Family Medicine Commons^™

Provider-Led Intervention For Overweight Or Obese African American Women Ages 18-65 With A Bmi 25 Kg/ M₂, Tonya A. Harvey

Evidence-Based Practice Project Reports

Overweight and obese African American women tend to suffer most from the impacts of diseases, health disparities, disabilities, and decreased qualities of life (Sutton et al., 2016). Most weight loss programs are not culturally specific, despite the benefits of dietary changes and increased physical activity for all groups. The purpose of this EBP project was to implement a provider-led program including lifestyle, dietary, and activity components to decrease weight, BMI, waist circumference and blood pressure in African American women. The Iowa Model of Evidence-Based Practice to promote quality care was used to guide the EBP project, aimed to address obesity …

The Effect Of Care Coordination On Hemoglobin A1c For Type 2 Diabetes Patients, Lee Ann Hinsky

Electronic Theses and Dissertations

The purpose of the study was to test the impact of care coordinator visits by primary care registered nurses on serum hemoglobin A1c (HbA1c) levels in patients with type 2 diabetes. In the study, the researcher compared 2 groups of type 2 diabetes patients—those who had care coordinator visits from registered nurses and those who did not—through retrospective data collection and analysis from the patients’ electronic medical record from July 2018 through December 2018. An independent samples t test was used to compare the means of the intervention and control groups’ change in HbA1c levels. The intervention and control groups …

Evaluating The Effectiveness Of Online Educational Modules And Interactive Workshops In Alleviating Symptoms Of Mild To Moderate Depression: A Pilot Trial, Luis A. Murillo, Emily Follo, Julienne Balestrier, April Smith, Deborah L. Bevvino

Reading Hospital Family Medicine Residency

Introduction: Depression is a common health concern in primary care with barriers to treatment well documented in the literature. Innovative online psychoeducational approaches to address barriers to care have been well received and can be cost effective. This pilot trial evaluated the effectiveness of an online psychoeducation curriculum intended to alleviate symptoms of depression while utilizing minimal staff resources. Methods: A small (n=29) randomized control pilot study was conducted. Online psychoeducational content was delivered in 5 to 10-minute videos over 8weeks. Participants engaged in moderated discussions on workshop topics. The Patient Health Care Questionnaire (PHQ-9) was used to measure pre/ …

Patient And Provider Perspectives On Sexual History Taking During Gynecological Care: A Pilot Study In An Academic Family Medical Setting In New York City, Ashley M. Chastain

Dissertations and Theses

Background: In the United States (US), women face a number of serious issues concerning sexual health. Current surveillance data indicates that overall rates of bacterial sexually transmitted infections (STIs) are increasing rapidly. While rates of new diagnoses have decreased, the risks of acquiring HIV are still relatively high for some females, specifically Black/African-American women. In New York City (NYC), where this dissertation research was conducted, similar HIV/STI rates exist among females of reproductive age (aged 15-44). Among women in the US, there are also high estimated rates of other sexual health problems, such as sexual anxiety, sexual dysfunction, and intimate …

Primary Care Providers' Attitudes And Practices Regarding Cancer Screening In Older Adults., Randa Sifri, Brooke Salzman, Amy Cunningham, Alexis Silverio, Madalene Zale, Christine Talerico

Department of Family & Community Medicine Faculty Papers

Introduction: Cancer-screening decisions for older adults should be individualized. However, conducting such complex shared decisions may be challenging for primary care providers (PCPs). Additionally, there is little information on how PCPs make these decisions. This study consisted of a provider survey and chart review to assess current PCP approaches to breast and colorectal cancer (CRC) screening with patients age ≥75.

Methods: PCP survey questions: panel age, comfort with discussion of screening harms and benefits, screening decision-making process, and discussion style. One Hundred charts were chosen from a random sample of male and female patients ≥75 with a recent office …

Incorporating Home Visits In A Primary Care Residency Clinic: The Patient And Physician Experience, Mary Caitlin St. Clair, Jessica J. F. Kram, Glenda Sundberg

Journal of Patient-Centered Research and Reviews

Purpose: Home visits, once a popular but now uncommon form of health care delivery, are on the rise. Few studies have focused on the value the experience brings to resident physicians and their patients.

Methods: A 6-month pilot was conducted with 11 residents who participated in 32 home visits with 11 patients. Patient and resident experiences were captured through a survey following the home visits.

