Primary Care Commons^™

Integrating Social Work In An Aboriginal Community Controlled Health Service Primary Health Care Setting: The First Three Months Of Data, Ines Sofia Zuchowski, Erin Waters, Albert Kuruvila, Brodie Kuhn, Rebecca Lee

Journal of the Australian Indigenous HealthInfoNet

Background

Social work within General Practice is an emerging contributor to primary healthcare aiming to address social determinants of health. Aboriginal and Torres Strait Islander people experience higher rates of health inequity and racism than non-Indigenous Australians. The Townsville Aboriginal and Islander Health Service [TAIHS] is an Aboriginal and Torres Strait Islander Community Controlled Health Service [ATSICCHS] whose mission is to deliver culturally appropriate services to achieve better health and wellbeing outcomes for Aboriginal and Torres Strait Islander people.

Objective

This article reports on the first three months of data collection of a social worker employed at TAIHS as part …

Enhancing Primary Care Navigation For D/Deaf And Hard-Of-Hearing Patients: A Wayfinding Intervention Proposal, Mikyla R. Futz, Mary L. Micou, Robert S. Pugliese, Pharmd, Bcps, Jesse Edwards, Md, Fhm

Health Equity and Quality Improvement (HEQI) Summit

Background

Auditory-dependent healthcare environments present persistent barriers to patients who are d/Deaf or hard of hearing (d/DHH), particularly where verbal instructions and auditory notifications dominate communication workflows. This contributes to delayed access to care, decreased satisfaction and strained patient provider-relationships, and significantly higher hospitalization rates —16-21% for individuals with mild to moderate hearing loss, respectively. Additionally, these patients experience higher rates of chronic conditions, lower health literacy, and reduced healthcare satisfaction. Existing interventions are often fragmented and narrowly focused, failing to capture the heterogeneity of d/DHH patients’ needs. This project introduces a scalable, continuous solution grounded in inclusive design principles …

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, …

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 …

Impact Of Implementing An Updated Cervical Cancer Screening Protocol In The Primary Care Setting, Teri A. Koch

Evidence-Based Practice Project Reports

Cervical cancer is one of the most common types of cancer among women globally. Current screening methods by clinicians include cytology sampling, high-risk human papillomavirus sampling, or co-testing with both methods. These tests may detect cell changes before they become cancerous, yet the uptake of these methods has decreased in recent years (Aginga, 2022; Office of Disease Prevention and Health Promotion, 2023; Popalis et al., 2022; Sung et al., 2021). The primary purpose of this evidence-based practice project was to determine if the implementation of an updated cervical screening protocol improved the linkage of abnormal results to appropriate clinical follow-up …

A Multi-Modal Intervention To Improve Identification, Management, And Prevention Of Early Childhood Caries In The Primary Care Setting, Rieley M. Hull

Evidence-Based Practice Project Reports

Early childhood caries (ECC) is the most prevalent chronic childhood disease and, if untreated, can lead to significant long-term health and social consequences, posing a substantial healthcare burden (AAPD, 2023; ADA, 2023; USPSTF, 2021; WHO, 2022). This evidence-based practice (EBP) project aimed to implement a multi-modal intervention to reduce ECC risk factors, prevent new dental caries, and halt the progression of existing dental caries. Conducted in a pediatric primary care setting in West Michigan, the project included patients five and under who received an oral examination and dental caries risk assessment following the AAP’s guidelines. Based on their oral health …

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 …

Implementing Early Detection Of Cognitive Impairment In Primary Care To Improve Care For Older Adults, Nicole R. Fowler, Katherine A. Partrick, James Taylor, Michael Hornbecker, Malaz Boustani, Jeffrey L. Cummings, Tim Macleod, Michelle M. Mielke, Jared R. Brosch, Chinedu Momoh

Brain and Mind Institute

Primary care is the ideal setting for early detection of mild cognitive impairment (MCI) and Alzheimer's disease and related dementias (ADRD), as it serves as the primary point of care for most older adults. With the growing aging population, reliance on specialists for detection and diagnosis is unsustainable, highlighting the need for primary care-led assessment. Recent research findings on successful brain health prevention strategies, AD diagnostic tools, and anti-amyloid treatments empower primary care to play a central role in early detection and intervention. Primary care-focused resources are being developed, including tools for cognitive assessments and materials designed to educate patients …

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 …

Assessing The Accessibility Of Wound Care Education For Unhoused Individuals Of South Jersey, Marilyn A. Chen, Selma S. Benkhoukha, Allysone Martinez

