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Re: Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Shermeeka Hogans-Mathews, Brett Thomas, Stacy A. Ogbeide
To the Editor: We were pleased to read the article entitled, “Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine” by Sanders et al, which focuses on the use of Diffusion of Innovation Theory to evaluate antiracism trainings in departments of
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Re: An Estimate of Severe Harms Due to Screening Colonoscopy: A Systematic Review J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Andrew W. Swartz, Kade Klippenstein, Drake Lavender
To the Editor: In the review of screening colonoscopy harms by Huffstetler et al.,[1][1] technical and methodological weaknesses undermine the study’s results. The authors dismiss meta-analysis in favor of reporting a “credible range” of harms, wherein they report the results of 2
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Response: Re: Integrating a Systematic, Comprehensive E-Cigarette and Vaping Assessment Tool into the Electronic Health Record J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Niharika Khanna, Michael Dark,, Elena Klyushnenkova
To the Editor: We thank the authors for their letter to the editor and appreciate their point of view. We agree that integrating vaping cessation and relapse prevention into the clinical duties of physicians is ideal, and we also agree that counseling for vaping should be part of the E-cigarette and
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Integrated Behavioral Health Implementation and Training in Primary Care: A Practice-Based Research Network Study J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Melissa K. Filippi, Jeanette A. Waxmonsky, Mark D. Williams, Elise Robertson, Chyke Doubeni, Christina M. Hester, Andrea Nederveld
Introduction: Integrating behavioral health services into primary care has a strong evidence base, but how primary care training programs incorporate integrated behavioral health (IBH) into care delivery and training has not been well described. The goal of this study was to evaluate factors related to successful IBH implementation in family medicine (FM) residency programs and assess perspectives
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Friendship as Medicine J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Hugh Silk
Social isolation is a risk factor for many diseases and overall increased mortality. Alternatively human connection has been noted to lead to healthier lives and longevity. Medical clinicians need to be more aware of this condition and consider how to prescribe friendship. This is not just an issue for the elderly; many Americans are being ravaged by being alone. There are many organizations that we
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Failure to Participate in Sports: An Evaluation of Preparticipation Physicals in a Local School District J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Namita Bhardwaj, Grant S. Pierre, Alexandra P. Halloran, Taylor C. Alexander, Stacy H. Leung, Yu Lu, Kendall M. Campbell
Purpose: To determine the incidence of the documentation of athlete failure of preparticipation sports physicals. Methods: This was a retrospective observational study that involved review of preparticipation examination physical form documentation from multiple clinicians for all student athletes who participated in athletics during the 2018 to 2019 academic year at Galveston Independent School District
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Pharmacy Benefit Managers in the Eye of the Storm: Growing Multipartite Scrutiny J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Eli Y. Adashi, Daniel P. O’Mahony, David S. Guzick
The high cost of prescription drugs in the U.S. remains an ongoing national challenge. A recurring focal point in discussions over this distressing steady state is the role(s) played by Pharmacy Benefit Managers (PBMs) who negotiate drug prices with pharmaceutical manufacturers, conduct drug utilization reviews, engage in disease management, and see to formulary creation. At their inception, the multiple
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Ensuring Community Is at the Table in Family and Community Medicine Research: Highlighting Dr. Kevin Grumbach’s Speech as Recipient of the 2022 NAPCRG Wood Award J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Danielle Hessler Jones, Megan Mahoney
“If you are not at the table, you are on the menu” is a caption of a cartoon examining health systems inequities. With his signature wit, Dr. Kevin Grumbach (hereafter, “Kevin”) delivered the punchline in his acceptance award at the 2022 NAPCRG conference to reflect on the state of Primary
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Response: Re: An Estimate of Severe Harms Due to Screening Colonoscopy: A Systematic Review J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Alison N. Huffstetler, Joseph Fraiman, Shannon Brownlee, Kenneth W. Lin
