD. This study explored the potential benefits of trainer-led, individualized, physical fitness sessions specialized for ASD. Eleven individuals (ages 7–24 years) with ASD were assessed at baseline and following 15 fitness sessions. Participants demonstrated improvements in core and lower-body strength and reductions in restricted and repetitive patterns of behavior, along with non-significant but marked reductions in issues with daytime sleepiness. Results suggest the merit of specialized fitness programs and emphasize the need for larger and more rigorous research studies on this topic. [ABSTRACT FROM AUTHOR]

Background: Emergency medicine (EM) physicians routinely care for patients with serious life-limiting illnesses. Educating EM residents to have general skills and competencies in palliative medicine is a global priority. The purpose of this study was to describe the current status of palliative and end-of-life education in EM residency programs in the United Arab Emirates (UAE) and to identify barriers and opportunities to inculcating palliative care (PC) instruction into EM training in a non-Western setting. Methods: Using the American College of Emergency Medicine's milestones for Hospice and Palliative Medicine for Emergency Medicine as a question guide, semi-structured interviews were conducted with program directors of all 7 EM residency programs in the UAE from January through July 2023. Qualitative content analysis was conducted to identify recurring themes. Results: All program directors agreed that PC knowledge and skills are essential components of training for EM residents but have had variable success in implementing a structured PC curriculum. Six themes emerged, namely the educational curriculum, PC policies and practices, comprehensive PC services, cultural and religious barriers to PC, EM scope of practice, and supporting residents after patient death. Conclusion: UAE national EM residency curriculum development is evolving with an emphasis on developing a structured PC curriculum. As EM residencies implement policies and programs to improve care for patients and families dealing with serious illness, future studies are needed to assess the impact of these initiatives on patient quality of life and physician well-being. [ABSTRACT FROM AUTHOR]

Recent studies have reported that strengths-based programs, leveraging autistic adolescents' abilities and interests, could improve their skills and facilitate social engagement. However, little is known about the long-term impact of strengths-based approaches. This study aimed to explore the long-term outcomes of community strengths-based programs designed to support autistic adolescents in developing interests and skills in Science, Technology, Engineering, Arts, and Mathematics (STEAM) and the factors influencing their participation in these programs. A repeated cross-sectional survey study over three years recruited 52 parents in 2018, 52 parents in 2019, and 38 parents in 2020. Results highlighted the positive impact of these programs on autistic adolescents' health and well-being, social relationships and interactions, self-confidence and self-esteem, sense of belonging, and activities and participation. Five key elements influencing participation included the enthusiasm of the participants, their self-perception, the approach of the programs, the learning environment, and the attitudes of the mentors. This study implies that strengths-based approaches to intervention and support for autistic adolescents in a supported environment are a social model solution that could potentially have positive participant outcomes. Findings from this study could provide a framework underpinning future strengths-based interventions. [ABSTRACT FROM AUTHOR]

A systematic review and meta-analysis were utilised to explore the methodological quality, program fidelity, and efficacy of social skills group programs (SSGPs) aiming to support autistic adolescents in navigating their everyday social worlds. The study evaluated the methodological quality and theoretical fidelity of studies, with a random effect meta-analysis conducted to summarise the overall efficacy of SSGP and its effect on social communication and interaction, behavioural/emotional challenges, adaptive functioning, and autism characteristics. Although findings from the 18 identified studies indicated an adjusted medium overall effect with these programs successfully supporting autistic adolescents' socialisation needs (g = 0. 60, p < 0.001), most studies demonstrated medium to low program fidelity despite their good methodological quality. Given the significant heterogeneity of SSGPs and variations in the design and measurement frameworks of efficacy studies, understanding the generalisability of the findings of this research is unclear. [ABSTRACT FROM AUTHOR]

The effects of technology-supported behavior change interventions for reducing sodium intake on health outcomes in adults are inconclusive. Effective intervention characteristics associated with sodium reduction have yet to be identified. A systematic review and meta-analysis were conducted, searching randomized controlled trials (RCTs) published between January 2000 and April 2023 across 5 databases (PROSPERO: CRD42022357905). Meta-analyses using random-effects models were performed on 24-h urinary sodium (24HUNa), systolic blood pressure (SBP), and diastolic blood pressure (DBP). Subgroup analysis and meta-regression of 24HUNa were performed to identify effective intervention characteristics. Eighteen RCTs involving 3505 participants (51.5% female, mean age 51.6 years) were included. Technology-supported behavior change interventions for reducing sodium intake significantly reduced 24HUNa (mean difference [MD] −0.39 gm/24 h, 95% confidence interval [CI] −0.50 to −0.27; I2 = 24%), SBP (MD −2.67 mmHg, 95% CI −4.06 to −1.29; I2 = 40%), and DBP (MD −1.39 mmHg, 95% CI −2.31 to −0.48; I2 = 31%), compared to control conditions. Interventions delivered more frequently (≤weekly) were associated with a significantly larger effect size in 24HUNa reduction compared to less frequent interventions (>weekly). Other intervention characteristics, such as intervention delivery via instant messaging and participant-family dyad involvement, were associated with larger, albeit non-significant, effect sizes in 24HUNa reduction when compared to other subgroups. Technology-supported behavior change interventions aimed at reducing sodium intake were effective in reducing 24HUNa, SBP, and DBP at post-intervention. Effective intervention characteristics identified in this review should be considered to develop sodium intake reduction interventions and tested in future trials, particularly for its long-term effects. [ABSTRACT FROM AUTHOR]

