Primary Care Commons^™

A Letter To The Editor: Under-Represented Minority Faculty In Academic Medical Centers, Kendall M. Campbell Md

Family Medicine and Rural Health Faculty Publications

No abstract provided.

Awareness Of Type Ii Diabetes In The Developing World: Case Study In Binh Du’O’Ng, Vietnam, Anna Hong Le

Independent Study Project (ISP) Collection

Vietnam’s rapid economic development after 1986 forever changed the lifestyle of the Vietnamese. Economic development has highly impacted behavior, “changing from a traditional lifestyle to an industrial lifestyle [increasing] noncommunicable diseases (NCDs) : diabetes, overweight, high blood pressure, and high cholesterol disorders” (Danh, Personal Interview). With the increase of NCDs within the country, it is important to focus on awareness education that motivates the population especially those living in the urban sector to practice healthy behaviors. This study project focuses on the evaluating the reach and effectiveness of current diabetes awareness educational materials. One week was spent in Ha Noi ...

The Current State Of Health Care In China, Jonathan Yadlosky

CWiC-PH

After decentralizing health management in the early 1980s, China’s health care system developed many of the problems that we in the United States are currently working to solve. Though China is literally on the other side of the world, I think we might learn a few very important lessons from a close look at their successes, failures, trends, and goals in health care administration and delivery.

Wellbody Alliance, Sierra Leone, Kevin Rurak

CWiC-PH

Pharmacy Project:

Inventory database development

• Streamlined tracking of daily and monthly drug dispensing
• New database to plan requisitions based on trends

Analysis Of Importance Of Implementing Spiritual Assessment And Care Of Patients In Clinical Settings, You Na Park

CWiC-PH

Health professionals need to take care of patients’ spirituality, evaluate various spiritual approaches from both professional and public voices, and address concerns and potential conflicts in meeting the patients’ spiritual needs. There is a number of strategies and solutions to addressing the concerns of spiritual assessments and management of the patients in clinical setting.

Where Are They Now? Understanding How Src Directorship Influences Medical Student Career Trajectories And Outcomes Post-Graduation, Anita Modi,, Ann Vale, James D. Plumb, Md, Mph

CWiC-PH

JeffHOPE, a student-run clinic (SRC) designed to empower and care for Philadelphia's underserved population, was established in 1991 by the students of Jefferson Medical College. Since its inception, the program has been led by over 100 student directors, who oversee each of the five JeffHOPE clinics staffed by fellow medical students every week. But where are the directors now, and how did their leadership experiences caring for the underserved influence their career trajectories? Through the administration of a 20-question survey, we aimed to explore the experiences and accomplishments of medical student directors throughout the 20-year history of JeffHOPE, as ...

Jeffhealth Soil-Transmitted Helminths, David Maniscalco

CWiC-PH

Soil-transmitted helminth (STH) infections are known to be a significant problem in Rwanda. The Ministry of Health and individual villages are aware of its impact on people’s health and well-being as well as its impact on the country’s economy. The goal of the JeffHEALTH project is to educate poor, rural villages in Rwanda so that village members can take the knowledge they gain, put it into practice and share this knowledge with generations to come.

Continued Clinic Staff Education, Joseph S. Hong

CWiC-PH

Improving patient care by providing teaching sessions to hospital and clinic staff. The staff include medical assistants, technicians, and front office staff. The desired result would be to create an environment of scientific curiosity and improved understanding, for what the patients are dealing with. Thereby improving empathetic care when interacting with the patient.

The Contribution Of Schizophrenia To Homelessness: Analysis Of The Housing First Model And Possible Prevention Of Serious Mental Illness, Elijah Grillo

CWiC-PH

The Problem

• 2.6 million schizophrenics in the US accounting for more inpatient treatment days than any other medical illness (national cost: $62 billion/year).

• 6% (~160,000) are homeless or live in shelters

• Make up 36% of the 700,000 homeless individuals in the US.

Supplementary Trainings On Non-Medical Topics For Community Health Workers In Mutsengo, Kenya, Steven Fox

CWiC-PH

• Assessed needs and looked for solutions that are
• Executed and maintained locally Income-generating
• Provided skills trainings to CHWs on these topics
• Help initiate projects using these skills
• These projects show some modest continuing success

Helping Refugees Navigate The Health Care Maze, Jenna Fox, Andy Kay

CWiC-PH

Jenna’s main focus during her Bridging the Gaps assignment at NSC was an outcomes assessment for use in grant applications. Her side projects included client service and education development

Increasing Human Papillomavirus (Hpv) Vaccination Rate Among Adolescent And Young Adult Males In A Primary Care Setting, Michele Fascelli, Anna Marie Quinn, Amy Leader, Christopher Chambers

CWiC-PH

Study Purpose:

To increase HPV vaccination rates among adolescent males through the use of an informational aid designed to increase knowledge and favorable attitudes about HPV vaccination.

Evaluate the educational aid for feasibility of use in a primary care setting, interest among patients for participating, and increases in intentions to vaccinate among patient and providers.

Asthma Questionnaire For An Immigrant Chinese Population, Ho-Hin Choy, Whitney Shiau, Md, Audrey Lung Md, Faap

CWiC-PH

Asthma is a key public health problem for the pediatric population of the United States. 7 million children in the United States have been diagnosed with asthma at some point in their lives (1). Asthma remains a disease that occurs in higher rates among minority populations. Those living in inner-city environments are most at risk. A study performed in an inner-city area of Boston, MA showed that 16% of an Asian American school age population had previously diagnosed asthma with an additional 3% having possible undiagnosed asthma (2). Northeast Medical Services (NEMS), a federally qualified community health center (FQHC), serves ...

