J Am Board Fam Med
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The majority of climate change research and policy centers around the physical health effects of planetary degradation. The mental health impacts of climate change are just now starting to be elucidated and discussed more commonly among mental health providers and policymakers. There is a huge area of opportunity in primary care to discuss and address climate anxiety in patients, many of whom may not be forthcoming in discussing how climate anxiety is contributing to their mental health.
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Randomized Controlled Trial
Smoking Cessation Support in the Context of Other Social and Behavioral Needs in Community Health Centers.
Cigarette smoking rates remain disproportionately high among low income populations with unmet social and behavioral health needs. To address this problem, we sought to develop and evaluate the feasibility, acceptability, and preliminary effectiveness of a novel smoking cessation program for community health centers that serve these populations. ⋯ Lessons learned from this pilot study may inform the development of effective smoking cessation programs for CHCs that combine elements of both interventions.
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Many adolescents do not receive basic preventive care such as influenza vaccinations. The Affordable Care Act (ACA) temporarily increased Medicaid reimbursements for primary care services, including vaccine administration, in 2013 to 2014. The objective of this study is to assess the impact of reimbursement increases on influenza vaccination rates among adolescents with Medicaid. ⋯ That reimbursement increases were not associated with higher vaccination rates suggests additional efforts are needed to improve influenza vaccination rates in this population.
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Understanding how physicians' practice patterns change over a career is important for workforce and medical education planning. This study examined trends in self-reported practice activity among early- and later-career stage family physicians (FPs). ⋯ Although early-career FPs more frequently reported providing both inpatient and outpatient care and serving as hospitalists compared with later-career FPs, both groups had a decline in frequency of providing mixed practice. This change after only 3 years in practice has significant implications for patient care and medical education.
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Screening for adverse childhood experiences (ACEs) in the clinical setting is set to become more commonplace with continued efforts to reimburse clinicians for screening. However, an examination of disparities in ACEs screening and related attitudes and beliefs is needed. ⋯ Efforts to expand ACEs screening should consider the disparities in screening that currently exist. Given the wide-ranging impacts that ACEs have on health, an equitable approach to screening is necessary.