Family Medicine Commons^™

Goals Of Care Conversations In Clinic–Gauging Patient Motivation, Daniel Cho Md, Lilian Pham Md, Anet Kirkconnell Md, Lauren Tran Md, Aaron Hochman-Zimmerman, Houston Bonnyman Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Impact Of Brief Educational Supplement Of Colon Cancer Screening Alternatives And Its Impact On Orders Placed By Primary Care Providers, Kimberly Tu Md, Cynthia Kudji Sylvester Md, Martin Gantt Md, Michael Do Md, Shawn Brignac Md, Chardiel Delgado Miranda Md, Lindsay Liles Md, Lindsay Liles Md, Lindsay Liles Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Sweet Signs: The Impact Of Cgm Signage On Freestyle Libre Prescription Rates In A Resident Clinic, Dustin Landgrave Do, Allison Venus Md, Alex Robertson Md, Kristy Paul Md, Bhindhyaa Kaur Md, Alejandro Castaneda Md, Madeline Cozad Md

Quality Improvement & Patient Safety Forum

No abstract provided.

Broadening Inclusion Of Primary Care: Trainee Insights And Commentary On Diversity, Equity, And Inclusion., K Taylor Bosworth, Meghan Gilfoyle, Kimberley Norman, Kimberley Norman, Ashley Chisholm, Ione Locher, Naod F Belay, Bryce Ringwald, Chloe Warpinski, Geetika Gupta, Minika Ohioma, Macee Boyle

Medical Education Articles

We, as the current and immediate-past NAPCRG Trainee Committee, share our perspectives as an international and diverse group of primary care research trainees. In this essay, we discuss the challenges and opportunities for achieving a more diverse, equitable, and inclusive primary care workforce by reflecting on 2 main challenges: (1) insufficient support for underrepresented identities in medicine, and (2) inadequate integration within existing primary care teams. Within each of these challenges, we pose potential opportunities for improvement using a trainee lens.

Implementation Of A Health Care Transition Pathway For Children And Adults With Inborn Errors Of Metabolism: A Pilot Project, Brittany M. Murray

Doctor of Nursing Practice Scholarly Projects

Background: Children with medically complex diseases require highly specialized care by a highly specialized team. Those with rare disease, including inborn errors of metabolism (IEMs), are a medically complex population and face significant challenges undergoing the health care transition from a child/family-centered model to an adult/patient-centered model of care. The project site follows patients with IEMs in the Metabolism Program, but previously did not have a coordinated process and had insufficient resources for patients/families for the health care transition.

Methods: The Plan-Do-Study-Act (PDSA) method was utilized as the model for improvement. Due to the complexity of the population and time …

Improving Guideline-Based Prep Management In A Philadelphia-Based Academic Family Medicine Office, Brittany Macdonald, Md, Marshall Miller, Md, Nwando Ekezie, Md, Maia Mandel, Md, Christina Boras, Md, Eunice Choe, Md, Meghan Swyryn, Md, Meg Broderick, Md, Pascaline Karanja, Md, Julia Beatini, Md, Julie Jones

Health Equity and Quality Improvement (HEQI) Summit

Background

Pre-Exposure Prophylaxis (PrEP) significantly reduces the risk of contracting HIV:

• Reduces risk from sexual contact by 99%
• Reduces risk from injection drug use by at least 74%

Despite its effectiveness, PrEP is underutilized in the USA.

• In 2019, an estimated 224,000 Americans received a prescription for PrEP despite 1.1 million people having indications for PrEP.
• Lack of provider knowledge surrounding PrEP clinical guidelines is a common reason for underutilization.