To the Editor: Swartz and his colleagues bring concerns regarding methods of our analysis and methodologies.[1][1] In our systematic review of the literature pertaining to the harms of screening colonoscopy, we judged that a meta-analysis was not statistically sound due to the very high
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Response: Re: Developing and Validating a Novel Tool to Enhance Functional Status Assessment: The Tennessee Functional Status Questionnaire (TFSQ) J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Stephanie G. Vanterpool, Robert E. Heidel, Julie W. Jeter
To the Editor: Thank you, Dr. Ogbeide, for your thoughtful inquiry regarding our article “Developing and Validating a Novel Tool to Enhance Functional Status Assessment: The Tennessee Functional Status Questionnaire (TFSQ).”[1][1],[2][2] We are pleased that you see value in our published tool
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Re: The FDA Initiative to Assure Racial and Ethnic Diversity in Clinical Trials J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Forrest Bohler, Nikhil D. Aggarwal, Garrett W. Peters
To the Editor: We greatly appreciate the work of Adashi and Cohen and strongly agree with the importance of increasing diversity and representation of all groups of Americans within biomedical research. As previously stated, inclusion of minority groups within clinical trials is likely to improve
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Re: Integrating a Systematic, Comprehensive E-Cigarette and Vaping Assessment Tool into the Electronic Health Record J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Alan Blum, Edward Anselm
To the Editor: Although the authors of the article “Integrating a Systematic, Comprehensive E-Cigarette and Vaping Assessment Tool into the Electronic Health Record”[1][1] should be commended for including questions about the use of e-cigarettes or vape pens in the electronic medical record at
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Lingering Impact of COVID-19, Preventive Care Considerations, and US Health System Challenges J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Marjorie A. Bowman, Dean A. Seehusen, Christy J. W. Ledford
This issue includes articles on the lingering impact of COVID-19, often negative but occasionally positive, on patients, treatment, practices, and health care personnel. Other articles inform on prevention, such as awareness of lung cancer screening among women undergoing screening mammography; failures on sports preparticipation physicals; advance care planning as prevention; and screening for social
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Health Care Costs Following COVID-19 Hospitalization Prior to Vaccine Availability J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Tamkeen Khan, Stavros Tsipas, Gregory D. Wozniak, Kate Kirley, Arch G. Mainous
Background: Postacute sequelae of coronavirus (PASC) disease of 2019 (COVID-19) include morbidity and mortality, but little is known of the impact on medical expenditures. This study measures patients’ health care costs after COVID hospitalization before vaccinations. Methods: The Merative MarketScan database is used to track trends in medical expenditures for commercially insured patients hospitalized
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Impact of COVID-19 on American Family Physicians’ Intent to Retreat from Clinical Care J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Chantal M. L. R. Brazeau, Ping-Hsin Chen, Christopher P. Morley, Kristine Olson
Purpose: This survey evaluated whether the COVID-19 pandemic was a traumatic stress event for family physicians associated with burnout, changes in life priorities, and intentions to retreat from clinical practice. Methods: We report on 683 clinically active family physicians surveyed through the Council of Academic Family Medicine’s Educational Research Alliance (CERA) in the fall of 2021. Results:
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COVID-19 mRNA Vaccination Trends Among Immunocompromised Patients J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Bojan Lazarevic, Allison R. Casola, Christopher V. Chambers
Introduction: Immunocompromised patients are at increased risk of contracting severe COVID-19 infection. The purpose of this study was to assess COVID-19 vaccination trends of immunocompromised patients at a large, urban primary care setting. Methods: A retrospective chart review of immunocompromised patients who had a visit between 1/1/2021 and 5/15/2022 at Thomas Jefferson University’s Department
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Effects of Academic Detailing, Panel Management and Mailed Multi-Target Stool-DNA Testing on Colorectal Cancer Screening J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Arturas Klugas, Sara Elsayed, Michael Rodriguez, Shourya Verma, Andre’ Bateman, Matthew Stack
