Annals of family medicine
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Annals of family medicine · Apr 2022
Community voices for health: developing methods of engagement in Somali immigrant communities in the era of COVID-19.
Context: The Somali community in Minnesota has suffered a disproportionate impact of COVID-19. Engaging community members in COVID-19 patient centered outcome related research will be needed to find effective ways to address these disparities. However, COVID-19 disrupted usual methods of community engagement and research is needed to identify how to continue effective engagement. ⋯ Survey participants were provided with a list of 14 different topics relating to COVID-19, which were identified in collaboration with a Community Advisory Group. The top three topics considered a priority for future research in relation to COVID-19 were the care provided to Somali patients with COVID-19, ways to encourage prevention of COVID-19 and experiences of racism in the health system in seeking help for COVID-19 Conclusions: The Somali community in Minnesota is very engaged and keen to participate in community engagement when it is presented in a culturally relevant, trusted way. The survey was able to use methods that supported a reach across the state of Minnesota and is one of the most comprehensive engagement efforts conducted with the Somali community in Minnesota on any topic.
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Annals of family medicine · Apr 2022
Comparing race and ethnicity across safety-net and non-safety net practices pre- and post-an HIV screening alert.
Evaluate HIV screening demographics by safety-net and non-safety net practices. STUDY DESIGN and ANALYSIS: Pre-post analysis. SETTING: Atrium Health is a non-profit, vertically integrated healthcare system with approximately 16 million patient encounters per year across the Southeast US. POPULATION STUDIED: Twelve primary care practices, including four safety-net practices serving predominantly Medicaid and uninsured patients, with over 115,00 patients between the ages of 18 and 64 were selected for the educational intervention. INTERVENTION/INSTRUMENT: A system-wide electronic medical record alert prompting HIV screening was implemented in October 2017 targeting adults between 18-64 years old. In addition to the system alert, a provider peer-to-peer educational program detailing HIV disease epidemiology, screening recommendations, and algorithms to guide screening efforts was developed. OUTCOME MEASURES: HIV screenings. ⋯ While race and practice characteristics influence the likelihood of HIV screening, EMR modifications and provider education can significantly enhance screening and care for patients with HIV regardless of race and practice type.
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Annals of family medicine · Apr 2022
A qualitative study of adolescent perspectives on COVID-19 pandemic: considerations in the provision of primary virtual care.
Context: Amidst school shutdowns, sheltering in place, and social distancing, the COVID-19 pandemic uniquely affected adolescents. Understanding the experiences of adolescents with respect to social distancing, health changes, information sources and virtual care can inform effective health care for adolescents both during and after the pandemic. Objective: An exploration into their health care experiences during the beginning stage of the pandemic was undertaken to increase knowledge among family physicians to enable adjustments to the provision of care, primarily done virtually. ⋯ Parents were described as the most trusted source of information about the pandemic. Conclusions: Adolescents primarily look to parents for guidance and the increased family time promoted well-being. Physicians that are able to help adolescents negotiate privacy and mitigate communication challenges are able to provide effective virtual care.
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Annals of family medicine · Apr 2022
Association of psychiatric consultant characteristics with clinical outcomes of collaborative care for depression.
Context: Adult depression treatment in primary care is improved by integrated behavioral health such as the Collaborative Care Model (CoCM) but outcomes vary across health centers. Objective: Identify CoCM team factors associated with variation in clinical outcomes. Study Design: Correlative study of survey with linked clinical data from routine care. ⋯ Perceived characteristics of psychiatric consultants was associated with likelihood of depression remission. Characteristics included interest in teaching, commitment to the site, making efforts to have weekly meetings, and willingness to assist care managers on adjustment of treatment strategies. This study is the first to quantify variation in CoCM team functioning with patient outcomes and can be used to inform training and the use of the CoCM.
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Annals of family medicine · Apr 2022
Achievement of glycemic control and antidepressant medication use in comorbid depression and type II diabetes.
Limited previous work has suggested that treatment of co-morbid patients with anti-depressant medication (ADM) is associated with improved glycemic control. ⋯ Receipt of adequate ADM therapy is associated with achieving glycemic control in the first 3 years after a T2DM diagnoses with uncontrolled A1c.