Public Health Commons^™

Portable Air Purifiers To Mitigate The Harms Of Wildfire Smoke For People With Asthma, Tianshi David Wu

Faculty, Staff and Students Publications

No abstract provided.

Covid-19 And Burnout Among Community Pharmacists In The West Bank – Palestine, Amjad H. Bazzari, Firas H. Bazzari

Journal of the Arab American University مجلة الجامعة العربية الامريكية للبحوث

The coronavirus disease 2019 (COVID-19) pandemic had a strong impact on the physical and mental well-being of healthcare workers. However, the focus has been directed towards nurses and physicians compared to pharmacists. Here, the researchers investigated the prevalence of burnout among community pharmacists in the West Bank – Palestine during the pandemic and the associated COVID-19 factors. The study was conducted using a written questionnaire and the sample included a total of 70 pharmacists. The results showed a burnout prevalence of 45.7% with work-related burnout having the highest impact on both males (50%) and females (54.8%). The level of burnout …

Digital Phobia: An Inquiry For Mapping The Unseen Dimension Of New Digital Anxiety, The ‘Digiphobia’, Amarjit Kumar Singh ,Library Assistant, Md. Arshad Ali , Professional Assistant, Dr. Pankaj Mathur, Deputy Librarian,

Library Philosophy and Practice (e-journal)

Background: As technology continues to advance, individuals' interactions with digital platforms have become integral to daily life. Amidst this technological evolution, a novel concern emerges—Digital Phobia, hereafter referred to as “Digiphobia.” This phenomenon, although not previously explored in scholarly literature, necessitates an in-depth investigation due to its potential impact on individuals' well-being. Our research employs a two-step methodology to investigate its existence, implications, and manifestations.

Introduction: This research paper introduces and proposes the term "Digiphobia" as a comprehensive conceptualization of anxiety arising from interactions with digital spaces, applications, and environments. The proliferation of digital technologies has led to the emergence …

Coronary Flow Capacity And Survival Prediction After Revascularization: Physiological Basis And Clinical Implications, K Lance Gould, Nils P Johnson, Amanda E Roby, Linh Bui, Danai Kitkungvan, Monica B Patel, Tung Nguyen, Richard Kirkeeide, Mary Haynie, Salman A Arain, Konstantinos Charitakis, Abhijeet Dhoble, Richard Smalling, Angelo Nascimbene, Marwan Jumean, Sachin Kumar, Biswajit Kar, Stefano Sdringola, Anthony Estrera, Igor Gregoric, Dejian Lai, Ruosha Li, David Mcpherson, Jagat Narula

Faculty, Staff and Student Publications

BACKGROUND AND AIMS: Coronary flow capacity (CFC) is associated with an observed 10-year survival probability for individual patients before and after actual revascularization for comparison to virtual hypothetical ideal complete revascularization.

METHODS: Stress myocardial perfusion (mL/min/g) and coronary flow reserve (CFR) per pixel were quantified in 6979 coronary artery disease (CAD) subjects using Rb-82 positron emission tomography (PET) for CFC maps of artery-specific size-severity abnormalities expressed as percent left ventricle with prospective follow-up to define survival probability per-decade as fraction of 1.0.

RESULTS: Severely reduced CFC in 6979 subjects predicted low survival probability that improved by 42% after revascularization compared …

Antibiotic Use, Obesity, And Preterm Birth Among Women In The United States, Mya Thuzar Win

Walden Dissertations and Doctoral Studies

No abstract provided.

Pastoral Leaders’ Perception Of Obesity And Their Role Within Faith-Based Organizations, Darren D. Moore, Clinton E. Cooper, Charles Williams

The Qualitative Report

The purpose of this study was to explore the perspectives of pastoral leaders regarding obesity and health within faith-based organizations (FBOs). In this study, the authors focused on gaining additional insight regarding how pastoral leaders conceptualize and make sense of their roles in terms of health promotion within FBOs. Utilizing a qualitative research methodological approach, specifically Qualitative Description, authors administered a qualitative survey to 12 participants which yielded three emerging themes: (1) perceived scope, (2) understanding and use of resources, and (3) defining obesity through pastoral leaders’ perspectives. In the study, investigators discuss clinical implications and provide recommendations.

The Association Between Dietary Flavonoid Intake And Cardiovascular Health Indicators In Women Aged 45 To 65, Melissa Wedel

Walden Dissertations and Doctoral Studies

No abstract provided.

