Family Medicine Commons^™

Family Physicians And Menstrual Care: An Analysis Of Cera 2023, Allison Casola, Olivia Rea, Tiffany Ho

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Menstrual health is an important indicator of overall health and has large impacts on quality of life. Despite number and impact, discussion of menstruation remains largely taboo within health care. Patients and physicians are not engaging in regular, meaningful discussions on menstruation. Family physicians, as primary care providers, can facilitate these important conversations.

OBJECTIVES: We sought to understand the profile of menstrual care providing family physicians and assessed physician comfort, knowledge, training, and perceived importance regarding menstrual care.

DESIGN/METHODS: This is a cross-sectional analysis of the 2022 Council of Academic Family Medicine Educational Research Alliance survey. The survey included …

Assessment Of Breastfeeding Education In Medical Training, Saranya Madan, Abigail Kuplicki

Medical Student Research Symposium

In 2019, the Academy of Breastfeeding Medicine issued a revised set of educational objectives for medical trainees at various stages of education. In this statement, objectives for medical school were broken down into preclinical and clinical training objectives. In this project, our goal is to assess the degree to which medical training at Wayne State University School of Medicine is addressing these aims.

The assessment of breastfeeding education is accomplished by surveying medical students at various stages of training (M1-M4) and eliciting their level of confidence in and understanding of the topics outlined in the objectives by the Academy of …

The Impact Of Telehealth In Urgent Care Settings, Annie Dong

Applied Research Projects

Telehealth is an emerging modality of patient care and has since expanded to urgent care facilities. Urgent care facilities have been around for decades; however, along with telehealth, it has only grown in popularity in recent years due to the COVID-19 pandemic. However, the implementation and usage of telehealth in urgent care facilities is dependent on the provider being able to use it. This study aimed at looking at the perspective of the provider on the implementation and usage of telehealth in the urgent care setting.

Multilevel Community Engagement To Inform A Randomized Clinical Trial, Kirby L. Wycoff, Jabina G. Coleman, Christine M. Santoro, Leah L. Zullig, Niesha Darden, Porsche M. Holland, Jane F. Cruice, Shukriyyah Mitchell, Michelle Smith, Saleemah J. Mcneil, Sharon J. Herring

Counseling and Behavioral Health Faculty Papers

OBJECTIVE: To explore how patients, community-based perinatal support professionals, and health system clinicians and staff perceived facilitators and barriers to implementation of a randomized clinical trial (RCT) designed to optimize Black maternal heart health.

METHODS: This article describes the formative work that we believed needed to occur before the start of the Change of H.E.A.R.T (Here for Equity, Advocacy, Reflection and Transformation) RCT. We used a qualitative, descriptive design and community-based, participatory approach, the latter of which allowed our team to intentionally focus on avoiding harm and equalizing power dynamics throughout the research process. Data were collected between November 2021 …

The Effectiveness Of Disinfection Protocols In Osteopathic Family Medicine Offices, Riley Phyu, Harrison A Patrizio, Thomas Boyle, Todd Schachter

Rowan-Virtua School of Osteopathic Medicine Faculty Scholarship

CONTEXT: Healthcare-associated infections (HAIs) pose a substantial public health threat. Despite significant strides to curb HAIs in hospital environments, outpatient settings have not received the same degree of attention. Given their emphasis on holistic, patient-centered care, osteopathic family medicine offices are pivotal in both disease prevention and comprehensive patient treatment. The importance of simple yet effective disinfection protocols, such as thorough cleaning between patient appointments, cannot be overstated in these settings because they are integral to minimizing disease transmission.

OBJECTIVES: This study aims to assess the effectiveness of the current disinfection protocols in osteopathic family medicine offices.

METHODS: A cross-sectional …

Residential Racial Segregation And Neighborhood Adversity: Associations With Hemoglobin A1c In Adolescents With Type 1 Diabetes, Zechariah Jean, April Carcone, Deborah Ellis

Medical Student Research Symposium

Black adolescents with Type 1 Diabetes (T1D) are at increased risk for disparities in health outcomes. More research is necessary on the effects of neighborhood characteristics such as residential racial segregation (RRS) and neighborhood adversity on health.