By The Book: A Look At Whether Guidelines Impact Clinical Decision Making In Sglt2i Prescriptions, Marc Mounzer, Vacha Shah, Antony Fuleihan, Brian Osler

Health Equity and Quality Improvement (HEQI) Summit

Introduction

• Specialty-specific guidelines reduce medical errors and support clinical decision- making
• Effective implementation requires timeliness and accuracy, often limited by systemic barriers
• This study investigates factors affecting sodium glucose cotransporter 2 inhibitor (SGLT2i) prescribing in heart failure to enhance guideline adherence and care quality

Pcsk-9 Inhibitors Treatment: The Cardiovascular Disparity, Julia Lees, Seana-Pierre Williams, Tahir Razzaq, Michael B. Roberts

The Journal of Integrated Primary Care

Introduction: According to the Center for Disease Control and Prevention (CDC) and American Heart Association (AHA), cardiovascular disease is the leading cause of death in the United States. This phenomenon disproportionally affects the African American population, who have a 31% higher mortality rate than non-Hispanic Caucasian individuals. A retrospective review of PCSK-9 medication use, specifically in a patient population that had minimal representation in the large, landmark clinical trials, can lead to better understanding about the therapeutic potential in cardiovascular disease reduction and patient outcomes attributed to medication use. Education regarding this novel drug class, medication access and patient support, …

Re: Physician And Advanced Practice Clinician Burnout In Rural And Urban Settings., Cody J Klinker

Ambulatory and Primary Care Articles

No abstract provided.

Integrating Positive Psychology And Spirituality To Foster Meaning And Well-Being In Older Adults, Crystal Morris

Adultspan Journal

This perspective article explores the integration of positive psychology interventions (PPIs) and spirituality in therapy to foster meaning and well-being in older adults. It highlights exercises such as the positive introduction, positive legacy, character strengths, mindfulness, mindful-based yoga, and a manifestation prayer journaling. The interventions presented are tools to support older adults that may experience depression, difficult life transitions, and the search for renewed meaning. Therapists who integrate PPIs and spirituality into therapy can promote a holistic, non-pathological approach to treatment.

Iron Deficiency—More Than Just Anemia: A Literature Review, Arianna S Moss, Zahra Pakbaz

Journal of Community Hospital Internal Medicine Perspectives

Iron deficiency (ID) is a global public health concern, as it can be a prodrome of gastrointestinal (GI) malignancies, exacerbate chronic conditions, and lead to an overall decreased quality of life. Despite being the most prevalent nutritional deficiency, it remains underdiagnosed by many healthcare professionals. Misconceptions regarding the clinical and laboratory manifestations of ID lead to delayed or missed diagnoses, contributing to poor patient outcomes. Though anemia is a commonly known consequence of ID, there are additional consequences that remain underrecognized by the medical community, including vague signs and symptoms, such as fatigue, depression, and abnormalities in white blood cell …

Evaluation Of A Multistage Implementation Of Medication For Opioid Use Disorder Services In Primary Care, Sarah Lawson, Allie Hamilton, Jordan Lazarus, Gregory A. Jaffe, Erica Li, Lara Weinstein, Susan Fidler, Erin Kelly

Department of Family & Community Medicine Faculty Papers

INTRODUCTION: Despite effective treatment for opioid use disorder, access to care is limited. Increased availability of evidence-based medication for opioid use disorder (MOUD) treatment within primary care is urgently needed. This study describes efforts to increase MOUD services within a large urban primary care practice.

METHODS: After an internal assessment of barriers to MOUD services, a two-phase approach was used to educate providers and to implement MOUD services within a primary care practice over 2.5 years. Physicians became X-waiver certified in the education phase and completed four internal training sessions. Physicians completed pre-post surveys to assess their intention to prescribe …

Preserving What Matters: A Multimodal Approach To Maintaining Fat-Free Mass During Anti-Obesity Medication Based Weight Loss, Sarah Gore

Evidence-Based Practice Project Reports

Weight loss is often associated with reductions in fat-free mass (FFM), which can negatively impact metabolic rate, thermoregulation, bone density, functional capacity, and overall quality of life (Roth et al., 2022; Sedlmeier et al., 2021). This Evidence-Based Practice project aimed to reduce FFM loss in adults prescribed anti-obesity medications (AOMs) for weight management through a targeted, multimodal intervention. Twenty-two patients beginning AOM treatment at a family practice in northwest Indiana were invited to participate, with 19 consenting to enroll. Each participant received personalized guidance, including tailored calorie and protein intake goals to support a hypocaloric, high-protein diet, alongside evidence-based aerobic …