Fecal Pharmacokinetics And Gut Microbiome Effects Of Oral Omadacycline Versus Vancomycin In Healthy Volunteers, Jinhee Jo, Chenlin Hu, Khurshida Begum, Weiqun Wang, Thanh M Le, Samantha Agyapong, Blake M Hanson, Hossaena Ayele, Chris Lancaster, M Jahangir Alam, Anne J Gonzales-Luna, Kevin W Garey

Faculty, Staff and Student Publications

BACKGROUND: Clostridioides difficile infection (CDI) is a common healthcare-associated infection with limited treatment options. Omadacycline, an aminomethylcycline tetracycline, has potent in vitro activity against C difficile and a low propensity to cause CDI in clinical trials. We aimed to assess fecal pharmacokinetics and gut microbiome effects of oral omadacycline compared to oral vancomycin in healthy adults.

METHODS: This was a phase 1, nonblinded, randomized clinical trial conducted in healthy volunteers aged 18-40 years. Subjects received a 10-day course of omadacycline or vancomycin. Stool samples were collected at baseline, daily during therapy, and at follow-up visits. Omadacycline and vancomycin stool concentrations …

Fbpp: Software To Design Pcr Primers And Probes For Nucleic Acid Base Detection Of Foodborne Pathogens, Mohamed A Soliman, Mohamed S Azab, Hala A Hussein, Mohamed M Roushdy, Mohamed N Abu El-Naga

Faculty, Staff and Student Publications

Foodborne pathogens can be found in various foods, and it is important to detect foodborne pathogens to provide a safe food supply and to prevent foodborne diseases. The nucleic acid base detection method is one of the most rapid and widely used methods in the detection of foodborne pathogens; it depends on hybridizing the target nucleic acid sequence to a synthetic oligonucleotide (probes or primers) that is complementary to the target sequence. Designing primers and probes for this method is a preliminary and critical step. However, new bioinformatics tools are needed to automate, specific and improve the design sets to …

Innovative Virtual Wellness Interventions At An Academic Medical Center: A Pilot Feasibility Study, Ritika Baweja, Michael Hayes, Aditya Joshi, Raman Baweja

Journal of Wellness

Introduction: There is generally a concerning likelihood of burnout in healthcare workers. Given the impact of COVID-19 on healthcare workers, our institution identified the need for wellness interventions to foster adaptive functioning and mitigate burnout. The purpose of this pilot project was to assess the feasibility of virtual holistic interventions like meditation, art, laughter therapy and dance and their impact on overall well-being of physicians and advanced practice providers (APPs).

Methods: A series of 12 virtual sessions (art therapy, dance therapy, mindfulness-based practices/meditation and laughter therapy) were offered to providers over a 6-month period. Participants completed an online survey reporting …

Mendelian Randomization With Incomplete Measurements On The Exposure In The Hispanic Community Health Study/Study Of Latinos, Yilun Li, Kin Yau Wong, Annie Green Howard, Penny Gordon-Larsen, Heather M Highland, Mariaelisa Graff, Kari E North, Carolina G Downie, Christy L Avery, Bing Yu, Kristin L Young, Victoria L Buchanan, Robert Kaplan, Lifang Hou, Brian Thomas Joyce, Qibin Qi, Tamar Sofer, Jee-Young Moon, Dan-Yu Lin

Faculty, Staff and Student Publications

Mendelian randomization has been widely used to assess the causal effect of a heritable exposure variable on an outcome of interest, using genetic variants as instrumental variables. In practice, data on the exposure variable can be incomplete due to high cost of measurement and technical limits of detection. In this paper, we propose a valid and efficient method to handle both unmeasured and undetectable values of the exposure variable in one-sample Mendelian randomization analysis with individual-level data. We estimate the causal effect of the exposure variable on the outcome using maximum likelihood estimation and develop an expectation maximization algorithm for …