Introduction: Academic detailing, patient-panel management, and mailed, stool-based testing have each been utilized to increase colorectal cancer (CRC) screening in rural clinics. The effectiveness of combining these interventions to increase CRC screening during COVID-19 restrictions was unclear. Methods: We explored the effects of a multi-component intervention including academic detailing, active
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Factors Influencing Patient Confidence in Screening Mammography J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Hannah Jarvis, Lanyu Mi, Bhavika Patel, Regino P. Cube, Sandhya Pruthi, Suneela Vegunta
Background: We aimed to assess factors associated with patients’ confidence in the ability of screening mammography to detect breast cancer. Methods: Data were analyzed from a cross-sectional, prospective survey conducted in 2017 of women without a breast cancer history who were undergoing screening mammography at our institution. Results: In total, 390 women completed the survey questions relevant
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Primary Care Providers Experiences Implementing Low-Dose Computed Tomography Recommendations for Lung Cancer Screening J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Sara E. Golden, Jessica J. Currier, NithyaPriya Ramalingam, Mary Patzel, Jackilen Shannon, Melinda M. Davis, Christopher G. Slatore
Purpose: Describe primary care providers’ (PCPs) barriers and facilitators to implementation of lung cancer screening programs in rural settings. Methods: We conducted qualitative interviews with PCPs practicing in rural Oregon from November 2019 to September 2020. The interview questions and analytic framework were informed by the 2009 Consolidated Framework for Implementation Research. We used inductive
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Deployment of a Digital Advance Care Planning Platform at an Accountable Care Organization J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 R. Lynae Roberts, Desh P. Mohan, Katelin D. Cherry, Samantha Sanky, Taylor R. Huffman, Christina Lukasko, Anthony Comito, Dara Hashemi, Zachary K. Menn, Tatiana Y. Fofanova, Julia D. Andrieni
Background: Advance care planning (ACP), a process of sharing one’s values and preferences for future medical treatments, can improve quality of life, reduce loved ones’ anxiety, and decrease unwanted medical utilization and costs. Despite benefits to patients and health care systems, ACP uptake often remains low, due partially to lack of knowledge and difficulty initiating discussions. Digital tools
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Physician-Level Continuity of Care and Patient Outcomes in All-Payer Claims Database J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Mingliang Dai, Zachary J. Morgan, Kyle Russel, Beth A. Bortz, Lars E. Peterson, Andrew W. Bazemore
Introduction: Being one of the few existing measures of primary care functions, physician-level continuity of care (Phy-CoC) is measured by the weighted average of patient continuity scores. Compared with the well-researched patient-level continuity, Phy-CoC is a new instrument with limited evidence from Medicare beneficiaries. This study aimed to expand the patient sample to include patients of all
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A Cluster Analysis of Initial Primary Care Orders for Patients with Acute Low Back Pain J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Christopher T. Joyce, Eric J. Roseen, Clair N. Smith, Charity G. Patterson, Christine M. McDonough, Emily Hurstak, Natalia E. Morone, Jason Beneciuk, Joel M. Stevans, Anthony Delitto, Robert B. Saper
Purpose: Primary care physicians (PCPs) often face a complex intersection of patient expectations, evidence, and policy that influences their care recommendations for acute low back pain (aLBP). The purpose of this study was to elucidate patterns of PCP orders for patients with aLBP, identify the most common patterns, and describe patient clinical and demographic characteristics associated with patterns
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Comparing Cannabis Use for Pain to Use for Other Reasons in Primary Care Patients J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Morgan A. Ford, Gwen T. Lapham, Theresa E. Matson, Casey Luce, Malia M. Oliver, Ingrid A. Binswanger
Background: Medical cannabis is commonly used for chronic pain, but little is known about differences in characteristics, cannabis use patterns, and perceived helpfulness among primary care patients who use cannabis for pain versus nonpain reasons. Methods: Among 1688 patients who completed a 2019 cannabis survey administered in a health system in Washington state, where recreational use is legal,
