Journal of general internal medicine
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Multicenter Study
Validation of screening questions for limited health literacy in a large VA outpatient population.
Previous studies have shown that a single question may identify individuals with inadequate health literacy. We evaluated and compared the performance of 3 health literacy screening questions for detecting patients with inadequate or marginal health literacy in a large VA population. ⋯ A single question may be useful for detecting patients with inadequate health literacy in a VA population.
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The objective of the study was to identify potential explanatory factors for racial differences in blood pressure (BP) control. ⋯ In this sample of hypertensive patients, there were a number of factors associated with poor BP control that partially explained the observed racial disparity in hypertension control including age, medication nonadherence, and worry about BP. Medication nonadherence is of particular interest because it is a potentially modifiable factor that might be used to reduce the racial disparity in BP control.
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To better understand the causes of racial disparities in health care, we reviewed and synthesized existing evidence related to disparities in the "equal access" Veterans Affairs (VA) health care system. ⋯ Existing evidence from the VA indicates several promising targets for interventions to reduce racial disparities in the quality of health care.
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Multicenter Study Comparative Study Clinical Trial
Primary versus specialty care outcomes for depressed outpatients managed with measurement-based care: results from STAR*D.
Whether the acute outcomes of major depressive disorder (MDD) treated in primary (PC) or specialty care (SC) settings are different is unknown. ⋯ Identical remission and response rates can be achieved in primary and specialty settings when identical care is provided.
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Randomized Controlled Trial
Caring and dominance affect participants' perceptions and behaviors during a virtual medical visit.
Physician communication style affects patients' perceptions and behaviors. Two aspects of physician communication style, caring and dominance, are often related in that a high caring physician is usually not dominant and vice versa. ⋯ Dominant and caring physicians elicit different emotional and behavioral responses from APs. Physician dominance reduces patient engagement in the medical dialog and produces submissiveness, whereas physician caring increases patient emotionality.