Covid-19 Convalescent Plasma Therapy Decreases Inflammatory Cytokines: A Randomized Controlled Trial, Feben Habtehyimer, Xianming Zhu, Andrew D Redd, Kelly A Gebo, Alison G Abraham, Eshan U Patel, Oliver Laeyendecker, Thomas J Gniadek, Reinaldo E Fernandez, Owen R Baker, Malathi Ram, Edward R Cachay, Judith S Currier, Yuriko Fukuta, Jonathan M Gerber, Sonya L Heath, Barry Meisenberg, Moises A Huaman, Adam C Levine, Aarthi Shenoy, Shweta Anjan, Janis E Blair, Daniel Cruser, Donald N Forthal, Laura L Hammitt, Seble Kassaye, Giselle S Mosnaim, Bela Patel, James H Paxton, Jay S Raval, Catherine G Sutcliffe, Matthew Abinante, Kevin S Oei, Valerie Cluzet, Marie Elena Cordisco, Benjamin Greenblatt, William Rausch, David Shade, Amy L Gawad, Sabra L Klein, Andrew Pekosz, Shmuel Shoham, Arturo Casadevall, Evan M Bloch, Daniel Hanley, Aaron A R Tobian, David J Sullivan

Faculty, Staff and Student Publications

This study examined the role that cytokines may have played in the beneficial outcomes found when outpatient individuals infected with SARS-CoV-2 were transfused with COVID-19 convalescent plasma (CCP) early in their infection. We found that the pro-inflammatory cytokine IL-6 decreased significantly faster in patients treated early with CCP. Participants with COVID-19 treated with CCP later in the infection did not have the same effect. This decrease in IL-6 levels after early CCP treatment suggests a possible role of inflammation in COVID-19 progression. The evidence of IL-6 involvement brings insight into the possible mechanisms involved in CCP treatment mitigating SARS-CoV-2 severity.

Determining The Feasibility Of A Codesigned And Personalised Intervention (Veg4me) To Improve Vegetable Intake In Young Adults Living In Rural Australian Communities: Protocol For A Randomised Controlled Trial, Katherine M. Livingstone, Jonathan C. Rawstorn, Stephanie R. Partridge, Yuxin Zhang, Eric O, Stephanie L. Godrich, Sarah A. Mcnaughton, Gilly A. Hendrie, Kate Dullaghan, Gavin Abbott, Lauren C. Blekkenhorst, Ralph Maddison, Scott Barnett, John C. Mathers, Laura Alston

Research outputs 2022 to 2026

Introduction:

Diets low in vegetables are a main contributor to the health burden experienced by young adults in rural communities. Digital health interventions provide an accessible delivery model that can be personalised to meet the diverse preferences of young adults. A personalisable digital vegetable intake intervention (Veg4Me) was codesigned to meet the needs of young adults living in rural communities. This study will determine the feasibility of delivering a personalised Veg4Me programme and compare preliminary effects with a non-personalised Veg4Me (control).

Methods and Analysis:

A 12-week assessor-blinded, two-arm, parallel randomised controlled trial will be undertaken from August 2023 until April …

Proceedings Of The 23rd International Conference Of Public Health Sciences

Journal of Health Research

Chulalongkorn University aims to be a prominent national institution with global recognition. Its primary focus is on producing knowledge and innovation that are crucial for the creative and sustainable development of Thai society. To achieve this vision, the university consistently provides support to all of its faculties, institutes, colleges, and other entities in carrying out a range of academic activities, including in-class teaching, research, and conferences, such as the one we are gathered for today. With a primary focus on graduate-level teaching in the field of public health and public health sciences, the College of Public Health Sciences is a …

Barriers To Care For Children With Cerebral Palsy In The Rural State Of Maine: A Mixed-Methods Study, Rayne L. Whitten, Anya K. Cutler, Alexa K. Craig

Journal of Maine Medical Center

Introduction: Guidelines on orthopedic hip surveillance in children with cerebral palsy have been published to minimize the effects of cerebral palsy and maximize quality of life. Researchers aimed to identify barriers to cerebral palsy care and to assess adherence to national hip-surveillance guidelines among a small subset of children with cerebral palsy who live in a rural state.

Methods: Parents of children with cerebral palsy were interviewed, and thematic analyses were performed on the recorded transcripts. Patient-specific data about imaging and demographics were manually extracted from the electronic health record to perform a mixed-methods analysis.

Results: Twenty-one parents were interviewed, …

A Life-Threatening Emergency Exacerbated By Untreated Mental Illness In A Low-Barrier Health Center, Brendan J. Prast, Byron Marshall

Journal of Maine Medical Center

Introduction: We report on a patient with untreated severe mental illness who presented with a life-threatening emergency: retained products of conception and hemorrhage.