149 Black youth with T1D were recruited from seven pediatric diabetes clinics in Detroit and Chicago to participate in a clinical trial to improve diabetes management. RRS was calculated at the census block group level based on US census data using Location Quotients. LQs represented the ratio of patients to total population in the block group compared to the same ratio in the …

A Single Bout Of Breast Milk Expression Does Not Increase Resting Metabolic Rate, Leryn J. Reynolds, Kayla R. Powell, Taskina Akhter, Hannah M. Twiddy, Patrick B. Wilson

Human Movement Sciences & Special Education Faculty Publications

Introduction: Breastfeeding women have elevated resting metabolic rate (RMR); however, whether a single bout of lactation increases RMR is unknown. This study aimed to determine if a single bout of lactation acutely increased RMR.

Methods: Twenty-two lactating women (age: 31 ± 0.9 year, body mass index: 27.3 ± 1.2 kg/m²) were recruited. RMR was assessed at baseline and at 1- and 2-h following breast milk expression.

Results: RMR was unchanged in lactating women following a single bout of lactation (baseline: 1437 ± 39; 1 h: 1425 ± 37 2 h: 1440 ± 31 kcal/day) (p > .05). RMR was …

Lifestyle Tools For Men’S Health And Disease Prevention: Well-Being Through Nutrition, Physical Activity, Stress Management, And Connection, Leigh A. Frame

Clinical Research and Leadership Faculty Publications

Mental health is an often-overlooked aspect of overall health and wellness (well-being). Mental illness is increasingly common with 1 in 5 American adults experiencing it annually, and 1 in 20 suffering from a serious mental illness each year [1]. Treatment rates for mental illness are lower in men (37.4%) compared to women (51.2%) [1]. Globally, treatment rates are similar with an estimated cost to the global economy of $1 trillion annually, yet less than 2% of government health expenditure is for mental health worldwide [2]. Despite this, only nine studies have been published specifically targeting men’s mental health through lifestyle …

Monkeypox Outbreak In The Age Of Covid-19: A New Global Health Emergency, Rahim Hirani, Dawood Rashid, Joshua Lewis, Rasheed Hosein-Woodley, Ali Issani

Department of Emergency Medicine

No abstract provided.

Efficacy Of Various Interventions For Achieving Target Hba1c Levels For Patients With Type Ii Diabetes Mellitus And On Exogenous Insulin, Caitlin S. Welch, Archie Troxel

Longitudinal Scholar's Project

Objective: To learn the rates at which patients at UT Family Medicine–St. Francis (UTFM–SF) with type II diabetes mellitus are being prescribed recommended medications—namely metformin, sodium-glucose cotransporter 2 (SGLT2) inhibitors, and glucagon-like peptide 1 receptor agonists (GLP1RAs)—whether these rates correspond to the severity of hyperglycemia (as indicated by HbA1C level). A secondary goal of the study was to investigate if HbA1C levels are being checked at recommended intervals.

Methods: A retrospective chart review was conducted using records of patients seen at the clinic in the previous four years between the ages of 18 and 65 who had visits with ICD …

The Hearst Health Prize: The First Five Years, Alexa M. Waters, Alexis Skoufalos, Emily Frelick, Gregory Dorn, David B. Nash

Department of Family & Community Medicine Faculty Papers

The Hearst Health Prize is the first national annual award for excellence in population health. The prize was established "to discover, support, and showcase the work of an individual, group, organization, or institution that has successfully implemented a population health program or intervention that has made a measurable difference" in health outcomes. Now, 5 years since the award's inception, this article reflects on how submissions for the prize collectively mirror - and may even predict - changes within the field of population health. It examines how the most successful programs demonstrated genuine, measurable improvements in health outcomes and/or health behaviors. …

Interventions To Improve Adherence To Recommended Diabetic Retinopathy Screening In Adult Patients With Diabetes Mellitus: A Scoping Review, Clare Anderson Bsn, Rn, Dnp, Fnp, Sarah May Bsn, Rn, Dnp, Fnp, Diana Dedmon Dnp, Aprn, Fnp-Bc

Doctor of Nursing Practice Projects

Purpose/Background Diabetic retinopathy (DR) is the leading cause of blindness in adults. Current guidelines recommend that all patients with type 2 diabetes mellitus (T2DM) have a DR screening (DRS) upon diagnosis of T2DM and then annually, but the adherence rate is only approximately 60%. This scoping review aims to evaluate the effectiveness of primary care providers (PCPs) employing strategies to increase compliance with annual DRS among adult patients with T2DM.

