Medicine and Health Sciences Commons^™

Mental Health Care Transitions From Incarceration, Graham Stratton, Md

Department of Family & Community Medicine Presentations and Grand Rounds

The scope of the problem of mental health and incarceration

• Case & Consideration 1: Severe Mental Illness ○ Brief history of de institutionalization and re institutionalization ○ Philadelphia’s jails at a glance
• Case & Consideration 2: Violence and trauma
• Consideration & Consideration 3: Addiction and substance use
• Models of transitions of care for reentry
• Community teams and resources
• Next steps for a Family Medicine physician

Refugee Health In Philadelphia, Marc Altshuler

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

1. Define the U.S. refugee resettlement process
2. Discuss the history of refugee health in Philadelphia and the creation of the Jefferson Center for Refugee Health
3. Review selected data on our patients
4. Learn how to utilize new resources to care for refugees

Barriers And Facilitators To Cervical Cancer Screening Among Iraqi Refugees Resettled In Philadelphia: A Qualitative Analysis Of Patient And Provider Perceptions, Colleen Payton, Mph, Ches, Laura Parente, Md, Dalea Al-Hawarri, Md, Philip Manasseh, Mph, Kevin Scott, Md, Marc Altshuler, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Oral presentation at the 6^th Annual North American Refugee Health Conference, Niagara Falls, New York.

Research Questions:

1. What is the prevalence of cervical cancer and cervical cancer screening among recently resettled refugees seen at Jefferson's Center for Refugee Health?

2. Are patient-and provider-identified barriers to cervical cancer screening at CRH consistent with those identified in previous research efforts?

3. What are patient-and provider identified facilitators to cervical cancer screening for Iraqi refugee women?

Jfma Street Outreach: A Resident-Run Street Medicine Program A Retrospective Chart Review Examining The Needs Of A Vulnerable Population And Services Provided, Kenneth E. Hemba, Md, Rebecca Simon, Bs, Lara Carson Weinstein, Md

Department of Family & Community Medicine Presentations and Grand Rounds

In Philadelphia it is estimated that over 12,000 people experience homelessness annually, and up to 500 individuals live on the street on any given day.¹

Project HOME coordinates the City of Philadelphia’s outreach effort aimed at forming relationships with unsheltered individuals, identifying their barriers to entering permanent supportive housing and assisting them in overcoming these barriers.

Having identified this population’s need for medical services, in 2007 faculty in Jefferson Family Medicine Associates (JFMA) reached out to Project HOME and extended an ongoing community-academic partnership.

Since then Family Medicine residents and students have been traveling with the outreach team, meeting …

An Interdisciplinary Model To Improve Completion Of Latent Tuberculosis Infection Treatment In The Refugee Population, Christine O'Leary, Pharmd, Marc Altshuler, Md, Kevin Scott, Md, Karen Kitagawa-James, Rn, Bsn, Maria Hervada-Paige, Mss

Department of Family & Community Medicine Presentations and Grand Rounds

Background: Refugees are disproportionately affected by latent tuberculosis infection (LTBI) and active tuberculosis (TB) compared to the general US population. More than 50% of TB cases in the US occur in foreign-born persons. In addition, approximately 80% of TB cases in the US are a result of reactivation of LTBI. Treatment of LTBI is effective to prevent and control TB. Unfortunately, LTBI treatment completion rates in the foreign-born are less than 50%. Methods: After conducting a retrospective chart review to establish baseline rates of treatment completion in our LTBI refugee patients, we implemented a model of prospective chart review, initial …

Participatory Research At Pathways To Housing-Pa: A Consumer Perspective, Patways To Housing Consumer Health Research Team And Department Of Family And Community Medicine

Department of Family & Community Medicine Presentations and Grand Rounds

Research Question: How does housing affect healthcare decision making?

Methods: 11 Clients took part in a 9-week project focused on health. Using qualitative methodology, weekly meetings were recorded, transcribed, then analyzed resulting in the development of thematic findings.

Performance Of Colorectal Cancer Screening Steps In Primary Care, Salini Mohanty, Mph, Mona Sarfaty, Md, Mph, Faafp, Randa Sifri, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Discussion:

This analysis revealed the differences in which physicians in primary care complete CRC screening steps. The approach and completion of screening steps varied greatly among practices.

There was a correlation between the quantitative data and the qualitative data. The analysis from both methodologies produced similar results and supports each other's assessment.

All of the practices analyzed possessed one of the essential elements (a physician recommendation) which is the foundation for increased screening. All of the practices have the potential to expand upon this foundation in order to ensure that all eligible patients are approached and screened for CRC.

The …

Capacity Building For Participatory Health Services Research In Housing First, Lara Carson Weinstein, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Background:

Pathways to Housing ends chronic homelessness for individuals with serious mental illness (SMI) by providing housing first, and then combining that housing with supportive treatment services in the area of mental and physical health, substance abuse, education, and employment. Housing is provided in apartments scattered throughout a community. This "scattered site" model fosters a sense of home and self-determination, and it helps speed client's reintegration into the community. The Pathways model has been remarkable successful in addressing chronic homelessness.

Research Question

What are the chronic physical disease self management support needs of Pathways to Housing clients?

Implementing Integrated Primary And Behavioral Healthcare Within A Housing First Program, Lara C. Weinstein, Md, Benjamin Henwood, Lcsw

Department of Family & Community Medicine Presentations and Grand Rounds

At Pathways to Housing-Philadelphia, mental health services to support consumers' independent living are delivered through Assertive Community Treatment (ACT) teams. ACT is an evidence-based mental health intervention known to reduce psychiatric hospitalization and increase housing stability. ACT team members include social workers, substance abuse, counselors, nurses, and psychiatrists, with ideal staff to client ratios of 1 to 10. Through a novel collaboration between the program and the Deparment of Family and Community Medicine at Thomas Jefferson University, a primary-care physician was embedded into the ACT services to form an integrated health-care team.

Obesity And Cancer Screening According To Race And Gender., Heather Bittner Fagan, Richard Wender, Ronald E Myers, Nicholas Petrelli

Department of Family & Community Medicine Faculty Papers

The relationship between obesity and cancer screening varies by screening test, race, and gender. Most studies on cervical cancer screening found a negative association between increasing weight and screening, and this negative association was most consistent in white women. Recent literature on mammography reports no association with weight. However, some studies show a negative association in white, but not black, women. In contrast, obese/overweight men reported higher rates of prostate-specific antigen (PSA) testing. Comparison of prostate cancer screening, mammography, and Pap smears implies a gender difference in the relationship between screening behavior and weight. In colorectal cancer (CRC) screening, the …