Clinical Findings: A female patient experiencing homelessness developed life-threatening hemorrhage. Her mental illness impaired effective communication and treatment.

Clinical Course: The patient presented with fatigue, vaginal bleeding, and known retained products of conception. Her active mental illness complicated the situation as it limited effective communication and treatment due to delusions. She requested only treatment for an infectious cause of her symptoms. She refused most interventions and had a self-directed discharge from the hospital. Throughout this process, we …

Association Of Depression With Myocardial Infarction With Non-Obstructive Coronary Arteries: A Systematic Review, Sarim Rashid, Khawaja Usama Maqbool, Umer Hassan, Subhan Ahmed, Hamayle Saeed, Fnu Avanteeka, Syed Muhammad Jawad Zaidi, Jahanzeb Malik, Amin Mehmoodi

Journal of Community Hospital Internal Medicine Perspectives

This systematic review examined the association between depression and myocardial infarction with non-obstructive coronary arteries (MINOCA). A comprehensive literature search was conducted using electronic databases, resulting in the inclusion of six small case-control and cohort studies reported from Spain, Australia, China, and Pakistan. The studies included various study designs, such as cohort studies, case-control studies, and prospective cohort studies. The results of the systematic review indicate a significant association between depression and MINOCA. Several studies reported a higher prevalence of depression among MINOCA patients compared to those with obstructive coronary artery disease. Additionally, depression was found to be associated with …

Contrasting Tick Species Behaviors: A Course-Based Undergraduate Research Experience (Cure), Sara Benham, Shovan Dutta, Rohan Maddamsetti, Clayton Wright, Alena Anderson, David T. Gauthier, Holly D. Gaff

Spora: A Journal of Biomathematics

Tick-borne diseases are on the rise throughout the world, and there is a need to better understand tick behavior in order to identify potential new interventions. Ticks have a complex life history and can survive months off-host. There is a lack of large-scale data on off-host tick behavior, which leaves a gap in understanding of tick biology outside of tick-host interactions. Introducing undergraduate students to authentic research early in their studies can help prepare them for independent inquiry in upper-level classes. To address the student needs and fill gaps in tick research, students in introductory biology courses recorded observations of …

Editorial: Care During Pregnancy And Early Childhood For Growth And Development In Low- And Middle- Income Countries, Ranadip Chowdhury, Ravi Prakash Upadhyay, Bireshwar Sinha, Nita Bhandari, Sunita Taneja, Jai K. Das

Centre of Excellence in Women and Child Health

No abstract provided.

Differences In Provider Hepatitis C Virus Screening Recommendations By Patient Risk Status, Alfu Laily, Robert Duncan, Kaitlyn M. Gabhart, Lauren D. Nephew, Shannon M. Christy, Susan T. Vadaparampil, Anna R. Giuliano, Monica L. Kasting

Purdue University Libraries Open Access Publishing Fund

Providers’ recommendation is among the strongest predictors to patients engaging in preventive care. Therefore, the aim of this study was to compare providers’ Hepatitis C Virus (HCV) screening recommendation quality between high-risk and average-risk patients to determine if providers are universally recommending HCV screening, regardless of risk behaviors. This cross-sectional survey of 284 Indiana providers in 2020 assessed provider characteristics, HCV screening recommendation practices (strength, presentation, frequency, timeliness), self-efficacy, and barriers to recommending HCV screening. T-test and Chi-square compared recommendation practices for high-risk and average-risk patients. Prevalence ratios were calculated for variables associated with HCV recommendation strength comparing high-risk and …

Shaping The Future Of Global Access To Safe, Effective, Appropriate And Quality Health Products, Raffaella Ravinetto, Rodrigo Henriquez, Prashant N Srinivas, Hazel Bradley, Renier Coetzee, Theresa J Ochoa, Jean Claude Semuto Ngabonziza, Jean-Baptiste Mazarati, Wim Van Damme, Remco Van De Pas, Nico Vandaele, Els Torreele

Faculty, Staff and Student Publications

No abstract provided.

Cd36 Regulates Factor Viii Secretion From Liver Endothelial Cells, Paula Reventun, Pablo Toledano-Sanz, Nunzio Alcharani, Maria Viskadourou, Alanna C Morrison, Maria Sabater-Lleal, Alisa S Wolberg, Paul S De Vries, Nicholas L Smith, William O Osburn, Marios Arvanitis, Charles J Lowenstein

Faculty, Staff and Student Publications

No abstract provided.