Methods Between September 2021 and January 2022, a literature review was performed to collect studies evaluating interventions to increase adherence to DRS. Individual searches of PubMed, SCOPUS, and CINAHL were …

Annual Hepatitis C Screening Qi: A Scoping Review, Sadiat Omowunmi Adebiyi Bsn, Rn, Sakinah Shaw Bsn, Rn, Tracy Mcclinton Dnp, Ag-Acnp-Bc, Sharon Little Dnp, Fnp-Bc, Aprn

Doctor of Nursing Practice Projects

Purpose/Background Despite the surge in HCV prevalence among pregnant women and the threat of perinatal HCV transmission, infants exposed to HCV in the United States are inadequately screened (Chappell et al., 2018). It is estimated that between 4% and 8% of babies exposed to HCV during pregnancy become infected (Watts et al., 2017). Incorporating Hep C screening with other mandated prenatal screening will play an essential role in reducing the complications associated with Hep C transmission to the newborn.

Methods Article search was done in the first three weeks of the fall 2021 semester, and a total of 63 articles …

Factors Influencing Family Health History Collection Among Young Adults: A Structural Equation Modeling, Ming Li, Shixi Zhao, Yu Yu Hsiao, Oi Man Kwok, Tung-Sung Tseng, Lei Shih Chen

School of Public Health Faculty Publications

Family health history (FHH) can serve as an entry point for preventive medicine by providing risk estimations for many common health conditions. College is a critical time for young adults to begin to understand the value of FHH collection, and to establish healthy behaviors to prevent FHH-related diseases. This study seeks to develop an integrated theoretical framework to examine FHH collection behavior and associated factors among college students. A sample of 2670 college students with an average age of 21.1 years completed a web-based survey. Less than half (49.8%) reported actively seeking FHH information from their family members. Respondents’ knowledge …

Variants Associated With Bedaquiline (Bdq) Resistance Identified In Rv0678 And Efflux Pump Genes In Mycobacterium Tuberculosis Isolates From Bdq Naïve Tb Patients In Pakistan, Dania Khalid Saeed, Sadia Shakoor, Safina Abdul Razzak, Zahra Hasan, Saba Faraz Sabzwari, Zahida Azizullah, Akber Kanji, Asghar Nasir, Samreen Shafiq, Najia Karim Ghanchi, Rumina Hasan

Department of Pathology and Laboratory Medicine

Background: Mutations in the Rv0678, pepQ and atpE genes of Mycobacterium tuberculosis (MTB) have been reported to be associated with reduced antimycobacterial susceptibility to bedaquiline (BDQ). Resistance conferring mutations in treatment naïve MTB strains is likely to have implications for BDQ based new drug regimen that aim to shorten treatment duration. We therefore investigated the genetic basis of resistance to BDQ in MTB clinical isolates from BDQ naïve TB patients from Pakistan. In addition, mutations in genes associated with efflux pumps were investigated as an alternate mechanism of resistance.
Methods: Based on convenience sampling, we studied 48 MTB clinical isolates …

Choice Bundling Increases Valuation Of Delayed Losses More Than Gains In Cigarette Smokers, Jeffrey S. Stein, Jeremiah M. Brown, Allison N. Tegge, Roberta Freitas-Lemos, Mikhail N. Koffarnus, Warren K. Bickel, Gregory J. Madden

Family and Community Medicine Faculty Publications

Choice bundling, in which a single choice produces a series of repeating consequences over time, increases valuation of delayed monetary and non-monetary gains. Interventions derived from this manipulation may be an effective method for mitigating the elevated delay discounting rates observed in cigarette smokers. No prior work, however, has investigated whether the effects of choice bundling generalize to reward losses. In the present study, an online panel of cigarette smokers (N = 302), recruited using survey firms Ipsos and InnovateMR, completed assessments for either monetary gains or losses (randomly assigned). In Step 1, participants completed a delay-discounting task to …