Results: In all, 100% of patients and a majority of residents were very interested in being a part of and incorporating future home visits, respectively. Every patient in the survey said that the visits resulted …

Effects Of An Obstructive Sleep Apnea Screening Program On Providers' Adherence, Kelsie A. Tokarczyk

Evidence-Based Practice Project Reports

Obstructive sleep apnea (OSA) is a widely prevalent chronic disease estimated to affect 22 million Americans, with 80 percent of moderate to severe cases undiagnosed (American Sleep Apnea Association [ASAA], 2017). Unmanaged OSA has been associated with numerous detrimental health outcomes including hypertension, chronic heart failure, atrial fibrillation, stroke, and other cardiovascular conditions (ASAA, 2017). The purpose of this evidence-based practice project was to determine if the implementation of a screening protocol would affect providers’ adherence to screening for OSA. The Theory of Planned Change was used as a guide to optimize providers’ adherence to the protocol at a family …

Career Regret Among Physician Assistants: A Comparative Survey Of Primary And Specialty Care Careers, Talia Sierra, Jennifer Forbes, Michael Nelson

Internet Journal of Allied Health Sciences and Practice

Purpose: This study investigated if career regret varies among physician assistants (PAs) practicing in primary and specialty care fields. This information may assist practicing and aspiring physician assistants when selecting or changing their career path.

Methods: A survey was emailed to 5,000 primary and specialty care physician assistants. Items indicating career regret were compared between primary and specialty care groups.

Results: Eight hundred and thrity-four (16.7%) completed surveys were received back. Career regret is similar between primary and specialty care physician assistants, with low reports from both groups. No statistical significance was found between primary care and specialty care groups …

Conference Proceedings: Aurora Scientific Day 2018

Journal of Patient-Centered Research and Reviews

This journal supplement includes selected abstracts from among the more than 50 presented at the 44th annual Aurora Scientific Day research symposium. Held May 25, 2018, in Milwaukee, Wisconsin, Aurora Scientific Day provides a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system with hospitals and clinics in Wisconsin and Illinois.

Ot In Pediatric Primary Care, Anne H. Zachry, J. Flick

Faculty Presentations

This session described a program where licensed occupational therapists and master’s level OT students provide free developmental screenings to infants and young children in local pediatric medical practice. Strategies for strategies for developing relationships and bridging communication between occupational therapists, primary practice physicians, and families were reviewed.

Challenges Of Refugee Health Care: Perspectives Of Medical Interpreters, Case Managers, And Pharmacists, Fabiana Kotovicz, Anne Getzin, Thy Vo

Journal of Patient-Centered Research and Reviews

Purpose: Our objective was to identify perceived challenges in the provision of health care for refugees from the perspective of medical interpreters, case managers, and pharmacists working with refugee patients in Milwaukee, Wisconsin.

Methods: Two 60-minute focus groups were performed exploring challenges in refugee health care using a literature-based semi-structured protocol. Focus groups were transcribed and de-identified prior to independent analysis by two of the investigators. Using a memoing-process qualitative approach, major concepts, cross-cutting themes, and subthemes were established and ultimately developed a narrative. The project protocol was approved as not human subject research by the local institutional review board. …

Improving Early Child Developmental Screenings In A Primary Care Setting: A Quality Improvement Project, Marlischa Jackson

Doctor of Nursing Practice

A dramatic growth of physical, motor, cognitive, communication, emotional, and social development will occur during the 3 years of life. Of children ages 3-17 years of age, 13% have some type of developmental or behavioral condition that goes undiagnosed before the age of 10. Children with multiple health and social risk factors, or those with chronic health disorders, are at greater risk to develop early child delays or disabilities. In the U. S., developmental screenings are only completed 21% of the time during well-child visits. Therefore, the purpose of this quality improvement project was to increase the adherence of health …

Conference Proceedings: Aurora Scientific Day 2017

Journal of Patient-Centered Research and Reviews

This supplement includes select abstracts presented at the 43rd Annual Aurora Scientific Day research symposium on May 24, 2017. Aurora Scientific Day hosts a forum for original research conducted by faculty, fellows, residents, and other allied health professionals affiliated with Aurora Health Care, an integrated health system headquartered in Milwaukee, Wisconsin.

Improving Chronic Pain Management Processes In Primary Care Using Practice Facilitation And Quality Improvement: The Central Appalachia Inter-Professional Pain Education Collaborative, Roberto Cardarelli, Sarah Weatherford, Jennifer Schilling, Dana King, Sue Workman, Wade Rankin, Juanita Hughes, Jonathan Piercy, Amy Conley-Sallaz, Melissa Zook, Kendra Unger, Emma White, Barbara Astuto, Bobbi Stover

Journal of Patient-Centered Research and Reviews

Purpose: With the increasing burden of chronic pain and opioid use, provider shortages in Eastern Kentucky and West Virginia have experienced many challenges related to chronic pain management. This study tested a practice facilitator model in both academic and community clinics that selected and implemented best practice processes to better assist patients with chronic pain and increase the use of interdisciplinary health care services.

