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There are meaningful cancer-related disparities in the Appalachian region of the U.S. To address these disparities, the Appalachia Community Cancer Network (ACCN), a collaboration of investigators and community partners in five states (Kentucky, Ohio, Pennsylvania, Virginia, and West Virginia), is involved in increasing cancer education and awareness, conducting community-based participatory research (CBPR), and creating mentorship and training opportunities. The primary objective of this paper is to describe cancer-related disparities in the Appalachian region of the U.S. as an example of the disparities experienced by underserved, predominantly white, rural populations, and to describe ACCN activities designed to intervene regarding these disparities. An ACCN overview/history and the diverse activities of ACCN-participating states are presented in an effort to suggest potential useful strategies for working to reduce health-related disparities in underserved white populations. Strengths that have emerged from the ACCN approach (e.g., innovative collaborations, long-standing established networks) and remaining challenges (e.g., difficulties with continually changing communities, scarce resources) are described. Important recommendations that have emerged from the ACCN are also presented, including the value of allowing communities to lead CBPR efforts. Characteristics of the community-based work of the ACCN provide a framework for reducing health-related disparities in Appalachia and in other underserved white and rural populations. [ABSTRACT FROM AUTHOR]

Managing type 1 diabetes involves coordinating complex daily behaviors that may rely on the cognitive abilities of people with diabetes (PWD) and spouses, especially as couples collaborate surrounding diabetes care. The aims of the study were to examine whether 1) the cognitive abilities of PWD and their spouses predicted lower A1C, 2) collaborating with a spouse with higher cognitive abilities was especially beneficial for PWD with lower cognitive abilities, and 3) the benefit of the cognitive abilities of PWD and their spouse occurred through better self-care. Couples (n = 199) were recruited with one member diagnosed with type 1 diabetes (PWD 52% female sex, average age 46.81 years, average duration of diabetes 27 years; spouses 48% female sex; average age 46.40 years). PWD and spouses completed fluid (trail making tests from the Delis-Kaplan Executive Function System) and crystallized (information subtest from the Wechsler Adult Intelligence Scale—4th Edition) ability tests. PWD rated their spouse's collaboration in diabetes and reported self-care behaviors through surveys. A1C was assessed as a measure of blood glucose through a blood assay. Multiple regressions revealed that spouses' crystallized ability was the only statistically significant predictor, with higher values associated with lower A1C (t = −2.17, P <0.05). The interaction of crystallized ability of PWD × spouse crystallized ability × collaboration indicated that PWD with lower ability tended to benefit more when they collaborated with a spouse who scored higher in ability (t = −2.21, P <0.05). Mediational analyses indicated that spouses' crystallized ability was associated with lower A1C through better self-care behaviors of PWD (B = 0.03, SE = 0.01, P <0.01). We conclude that PWD benefit from the cognitive abilities of their spouses through better self-care behaviors that are important for maintaining lower A1C across adulthood. [ABSTRACT FROM AUTHOR]

A mandatory component of the training of occupational therapy assistant (OTA) students is the development of their clinical reasoning skills. As the demand for OTAs continues to increase in response to the growing need for occupational therapy services, the number of academic programs to prepare these future therapists has expanded. Unfortunately, there is no empirical literature addressing the preparation of OTA students, specifically the development of their clinical reasoning skills. Artifact analysis, focus groups, and questionnaires were used to explore OTA students' perceptions of what Level II fieldwork learning experiences facilitated the development of their clinical reasoning skills. The results suggest OTA students develop clinical reasoning skills during Level II fieldwork by engaging in a variety of learning experiences with support from fieldwork educators who are welcoming and approachable. Learning experiences that students perceived as most helpful to the development of clinical reasoning included hands-on learning, opportunities to witness best practice, receipt of clear expectations and regular feedback, gradual responsibility for caseload management, and opportunities for collaboration. This study adds to the profession's body of knowledge and has implications for OTA educators, fieldwork educators, OTA students, and future consumers of occupational therapy services. [ABSTRACT FROM AUTHOR]

Objective: The study examined the efficacy of an interprofessional information and historical literacy project implemented by an occupational therapy educator and a librarian. Methods: A graduate course was revised to include information and historical literacy objectives and instruction. A course-specific questionnaire administered on the first and last day of class, assignment grades, and course evaluations provided measures of project outcomes for six years. Differences between questionnaire pre- and post-test means were determined using t-tests. Course evaluation comments were analyzed to obtain qualitative perceptions. Results: A significant difference (p<0.0001) was found between pre-test (M=3.93, SD=0.48) and post-test (M=4.67, SD=0.30) scores of total information and historical literacy competence across all years (n=242). Responses to individual items also differed significantly (p<0.0001). Student ratings (n=189) from the course evaluation historical literacy objectives were high (M=4.6 on a 5-point scale). Assignment quality and grades improved, and course evaluation comments reflected student satisfaction. Conclusions: The findings supported the hypothesis that students' self-reported information and historical literacy competencies would increase after project participation. Acquired skills were evident in students' assignments. Research to determine if these capabilities were used post-graduation is needed. Because this was a course-specific project, findings are not generalizable; however, the instructional methods developed for this project can serve as a model for effective interprofessional collaboration. The broadening of information literacy instruction to include discipline-specific historical literacy provides a unique opportunity for health sciences librarians and educators. Developing students' historical literacy in their chosen fields can help them understand their profession's present status and be informed participants in shaping its future. [ABSTRACT FROM AUTHOR]