A Multimodal Intervention To Improve Treatment And Clinical Outcomes In Children With Recurrent Otitis Media, Daniel Courtaney

Evidence-Based Practice Project Reports

Acute otitis media is the number one cause for primary health care visits and antibiotic prescriptions in the pediatric population (El Feghaly & Jackson, 2023). Upwards of 27% of children experience multiple episodes of otitis media (OM) that meet recurrent otitis media (ROM) diagnosis criteria (Pelton & Marchisio, 2023). Guided by the Iowa Model (Iowa Model Collaborative, 2017), the project’s purpose was to implement a multimodal intervention to decrease recurrent OM and repeat clinic visits. A comprehensive literature search of 5 databases yielded 16 sources ranging from levels I-IV (Melnyk & Fineout-Overholt, 2023). Using the AGREE II and JBI Critical …

Assessing The State Of Nutrition Education In Michigan Medical Schools, Sarah Bdeir, James Meza, Kareem Tayeb

Conference Presentation Abstracts

Despite the National Academy of Science recommending a minimum of 25 hours of nutrition education, U.S. medical schools dedicate an average of only 19 hours, and 75% lack mandatory clinical nutrition classes¹. Alarmingly, only 14% of current healthcare providers feel confident discussing nutrition with patients, despite its critical role in disease prevention and management². To address this gap, we surveyed medical students at five of seven Michigan medical schools about their schools' approaches to culinary medicine, self-perceived competence, and recommendations for improving nutrition education curricula. The survey was given to key representatives at each medical school, who distributed the survey …

The Moderating Effect Of Self-Efficacy On The Interaction Between The Patient-Provider Relationship And Medication Adherence, Jonas M. Manalo

2025 Spring Honors Capstone Projects - Archive

Older adults taking multiple medications are at high risk for experiencing adverse drug events that result in hospitalization. Nurses are one of the first points of contact for patients and serve as patient educators. Many factors influence medication adherence, such as the patient-provider relationship and patient self-efficacy. This study aims to assess what impact patient self-efficacy has on the interaction between the patient-provider relationship and medication adherence.

The sample comprises adults aged 50 or older taking five or more medications. The Medication Understanding and Use Self-Efficacy (MUSE) Scale was used to measure patient self-efficacy and the patient-provider relationship while the …

Broadening And Broadcasting The Impact Of Cardiovascular Risk Factors Among Muslim Residents Of Southern New Jersey With Special Emphasis On Opportunities Of Future Interventions And Prevention Tactics, Maikel Mansour, Ocean Alam, Samiha Hossain, Kirsten M. Carlberg, Katarina Rusinak

Rowan-Virtua Research Day

According to AHA and NIH, CVD includes stroke, congenital heart disease, rhythm disorders, subclinical atherosclerosis, coronary heart disease, heart failure, valvular disease, venous disease, and peripheral artery disease. Between 2017 and 2020, 127.9 million US adults (48.6%) had some form of CVD.

Among the target population, it was found that observing Ramadan fasting leads to an increase in total cholesterol, low-density lipoprotein cholesterol, and triglycerides levels post-fasting. Yet, Islam emphasizes the importance of physical health as a privilege from God (Allah (swt)) and is seen as a religious duty.

The objective of the HCOP service project was to investigate the …

Patient Perspectives On The Role Of Healthcare Providers In Addressing Food Insecurity In A Nj Primary Care Setting, Anna Flts, Lisa Huang, Aarsa Moosavi, Jha Stuti, Philip B Collins

Rowan-Virtua Research Day

Background:

Food insecurity is a critical social determinant of health, yet is rarely discussed with patients in primary care settings. The objective of this project is to explore patient perspectives on the physician role in addressing food insecurity as well as to identify factors associated with food insecurity among patients in family medicine clinics.

