Primary Care Commons^™

Anxio-Depressive Disorders In A Pandemic Context: A Comparative Analysis: Year 2019 Versus 2020, Andreea Roxana Droahnă, Lavinia-Alexandra Moroianu, Valeria-Anca Pietroșel, Cristina Ioana Bica, Teodor Salmen, Cecilia Curis, Emanuele Maria Merlo, Roxana Adriana Stoica, Marius Moroianu

Journal of Mind and Medical Sciences

The outbreak of SARS-CoV-2 pandemic has resulted in increased rates of anxiety and depression worldwide. Objective. To comparatively evaluate factors associated with the psychological impact of Coronavirus disease between 2019 and the pandemic year 2020. Materials and Methods. The study was performed on a group of 3224 patients, of which 197 were hospitalized, selected from Jan 1st 2019 until 30th Dec 2020 in a tertiary care center for psychiatric disorders. Data were collected from the observation charts. Results. The incidence of anxiety disorders is higher in the age range 40-70 years with an average value of 53 years old. In …

Management Of Pelvic Pain Caused By Endometriosis, Denisa Oana Balalau, Ioana Andreea Ciupitu, Delia-Maria Bogheanu, Alexia-Ioana Ghiocel-Zariosu, Cristian Balalau, Liana Ples, Daniela Gabriela Bălan, Ioana Paunica, Marina-Romina Sima

Journal of Mind and Medical Sciences

Endometriosis is a disorder of the epithelium and/or endometrial-like stroma outside the endometrium and myometrium, usually with an associated inflammatory process. It mainly affects young women of reproductive age, the prevalence being estimated at approximately 10%. Due to the varied clinical symptoms marked by chronic pelvic pain, dysmenorrhea, infertility, dyspareunia, dysuria, endometriosis requires a complex treatment. Endometriosis is a major health problem with socioeconomic impact, which is why many gynecological societies have published different guidelines to assist clinicians in the diagnosis and treatment of endometriosis. The variety of available treatments combined with the complexity of this disease leads to significant …

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 …

Advance Care Planning: An Evidence-Based Practice Project, Gabrielle Alanna Harvey

Evidence-Based Practice Project Reports

Advance care planning (ACP) is a topic that can be difficult for patients and providers to discuss due to lack of time, knowledge, communication skills, and discomfort surrounding the subject (Barkley et al., 2019; Hafid et al., 2021; Halpert et al., 2022; Marin, 2022). Delayed or absent ACP discussions may lead to nonbeneficial care, increased healthcare costs, end of life suffering and increased post-death family distress (Halpert et al., 2022; O’Hanlon et al., 2018). The purpose of this evidence-based practice (EBP) project was to increase the discussions and documentation regarding ACP in a family practice setting. The PICOT question guiding …

Increasing Colorectal Cancer Screening Uptake Among Hispanic/Latino Patients: A Quality Improvement Initiative, Erick Hernandez Campos, Elizabeth Morse, David Phillippi

DNP Projects

Background: In 2021, cancer (CRC) screening rates for Latino men (42%) and women (47.5%) remain well below the Health People 2020 target (70.5%). Extensive documentation of barriers for screening include language, insurance status, and other sociocultural barriers which contribute to delays in diagnosis and/or diagnosis at advanced stages of the disease, and worse health outcomes. Latinos need culturally and linguistically appropriate health promotion interventions aimed to increase CRC screening rates with any modality (FIT, Cologuard, or Colonoscopy).

Methods: The Donabedian Structure-Process-Outcome (S-P-O) Model for quality improvement was used to develop and target a provider-driven, language-concordant communication interventions for …

Antibiotic Over Prescription For Upper Respiratory Tract Infections, Amina Boudaia

Evidence-Based Practice Project Reports

Antibiotic overuse is a major contributor to antibiotic resistance that is estimated to be responsible for 23,000 deaths annually in the United States (Durante et al., 2017; Garcia et al., 2016). Upper respiratory tract infections (URTIs) are speculated to be a leading contributor to the overprescribing of antibiotics (Aplin-Snider et al., 2020). The purpose of this project was to address the PICOT question: Does the implementation of patient education posters and protocol plus online training modules for providers (I) over an 8-week period or 30 patient charts (T) help to decrease antibiotic overprescription (O) in upper respiratory tract infections (P) …

“Healing Can Be A Very Jagged Line”: Reflections On Life As A Covid-19 Long Hauler, Leah M. Hecht, Rhonda Adams, Danielle Dutkiewicz, Debbie Radloff, Mallory N. Wales, Jeffory Whitmer, Dana Murphy, Sara Santarossa

Journal of Patient-Centered Research and Reviews

“Long COVID” — a term referring to COVID-19-associated symptoms and conditions (ie, sequelae) that remain or emerge after resolution of a SARS-CoV-2 infection — is a multifaceted condition about which little is known. As part of formalized patient-engaged research at a large Midwestern health system, patient stakeholders with long COVID (N = 5) wrote stories based on their lived experience, as this was their preferred format for detailing their experience with the condition. These patient stakeholders reviewed one another’s stories, identified relevant quotes, and provided opportunities for elaboration. Independently, a trained researcher extracted quotes from the stories, identified themes, and …

Staff And Provider Education On Diabetic Foot Exams And Foot Care Using The Ophelia Process, Shasta Pickens

Doctoral Projects

Diabetes mellitus continues to grow in global prevalence and consumes an increasing amount of healthcare resources. Persons that live in disadvantaged groups have a higher prevalence due to a lack of understanding and access to care. Diabetes is one of the leading causes of chronic disease and limb loss worldwide. Diabetes foot care is essential, as diabetes can be dangerous to patients’ feet.

