J Am Board Fam Med
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Randomized Controlled Trial Pragmatic Clinical Trial
Patient and Clinician Perspectives on Two Telemedicine Approaches for Treating Patients with Mental Health Disorders in Underserved Areas.
Primary care practices in underserved and/or rural areas have limited access to mental health specialty resources for their patients. Telemedicine can help address this issue, but little is known about how patients and clinicians experience telemental health care. ⋯ Both approaches addressed patient needs and provided access to specialty mental health care. Each approach better aligned with different patients' needs, suggesting that having both approaches available to practices is optimal for supporting patient-centered care.
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The objective of this study was to adapt the National Diabetes Prevention Program (N-DPP) into a pragmatic tool for primary care settings by using daily text messaging to deliver all N-DPP content, supplemented by Fitbit technology to provide behavioral strategies typically delivered by personnel in traditional programs. Test the mobile health (mHealth), technology-based N-DPP adaptation (DPPFit) in primary care patients with prediabetes using a remote intervention based on the traditional 16 core sessions of the DPP. ⋯ The remote DPPFit intervention demonstrates a promising and practical approach to the management of prediabetes in a primary care setting. The results support the use of the DPPFit program and application to achieve meaningful outcomes in a population with prediabetes. A randomized controlled trial with a larger sample is warranted.
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Disparities in access to video-visit services have been described during the COVID-19 pandemic. Thus, we aimed to examine factors associated with not having a video-visit among a medically high-risk ambulatory population. ⋯ Our findings suggest that additional efforts are needed to eliminate disparate video-visit use.
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The use of telemedicine increased during the global Coronavirus disease 2019 (COVID-19) pandemic. Rural populations often struggle with adequate access to care while simultaneously experiencing multiple health disparities. Yet, telemedicine use during the COVID-19 pandemic has been understudied on its effect on visit completion in rural populations. The primary purpose of this study is to understand how telemedicine delivery of family medicine care affects patient access and visit completion rates in a rural primary care setting. ⋯ Telemedicine can be a tool to improve patient access to primary care in rural populations. Our findings suggest that telemedicine may facilitate access to care for difficult-to-reach patients, such as those in rural areas, as well as those who have rigid work schedules, live longer distances from the clinic, have complex health problems, and are from areas of higher poverty and/or lower education.
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Family physicians who self-identify as Black, Hispanic, and American Indian/Alaska Native (AIAN) are more likely to provide care to historically marginalized patients and provide care in disadvantaged areas compared with their White counterparts. However, these physicians also tend to have a narrower scope of practice. ⋯ Therefore, historically marginalized patients and those in disadvantaged areas would greatly benefit from a physician workforce with a broad scope of practice to help combat long standing and pervasive health inequities. This commentary will visit the context of this issue and provide suggestions to equip and support a diverse physician workforce to deliver trusted and comprehensive health care.