The Effect Of Travel Burden On Depression And Anxiety In African American Women Living With Systemic Lupus, Ashley A. White, Brittany L. Smalls, Aissatou Ba, Trevor D. Faith, Viswanathan Ramakrishnan, Hetlena Johnson, Jillian Rose, Clara L. Dismuke-Greer, Jim C. Oates, Leonard E. Egede, Edith M. Williams

Family and Community Medicine Faculty Publications

The United States has a deficit of rheumatology specialists. This leads to an increased burden in accessing care for patients requiring specialized care. Given that most rheumatologists are located in urban centers at large hospitals, many lupus patients must travel long distances for routine appointments. The present work aims to determine whether travel burden is associated with increased levels of depression and anxiety among these patients. Data for this study were collected from baseline visits of patients participating in a lupus study at MUSC. A travel/economic burden survey was assessed as well as the 8-item Patient Health Questionnaire (PHQ-8) and …

Perspectives Of Primary Care Physicians On Acceptance And Barriers To Covid-19 Vaccination, Philip Day, Chance Strenth, Neelima Kale, F. David Schneider, Elizabeth Mayfield Arnold

Family and Community Medicine Faculty Publications

OBJECTIVES: The purpose of this study was to examine the perspectives of primary care physicians in Texas around vaccine acceptance and potential patient barriers to vaccination. National surveys have shown fluctuating levels of acceptance for COVID-19 vaccination, and primary care physicians could play a crucial role in increasing vaccine uptake.

DESIGN: This study employed a cross-sectional anonymous survey design to collect data using an online questionnaire. Participants were asked about vaccination practices and policies at their practice site, perceptions of patient and community acceptance and confidence in responding to patient vaccine concerns.

SETTING: From November 2020 to January 2021, family …

Adverse Childhood Experiences And Urinary Incontinence In Elementary School Aged Children, Amanda Jill Travis Msn, Fnp-C, Margaret C. Harvey Phd, Aprn, Acnp-Bc, Chfn, Michelle Rickard Dnp, Apnp-C

Doctor of Nursing Practice Projects

Purpose/Background: Adverse Childhood Experiences (ACEs) have an impact on health throughout the lifespan (Filletti et al., 1999; Hughes et al., 2017). These experiences range from physical and mental abuse, substance abuse in the home, parental separation or loss, financial instability, acute illness or injury, witnessing violence in the home or community, and incarceration of family members (Hughes et al., 2017). Understanding and screening for ACEs in children with urinary incontinence can help practitioners identify psychological stress as a potentially modifiable risk factor.

Methods: A 5-month chart review was performed identifying English speaking patients ages 6-11 years presenting to the outpatient …

Application Of The Ultra-Poverty Graduation Model In Understanding Community Health Volunteers’ Preferences For Socio-Economic Empowerment Strategies To Enhance Retention: A Qualitative Study In Kilifi, Kenya, Njeri Nyanja, Nelson Nyamu, Lucy Nyaga, Sophie Chabeda, Adelaide Lusambili, Marleen Temmerman, Michaela Mantel, Anthony Ngugi

Family Medicine, East Africa

Background: A significant shortage of healthcare workforce exists globally. To achieve Universal Healthcare cover- age, governments need to enhance their community-based health programmes. Community health volunteers (CHVs) are essential personnel in achieving this objective. However, their ability to earn a livelihood is compromised by the voluntary nature of their work; hence, the high attrition rates from community-based health programmes. There is an urgent need to support CHVs become economically self-reliant. We report here on the application of the Ultra-Poverty Graduation (UPG) Model to map CHVs’ preferences for socio-economic empowerment strategies that could enhance their retention in a rural area …

Examining Factors Associated With Bcg And Poliomyelitis Vaccination Coverage In Tanzanian And Kenyan Children Aged 12 To 23 Months Using Dhs Surveys, Ognyan Simeonov