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Integrated Behavioral Health Adaptations During the COVID-19 Pandemic J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Melissa K. Filippi, Andrea Nederveld, Mark D. Williams, Elise Robertson, Chyke Doubeni, Jeanette A. Waxmonsky, Christina M. Hester
Introduction: COVID-19 pandemic lockdowns threatened standard components of integrated behavioral health (IBH) such as in-person communication across care teams, screening, and assessment. Restrictions also exacerbated pre-existing challenges to behavioral health (BH) access. Methods: Semistructured interviews were completed with clinicians from family medicine residency programs on the impact of the
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Management of Women at High Risk for Breast Cancer J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Lashika Yogendran, Lindsey Meis, Elizabeth Burnside, Sarina Schrager
Background: Primary care clinicians screen for breast cancer risk factors and assess the risk level of their patients. Women at high risk for breast cancer (eg, 5-year risk of at least 3% or lifetime risk of ≥20%) are eligible for enhanced screening and/or chemoprophylaxis. However, many clinicians do not identify women at high risk and offer appropriate referrals, screening, or chemoprophylaxis. Methods:
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Association of Early Childhood Wheeze and Asthma Diagnosis Documentation by Race, Ethnicity, and Language in Children J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Jennifer A. Lucas, Miguel Marino, Michelle Trivedi, Roopradha Datta, David Ezekiel-Herrera, Steffani R. Bailey, Sophia Giebultowicz, John Heintzman
Objective: To determine whether electronic health record (EHR) documentation of certain early childhood risk factors for asthma, such as wheeze differ by race, ethnicity, and language group, and whether these children have different subsequent asthma prevalences. Methods: We used EHR data from the Accelerating Data Value Across a National Community Health Center (ADVANCE) Clinical Research Network
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Virtual Music Therapy for Substance Use Disorders in a Federally Qualified Health Center J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Julie Schoonover, Andrew Rossetti, Ariel Jacobs, Susan E. Rubin
Background: Music therapy (MT) is an effective adjunctive treatment for substance use disorders (SUD), which is primarily available in inpatient treatment centers and rarely provided in outpatient primary care. Methods: We evaluated the feasibility and acceptability of a virtual group MT program for SUD in a Federally Qualified Health Center (FQHC), and secondarily assessed patient perceptions of its
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Why Do Physicians Depart Their Practice? A Qualitative Study of Attrition in a Multispecialty Ambulatory Practice Network J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Ryan O’Connell, Fatima Hosain, Leah Colucci, Bidisha Nath, Edward R. Melnick
Background: Physician departure causes considerable disruption for patients, colleagues, and staff. The cost of finding a new physician to replace the loss coupled with lost productivity as they build their practice can cost as much as $1 million per departure. Therefore, we sought to characterize drivers of departure from practice with the goal of informing retention efforts (with a special emphasis
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Advanced Practice Providers in Departments of Family Medicine: Status, Supervision, and Services J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Maribeth Williams, Stephen M. Carek, Arch G. Mainous, John Malaty, Jihane Naous, Peter J. Carek
Background: Nurse practitioners (NP), physician assistants (PA), and other advanced practice providers (APP) are one solution to meet health care workforce shortage. Our study examined clinical workforce decisions and perceptions of APPs and family physicians (FPs) from the perspective of a national survey chairs of Departments of Family Medicine. Methods: A survey was developed and distributed to
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Medicare Advantage: Growth Amidst Mounting Scrutiny J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Eli Y. Adashi, Daniel P. O’Mahony, I. Glenn Cohen
The Medicare Advantage Program, home to nearly half of the eligible Medicare population, has recently come under increased scrutiny. The Government Accountability Office called on the Centers for Medicare & Medicaid Services to monitor “disenrollment of MA beneficiaries in the last year of life, validate MA-provided encounter data, and strengthen audits used to identify and recover improper payments
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Perinatal Depression: A Guide to Detection and Management in Primary Care J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Manish H. Dama, Ryan J. Van Lieshout
