Social and Behavioral Sciences Commons^™

Refugees' Perceptions Of Primary Care: What Makes A Good Doctor's Visit?, Anne Mutitu, Bev Zabler, Jeana M. Holt

Patient Experience Journal

Redesigning primary care is a national priority, as the United States (US) struggles with issues of poor access, high cost, and suboptimal quality. Refugees are among the populations who suffer from America’s disjointed health care system, resulting in disproportionate health disparities. Although there are many studies on refugee health, few share refugees' perceptions of primary care. We asked local refugees who were seen for primary care services at a midwestern academic nurse-led clinic, what makes a good doctor's visit?  The clinic served as the hub of a federally funded refugee Community Centered Health Home (CCHH) pilot project. This qualitative study …

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 …

Preliminary Outcomes, Acceptability, And Feasibility Of A Brief Crisis Response Planning Intervention For Reducing Suicide Risk In Primary Care Behavioral Health Patients, Aubrey R. Dueweke

Graduate Theses and Dissertations

Primary care is an important setting for improving identification and treatment of people at risk for suicide. However, there are few developed protocols for management of suicide risk in this setting. This study aimed to evaluate the preliminary outcomes, acceptability, and feasibility of a brief crisis response planning intervention for patients at a moderate risk for suicide in a primary care behavioral health (PCBH) setting. The outcomes examined included change in suicidal cognitions, suicidal intent, hope, and coping efficacy. Twenty-two adult primary care patients at moderate risk for suicide participated in this study, which involved filling out self-report measures before …

Implementation Of An Advance Care Planning Protocol To Increase Advance Directive Completion Rates, Christine Engle

Evidence-Based Practice Project Reports

Advanced directives (AD) allow an individual to retain autonomy in end-of-life decisions and can prevent unnecessary costs and treatments associated with aggressive life-prolonging measures. As of 2017, only an estimated 36.7% of the United States adult population had a form of advance directive documented (Yadav et al., 2017). The purpose of this evidence-based project was to determine if implementation of an advanced care planning (ACP) protocol would increase ACP discussions, AD completion, and result in a modification in stage of change or behavior. The Transtheoretical Model (TTM) and Stetler Model of evidence-based practice were used as the framework to guide …

Can Doctors Improve The Patient Experience By Rearranging The Furniture And Equipment In Their Office? A Video Recorded Simulation, Moyez Jiwa, Catherine Krejany, Lee Gaedtke, Epi Kanjo, Ruthra Nagendran, Carolyn O'Shea, Iain Greenlees

Patient Experience Journal

The design of this study is a video-recorded simulated consultation. Its aim is to evaluate the effect of changing seating arrangements and stethoscope visibility on patient enablement and non-verbal behaviour. Twelve simulated consultations with six actor-patients and a ‘real’ doctor were video recorded. Either the ‘real’ doctor or actor-patient, blind to the hypothesis sat in large executive office chair during the consult. The patient entered the room afresh for each consult. Consultation quality and outcomes were independently evaluated on three measures: The Patient Enablement Index (PEI), the Leicester Assessment Package (LAP); Non-Verbal Communication (NVC). Both expert reviewers were also blind …

One Patient's Experiences And Expectations In The Healthcare System: Complicated And Critical Illness With Rare Diagnosis Described By His Advocate, Jennifer Cademartori

Patient Experience Journal

The health care business serves as a profession in the art of human illness. But unlike other businesses there is the human side, the patient experience. These patients are the “customers” receiving the care, but they, unlike customers at a retail store, are vulnerable and scared and must trust their lives in the hands of people they don’t know. The paradigm must change to reflect how the health care business is handled from the eyes of the person receiving the care from the first office visit, through the inpatient stay, to follow up visits. Patient focused training on all levels …

Acceptability And Feasibility Of A Multicomponent Group Intervention To Initiate Health Behavior Change: The Kickstart Health Program, Shannon Marie Clark