Independent Study Project (ISP) Collection

The rapid spread of infectious diseases in eastern Africa has made vaccination a major health factor in the region. This study aims to evaluate the factors affecting vaccination coverage with the BCG and Poliomyelitis vaccines in Tanzanian and Kenyan children aged 12 to 23 months. In May 2021, we collected data from the Demographic and Health Surveys (DHS) from 2014-2016 for Kenya and Tanzania and evaluated how different variables such as the sex of the child, maternal age, maternal educational level, availability of health facilities, access to electricity in the household, and birth order affect the vaccination coverage. We used …

Assessment Of Knowledge, Attitude, And Practice Of Child Abuse Amongst Health Care Professionals Working In Tertiary Care Hospitals Of Karachi, Pakistan, Khuld Nihan, Aamir Makda, Huzaifah Salat, Munawar Khursheed, Jabeen Fayyaz, Uzma Rahim Khan

Department of Emergency Medicine

Introduction: UNICEF report (2004) states that a significant percentage of total child population under the age of 5 years suffered malnutrition. Child sexual abuse remains undiscussed across Pakistan. Health care professionals (HCPs) are usually the first notifiers of child abuse and are ethically obliged to manage and report it.
Objective: This study was conducted to assess HCPs' response in dealing with patients of child abuse. With a better understanding, we can have a better outcome for the victims.
Methods: A total of 101 participants filled out a structured questionnaire by HCPs working in three tertiary hospitals of Karachi i.e., Aga …

Association Of Cardiovascular Health And Epigenetic Age Acceleration, Tess D. Pottinger, Sadiya S. Khan, Yinan Zheng, Wei Zhang, Hilary A. Tindle, Matthew Allison, Gretchen Wells, Aladdin H. Shadyab, Rami Nassir, Lisa Warsinger Martin, Joann E. Manson, Donald M. Lloyd-Jones, Philip Greenland, Andrea A. Baccarelli, Eric A. Whitsel, Lifang Hou

Nursing Faculty Publications

BACKGROUND: Cardiovascular health (CVH) has been defined by the American Heart Association (AHA) as the presence of the "Life's Simple 7" ideal lifestyle and clinical factors. CVH is known to predict longevity and freedom from cardiovascular disease, the leading cause of death for women in the United States. DNA methylation markers of aging have been aggregated into a composite epigenetic age score, which is associated with cardiovascular morbidity and mortality. However, it is unknown whether poor CVH is associated with acceleration of aging as measured by DNA methylation markers in epigenetic age.

METHODS AND RESULTS: We performed a cross-sectional analysis …

Epidemiology, Biostatistics, And Population Health Concepts, Allison R. Casola, Phd, Mph, Mches

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

Study Designs

• Overview

Epidemiology and Biostatistics

• Vocabulary Review
• Reliability, Variability, and Bias
• Diagnostic Testing and Measures of Association

Population Health

• Evidence Based Medicine
• Interpreting and Evaluating Literature
• Clinical Decision Making

Impact Of Covid-19 On Service Utilization By Those Experiencing Homelessness In Detroit, Anneliese Petersen, Richard Bryce D.O.

Medical Student Research Symposium

Background:

Current research has demonstrated increased levels of fear and anxiety due to the Coronavirus pandemic. While fear can have a significant impact on any individual, fear among individuals experiencing homelessness is particularly impactful as this may affect service utilization and thus the ability of to access basic necessities such as food, shelter and water. This study seeks to understand the impact of fear of contracting COVID on service utilization among those experiencing homelessness in Detroit, MI.

Methods and Results:

From July-August 2020, 35 individuals who self-identified as homeless participated in a multiple-choice survey. 40% of surveyed individuals stated that …

Elderly Musculoskeletal Disease Burden In Karachi, Pakistan: Associations And Implications For Developing Countries, Saniya Sabzwari, Zafar Fatmi, Adeel Ahmed Khan