Introduction: Existing guidelines for primary care clinicians (PCCs) on the detection and management of perinatal depression (PD) contain important gaps. This review aims to provide PCCs with a summary of clinically relevant evidence in the field. Methods: A narrative literature review was conducted by searching PubMed and PsycINFO for articles published between 2010 to 2023. Guidelines, systematic
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Re: Estimating the Cardiovascular Disease Risk Reduction of a Quality Improvement Initiative in Primary Care: Findings from EvidenceNOW J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Richard A. Young
To the Editor: The recent article by Lindner et al concluded, “This [cardiovascular disease] risk reduction would … avoid $150 million in 90-day direct costs.”[1][1] It was grossly irresponsible of the authors to write this and for the editors to publish this. This medical economic
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Response: Re: Estimating the Cardiovascular Disease Risk Reduction of a Quality Improvement Initiative in Primary Care: Findings from EvidenceNOW J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Stephan R. Lindner, Bijal Balasubramanian, Miguel Marino, K. John McConnell, Thomas E. Kottke, Samuel T. Edwards, Sam Cykert, Deborah J. Cohen
To the Editor : In a comment regarding our recent publication,[1][1] Young states that the phrase “[cardiovascular disease] risk reduction would (…) avoid $150 million in 90-day direct costs” was misleading because our calculations did not include intervention costs.[2][2] We would like to
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Response: Re: Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Peter F. Cronholm, Jennifer Edgoose, Susan H. McDaniel, Mechelle Sanders, Colleen T. Fogarty, Ebony Parker-Featherstone, Cleveland Piggott, Kevin Fiscella
To the Editor : In their letter to the editor, Hogans-Mathews et al[1][1] provide important considerations that expand the scope of the conversation related to our article “Evaluating the Uptake of Antiracism Training, Policies, and Practices in Departments of Family Medicine.”[2][2] In their
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Re: Developing and Validating a Novel Tool to Enhance Functional Status Assessment: The Tennessee Functional Status Questionnaire (TFSQ) J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Angel Ogbeide
To the Editor: Thank you to the authors of “Developing and Validating a Novel Tool to Enhance Functional Status Assessment: The Tennessee Functional Status Questionnaire (TFSQ)” by Vanterpool et al.[1][1] I commend the authors for developing this questionnaire and the primary care community at
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The Journal of the American Board of Family Medicine: 36 (6) J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05
Abstract not available
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Increased Organizational Stress in Primary Care: Understanding the Impact of the COVID-19 Pandemic, Medicaid Expansion, and Practice Ownership J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Jacqueline B. Britz, Alison N. Huffstetler, E. Marshall Brooks, Alicia Richards, Roy T. Sabo, Ben K. Webel, Neil McCray, Alex H. Krist
Background: Primary care is the foundation of health care, resulting in longer lives and improved equity. Primary care was the frontline of the COVID-19 pandemic public response and essential for access to care. Yet primary care faces substantial structural and systemic challenges. As part of a longitudinal analysis to track the capacity and health of primary care, we surveyed every primary care practice
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Care Delivery in Community Health Centers Before, During, and After the COVID-19 Pandemic (2019–2022) J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05 Nicole Cook, Brenda M. McGrath, Suparna M. Navale, Siran M. Koroukian, Anna R. Templeton, Laura C. Crocker, Stephen J. Zyzanski, Wyatt P. Bensken, Kurt C. Stange
Introduction: Health centers provide primary and behavioral health care to the nation’s safety net population. Many health centers served on the frontlines of the COVID-19 pandemic, which brought major changes to health center care delivery. Objective: To elucidate primary care and behavioral health service delivery patterns in health centers before and during the COVID-19 public health emergency (PHE)
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Author Index to Volume 36, 2023 J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05
Abstract not available
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Subject Index to Volume 36, 2023 J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-05
Abstract not available