Rowan-Virtua Research Day

Unhoused individuals face disproportionately high rates of wound-related complications due to environmental exposure, limited access to hygiene facilities, and delayed care. This study assessed the accessibility of wound care for the unhoused population in South Jersey, where approximately 2,607 individuals experience homelessness on any given night. Our research identified significant barriers to wound care access, including transportation limitations, lack of identification documents, absence of a physical mailing address, and language barriers. Data analysis revealed concerning trends: a 24% increase in New Jersey's homeless population in 2024, with Black/African American individuals representing 49% of the homeless population despite comprising only 12% …

Time-Of-Day And Chronotype Influence On Cardiorespiratory And Metabolic Responses To Aerobic Exercise, Brian Fardman, Jie Kang, Nicholas Ratamess, Avery Faigenbaum, Jill Bush, Ariselle Vargas, Tyler Andriopoulos, Julia Melao, Eamonn O’Connell, Andrew Duff, Amy Cmielewski, Jena Desalvo, Alexander Johnson, Matthew Watts

Rowan-Virtua Research Day

Exercise enhances skeletal muscle metabolism and promotes overall health. However, the time-of-day effect of exercise on physiological responses in humans remains less clear. This study investigated how exercise timing and individual chronotype influence cardiorespiratory and metabolic responses during aerobic exercise. Thirty healthy, young (20.9 ± 1.5 years) adults comprising 15 men and 15 women were recruited and classified using the Morningness-Eveningness Questionnaire into morning types (M-types, n = 5), neither types (N-types, n = 20), and evening types (E-types, n = 5). All subjects underwent a V̇o2max test and 2 randomized exercise trials at ∼75% V̇o2max for 30 minutes, 1 …

Maternal Responsiveness To Infant Hunger Cues: Is It Possible To Mitigate Risk Of Obesity Starting In Infancy?, Arrianna A. Powers

Rowan-Virtua Research Day

Background: Childhood obesity is becoming a predominant health concern with over 37 million children under the age of 5 being overweight. Instances of rapid weight gain in infancy correlate to greater risk for obesity later on in life.

Methods: This study aimed to look at feeding modality and style for their impact on maternal responsiveness to infant hunger cues and RWG. A database search identified 21 studies eligible to be included in the review out of 150.

Discussion: Key findings showed breast-feeding mothers were most responsive to hunger cues, breastfed infants expressed greater cues than their formula-fed peers, and responsive …

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 …

Analyzing Preventative Skin Care Practices Among Diabetic, Pre-Diabetic And Non-Diabetic Patients, Hetasvi A. Saraiya, Nils Brolis

Rowan-Virtua Research Day

Background and Hypothesis: Diabetes Mellitus refers to a chronic metabolic syndrome where patients have high blood glucose due to the body’s inability to produce adequate amounts of insulin. This hyperglycemia and other factors make diabetic patients more prone to a number of skin conditions such as dry skin, skin rashes, itchiness and bacterial or fungal infections. There are specific skin practices recommended to reduce the risk of these skin ailments including moisturizing regularly, avoiding hot showers, examining feet regularly for any changes, seeing a physician for major cuts/burns/infections amongst several others. However, there is no available literature that analyzes the …

Exploring Anticoagulant Prescription Disparities: A Focus On Hispanic Patient Care, Michael Acevedo, Vanessa Veltre

Rowan-Virtua Research Day

Anticoagulants play a critical role in preventing thromboembolic events, yet disparities persist in their prescription among minority populations. This presentation explores inequities in anticoagulant prescribing patterns, with a specific focus on Hispanic patient care. Using retrospective electronic health record data, we analyzed the prescription rates of warfarin versus direct oral anticoagulants (DOACs) among adults with clinical indications for anticoagulation. Our findings reveal that Hispanic patients are significantly less likely to receive DOACs compared to non-Hispanic White patients, even after adjusting for demographics, comorbidities, and insurance status. Contributing factors include language barriers, lack of insurance, and potential implicit bias in provider …

Examining The Relationship Between Sleep Habits And Caffeine Consumption, Daniel Calaff, Rachel Pruchno

Rowan-Virtua Research Day

Sleep is essential for cognitive function, mood regulation, immune defense, and metabolic health. Despite widespread caffeine use, its impact on sleep remains debated. It was initially hypothesized that higher caffeine consumption would correlate with greater sleep disturbances. This study explored the relationship between caffeine consumption and sleep habits in a general adult population using a Qualtrics-based self-report survey. Participants (n=93) reported average hours slept per night, time to fall asleep, and number of nighttime awakenings. Caffeine consumption was calculated based on reported intake and categorized into four dosage groups. Sleep outcomes were statistically compared using ANOVA, t-tests, and Pearson correlation. …

Understanding Obesity Risk In Intellectual And Developmental Disabilities: Key Diagnoses And Factors, Elizabeth Kolaski, Wendy Aita, Jennifer Lecomte, Andrea Iannuzzelli

Rowan-Virtua Research Day

Background:

Individuals with intellectual and developmental disabilities (IDD) have obesity rates nearly twice those of the general population, leading to higher rates of diabetes, hypertension, sleep apnea, and reduced quality of life.¹ Genetic syndromes such as Prader-Willi syndrome (PWS) and conditions like autism spectrum disorder (ASD) and Down syndrome (DS) feature distinct mechanisms driving weight gain.² The burden of obesity in IDD exacerbates health disparities and strains caregivers and healthcare systems.³ Yet, comparative obesity prevalence and its drivers across specific IDD diagnoses remain poorly characterized.⁴

Hypothesis:

Obesity prevalence and underlying risk factors differ among IDD diagnoses …

Effect Of Time-Restricted Feeding On Anthropometric, Metabolic, And Fitness Parameters: A Systematic Review, Brian Fardman, Jie Kang, Nicholas Ratamess, Avery Faigenbaum, Jill Bush, Noah Beller, Ariselle Vargas, Tyler Andriopoulos

Rowan-Virtua Research Day

Time restricted feeding (TRF) as a form of intermittent fasting (IF) has gained popularity because its ability to reduce body mass (BM) without an emphasis on caloric restriction. However, how this dietary protocol may affect health, fitness, and performance in a relatively healthy cohort remains less clear. The purpose of this article was to systematically review the current literature concerning the effect of TRF on anthropometric, metabolic, and fitness parameters in normal-weight adults and overweight and obese individuals. A systematic search of English literature was conducted through databases including PubMed, CINAHL, and Google Scholar. The search was facilitated by using …

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.

Comparison Of Patient Retention Of Pcl-5 Vs. Caps-5 In A Study On Tracking Ptsd Symptoms After A Mobile App Intervention, Kaylea Shoulders, Deep Patel, Muntaha Rana, Anne C. Jones

Rowan-Virtua Research Day

Background: Due to mental health provider shortages, primary care providers are seeing more patients with mental health concerns.1 Due to the COVID-19 pandemic, mental health concerns increased requiring primary care to adapt new multidisciplinary interventions to assist patients.2 When assessing patients for PTSD, either the CAPS-5 or PCL-5 can be used, but they have different qualities that may affect retention.

Hypothesis: The PCL-5 will have a higher retention due to the ease of administration.

Methods: Providers identified eligible patients at the Rowan-Virtua family medicine office in Sewell. Upon consent, the CAPS-5 or PCL-5 was administered, and then the PTSD Coach …

Assessing The Impact Of The Covid-19 Pandemic On Health Literacy In Patients Presenting To A Student-Run Free Clinic, Sabah Iqbal, Kirsten Carlberg, Krisha S. Patel, Ashlyn Mcclelland, Sarah Marotta, Rebecca Moore

Rowan-Virtua Research Day

Background

Health literacy as defined by the Center for Disease Control and Prevention (CDC), refers to an individual’s ability to find, understand, and use health information and services1. This definition has evolved with the onset of the COVID-19 pandemic and increasing emphasis on preventative healthcare. We aimed to observe the impact of the pandemic on the health literacy of patients in a free community clinic run by medical students.

Hypothesis

This study aims to assess the effect of various demographic and socioeconomic factors and the COVID-19 pandemic on health literacy levels estimated by the NVS assessment in the patient population …

Exploring The Effects Of Target Race, Gender, And Weight On Pain Perception, Catherine Awad, Theresa Miller, Azer Tuerxuntuoheti, Peter Mende-Siedlecki

Rowan-Virtua Research Day

Healthcare equity is an essential right, and while the quality of care is assumed to be uniform, notable disparities in care are associated with factors of race, gender, and weight-particularly in the domain of pain evaluation and care. In experimental work, target race and gender have varying, and interacting effects on visual thresholds for perceiving painful expressions. Racial bias in pain perception is well established as participants see pain on black faces less readily than pain on white faces; gender also impacts pain treatment, where women are susceptible to having their pain discredited. Across two experiments, the influence of weight …

Disparities In Demographics Of Patients Presenting To A Student-Run Free Clinic In South Jersey, Kirsten Carlberg, Sabah Iqbal, Christian Moya Gamboa, Daliza Diaz, Cerena Moreno, Rebecca Moore

Rowan-Virtua Research Day

Medical schools around the country have established free clinics to better serve the underserved patient populations. In this study, we aimed to evaluate demographic characteristics in the patient population at our free clinic, Rowan-Virtua Community Health Clinic (RVCHC), compared to the general population of Camden County. We found a disproportionately higher percentage of black patients at our clinic when compared to the county overall. Addressing these disparities would require targeted outreach to specific patient populations and improved transit access. Future studies should aim to identify RVCHC health outcomes through the management of chronic disease and understanding emergency room utilization.