Low-Level Resource Partitioning Supports Coexistence Among Functionally Redundant Bacteria During Successional Dynamics, Xiaoqian Annie Yu, Craig Mclean, Jan-Hendrik Hehemann, David Angeles-Albores, Fuqing Wu, Artur Muszyński, Christopher H Corzett, Parastoo Azadi, Elizabeth B Kujawinski, Eric J Alm, Martin F Polz

Faculty, Staff and Student Publications

Members of microbial communities can substantially overlap in substrate use. However, what enables functionally redundant microorganisms to coassemble or even stably coexist remains poorly understood. Here, we show that during unstable successional dynamics on complex, natural organic matter, functionally redundant bacteria can coexist by partitioning low-concentration substrates even though they compete for one simple, dominant substrate. We allowed ocean microbial communities to self-assemble on leachates of the brown seaweed Fucus vesiculosus and then analyzed the competition among 10 taxonomically diverse isolates representing two distinct stages of the succession. All, but two isolates, exhibited an average of 90% ± 6% pairwise …

A Conceptual Analysis Of Sbirt Implementation Alongside The Continuum Of Prep Awareness: Domains Of Fit And Feasibility., Lesley M. Harris, Kerr C. Jelani, Blake D. Skidmore, Smita Ghare, Andrea Reyes-Vega, Vania Remenik-Zarauz, Harideep Samanapally, Rana U. Anwar, Rishikesh Rijal, Kendall Bryant, Martin T. Hall, Shirish Barve

Faculty and Staff Scholarship

Screening, Brief Intervention, and Referral to Treatment (SBIRT) is a supplementary intervention that can be incorporated into the Pre-Exposure Prophylaxis (PrEP) Care Continuum, complementing initiatives and endeavors focused on Human Immunodeficiency Virus (HIV) prevention in clinical care and community-based work. Referencing the Transtheoretical Model of Change and the PrEP Awareness Continuum, this conceptual analysis highlights how SBIRT amplifies ongoing HIV prevention initiatives and presents a distinct chance to address identified gaps. SBIRT's mechanisms show promise of fit and feasibility through (a) implementing universal Screening (S), (b) administering a Brief Intervention (BI) grounded in motivational interviewing aimed at assisting individuals in …

County-Level Trends And Potential Disparities In The Suicide Rates In Virginia, 2020 – 2022, Sharon A. Olowoyo, Oluwatosin M. Oduneye, Glodi B. Bokanya, Ayooluwa G. Olowoyo, Coralie E. Mugenga, Yuhan Yan, Robyn L. Anderson

Montview Journal of Research & Scholarship

Abstract

Objectives

This study aims to investigate the influence of social determinants of health (SDH) on suicide patterns in the state of Virginia.

Methods

A secondary statistical analysis was conducted using publicly accessible data from the County Health Rankings & Roadmaps database for Virginia. Data from 2020 to 2022 were analyzed, focusing on age-adjusted suicide rates and SDH factors, including % rural, mental health provider rate, median household income, high school completion, and unemployment rates. Multiple regression analysis and visualizations were employed for data interpretation.

Results

The analysis revealed that SDH factors significantly predicted suicide rates across the study period. …

Cov2var, A Function Annotation Database Of Sars-Cov-2 Genetic Variation, Yuzhou Feng, Jiahao Yi, Lin Yang, Yanfei Wang, Jianguo Wen, Weiling Zhao, Pora Kim, Xiaobo Zhou

Faculty, Staff and Student Publications

The COVID-19 pandemic, caused by the coronavirus SARS-CoV-2, has resulted in the loss of millions of lives and severe global economic consequences. Every time SARS-CoV-2 replicates, the viruses acquire new mutations in their genomes. Mutations in SARS-CoV-2 genomes led to increased transmissibility, severe disease outcomes, evasion of the immune response, changes in clinical manifestations and reducing the efficacy of vaccines or treatments. To date, the multiple resources provide lists of detected mutations without key functional annotations. There is a lack of research examining the relationship between mutations and various factors such as disease severity, pathogenicity, patient age, patient gender, cross-species …

