Annals of family medicine
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Annals of family medicine · Jan 2023
Community Based Participatory Research (CBPR) to develop a Deprescribing Intervention.
Context: Older adults are at high risk for medication harm from polypharmacy and potentially inappropriate medications. Patient-driven deprescribing is an emerging approach aimed at increasing patient knowledge and strengthening self-advocacy skills. We used Community Based Participatory Research (CBPR) to engage stakeholders in developing an educational intervention on patient-driven deprescribing. ⋯ The study contributes to deprescribing research as an example of how CBPR may be used to engage older adults in developing a deprescribing study. Including stakeholders in the research design provides an equitable voice to those impacted by the intervention. Further, it provides insight to the research team on how to better equip patients with the correct knowledge and tools to become empowered participants in their healthcare decisions.
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Annals of family medicine · Jan 2023
A Survey Snapshot Measuring Insulin Underuse in a Primary Care Clinic.
The rising cost of insulin has created problems for physicians in the management of diabetes. The objective of our study was to determine the prevalence of cost-related insulin underuse in a primary care environment. ⋯ Ninety respondents completed the survey with results indicating 44% experienced cost-related suboptimal therapy. Prevalence of insulin underuse remains high in primary care and prescribers should regularly assess medication cost barriers with all patients.
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On October 31, 2021, I learned the electronic health record in my independent, solo practice had been attacked by a Russian syndicate who was holding our data and our practice management system for "ransom." An encryption key could be given to our cloud provider once $5,100,000 was delivered in bitcoin to the hacking entity. After 3 long months of negotiations, with us going back to a completely paper-based system in the interim, our cloud provider paid the Russian syndicate and access was restored. There were many lessons to be learned from our experience. We were fortunate, and through the help of many of our business associates we were able to survive and live to see another day.
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Annals of family medicine · Jan 2023
Understanding Indigenous Health Literacy Through Community-Led Engagement.
Context: This is the last in a four-part series that describes the outcome of a mixed-methods participatory social justice (MMPSJ) research project. A community engagement model was designed by participants as a synthesis of working with urban Indigenous peoples living on Treaty Six Territory and traditional homeland of the Metis in Saskatchewan, Canada. It responds to the Truth and Reconciliation Commissions calls to Action 10, 18-20. ⋯ Participants: Twelve Indigenous people representing four intergenerational families were invited to two Talking Circles to respond to questions derived from the Aboriginal Regional Health Surveys; as well as answer the following questions: What are the current connections between literacy and health within urban Indigenous families? What literacy issues continue to marginalize the community? How would you like this knowledge disseminated? This research was reviewed and approved by the University of Saskatchewan's Behavioural REB. Results/Findings: Knowledge of Treaty Six teachings was increased; participants described the social justice/transformative nature of this work an opportunity to be seen well and whole; and the Community Engagement Model evolved within the MMPSJ design. Conclusions: Community-based research can be transformed to being community-led through careful consideration of power and authentically engaging with the community at each step in the process.
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Annals of family medicine · Jan 2023
Community Engaged Translation of Adverse Childhood Experiences Information Into Locally Relevant Public Health Messaging.
Objective: Conduct Boot Camp Translation to develop locally relevant messages about Adverse Childhood Experiences. Setting: The Oxford Hills region of Maine is home to Stephen's Memorial Hospital, which funds Healthy Oxford Hills, a coalition dedicated to promoting a caring, self-reliant, and healthy community. Residents of Oxford Hills bare a disproportionate burden of poverty, low income, chronic disease and ACEs as compared to other counties in Maine. ⋯ Data collection included observations using the Pyramid of Engagement Rubric, participant surveys and interviews. Additional descriptive measures included number of materials created, distribution locations and the use of QR codes mapped to a partner website and social media hashtags to assess engagement. Results: 100% of respondents found the BCT process valuable and thought the right mix of people were involved. 44% of participants were not able to participate at much as they would have liked due to issues with technology and scheduling. 75% of initial participants completed the project.