Methods:

A cross-sectional survey was distributed to patients (n=250) across two academic family medicine clinics in South New Jersey between May 2023 and December 2024. Demographics, self-reported health status, and comfort with discussing food insecurity were collected. Additionally, food insecurity status was determined based on the …

Is The Vaping Epidemic Linked To Neurologic Changes And Mental Health Diagnoses Amongst Us Adolescents?, Tracy Lin, Victoria Shwe

Rowan-Virtua Research Day

Vaping has significantly increased among U.S. adolescents, driven by the rise of e-cigarettes and flavored pods. Nicotine exposure during brain development is linked to changes in the limbic-dopaminergic system, white matter integrity, and increased risk of emotional and behavioral dysregulation. Higher rates of depression, anxiety, and suicidality are reported among adolescent users, with greater symptom severity seen in those with high vaping dependence. Though studies show correlation rather than causation, findings suggest vaping may contribute to rising mental health diagnoses. Addressing vaping’s neurological and psychological impact is critical to guiding prevention efforts, regulatory policies, and support for at-risk youth.

Assessing The Efficacy Of Using The Ptsd Coach Mobile Application For Managing Ptsd Symptoms: Results Using The Hopkins Symptom Checklist-21, Muntaha Rana, Kaylea Shoulders, Deep Patel, Anne Jones

Rowan-Virtua Research Day

Background: Primary care settings often become the first place where patients with mental health concerns go, especially with shortages of mental health providers. During Covid-19 mental health concerns increased, increasing the demand of primary care providers to help assist patients navigate their concerns. Hypothesis: Participants that use the PTSD Coach App for 30 days will have reduced HSCL-21 follow-up scores compared to their intake. Methods: Patients were recruited from the Rowan-Virtua family medicine office in Sewell. The PCL-5 with the HSCL-21 was administered, with patients then using the PTSD Coach app for 30 days. Researchers followed up with patients after …

Pain Management In Pregnant Women With Opioid Use Disorder: A Systematic Review, Adeena Javed

Rowan-Virtua Research Day

Background: The prevalence of opioid use disorder (OUD) among pregnant individuals has risen significantly, posing challenges in managing labor and postpartum pain. Factors such as opioid tolerance, opioid-induced hyperalgesia, and concerns about relapse complicate analgesic strategies. Despite these complexities, evidence-based guidelines for pain management in this population remain limited.

Hypothesis: Pregnant women with OUD experience disparities in pain management during labor and postpartum periods, leading to suboptimal outcomes.

Methods: A systematic review was conducted, analyzing peer-reviewed studies from databases including PubMed and Embase. Inclusion criteria encompassed studies focusing on pain management in pregnant women with OUD. Data extraction focused on …

Maternal Health And Nutrition: Combating Maternal Mortality Through Proper Nutrition, Archna Mahendru, Yeisanai Cardona Torres, Maya Blayne Partee, Katarina Rusinak

Rowan-Virtua Research Day

Maternal mortality is an increasing concern in the United States. According to the WHO, from 2018-2022 the Maternal Mortality Rate (MMR) was 23.3 deaths per every 100,000 live births. New Jersey's MMR exceeded this average at 26 per 100,000 during the same period, with 91% of cases deemed preventable. While medical care plays a crucial role, research shows that non-medical determinants such as food insecurity, lack of nutritional education, limited access to transportation, and systemic barriers to health care contribute significantly to maternal health outcomes. Among these factors, proper nutrition plays a critical role before and during pregnancy, particularly in …

Cardiovascular Risk Factors In The Autism Spectrum Disorder Population, Christian C. Iannuzzelli, Andrea L. Iannuzzelli

Rowan-Virtua Research Day

The population of patients with Autism Spectrum Disorder (ASD) have multiple risks and barriers that may make access to proper health care more difficult. After extensive research, some of these barriers may have been identified that pose greater risks to generating proper care for those with ASD. Some of these barriers include medical complexity, more sedentary lifestyles, poor food choices, as well as health comorbities. Some of these health comorbidities include hypertension, metabolic dysfunction, sleep apnea, and inflammation. This study aims to understand what barriers and risks for CVD are present in those with ASD.

Assessing Cervical Cancer Health Literacy Among Karen Women In The Omaha Area, Grace Berentson, Michaela Bartels, Monica Angeletti, Jennifer Liu

Posters and Presentations: Family Medicine

No abstract provided.