Compliance For Latent Tuberculosis Infection Treatment Among Incoming Refugees At Jefferson Center For Refugee Health, Elizabeth Bates, Marc Altshuler, Md, Kevin Scott, Md

CWiC-PH

80% of active TB cases in the US originate from reactivation of Latent Tuberculosis Infection (LTBI), identifying treatment of LTBI as a public health imperative. All incoming refugees at the Jefferson Center for Refugee Health (JCRH) are screened for LTBI upon arrival. Incidence of LTBI and compliance rates were assessed using a retrospective chart review and analysis of prescription refill records. The study showed 23.1% of incoming refugees were diagnosed with LTBI. Once treatment was initiated, only 33.1% were completed, while 56.2% were lost to follow up. Nepali women showed the highest rates of adherence, while Iraqi ...

Integrated Medical Pluralism To Sustain Health Care In The Indian Trans-Himalayas, Jane Babiarz

CWiC-PH

Inadequate health care delivery in the Indian trans-Himalayas arises from the harsh landscape and climate, poverty, the inaccessibility of health care centers, and a burden of chronic diseases and preventable acute illnesses that exceeds the number of traditional healers in the region. Systematizing a pluralistic healer network that integrates NGOs, international health organizations, mobile camps, district clinics, and traditional healers could address the issue of sustaining health care in this region. The backbone of this strategy would be a pre-existing resource relied upon by public and private health organizations: community health workers.

What Shapes Family Physicians' Patterns Of Care For Community Patients At End Of Life?, Joshua D. Shadd

University of Western Ontario - Electronic Thesis and Dissertation Repository

Family physicians (FPs) care for the majority of community patients approaching end of life. Variations among FPs in care activities for these patients have potential implications for equitable access to care. This thesis used mixed methods to explore how FPs in southwestern Ontario, Canada care for these patients, and what shapes the variations. In the primary study, using grounded theory based on in-depth interviews, FPs reported differing in the timing, location and purpose of their activities. These variations were shaped by a process of ‘making it fit’, in which FPs weighed the implications of choices in their unique contexts. In ...

Assessing Oral Health Curriculum In Us Family Medicine Residency Programs: A Cera Study, Hugh Silk, Ronnelle King, Ian M. Bennett, Alexander W. Chessman, Judith A. Savageau

Family Medicine and Community Health Publications and Presentations

BACKGROUND AND OBJECTIVES: During the past decade, national initiatives have called for improved oral health training for physicians. We do not know, however, how family medicine residency programs have answered this call.

METHODS: Family medicine residency directors completed a survey that asked how many hours of oral health teaching are included in their programs in addition to what topics are covered and the perceived barriers to this education. The response rate was 35%.

RESULTS: A total of 72% of respondents agreed that oral health is an important topic, but only 32% are satisfied with their residents' competency in oral health ...

An Ounce Of Prevention: How Are We Managing The Early Assessment Of Residents' Clinical Skills?: A Cera Study, Tracy Kedian, Lisa S. Gussak, Judith A. Savageau, Andreas Cohrssen, Ilene Abramson, Kelly Everard, Alison Dobbie

Family Medicine and Community Health Publications and Presentations

BACKGROUND AND OBJECTIVES: Clinical skills deficits in residents are common but when identified early can result in decreased cost, faculty time, and stress related to remediation. There is currently no accepted best practice for early assessment of incoming residents' clinical skills. This study describes the current state of early PGY-1 clinical skills assessment in US family medicine residencies.

METHODS: Eleven questions were embedded in the nationwide CERA survey to US family medicine residency directors regarding the processes, components, and barriers to early PGY-1 assessment. Responses are described, and bivariate analyses of the relationship between assessment variables and percentage of international ...

Innovations In Primary Care: Implementing Clinical Care Management In Primary Care Practices, Sai Cherala, Jeanne Cohen, Christine Johnson, Judith Steinberg

Community Engagement and Research Symposium

The Massachusetts Patient Centered Medical Home Initiative (MA PCMHI) is a statewide, multi-payer demonstration that seeks to transform 46 primary care practices into PCMHs. Clinical care management of high-risk patients is a key element of the PCMH and a new service for most primary care practices. Training for practices in the MA PCMHI includes the clinical care manager (CCM) role, identification/tracking of highest-risk patients, care plan development/implementation, care coordination, and communications. Content is delivered through learning collaborative sessions, monthly webinars and practice-based transformation facilitation. Assessment of progress towards implementation is made through practice-based data on clinical care management ...

Medication Intensification In Diabetes In Rural Primary Care: A Cluster-Randomised Effectiveness Trial, Katherine L. Billue, Monika M. Safford, Amanda H. Salanitro, Thomas K. Houston, William Curry, Yongin Kim, Jeroan J. Allison, Carlos A. Estrada

Quantitative Health Sciences Publications and Presentations

OBJECTIVE: To determine the effectiveness of a provider-based intervention to improve medication intensification among patients with diabetes. DESIGN: Effectiveness cluster-randomised trial. Baseline and follow-up cross-sections of diabetes physicians' patients.

SETTING: Eleven U.S. Southeastern states, 2006-2008.

PARTICIPANTS: 205 Rural primary care physicians, 95 completed the study.

INTERVENTION: Multicomponent interactive intervention including web-based continuing medical education (CME), performance feedback and quality improvement tools.

PRIMARY OUTCOME MEASURES: Medication intensification, a dose increase of an existing medication or the addition of a new class of medication for glucose, blood pressure and lipids control on any of the three most recent office visits.

RESULTS ...