J Am Board Fam Med
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Social determinants of health (SDOH) influence health outcomes. Food insecurity (FI) is the most common need related to SDOH. Many primary care practices and health systems have begun to screen for FI and refer patients to resources. How this process is viewed by multiple stakeholders, including patients, health care workers, and staff at food assistance organizations (FAOs), will influence its impact. ⋯ Successfully designing systems to address FI through referral to FAOs requires input of multiple stakeholders because perspectives on the value and work required for this process vary.
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Despite the Affordable Care Act's insurance expansion, low-income Latinos are less likely to have a primary care provider compared with other racial/ethnic and income groups. We examined if community-based health care navigation could improve access to primary care in this population. ⋯ Community-based navigation has the potential to reduce barriers and improve access to primary care for low-income Latinos. In addition to expanding insurance coverage, policymakers should invest in health care navigation to reduce disparities in primary care.
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Breast cancer is one of the leading causes of death among women residing in the United States. Early detection through mammogram screening can decrease the morbidity and mortality associated with the disease. For women with diabetes, however, incidence and mortality rates of breast cancer are increased. ⋯ Patients with diabetes were significantly less likely to complete mammogram screenings (51.6%) compared with patients without diabetes (55.3%), despite there being an increased incidence of breast cancer among patients with diabetes. Factors such as the lack of access to treatment centers, affordability, patient education, among others may have contributed to low completion rates.
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Practice-based research networks (PBRNs) have long sought to engage with communities and address questions relevant to multiple stakeholders and real-world primary care practice. Topic-generating processes that involve these stakeholders are crucial for identifying these questions. PBRNs often focus on certain populations or geographic areas. We are forming a new PBRN to address the health concerns and research interests of people in communities in Western Colorado. ⋯ Using participatory methods increased our stakeholder engagement and helped build strong community-academic partnerships for our PBRN-related research. Use of Photovoice allowed all participants to express their thoughts and ideas and led to a clear path forward for this new research network.
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Primary care is well-poised to address unmet social needs that affect health. Integrated primary care is increasingly common and can be leveraged to facilitate identification of practice and clinician-level modifiable characteristics and assist practices to address unmet social needs for patients and families. ⋯ This article outlines how integrated primary care characteristics, such as routine screening, functional workflows, interprofessional team communication, and patient-centered practices, exemplify the NASEM report's activities and offer robust biopsychosocial tools for addressing social needs. We provide a case to illustrate how these strategies might be used in practice.