Contextualizing The Revised Patient Perception Of Patient-Centeredness (Pppc-R) Scale In Primary Healthcare Settings: A Validity And Reliability Evaluation Study, Yiyuan Cai, Pengfei Guo, Jiong Tu, Mengyao Hu, Lingrui Liu, Bridget L Ryan, Jing Liao, Rubee Dev, Yiran Li, Tianyu Huang, Ruilin Wang, Li Kuang, Ruonan Huang, Xinfang Li, Edmundo Roberto Melipillán, Shuaixiang Zhao, Wenjun He, Xiaohui Wang, Nan Zhang, Dong Roman Xu

Faculty, Staff and Student Publications

BACKGROUND: An English version of the Patient Perception of Patient-Centeredness (PPPC) scale was recently revised, and it is necessary to test this instrument in different primary care populations.

AIM: This study aimed to assess the validity and reliability of a Chinese version of the PPPC scale.

DESIGN: A mixed method was used in this study. The Delphi method was used to collect qualitative and quantitative data to address the content validity of the PPPC scale by calculating the Content Validity Index, Content Validity Ratio, the adjusted Kappa, and the Item Impact Score. Confirmatory factor analysis (CFA) and exploratory factor analysis …

Sentinel Lymph Node Mapping With Indocyanine Green Using Spy-Phi In Open Radical Hysterectomy Or Trachelectomy, Maria A Fernandez, Helen D Clark, Maria D Iniesta, Mark F Munsell, Michael Frumovitz, Pedro T Ramirez

Faculty, Staff and Student Publications

Objective: To evaluate the detection rate of at least one sentinel lymph node (SLN) in patients with early cervical cancer who underwent open radical hysterectomy or trachelectomy using indocyanine green (ICG) with the SPY Portable Handler Imager (SPY-PHI) system.

Methods: We retrospectively reviewed patients with cervical cancer FIGO 2018 stage IA1 with lymphovascular invasion up to stage IIIC1p who underwent SLN mapping and open radical hysterectomy or trachelectomy from March 2018 through August 2022 at The University of Texas MD Anderson Cancer Center. ICG was the only tracer used with the SPY-PHI system. Patient demographics, surgical approach, and tumor factors …

Lung Cancer In Ever- And Never-Smokers: Findings From Multi-Population Gwas Studies, Yafang Li, Xiangjun Xiao, Jianrong Li, Younghun Han, Chao Cheng, Gail F. Fernandes, Shannon E. Slewitzke, Susan M. Rosenberg, Meng Zhu, Jinyoung Byun, Yohan Bossé, James D. Mckay, Demetrios Albanes, Stephan Lam, Adonina Tardon, Chu Chen, Stig E. Bojesen, Maria T. Landi, Mattias Johansson, Angela Risch, Heike Bickeböller, H-Erich Wichmann, David C. Christiani, Gad Rennert, Susanne M. Arnold, Gary E. Goodman, John K. Field, Diptasri Mandal, Et Al

School of Graduate Studies Faculty Publications

BACKGROUND: Clinical, molecular, and genetic epidemiology studies displayed remarkable differences between ever- and never-smoking lung cancer. METHODS: We conducted a stratified multi-population (European, East Asian, and African descent) association study on 44,823 ever-smokers and 20,074 never-smokers to identify novel variants that were missed in the non-stratified analysis. Functional analysis including eQTL colocalization and DNA damage assays, and annotation studies were conducted to evaluate the functional roles of the variants. We further evaluated the impact of smoking quantity on lung cancer risk for the variants associated with ever-smoking lung cancer. RESULTS: Five novel independent loci, GABRA4, inter-genic region 12q24.33, LRRC4C, LINC01088, …

Are Remote Health Clinics Primary Health Care Focused? Validation Of The Primary Health Care Engagement (Phce) Scale For The Australian Remote Primary Health Care Setting, Kylie Mccullough, Gemma Doleman, Melissa Dunham, Lisa Whitehead, Davina Porock

Research outputs 2022 to 2026

AIM: To test and validate a measure of primary health care (PHC) engagement in the Australian remote health context. BACKGROUND: PHC principles include quality improvement, community participation and orientation of health care, patient-centred continuity of care, accessibility, and interdisciplinary collaboration. Measuring the alignment of services with the principles of PHC provides a method of evaluating the quality of care in community settings. METHODS: A two-stage design of initial content and face validity evaluation by a panel of experts and then pilot-testing the instrument via survey methods was conducted. Twelve experts from clinical, education, management and research roles within the remote …