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What Assessments Are Being Used in Family Medicine Residencies? J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Warren P. Newton, Kevin Rode
On July 1, 2023, Family Medicine residencies entered the new world of competency-based residency education. The new residency standards[1][1] greatly reduce the number of month or hour based requirements and, instead, expect residencies to assess competence explicitly across a wide variety of
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Considering the Environmental Impact of Practice-Based Research J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Ben Webel, Gabriela Villalobos, Michelle S. Rockwell, Alison Huffstetler, Jacqueline B. Britz, E. Marshall Brooks, Alex H. Krist
Introduction: Practice-based research networks (PBRNs) improve primary care by addressing issues that matter to clinicians. Building trust between researchers and care teams is essential to this process, which often requires visiting practices to cultivate relationships and perform research activities. However, in a recent study using practice facilitation to improve the delivery of a preventive service
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Disparities in Screening for Adverse Childhood Experiences J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Héctor E. Alcalá, Amanda E. Ng, Nicholas Tkach, Dahai Yue, Mienah Sharif
Introduction: 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. Methods: Using the 2021 California Health Interview Survey (CHIS), this study examined if several measures of socioeconomic
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Just Pop It: Early AROM After Cervical Ripening Reduces the Time to Delivery J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Paige K. Macky, Haroon Samar, Stephen J. Conner, Ashley L. Urick, Catherine A. Yeager, Derrick J. Tiel, J. Scott Earwood, Bob Marshall
In pregnant patients at term undergoing induction of labor, early time-based artificial rupture of membranes (AROM) within 1 hour of Foley bulb expulsion results in a shorter duration of labor by nearly 9 hours with no significant difference in cesarean delivery rates or maternal or neonatal adverse outcomes.[1][1] [1]: #ref-1
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Smoking Cessation Support in the Context of Other Social and Behavioral Needs in Community Health Centers J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Michael B. Potter, Janice Y. Tsoh, Kara Lugtu, Jose Parra, Vicky Bowyer, Danielle Hessler
Background: 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. Methods: We implemented a randomized pilot
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The Effect of Veteran Status and Chronic Pain on Past 30-Day Sedative Use Among Community-Dwelling Adult Males J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Ayodeji Otufowora, Yiyang Liu, Aderonke Okusanya, Afeez Ogidan, Adedoyin Okusanya, Linda B. Cottler
Introduction: Given the high sedative prescription rate, the sedative-associated morbidity, and mortality nationally (especially among veterans), we aimed to test the hypothesis that veteran status in the presence of chronic pain would be associated with greater sedative use when compared with nonveteran status. Methods: The study participants were recruited by Community Health Workers (CHWs) through
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Changes in Metabolic Parameters of Hemoglobin A1c, Weight, and Blood Pressure During and After COVID-19 Stay-at-Home Orders J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Elizabeth M. Bickenbach, Caroline L. Keegan, Makenzie C. Brockel, Olivia G. Mast, Adithya Ghantae, Andrew Y. Hwang, Christina H. Sherrill
Background: Due to the COVID-19 pandemic, a “state of emergency” was declared in North Carolina on March 10, 2020. Subsequent “stay-at-home” (SAH) orders restricted activities including use of fitness facilities, and teleworking was encouraged. This study investigates metabolic effects of these changes in activity level. Methods: This retrospective prepost study included adults diagnosed with type
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The Impact of the Medicaid Reimbursement Bump on Influenza Vaccination Rates Among US Teens: Evidence from the National Immunization Survey–Teen 2011–2020 J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Felippe O. Marcondes, Mary Price, Alex McDowell, Joseph P. Newhouse, John Hsu, Vicki Fung
Background: 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. Methods:
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Less Is More: Backing off Sliding Scale Insulin for Hospitalized Patients J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Lakshmi Karra, Roxanne Radi, Corey Lyon
In hospitalized patients with type 2 diabetes (T2DM), a less aggressive supplemental insulin regimen is noninferior to a standard, more aggressive, supplemental regimen.
