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# Research Workshop Erica Frank, MD, MPH

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### Research Workshop Erica Frank, MD, MPH

1. 1. Research Workshop Erica Frank, MD, MPH Professor and Canada Research Chair School of Population and Public Health University of British Columbia
2. 2. Bottom line: Don’t try this at home without supervision
3. 3. Summary of Principles: 1. Pick a question that matters 2. Build it strong 3. Put your data in context 4. Extrapolate/build 5. Milk it
4. 4. Principle 1: Pick a question that matters: • Big implications (but doable) • Interesting no matter the outcome
5. 5. Principle 2: Build it strong to withstand: • grant-givers • colleagues / participants • reviewers • editors • the test of time
6. 6. Principle 3: Put your data in context: • Use Qs with comparison populations
7. 7. Examples: Put your data in context: • 4% of U.S. women physicians smoke!!!!!
8. 8. Not high SES High SES Women Characteristic BRFSS BRFSS Physicians Cigarette smoking Smoking (%) Never 52.9(0.4)** 64.0(1.9)** 77.7(0.7) Current 25.0(0.4)** 8.0(1.0)** 3.7(0.4) Average cigarettes/day 17.6(0.2)** 16.0(0.2) 12.0(1.1) 1 cigarette-abstinent day 50.5(0.9)** 47.0(6.1)** 75.3(4.0) in last year (%) Number of years quit (%) <1 year 11.9(0.5)** 6.7(2.1) 3.5(0.8) 1 - <5 yrs. 20.8(0.7) 14.0(2.3) 16.2(1.7) >5 yrs. 67.3(0.8)** 79.3(2.9) 80.3(1.9) *p<0.01 for the difference between this BRFSS category and WPHS **p<0.0001 for the difference between this BRFSS category and WPHS Frank, et al Arch Intern Med 2/1998
9. 9. Physicians’ Personal Health Practices vs. Her Counseling or Screening Patients at Least 1x/yr. Physician’s fat consumption % counseling on cholesterol at least 1x/year** Below median fat score 30.2% Median fat score 22.6% Physicians’ exercise % counseling on exercise at least 1x/year** Complies with ACSM rec. 46.1% Doesn’t comply with ACSM rec. 39.6% Physicians’ alcohol consumption % counseling on alcohol at least 1x/year** < 2 drinks per week 41.7% > 2 drinks per week+ 31.9% Physicians’ cigarette smoking % counseling on tobacco at least 1x/year Non-smoker 63.4% Current smoker 47.8% **p<0.01 Frank, et al Arch Fam Med, 4/2000; Res Q Ex Sport, 6/2004
10. 10. Principle 4: Extrapolate / build • Women Physicians’ Health Study • Healthy Doc = Healthy Patient • Colombia • Deans • Canadian Physicians’ Health Study • Laos • Cambodia
11. 11. STUDY DESIGN: Healthy Doc=Healthy Patient • Population: the Class of 2003 at 17 medical schools from freshman orientation through fourth year • Two parallel studies • 228-item, self-reported questionnaire • Demographics & personal and clinic prevention practices of US medical students • Comparable with national surveys
12. 12. Principle 4: Extrapolate / build • Healthy Doc = Healthy Patient • Colombia • Deans • Canadian Physicians’ Health Study • Laos • Cambodia
13. 13. Pilot Study in Bogotá, Colombia • 44% of regularly active students (RAS) vs. 21% of sedentary students (S) “usually or always” counseled patients about exercise or physical activity (p=0.006) • 50% of RAS vs. 32% of S reported “having had extensive training on the topic of physical activity and exercise” (p=0.009). • 27% of current smokers (CS) vs. 52% of never/non-current smokers (NCS) “usually or always” counseled patients on smoking cessation (p=0.002) • 16.9% CS vs. 4.8% NCS disagree with the statement “I will be able to provide more credible and effective counseling if I don’t use tobacco” (p=0.001)
14. 14. Principle 4: Extrapolate / build • Healthy Doc = Healthy Patient • Colombia • Deans • Canadian Physicians’ Health Study • Laos • Cambodia
15. 15. Dean and student opinions about HD Principles Dean’s avg (n=17) Students’ avg (n=1336) Medical school faculty members should set a good example for medical students by practicing a healthy lifestyle. 1.4 2.1 Medical schools should encourage their students and residents to practice healthy lifestyles. 1.3 1.9 In order to effectively encourage patient adherence to a healthy lifestyle, a physician must adhere to one him/herself. 2.1 2.2 Scale = 1 (strongly agree) to 5 (strongly disagree)
16. 16. Principle 4: Extrapolate / build • Healthy Doc = Healthy Patient • Colombia • Deans • Canadian Physicians’ Health Study • Laos • Cambodia
17. 17. Principle 5: Milk it for all it’s worth • But no more
18. 18. Milking: say it Aspects of “The Healthy Doc – Healthy Patient Project” (1999-present) • Plenary speaker, AMA meeting, Section on Medical Schools, 1999 • Plenary speaker, Medical Society of Wisc’s Regional Summit on Women Physicians, 2000 • Invited speaker, Grand Rounds, University of Wisconsin, 2000 • Invited speaker, AMWA annual meeting, 2000 • Invited speaker, AMA/CMA International Conf. on Physician Health, 2000, 2002, 2004 • Invited speaker, CDC, National Ctr for Chronic Dis. Prevention & Health Promotion, 2001 • Invited speaker, National Medical Association annual student meeting, 2001 • Invited speaker, American Cancer Society National Office, 2001 • Invited speaker, Grand Rounds, Tulane University, 2002 • Invited speaker, Grand Rounds, University of Washington, 2002 • Invited speaker, Grand Rounds, University of British Columbia, 2002 • Invited speaker, Grand Rounds, Family Planning, Emory University, 2003 • Invited speaker, Grand Rounds, Surgery, Emory University, 2004 • Plenary speaker, Federation of State Physician Health Programs’ Annual Mtg, 2004 • Plenary speaker, International Healthy Lifestyles Seminar, Bogota, Colombia, 2004 • Keynote speaker, NH Academy of Family Physicians Annual Meeting, 2004 • Invited speaker, Grand Rounds, Dartmouth Medical School, 2004 • Keynote speaker, Ontario Physician Health Program Annual Meeting, 2004 • Plenary speaker, AMA meeting, Section on Medical Schools, 2004 • Keynote speaker, Annual Scientific Assembly, Alberta College of Family Physicians, 2005 • Invited speaker, Grand Rounds, Advocate Health System, 2005 • Invited speaker, CDC, Cancer Control Division, 2005 • Invited speaker, AAMC Physician Workforce Research Conference, 2005 • Invited speaker, Alabama Physician Health Program, 2005 • Invited speaker, Massachusetts Medical Society, 2005 • Podium presenter, annual mtg., American College of Preventive Medicine, Reno, NV, 2006 • Invited speaker, Grand Rounds, University of British Columbia, 2006 • Keynote speaker, Physician Health Program of British Columbia, Vancouver, 2006 • Moderator and panelist, Association of American Medical Colleges, Seattle, WA, 2006``