The purpose of this doctoral project was to increase diabetic foot care education and foot exams for staff and providers in a federally qualified health center (FQHC). Many people in this rural community do not understand the …

Examining The Feasibility Of Telehealth Trauma-Focused Cognitive Behavioural Therapy (Tf-Cbt) With Young People In Foster Care, Jill Mcleigh, Adrianna Martin, Laura Lamminen

Behavioral Health/Developmental Delay

Despite the high rate of trauma exposure among young people with child welfare involvement, various systematic and patient barriers exist that inhibit utilization of evidence-based trauma treatments. One strategy for alleviating barriers to such treatments is using telehealth. A few studies have found that the clinical outcomes of telehealth TF-CBT are comparable to those found from clinic-based, in-person treatment administration. Studies have yet to examine the feasibility of telehealth TF-CBT with young people in care. The current study sought to address this gap by examining outcomes for patients who received telehealth TF-CBT, along with factors that may have impacted successful …

Primary Care In Southern Illinois And Western Kentucky, Matthew J. Crabtree

Honors College Theses

There is a major physician shortage occurring across the United States as of 2023 and it is expected to get worse over the next five to ten years. A significant portion of the shortage is predicted to consist of primary care physicians in rural areas. Data on factors that affect primary care visits like rurality, household income, health insurance coverage, non-communicable disease, and primary care physician prevalence were analyzed from the regions of Southern Illinois and Western Kentucky. Health coverage was found to be average to above average in the two regions. However, almost all counties included in the study …

Diet, Physical Activity, And Stress Among Wheelchair Users With Multiple Sclerosis: Examining Individual And Co-Occurring Behavioral Risk Factors, Stephanie L Silveira, Brenda Jeng, Gary Cutter, Robert W Motl

Faculty, Staff and Student Publications

OBJECTIVE: This study examined individual and co-occurring behavioral risk factors (diet, exercise, and stress) in wheelchair users with multiple sclerosis (MS) and potential association with MS symptoms (ie, fatigue, depression, anxiety, pain, sleep, and health-related quality of life [HRQOL]).

DESIGN: Survey.

SETTING: General Community.

PARTICIPANTS: One hundred twenty-three wheelchair users with MS completed this study (N=123).

INTERVENTIONS: Not applicable.

MAIN OUTCOME MEASURES: Participants were mailed instructions for accessing online questionnaires (demographic and clinical characteristics, Godin Leisure-Time Exercise Questionnaire, Perceived Stress Scale, Automated Self-Administered 24-Hour Dietary Assessment Tool, and MS symptoms).

RESULTS: Standard cut-points were used to categorize behavioral risk factors …

What Makes A Family: How An Empowerment-Based Health Care Delivery Model Employs Family Planning To Positively Impact Families In Rural Maharashtra: A Study In Jamkhed, Ahmadneger, Sezin Sakmar

Independent Study Project (ISP) Collection

The paper examines how an empowerment-based health care delivery model employs family planning services to positively impact families in rural Maharashtra. Family planning services provide those with the ability to become pregnant the option to control their own reproductive lives, whether they choose in favor of or against having children. Contraceptive use advances people’s human rights to choose whether they want to bear children and how many children they want, and people should have the choice of their preferred contraceptive method. The paper examines this issue within the framework of the Comprehensive Rural Health Project’s Jamkhed Model. Through the Jamkhed …

Well-Being Content Inclusion In Pharmacy Education Across The United States And Canada, Elizabeth Buckley, Simi Gunaseelan, Benjamin D Aronson, Heidi N Anksorus, Victoria Belousova, Tram B Cat, Kristine M Cline, Stacey D Curtis, Christina E Deremer, David Fuentes, Mckenzie S Grinalds, Seena L Haines, Hannah E Johnson, Karen Kopacek, Jessica M Louie, Nkem P Nonyel, Natasha Petry, Shawn Riser Taylor, Suzanne C Harris, Cheryl A Sadowski, Anandi V Law

Faculty, Staff and Student Publications

Objective. To describe the landscape of well-being content inclusion across schools and colleges of pharmacy in the United States and Canada through identification of content implementation, incorporation, and assessment.

Methods. A cross-sectional survey was distributed to all accredited schools and colleges of pharmacy in the United States (n=143) and Canada (n=10). Survey questions included curricular and cocurricular timing, frequency, assessment strategies, and support for well-being initiatives, using a framework of eight dimensions (pillars) of wellness to categorize content.