The Impact Of Food Deserts And Food Insecurity On Cardiovascular Outcomes In New Jersey, Amina Baig, Cheyenne Myklebust, Jack Hennen, Leah Perez, Rhoda Ukenna-Izuwa, Tayyiaba Farooq

Rowan-Virtua Research Day

Food deserts - areas with limited access to affordable, healthful food - are increasingly being recognized as risk factors for adverse cardiovascular outcomes. This review discusses the link between food desert density and cardiovascular disease risk with a special emphasis on New Jersey. A systematic PubMed, Cochrane, and Embase literature review of studies from 2014 through 2024 was conducted, with some relevant older research dating back to 2001. Some of the keywords used in the search included "food desert," "food insecurity," "cardiovascular disease," and "New Jersey." The search was restricted to English-language research conducted within the United States. The literature …

Screening And Prevention Of The Female Athlete Triad, Lia Summer Goldberg, Kate Whelihan

Rowan-Virtua Research Day

Background The Female Athlete Triad—a syndrome of low energy availability, menstrual dysfunction, and decreased bone mineral density—poses a significant risk to female athletes, particularly those in sports emphasizing leanness or endurance. Despite its potential to impair both performance and long-term health, the Triad remains frequently underdiagnosed due to stigma, nonspecific symptoms, and limited screening practices. This review investigates current strategies for screening and preventing the Triad, aiming to identify best practices and areas needing improvement.

Methods A literature review was conducted using PubMed, focusing on studies published after 2005. Keyword searches included “female athlete triad screening,” “prevention,” “education,” and “awareness.” …

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 …

Cardiovascular Effects Of Glp-1 Receptor Agonists In Non-Diabetic Adults With Obesity: A Systematic Literature Review, Mariam Abdeen

Rowan-Virtua Research Day

Background: Cardiovascular disease (CVD) is the leading cause of morbidity and mortality in individuals with obesity. GLP-1 receptor agonists, initially developed for glycemic control in diabetes, are now approved for weight loss in non-diabetic populations. Recent clinical trials suggest these agents may also offer direct cardiovascular benefits.

Objective: This literature review aims to evaluate the cardiovascular effects of GLP-1 receptor agonists, specifically semaglutide, liraglutide, and tirzepatide, in non-diabetic adults with overweight or obesity.

Methods: A systematic search was conducted in January 2025 using PubMed as the primary database, supplemented by Google Scholar and Embase. Clinical trials were selected based on …

Assessing The Impact Of The Covid-19 Pandemic On Mental Health In Patients Presenting To A Student-Run Free Clinic, Sabah Iqbal, Kirsten Carlberg, Emily Reilly, Jessica Ivanov, Victoria Youssef, Lily Roessler, Maikel Monsour, Nils Brolis

Rowan-Virtua Research Day

Background

Mental health is an important part of patient care, therefore it is imperative to understand how it’s recognized and treated. Socioeconomic status and the COVID19 pandemic contribute to disproportionate incidences of mental illness^{1, 2, 10, 11, 12}. This study uses data from a student-run clinic, the Rowan-Virtua Community Health Center (RVCHC), to examine disparities in mental health needs and screenings among the local population.

Hypothesis

It was hypothesized that underserved populations are at a disadvantage when it comes to both mental health screenings and treatment due to restricted access to healthcare and other unmet needs. Additionally, the …

The Impact Of Environmental Deficiencies On Maternal Health Outcomes, Zahra Wallizadeh, Emiyah Bullock, Antoinette Jones, Katarina Rusinak

Rowan-Virtua Research Day

This study examines the environmental factors contributing to adverse maternal health outcomes in New Jersey, with particular focus on their disproportionate impact on minority women. Analysis of data from PubMed, Policy Map, NIH, CDC, EPA, and the New Jersey Department of Health reveals that women living in low-income areas face significant environmental challenges, including food deserts, air pollution, unsafe living conditions, inadequate infrastructure, and limited transportation options. These environmental determinants exacerbate maternal stress and contribute to complications such as preterm birth and hypertension. Black women are nearly three times more vulnerable to these adverse outcomes compared to white women, highlighting …

Patient Education And Health Literacy Effects On Statin Use And Adherence, Ian M. Smith, Richard G. Olarsch, Alison M. Mancuso

Rowan-Virtua Research Day

Background: While the use of statins (HMG-CoA reductase inhibitors) plays a significant role in the prevention of cardiovascular disease, it is estimated approximately 60% of patients who would benefit from a statin are receiving these medications. Current research suggests that a preference for life-style intervention over medical management, concern over medical adverse reactions, and a lower perceived risk of cardiovascular events is associated with statin non-adherence.

Methods: An IRB-approved paper survey was administered to patients aged 18 to 89 at an ambulatory primary care clinic for non-acute visits. Qualtrics was utilized to collect, store, and process data. Information elicited from …