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A Focus on Climate Change and How It Impacts Family Medicine J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Dean A. Seehusen, Marjorie A. Bowman, Jacqueline Britz, Christy J. W. Ledford
This issue highlights climate change, its effects on patients, and actions clinicians can take to make a difference for their patients and communities. The issue also includes several reports on current trends in family physician practice patterns and the influence of practice structure. Four articles focus on controlled or illicit substances. Noteworthy among them is the description of an innovative
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Climate Change: How Will Family Physicians Rise to the Challenge? J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Audrey Hertenstein Perez
Across the United States, communities are feeling the health impacts of climate change. It is undeniable that from heat waves to flooding, climate change currently poses a risk to the health of our patients. Though we can still mitigate the worst effects of climate change if we take action to reduce
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How Physicians Should Respond to Climate Change J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Mona Sarfaty
Urgent warnings about the existential threat of climate change are coming from leaders in nearly every sector of society, including virtually all climate scientists, notable heads of civil governments around the globe, the world’s top religious leaders, prestigious medical journals, as well as principals of the largest financial firms. Surveys show that the majority of U.S. physicians in several specialties
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Climate Change Psychological Distress: An Underdiagnosed Cause of Mental Health Disturbances J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Jessica de Jarnette
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
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When Climate Change Shows Up in the Exam Room J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Joanna G. Katzman, Stefan Wheat, Ann S. Christiano
Climate change is considered one of the greatest threats to humanity and the most significant global public health emergency of our lifetime. Millions of people from throughout the globe suffer and die each year from degraded air quality, extreme heat, water and vector-borne diseases as well as the mental health effects of climate change. Because clinicians are considered one of the most trusted sources
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Climate Change and Policy Reforms: A View from the Primary Care Clinic J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Daniel Wolk, Rebecca Porter
The medical community has been calling the public’s attention to the health harms of climate change for decades.[1][1] Commonly cited impacts include catastrophic weather, wildfires, excessive heat, migration of disease vectors, community dislocation, flooding, sea level rise, and the disruption
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Lack of Diversity in Female Family Physicians Performing Women’s Health Procedures J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Kendall Hancock
The JABFM policy brief “Racial Inequities in Female Family Physicians Providing Women’s Health Procedures”[1][1] shows that White female family physicians provide more women’s health procedures than their other race female counterparts. From the data presented in this brief, it is clear that
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Effectiveness of Long-Term Opioid Therapy for Chronic Low Back Pain J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 John C. Licciardone, Kush Rama, Antoine Nguyen, Cynthia Ramirez Prado, Chandler Stanteen, Subhash Aryal
Purpose: Clinical trials generally have not assessed efficacy of long-term opioid therapy (LTOT) beyond 6 months because of methodological barriers and ethical concerns. We aimed to measure the effectiveness of LTOT for up to 12 months. Methods: We conducted a retrospective cohort study among adults with chronic low back pain (CLBP) from April 2016 through August 2022. Participants reporting LTOT (>90 days)
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High-Performing Teamlets in Primary Care: A Qualitative Comparative Analysis J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Melinda A. Chen, Claude Rubinson, Eloise M. O’Donnell, Jing Li, Thomas Bodenheimer, Lawrence P. Casalino
Purpose: In efforts to improve patient care, collaborative approaches to care have been highlighted. The teamlet model is one such approach, in which a primary care clinician works consistently with the same clinical staff member. The purpose of this study is to identify the characteristics of high-performing primary care teamlets, defined as teamlets with low rates of ambulatory care sensitive emergency
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Drug Deactivation Pouches for Primary Prevention of Opioid Overdose: Perceptions and Attitudes of Community Members J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Ayodeji Otufowora, Kathleen L. Egan, Piyush V. Chaudhari, Aderonke A. Okusanya, Afeez O. Ogidan, Linda B. Cottler
Importance: A substantial number of opioid analgesics dispensed into communities will go unused and be susceptible to diversion for misuse. Convenient, efficient, and environmentally safe mechanisms for disposal are needed to prevent the diversion of unused opioid analgesics. Objective: This initiative piloted the feasibility of distributing drug deactivation pouches in a community setting and examined
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Racial Inequities in Female Family Physicians Providing Women’s Health Procedures J. Am. Board Fam. Med. (IF 2.9) Pub Date : 2024-01-01 Grace Walter, Radhika Laddha, Anuradha Jetty, Yalda Jabbarpour, Alison Huffstetler
Patient-physician race concordant dyads have been shown to improve patient outcomes; the race and ethnicity of family physicians providing women's health procedures has not been described. Using self-reported data, this analysis highlights the racial disparities in scope of practice; underrepresented in medicine (URiM) females are less likely to perform women's health procedures which may lead to disparities