Results. Descriptive data analyses were applied to 99 completed surveys (65%), 89 (62%) in the United States and 10 (100%) in Canada. …

Recruitment And Retention Of Primary Care Practices In The Southeastern Collaboration To Improve Blood Pressure Control, James M Shikany, Monika M Safford, Andrea L Cherrington, Jacqueline R Halladay, Muna Anabtawi, Erica L Richman, Alyssa D Adams, Charlotte Holt, Suzanne Oparil, Orysya Soroka, Doyle M Cummings

Faculty, Staff and Student Publications

BACKGROUND: Racial disparities related to hypertension prevalence and control persist, with Black persons continuing to have both high prevalence and suboptimal control. The Black Belt region of the US Southeast is characterized by multiple critical priority populations: rural, low-income, and minority (Black).

METHODS: In a cluster-randomized, controlled, pragmatic implementation trial, the Southeastern Collaboration to Improve Blood Pressure Control evaluated two multi-component, multi-level functional interventions - peer coaching (PC) and practice facilitation (PF) (separately and combined) - as adjuncts to usual care to improve blood pressure control in the Black Belt. The overall goal was to randomize 80 primary care practices …

Up-02 Pharmacological And Non-Pharmacological Interventions For The Treatment Of Neonatal Abstinence Syndrome, Taylor Meetze, Reagan Bradley, Peyton Smith, Emily Sisk, Ryan Crawford

SC Upstate Research Symposium

Background: Newborns diagnosed with Neonatal Abstinence Syndrome (NAS) often experience extreme symptoms as their body’s withdrawals from substances. Pharmacological and non-pharmacological interventions are provided that aim to treat NAS. However, nurses should be aware of what treatment leads to better outcomes and shorter hospitalization.

Aim: The aim of the project was to compare the length of hospitalization of pharmacological and non-pharmacological interventions for newborns with mild NAS.

Methods: The team of researchers devised a research question to guide a search in the Cumulative Index of Nursing and Allied Health Literature (CINAHL) to identify relevant literature focused on pharmacological …

Physician Workforce In The Mountain West, Hira Ahmed, Caitlin J. Saladino, William E. Brown Jr.

Health

Using data from the Association of American Medical College’s State Physician Workforce Data Report, this fact sheet synthesizes Mountain West data on the numbers of active physicians and active physician demographics in Arizona, Colorado, Nevada, New Mexico, and Utah. This fact sheet focuses on active physicians in the Mountain West region by gender, race and ethnicity, as well as the number of students pursuing medical and premedical education.

Screening For Social Determinants Of Health In The Primary Care Setting: A Quality Improvement Project, Winifred Ann Shouse

Graduate Theses, Dissertations, and Capstones

Social determinants of health are the conditions in which individuals are born, age, work, and live that affect health status and outcomes (Rivich et al., 2019). These social and environmental factors can create barriers to patients being able to access and adhere to recommendations for chronic disease management (Gold, et al., 2019). Communication gaps between patients and primary care providers make it challenging for healthcare providers to be completely aware of the financial burdens their patients encounter (Patel et al., 2016). Research supports that identifying and addressing the barriers related to social determinants of health can improve the management of …

Residential Racial Segregation And Neighborhood Adversity: Associations With Hemoglobin A1c In Adolescents With Type 1 Diabetes, Zechariah Jean, April Carcone, Deborah Ellis

Medical Student Research Symposium

Black adolescents with Type 1 Diabetes (T1D) are at increased risk for disparities in health outcomes. More research is necessary on the effects of neighborhood characteristics such as residential racial segregation (RRS) and neighborhood adversity on health.

149 Black youth with T1D were recruited from seven pediatric diabetes clinics in Detroit and Chicago to participate in a clinical trial to improve diabetes management. RRS was calculated at the census block group level based on US census data using Location Quotients. LQs represented the ratio of patients to total population in the block group compared to the same ratio in the …

Pediatric Adhd And Screening For Comorbidities, Colleen Kelly

SIU Journal of Medical Science Scholarly Works

Psychiatric disorders are very common in the general pediatric population. Attention Deficit Hyperactivity Disorder (ADHD) is a common psychiatric diagnosis in childhood but can mimic and be found comorbidity with other psychiatric disorders. It is necessary for primary care providers to perform a thorough initial workup for ADHD and possible comorbidity psychiatric disorders to ensure proper diagnosis and treatment of pediatric patients.

Electronic Health Records' Support For Primary Care Physicians' Situation Awareness: A Metanarrative Review, April Savoy, Himalaya Patel, Daniel R Murphy, Ashley N D Meyer, Jennifer Herout, Hardeep Singh

Faculty, Staff and Students Publications

OBJECTIVE: Situation awareness (SA) refers to people's perception and understanding of their dynamic environment. In primary care, reduced SA among physicians increases errors in clinical decision-making and, correspondingly, patients' risk of experiencing adverse outcomes. Our objective was to understand the extent to which electronic health records (EHRs) support primary care physicians (PCPs)' SA during clinical decision-making.

METHOD: We conducted a metanarrative review of papers in selected academic databases, including CINAHL and MEDLINE. Eligible studies included original peer-reviewed research published between January 2012 and August 2020 on PCP-EHR interactions. We iteratively queried, screened, and summarized literature focused on EHRs supporting PCPs' …