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Duong, David

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Duong, David

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2015 - 20162

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Author's Publications: search.filters.isAuthorOfPublication.7a4bb60e-5aec-485d-9d6b-4101a48ddc56

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    A model for training medical student innovators: the Harvard Medical School Center for Primary Care Abundance Agents of Change program
    (Co-Action Publishing, 2016) Duong, David; Sullivan, Erin; Minter-Jordan, Myechia; Giesen, Lindsay; Ellner, Andrew
    Background: In 2013, the Harvard Medical School Center for Primary Care established the Abundance Agents of Change (AoC) program to promote interprofessional learning and innovation, increase partnership between 15 academic and community health centers (CHCs) in Boston's most under-served communities, and increase medical student interest in primary care careers. Methods: The AoC is modeled in the form of a ‘grants challenge’, offering $20,000 to interprofessional student teams to develop an innovative solution that addresses a healthcare delivery need identified by CHCs. The program's initial two years were characterized by a four-stage process which included working with CHCs and crafting a request for proposals, forming interprofessional 20 student teams comprising students from across and outside of Harvard University, training students using a systems-based innovation curriculum, and performing program evaluation. Results: Our evaluation data from cohorts 1 and 2 of the AoC program demonstrate that we succeeded in training students as innovators and members of interprofessional teams. We also learned valuable lessons regarding creating better alignment with CHC priorities, extending the program cycle from 12 to 18 months, and changing the way funding is disbursed to 25 students, which will be incorporated in later versions of the program. Conclusions: Based on our experience and evaluation data, we believe that this program is a replicable way to train students as innovators and members of interprofessional teams to address the current complex healthcare environment.
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    Understanding the Service Availability for Non-Communicable Disease Prevention and Control at Public Primary Care Centers in Northern Vietnam
    (2015-05-13) Duong, David
    Background: Non-Communicable diseases (NCDs) are currently responsible for over 60% of global deaths, 80% of which are in low-and-middle-income countries. In Vietnam, a low-middle income country, between 1986 and 2008, the proportion of all hospital admissions attributable to NCDs increased from 39% to 69%, and mortality attributed to NCDs rose from 42% to 63%. Methodology: This mixed methods study involved a critical review of published and unpublished literature, and government documents to understand the current situation of NCDs service delivery. Additionally, from December 2013 until April 2014, 89 CHCs were surveyed in three provinces in northern Vietnam on NCD service availability using the World Health Organization Service Availability and Readiness Assessment (SARA) tool, adapted for the Vietnam context. Results: There is strong government support for NCD prevention and control at the highest levels, however, implementation of NCD programs have not resulted in substantial population health gains. In the current situation, Vietnam’s network of CHCs do not have adequate NCD service availability for either prevention or control, which can be explained by a vertical, disease specific program implementation model, a lack of medications, non-standard payment mechanisms, and low patient volume visiting the CHCs.