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Articles 1 - 8 of 8
Full-Text Articles in Primary Care
How Are You Doing… Really? A Review Of Whole Person Health Assessments, Kurt C. Stange
How Are You Doing… Really? A Review Of Whole Person Health Assessments, Kurt C. Stange
Faculty Scholarship
Policy Points A redirection of measurement in health care from a narrow focus on diseases and care processes towards assessing whole person health, as perceived by the person themself, may provide a galvanizing view of how health care can best meet the needs of people and help patients feel heard, seen, and understood by their care team. This review identifies key tensions to navigate as well as four overarching categories of whole person health for consideration in developing an instrument optimized for clinical practice. The categories (body and mind, relationships, living environment and finances, and engagement in daily life) include …
Social Needs Screening And Intervention In Pediatric Primary Care: Impact On Families’ Experience Of Care, Sarah D. Ronis, Marie Masotya, Kurt C. Stange
Social Needs Screening And Intervention In Pediatric Primary Care: Impact On Families’ Experience Of Care, Sarah D. Ronis, Marie Masotya, Kurt C. Stange
Faculty Scholarship
Introduction/Objectives: Social determinants of health (SDoH) screening and intervention in pediatric primary care depends upon caregiver disclosure of adverse household or social conditions and thus may be influenced by perceived bias or stigma. This paper examines to what extent parents’ experience of their child’s medical home is associated with their perceptions of a practice-based social needs intervention. Methods: We conducted a cohort study of data reported by 73 parents of children obtaining care in a medical home with an embedded SDoH navigation program. Using survey data collected in October 2021 and October 2022, we calculated descriptive statistics and non-parametric bivariate …
Identifying Virtual Care Modality In Electronic Health Record Data, Kurt C. Stange
Identifying Virtual Care Modality In Electronic Health Record Data, Kurt C. Stange
Faculty Scholarship
Background: Virtual care increased dramatically during the COVID-19 pandemic. The specific modality of virtual care (video, audio, eVisits, eConsults, and remote patient monitoring) has important implications for the accessibility and quality of care, but rates of use are relatively unknown. Methods for identifying virtual care modalities, especially in electronic health records (EHR) are inconsistent. This study (a) developed a method to identify virtual care modalities using EHR data and (b) described the distribution of these modalities over a 3-year study period. Methods: EHR data from 316 primary care safety net clinics throughout the study period (4/1/2020-3/31/2023) were included. Visit type …
The Sense Of Safety Theoretical Framework: A Trauma-Informed And Healing-Oriented Approach For Whole Person Care, Kurt C. Stange
The Sense Of Safety Theoretical Framework: A Trauma-Informed And Healing-Oriented Approach For Whole Person Care, Kurt C. Stange
Faculty Scholarship
Objectives: This research describes four aspects of the development of the Sense of Safety Theoretical Framework for whole person care: exploring the meaning of the phrase “sense of safety”—the whole person language; the range of human experience that impacts sense of safety—whole person scope; the dynamics that build sense of safety—the healing goals; and the personal and cross-disciplinary trauma-informed practitioner skills and attitudes that facilitate sense of safety. Methods: This qualitative participatory study was conducted in two phases. Researchers iteratively explored the concept of sense of safety using focus groups and semi-structured interviews. Overarching research questions were: “Does the transdisciplinary …
The Role Of Primary Care In Improving Population Health, Kurt C. Stange
The Role Of Primary Care In Improving Population Health, Kurt C. Stange
Faculty Scholarship
In widely quoted ecological analyses, primary care is associated with population health. Not only with population health, but with health equity, health care quality, and lower health care expenditure - a pretty good definition of value. Yet, there is a paradox about primary care. Despite these desirable population‐level attributes, at the disease level at which we typically measure, incentivize, and organize the work of health care, when assessed with one‐disease‐at‐a‐time quality measures, primary care does not perform as well as care focused on a single disease. What is going on here? In caring for patients’ individual diseases, primary care appears …
Screening Families In Primary Care For Social And Economic Needs: Patients’ Urgency And Activation For Social Care Navigation, Sarah D. Ronis, Marie Masotya, Kurt C. Stange
Screening Families In Primary Care For Social And Economic Needs: Patients’ Urgency And Activation For Social Care Navigation, Sarah D. Ronis, Marie Masotya, Kurt C. Stange
Faculty Scholarship
Introduction: Social determinants of health (SDoH) screening and intervention in primary care aim to alleviate adverse influences on health, but its efficacy may be diluted when offered supports are not well matched to families’ desire for such services. The purpose of this prospective cohort study was to provide guidance to social care navigation teams regarding which families would be most likely to make use of services. Methods: Analysis of registry data collected in April 1–September 30, 2021 from a social care navigation program embedded in a medical home was conducted. Multivariable regression models explored (1) whether family-reported urgency of needs, …
Exploration Of The Psychometric Properties Of The Person-Centred Primary Care Measure (Pcpcm) In A Chinese Primary Care Population In Hong Kong: A Cross-Sectional Validation Study, Stephen J. Zyzanski, Kurt C. Stange
Exploration Of The Psychometric Properties Of The Person-Centred Primary Care Measure (Pcpcm) In A Chinese Primary Care Population In Hong Kong: A Cross-Sectional Validation Study, Stephen J. Zyzanski, Kurt C. Stange
Faculty Scholarship
Objectives To evaluate the validity and psychometric properties of the Chinese Person-Centred Primary Care Measure (PCPCM) in a Chinese-speaking population. Design A cross-sectional study. Setting A primary care clinic in Hong Kong. Participants 300 Chinese adult patients (150 males and 150 females) were recruited from a primary care clinic to complete a questionnaire containing the PCPCM, Consultation and Relational Empathy (CARE), Patient Enablement Index (PEI) and Adult (short version) Primary Care Assessment Tool (PCAT). The Chinese PCPCM was readministered to 118 participants after 14 days for test-retest reliability. Outcome measures The construct validity, reliability and sensitivity of the Chinese PCPCM. …
Integrating Behavioral Health And Primary Care (Ibh-Pc) To Improve Patient-Centered Outcomes In Adults With Multiple Chronic Medical And Behavioral Health Conditions: Study Protocol For A Pragmatic Cluster-Randomized Control Trial, Terry Stancin, Kurt C. Stange, Kathryn Teng
Integrating Behavioral Health And Primary Care (Ibh-Pc) To Improve Patient-Centered Outcomes In Adults With Multiple Chronic Medical And Behavioral Health Conditions: Study Protocol For A Pragmatic Cluster-Randomized Control Trial, Terry Stancin, Kurt C. Stange, Kathryn Teng
Faculty Scholarship
Background: Chronic diseases that drive morbidity, mortality, and health care costs are largely influenced by human behavior. Behavioral health conditions such as anxiety, depression, and substance use disorders can often be effectively managed. The majority of patients in need of behavioral health care are seen in primary care, which often has difficulty responding. Some primary care practices are providing integrated behavioral health care (IBH), where primary care and behavioral health providers work together, in one location, using a team-based approach. Research suggests there may be an association between IBH and improved patient outcomes. However, it is often difficult for practices …