Wayne State University Dissertations

There is a growing need to address the difficulties that people face trying to engage in a healthier lifestyle and the integration of behavioral health into primary care settings may offer an opportunity to address this need. Health behavior change groups may be an effective style of intervention in medical settings; however, the experiences patients have attending these groups as well as how health behavior change groups best fit into integrated care settings is largely unknown. The purpose of the current study was to offer a preliminary test of feasibility and acceptability for a group intervention, conducted in a primary …

A Survey Of Providers And Patients Assessing The Need For And Use Of Prevention Practitioners To Combat Obesity In The Primary Care Setting, Amanda R. Lyons

DNP Projects

Purpose: The overall aim of this project was to gather information from two groups of stakeholders, providers and patients, on the feasibility of implementing prevention practitioners in the primary care system to address overweight and obesity.

Methods: This study utilized a quantitative descriptive design through the use of electronic surveys. Provider surveys were explained and presented during a monthly provider meeting. Patient flyers were posted in exam rooms and surveys were accessible through a provided link and QR code.

Results: Providers (N=10) agreed that they saw a need for the use of a prevention practitioner (Mean=4.44, SD=.88) as well as …

The Positive Predictive Value Of The Phq-2 As A Screener For Depression In Spanish-Speaking Latinx, English-Speaking Latinx, And Non-Latinx White Primary Care Patients., Ana J. Bridges, Aubrey R. Dueweke, Elizabeth A. Anastasia, Juventino Hernandez Rodriguez

Psychological Science Faculty Publications and Presentations

Although the Patient Health Questionnaire 2 (PHQ-2) is frequently used to screen for depressive disorders in primary care patients, there is little information about its psychometric properties in diverse populations. The present study evaluated the positive predictive value (PPV) of the PHQ-2 in three groups of primary care patients at a federally qualified health center (78% female, M age = 42.73 years, range 18–78): Spanish-speaking Latinxs (n = 490), English-speaking Latinxs (n = 134), and non-Latinx Whites (n = 690). Universal screening with the PHQ-2 of consecutive adult primary care patients took place during a 5-month period. Any “yes” response …

Competing Strength-Based Models Of Trauma And Suicidality In A High-Risk Primary Care Sample, Samantha Mladen

Theses and Dissertations

There is limited research on the relationship between trauma exposure, depression, and suicidality, particularly in high-risk primary care samples. The present study aims to: 1) characterize the prevalence of suicidality, depression, and trauma exposure in this sample; 2)develop and test models of the relationships between suicidality, depression, and trauma exposure in this sample; 3) augment the selected model with key protective factors, including social support and religiosity; and 4) further elaborate the nature of religiosity as a potential protective factor using the subscales of the Attitudes toward God scale, Anger toward God and Comfort with God.

Patients (n …

Racism, Healthcare Provider Trust, And Medication Adherence Among Black Patients In Safety-Net Primary Care: A Strength-Based Approach, Mickeal Pugh Jr

Theses and Dissertations

Integrated primary care has been incorporated into a variety of healthcare settings. The benefits of these services are empirically supported by a plethora of studies, which highlight the integration of behavioral and physical healthcare to be beneficial for both patient and healthcare providers. Integrated care models are typically incorporated in Veterans Affairs hospitals, general primary care facilities, and community clinics. Community-based clinics, such as safety-net clinics, typically serve underrepresented populations, and research has shown several mental and physical health disparities to exist among minority populations. Further, the minority stress model posits that distal and proximal minority-based stress processes can result …

Diabetes Management For Low-Income Patients: Within-Case Analyses In Primary Care, Samuel Collier

Antioch University Dissertations & Theses

The study evaluated the effectiveness of a diabetes management program in a co-located mental health and primary care setting in Nashua, New Hampshire. The patient-participants were primarily underserved, low-income, working-class or homeless patients from the surrounding region. A few participants were also older adults. Examination of the literature highlighted the growing diabetes epidemic at local, state, and national levels. A review of past clinical trials of diabetes programs indicated further investigation into diabetes self-management education programs that integrate medical and behavioral health components under the biopsychosocial model. Thus, for the present study, the Stanford Diabetes Self-Management Program (SDSMP; Lorig, Ritter, …