Methods: Using a quasi-experimental design, a practice facilitator was assigned to each state’s clinics and trained clinic teams in quality improvement methods to implement chronic pain tool(s) and workflow processes. Charts for 695 patients with chronic …

What Can A Primary Care Physician Discuss With Older Patients To Improve Advance Directive Completion Rates? A Clin-Iq, Judith M. Myers, Edmund Duthie Jr., Kathryn Denson, Steven Denson, Deborah Simpson

Journal of Patient-Centered Research and Reviews

Advance directives (ADs) provide patients with the opportunity to indicate their preferences for medical care while they still maintain the capacity to express their wishes, thus retaining autonomy. ADs increase the likelihood that patients will receive the care they desire, as their family members and physicians will better understand the level of care desired. Despite this, the AD completion rate by elderly patients continues to be low, especially for patients not facing serious illnesses. Primary care physicians (PCPs) are uniquely positioned to engage patients in discussions about ADs before a health crisis arises yet often do not due to time …

Using Implementation Science To Guide The Integration Of Evidence-Based Family Interventions Into Primary Care, Justin D. Smith, Jodi Polaha

ETSU Faculty Works

This article is a demonstration of how an implementation-science (IS) framework can be coupled with the measurement of implementation outcomes to effectively integrate evidence-based family interventions in primary care. The primary care environment presents a number of challenges for successfully integrating such interventions. However, IS methods can improve the prospect of successfully implementing a new intervention while simultaneously and rigorously evaluating the impact on salient outcomes. We used our experiences across 2 pilot trials in which the family check-up (Smith, Montaño, Mauricio, Berkel, & Dishion, 2016), an evidence-based family intervention, was integrated into primary care. In these pilot trials, the …

An Assessment Of Implementation Of Community - Oriented Primary Care In Kenyan Family Medicine Postgraduate Medical Education Programmes, Ian Nelligan, Jacob Shabani, Stephanie Taché, Gulnaz Mohamoud, Megan Mahoney

Family Medicine, East Africa

Background and objectives: Family medicine postgraduate programmes in Kenya are examining the benefits of Community-Oriented Primary Care (COPC) curriculum, as a method to train residents in population-based approaches to health care delivery. Whilst COPC is an established part of family medicine training in the United States, little is known about its application in Kenya. We sought to conduct a qualitative study to explore the development and implementation of COPC curriculum in the first two family medicine postgraduate programmes in Kenya.

Method: Semi-structured interviews of COPC educators, practitioners, and academic stakeholders and focus groups of postgraduate students were conducted with COPC …

Assessment Of Obesity Management In A Primary Care Setting, Katie Diffenderfer

DNP Projects

Purpose: The purpose of this study was to evaluate the current practices related to obesity in the primary care setting in University of Kentucky’s Healthcare System. The specific aims were to: 1) Determine the proportion of obese patients who had an ICD-9/10 diagnosis code for obesity, 2) Determine the proportion of obese patients who received interventions related to their obesity, 3) Determine whether obesity diagnosis and interventions varied based on patient demographics, and 4) Compare actual obesity interventions to those outlined in the clinical practice guidelines.

Methods: A retrospective chart review of male and female patients between the ages of …

Baseline Of Copd Management In A Norton Healthcare Primary Care Clinic, Angela Goldring

DNP Projects

Background: Chronic obstructive pulmonary disease (COPD) is a leading cause of death in the United States (U.S), with rates in Kentucky among the highest in the nation. Quality care in the primary care setting is key to optimizing the health outcomes of those with COPD.

Purpose: The objective of this study was to establish a baseline of COPD patient care in a primary care clinic. The specific aims of this study were to: 1) describe the demographic and health-related characteristics of patients with COPD who have a primary care provider (PCP) at one Norton Healthcare primary care clinic; 2) …

Training A Workforce For Primary Care, K. Van Sickle, A. Beecham, Jodi Polaha

ETSU Faculty Works

No abstract provided.

Pediatric Telebehavioral Health In Rural Primary Care: An Electronically-Mediated Warm Handoff, J. A. Correll, Jodi Polaha

ETSU Faculty Works

No abstract provided.

Primary Care Research: Opportunities And Challenges, Waris Qidwai

Department of Family Medicine

No abstract provided.