This study aimed to learn about the experiences of families of individuals with a dual diagnosis of Down syndrome (DS) and autism spectrum disorder (ASD) (DS-ASD), and to document the journey from early concerns to diagnosis and intervention. Caregivers completed an online survey describing their journey raising a child with DS-ASD. Survey responses were analyzed qualitatively and coded into categories to highlight common themes. Stereotypy, severe communication impairments, and behavioral difficulties prompted caregivers to pursue further evaluation. There was a mean 4.65-year gap between first noticing symptoms and receiving an ASD diagnosis. Several therapeutic interventions were identified as beneficial, including behavioral and communication support. Caregivers expressed frustration and described high levels of stress and social isolation. The diagnosis of ASD in children with DS is often delayed, and caregivers' initial concerns are frequently dismissed. Raising a child with DS-ASD can lead to social isolation and elevated caregiver stress. More research is needed to tailor diagnostic algorithms and therapeutic interventions to the unique needs of this patient population. Caregivers yearn for improved understanding of DS-ASD, more targeted therapies and educational programs, and more overall support. [ABSTRACT FROM AUTHOR]

Peer support has been an undeveloped pathway for filling the service gap and to generate employment opportunities for autistic individuals. Peer supports have been deployed widely in mental health and among veterans and understanding the utility of this service modality among autistic individuals illuminates opportunities for research, policy, and practice. This study examined characteristics of participants in an autistic-delivered peer support program and reports on use of and satisfaction with the program. Half of autistic participants had a co-occurring mental health diagnosis. Participants reported multiple areas of unmet needs and participant satisfaction with the program was high (90%). The findings of this study point toward autistic-delivered peer support as a promising avenue for future development. [ABSTRACT FROM AUTHOR]

Youth in foster care experience high rates of social, emotional, and behavioral challenges that are complicated by trauma and grief. To address these concerns, the current intervention study examines the efficacy of a newly developed peer grief support program, the L.Y.G.H.T. program, for youth in foster care, using an embedded sequential mixed methods design. Forty-two youth residing in three separate foster care group homes ("community sites") in a southeastern state participated in this study. Youth were randomly assigned to either the treatment program or a waitlist control group. Baseline and post-intervention (after 6 weeks) assessments of the Children's Hope Scale, the Inventory of Social Support, the Rosenberg Self-Esteem Scale, and the Strengths and Difficulties Questionnaire-Self Report were administered. After each weekly group, participants completed a survey to assess trauma-informed program environment and facilitators completed a survey to assess fidelity to the intervention. Focus groups (n = 3) were conducted at each of the community sites after the post-intervention assessments were completed. To examine program impact, we evaluated whether increases in well-being (i.e., social support, hopefulness, and self-worth) and decreases in total problem behaviors would be found for participants in the treatment group. Social support, hopefulness, and self-worth increased and total problems remained the same for youth in the treatment program. Large effects were found for program helpfulness, a trauma-informed program environment, and reduction in perceived problems. Focus group feedback explained why youth were initially interested in the program, perceived program benefits, program dislikes, barriers to program participation, recommendation of the program, and additional feedback. The findings suggest that the L.Y.G.H.T. program is an efficacious intervention which addresses loss and grief and enhances the well-being of youth in foster care who are grieving. [ABSTRACT FROM AUTHOR]

Background: Pre-hospital trauma life support (PHTLS) training courses have been developed and widely adopted to enhance the proficiency of pre-hospital personnel in handling trauma patients. The objective of this study was to assess the effectiveness of the educational program for managing trauma patients in the pre-hospital emergency setting, utilizing Kirkpatrick's educational evaluation model. Methods: This is an observational approach, consisting of four sub-studies. The PHTLS course was conducted over a 2-day period, encompassing both theoretical and practical components. For this study, we selected pre-hospital personnel from three emergency aid stations using a convenient sampling method. These personnel underwent their first-ever PHTLS course training, and we subsequently analyzed the effectiveness of the training program using Kirkpatrick's four levels of evaluation: satisfaction, learning, behavior, and results. Results: The study conducted on Kirkpatrick's first-level analysis revealed that participants expressed a high level of satisfaction with the quality of all aspects of the course. Moving on to the second and third levels, namely learning and behavior, significant improvements were observed in the average scores of various skills that were examined both immediately after the course and 2 months later (P < 0.05). However, when it comes to the fourth level and the impact of the course on indicators such as mortality rate and permanent disability, no significant changes were observed even after an average of 3 months since the course was introduced. Conclusion: The implementation of PHTLS has been linked to the enhancement of participants' skills in treating trauma patients, leading to the application of acquired knowledge in real-life scenarios and a positive change in participants' behavior. The evaluation of PHTLS courses in Iran, as in other countries, highlights the need for specialized training in pre-hospital trauma care. To ensure the continued effectiveness of the PHTLS course, it is advisable for managers and policymakers to encourage regular participation of PHTLS employees in the program. Key messages: What is already known on this subject • Pre-hospital trauma life support (PHTLS) serves as a standardized algorithm for managing trauma patients. • The PHTLS course successfully enhances prehospital personnel trauma management skills leading to improved learning and behavior change. What this study adds • Repeating the course annually may enhance its effectiveness, ensure stability in behavioral changes, and reduce the impact on the mortality rate of trauma patients. • Various aspects of the PHTLS course, based on Kirkpatrick's evaluation model, have been confirmed to have a significant impact on both learning outcomes and behavioral change. [ABSTRACT FROM AUTHOR]