Family practice
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To understand the implementation of the family doctor contract service system in China from the perspective of resident demand. ⋯ The current state of implementation of China's family doctor contract service system is far from the goals set out in the "Guidance on Promoting High-Quality Development of Family Doctor Contract Services". Inadequate promotion of the system and subpar service quality post-contract have led to low public trust and satisfaction. The construction of family doctor teams and the contract service guarantee mechanism remain underdeveloped.
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Randomized Controlled Trial
Case control study of access to medications during COVID-19 and longitudinal impact on health outcomes for primary care patients managing multiple chronic conditions.
During coronavirus disease 2019 (COVID-19), people managing multiple chronic conditions (MCCs) experienced barriers to obtaining needed medications. The purposes of this paper are to (i) determine risk factors for difficulty obtaining medications during COVID-19, (ii) document reasons for the difficulty, and (iii) evaluate the impact on later physical and mental health outcomes. ⋯ People with socioeconomic disadvantages experienced a disproportionate impact of difficulty obtaining medications and poorer health outcomes due to COVID-19. They may be at greater risk in the event of future pandemics and other societal disruptions.
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One role of primary care is to support people living with and beyond cancer, the number of whom is increasing worldwide. This study aimed to identify factors affecting cancer care provision within English primary care after the start of the coronavirus pandemic, during high healthcare service demand, and a depleted workforce. ⋯ The ability of primary care to deliver cancer care is affected by multiple factors at various levels. Future studies should identify the implementation strategies of local and national policies to better understand how to improve cancer care education, practice-level infrastructure, evidence-based workforce planning, and healthcare resourcing.
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Randomized Controlled Trial
Using an SMS to improve bowel cancer screening: the acceptability and feasibility of a multifaceted intervention.
The Australian National Bowel Cancer Screening Program sends an immunochemical faecal occult blood test to Australians aged 50-74 years to screen for bowel cancer, but uptake is low (40.9%). The SMARTscreen trial demonstrated that sending a short messaging services (SMS) prompt from the participant's general practitioner (GP) increased the proportion of kit returns by 16.5%. This research aimed to determine the acceptability and feasibility of implementing SMARTscreen. ⋯ The SMS-based intervention was widely accepted by GP staff and participants. Future research should test the SMS with and without the weblink, and send the SMS at a more convenient time of the day/week.
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Observational Study
Recent life events and adverse childhood experiences in predicting antenatal depression and anxiety: cross-sectional study.
Antenatal depression and anxiety are associated with preterm labour, low birth weight, and postpartum depression, and can impact the emotional and mental development of the child. Both adverse childhood experiences and recent stressful events are linked to negative health outcomes. However, certain events may be more impactful than others. ⋯ Recent stressful life events have a stronger association with postnatal mental health than adverse childhood events, implying that it might be useful for clinicians providing routine antenatal care to gather information on recent stressors.