American journal of preventive medicine
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Children from low-income and racial or ethnic minority populations in the U.S. are less likely to have a conventional source of medical care and more likely to develop chronic health problems than are more-affluent and non-Hispanic white children. They are more often chronically stressed, tired, and hungry, and more likely to have impaired vision and hearing-obstacles to lifetime educational achievement and predictors of adult morbidity and premature mortality. If school-based health centers (SBHCs) can overcome educational obstacles and increase receipt of needed medical services in disadvantaged populations, they can advance health equity. ⋯ Because SBHCs improve educational and health-related outcomes in disadvantaged students, they can be effective in advancing health equity.
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A recent Community Guide systematic review of effectiveness of school-based health centers (SBHCs) showed that SBHCs improved educational and health outcomes. This review evaluates the economic cost and benefit of SBHCs. ⋯ The economic benefit of SBHCs exceeds the intervention operating cost. Further, SBHCs result in net savings to Medicaid.
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Review
A Systematic, Multi-domain Review of Mobile Smartphone Apps for Evidence-Based Stress Management.
Chronic stress presents a growing, pervasive burden in healthcare, and mobile smartphone applications (apps) have the potential to deliver evidence-based stress management strategies. This review identified and evaluated stress management apps across domains of (1) evidence-based content; (2) transparency in app development; and (3) functionality of the app interface. ⋯ This review evaluated 60 iOS apps for stress management across domains of evidence-based content, transparency, and functionality; these apps have the potential to effectively supplement medical care. Findings further indicate that a comprehensive, multi-domain approach can distinguish apps that use evidence-based strategies from those that do not.
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Community health workers are increasingly recognized as useful for improving health care and health outcomes for a variety of chronic conditions. Community health workers can provide social support, navigation of health systems and resources, and lay counseling. Social and cultural alignment of community health workers with the population they serve is an important aspect of community health worker intervention. ⋯ The authors propose that care and care outcomes for people with sickle cell disease could be improved through community health worker case management, social support, and health system navigation. This paper outlines implementation strategies in current use to test community health workers for sickle cell disease management in a variety of settings. National medical and advocacy efforts to develop the community health workforce for sickle cell disease management may enhance the progress and development of "best practices" for this area of community-based care.
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Controlled Clinical Trial
Cost-Effectiveness Evaluation of Collaborative Care for Diabetes and Depression in Primary Care.
Information is limited on the cost effectiveness of strategies to improve depressive symptoms in patients with Type 2 diabetes in primary care outside of the U.S. ⋯ In primary care patients with Type 2 diabetes who screened positive for depression, physician notification and follow-up was a clinically effective strategy compared with usual care, but investing more resources in collaborative care yielded the most cost-effective strategy.