Department of Family Medicine

Objective: The global rise in the older population has increased the rates of osteoporosis and osteoarthritis, conditions that impact mobility and functionality. There is limited data on musculoskeletal disease in older populations residing in developing countries.
Methods: A community-based study using multistage cluster random sampling of older individuals was conducted in Karachi. Predefined criteria were used for osteoporosis and osteoarthritis. Gait assessment was performed.
Results: More than half of the participants were females and 53% reported illiteracy. Around 30% had osteoporosis and two-thirds had osteoarthritis. Multivariate analysis showed associations of female sex, Pashtun ethnicity, illiteracy, and hypertension with the combined …

Association Between Duration Of Residence And Prevalence Of Type 2 Diabetes Among Male South Asian Expatriate Workers In The United Arab Emirates: A Cross-Sectional Study, Syed Mahboob Shah, Lindsay M. Jaacks, Fatima Al-Maskari, Juma Al-Kaabi, Faisal Aziz, Elpidoforos Soteriades, Tom Loney, Hamed Farooqi, Anjum Memon, Raghib Ali

Department of Family Medicine

Expatriates account for about 80% of the total population in the United Arab Emirates (UAE). This study aimed to evaluate the hypothesis that prevalence of type 2 diabetes in male South Asian expatriates increases with increased length of residence in the UAE.
Design, settings and participants: This cross-sectional study recruited a representative sample (n=1375) of male South Asian expatriates aged ≥18 years in Al Ain, UAE. Sociodemographic, anthropometric and lifestyle data were obtained using a pilot-tested adapted version of the WHO STEPS instrument.
Main outcome measures: Duration of residence was used as a marker for acculturation. Type 2 diabetes was …

Perceptions, Knowledge And Attitudes Towards The Concept And Approach Of Palliative Care Amongst Caregivers: A Cross-Sectional Survey In Karachi, Pakistan, Sameera Shah, Faizan Qaisar, Iqbal Azam Syed, Khairunnisa Mansoor

Department of Family Medicine

Background: Limited comprehension of the concept of palliative care and misconceptions about it are barriers to meaningful utilisation of palliative care programs. As caregivers play an integral role for patients with terminal illness, it is necessary to assess their perceptions and attitudes towards the palliative care approach.
Method: A cross-sectional survey was conducted. Data was collected from the Aga Khan Hospital in-patient and out-patient departments and home-based palliative care services. All adult caregivers who met the inclusion criteria and consented, completed a questionnaire till the sample size was reached. Univariate and multivariate multivariable analysis was done and results were reported …

Health Screenings Administered During The Domestic Medical Examination Of Refugees And Other Eligible Immigrants In Nine Us States, 2014-2016: A Cross-Sectional Analysis., Clelia Pezzi, Deborah Lee, Gayathri S. Kumar, Breanna Kawasaki, Lori Kennedy, Jenny Aguirre, Melissa Titus, Rebecca Ford, Blain Mamo, Kailey Urban, Stephen Hughes, Colleen Payton, Kevin Scott, Jessica Montour, Emily S. Jentes

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Refugees and other select visa holders are recommended to receive a domestic medical examination within 90 days after arrival to the United States. Limited data have been published on the coverage of screenings offered during this examination across multiple resettlement states, preventing evaluation of this voluntary program's potential impact on postarrival refugee health. This analysis sought to calculate and compare screening proportions among refugees and other eligible populations to assess the domestic medical examination's impact on screening coverage resulting from this examination.

METHODS AND FINDINGS: We conducted a cross-sectional analysis to summarize and compare domestic medical examination data from …

Racial/Ethnic Differences In Glycemic Control In Older Adults With Type 2 Diabetes: United States 2003-2014, Brittany L. Smalls, Tiarney D. Ritchwood, Kinfe G. Bishu, Leonard E. Egede

Family and Community Medicine Faculty Publications

The aim of this study was to determine whether racial differences in HbA1c persist in older adults (≥65 years) living with type 2 diabetes. Data from The National Health and Nutrition Examination Survey (NHANES) 2003-2014 were used to examine the association between HbA1c and older adults (≥65 years) over time. Compared to non-Hispanic Whites, Mexican Americans had the greatest difference in average HbA1c among minority groups, followed by those with unspecified/mixed ethnicities and non-Hispanic Blacks. In the adjusted linear model, racial minorities had a statistically significant relationship with HbA1c. There was no relationship between HbA1c and older age and insulin …