Evaluation Of A Joint Staffing Model With Clinical Pharmacy In An Outpatient Family Medicine Residency Clinic, Daniela Cortes Reyes, Jessica Witt, Melanie Menning, Anthony Donovan

Posters and Presentations: Family Medicine

No abstract provided.

Heart To Heart: Exploring Why Cardiovascular Risk Is Higher In South Asians, Jasjeet Kaur Dhaliwal

Rowan-Virtua Research Day

Cardiovascular disease (CVD) is a leading global cause of mortality, but South Asians experience a disproportionately high burden of disease, often developing CVD at younger ages and with lower body mass indices compared to other populations. This project explores the underlying genetic and lifestyle factors contributing to elevated cardiovascular risk in South Asians, aiming to highlight the need for targeted prevention strategies and policy reforms.

A literature review was conducted using peer-reviewed studies, meta-analyses, and reviews published between 2007 and 2024. After screening 47 initial articles, 18 were selected for analysis based on their relevance to genetic and lifestyle risk …

Scoping Literature Review: The Role Of Leptin In Autism Spectrum Disorder (Asd) And Associated Obesity, Diana B. Riestra, Andrea Iannuzzelli

Rowan-Virtua Research Day

Overweight and obesity (OW/OB) are significant concerns among individuals with Autism Spectrum Disorder (ASD), yet the underlying causes remain unclear. Emerging evidence points to metabolic and hormonal factors—particularly leptin, a hormone involved in appetite regulation—as potential contributors. This scoping review examined five key studies from 2003 to 2024 that investigated the relationship between leptin and ASD in overweight populations. Across studies, individuals with ASD consistently exhibited elevated leptin levels compared to controls. While some findings also noted changes in other adipokines, such as lower resistin or progranulin, leptin was the most consistently dysregulated. These patterns suggest systemic alterations in energy …

Barriers To Care For Neonatal Abstinence Syndrome In Southern New Jersey, Gabriela Taslitsky, Hijab Zaidi, Nafisa Zalil

Rowan-Virtua Research Day

Neonatal Abstinence Syndrome (NAS) is a spectrum of clinical manifestations seen in newborns due to withdrawal secondary to intrauterine illicit and/or prescription drug exposure. Newborns with NAS present with common signs of withdrawal such as poor feeding, irritability, seizures, hypertonicity, low birth weight, loose stool, and premature birth. Maternal opioid use is the most common cause of NAS and with the increase in opioid use in the past decade the cases of NAS have also increased. This study examines the prevalence and challenges associated with NAS in Southern New Jersey. Our analysis reveals that Atlantic and Gloucester counties reported the …

On Death And Disease: How Physicians’ Perspectives Compare Across Specialties Through Written Work, Stephanie Anne C. Alkonga

Honors Capstones

Narrative medicine is a tool that the medical field is increasingly utilizing to cultivate patient-centered and culturally competent doctors and to reflect on lived experiences through texts that focus on psychosocial best practices. This study aims to examine the language used in physician-written works that address how physicians in different medical specialties treat the aging and the terminally ill, and how they view the deceased. Qualitative data guided by thematic questions will primarily be used in the analysis and comparison of these texts’ tone, rhetoric, diction, and similar literary devices to uncover if certain patterns arise across such specialties. Findings …

Produce Prescription Policy Project For The Securement Of A Grant To Address Food Insecurity For Low-Income Type Ii Diabetic Patients, Isabel D. Garcia-Gallegos

Doctor of Nursing Practice Final Project Abstract

PURPOSE

This policy-focused Doctor of Nursing Practice (DNP) quality improvement (QI) project aims to secure grant funding through the Gus Schumacher Nutrition Incentive Program (GusNIP) to implement a produce prescription program at a community clinic in Texas. The program targets low-income adults (18-65 years) with type II diabetes who experience food insecurity and are affected by Medicaid non-expansion.

BACKGROUND

Texas’ decision not to expand Medicaid has exacerbated food insecurity among low-income residents, particularly those managing type II diabetes. This decision creates a healthcare policy gap that this project aims to address with a food-as-medicine program.

METHODOLOGY

Using the Plan-Do-Study-Act (PDSA) …