Journal of general internal medicine
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Randomized Controlled Trial
A randomized trial of peer coach and office staff support to reduce coronary heart disease risk in African-Americans with uncontrolled hypertension.
Adopting features of the Chronic Care Model may reduce coronary heart disease risk and blood pressure in vulnerable populations. We evaluated a peer and practice team intervention on reduction in 4-year coronary heart disease risk and systolic blood pressure. ⋯ Peer patient and office-based behavioral support for African-American patients with uncontrolled hypertension did not result in a significantly greater reduction in coronary heart disease risk but did significantly reduce systolic blood pressure.
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Interventions to address obesity and weight loss maintenance among African Americans have yielded modest results. There is limited data on African Americans who have achieved successful long-term weight loss maintenance. ⋯ Influences and practices differ among educated African American women who maintain weight loss compared to those who regain it.
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Systemic lupus erythematosus (SLE) affects 1 in 2500 Americans and is associated with significant morbidity and mortality. The recent development of SLE quality measures provides an opportunity to understand gaps in clinical care and to identify modifiable factors associated with variations in quality. ⋯ We identified a number of gaps in clinical care for SLE. Factors associated with the health care system, including presence and type of health insurance, were the primary determinants of performance on quality measures in SLE.
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Multicenter Study
Professional language interpretation and inpatient length of stay and readmission rates.
The population of persons seeking medical care is linguistically diverse in the United States. Language barriers can adversely affect a patient's ability to explain their symptoms. Among hospitalized patients, these barriers may lead to higher readmission rates and longer hospitalizations. Trained interpreters help overcome communication barriers; however, interpreter usage among patients is suboptimal. ⋯ The length of a hospital stay for LEP patients was significantly longer when professional interpreters were not used at admission or both admission/discharge.