Family medicine
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Since obesity is a risk factor for hypertension, diabetes, and hypercholesterolemia, health care providers should screen obese individuals for these common diseases. It is possible that obese adults are not receiving appropriate screening for these diseases. This study's objective was to describe the prevalence of undiagnosed obesity, diabetes, hypertension, and hypercholesterolemia, in a nationally representative sample of obese US adults, by patients' recollection of whether they had received such a diagnosis. ⋯ Health care providers are missing valuable opportunities to address obesity and diagnose diabetes, hypercholesterolemia, and hypertension in obese adults. An emphasis on screening obese individuals for these diseases is needed to improve health promotion.
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Comparative Study
Assessing health literacy in African American and Caucasian adults: disparities in rapid estimate of adult literacy in medicine (REALM) scores.
The influence of literacy on health and health care is an important area of investigation. Studies with a literacy focus are most valuable when literacy is assessed with psychometrically sound instruments. ⋯ The REALM is a robust assessment of health literacy. However, the discordance in scores between African Americans and Caucasians with similar educational attainment needs to be further addressed. A much shorter instrument would still have internally consistent scores and potentially be more useful in clinical settings.
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Pediatric literacy promotion programs carried out in the primary care setting, such as Reach Out and Read (ROR), have been associated with improved language skills for preschool children. Primary care physicians have frequent contact with young families and may be well situated for a literacy promotion program for both children and adults. We examined whether introducing ROR and an adult literacy intervention improves family medicine residents' literacy knowledge, attitudes, and practices. ⋯ A family literacy promotion program improved family medicine residents' self-reported literacy knowledge, attitudes, and practices. Such interventions can be incorporated into the education of family medicine residents with meaningful results.
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Prescribing medications for chronic nonmalignant pain (CNMP) can be challenging for physicians for many reasons. In 1999, the state of Oregon implemented new guidelines governing the prescription of medications for CNMP. This study assessed the quality of care provided to CNMP patients, including the extent of compliance with the new state requirements 2 years after they were implemented. ⋯ Review of medical records in our clinic documented less-than-optimal compliance with state laws regulating prescribing for CNMP and the need for improvement in assessment and care of these patients.