Journal of Primary Care and Community Health最新文献

{"title":"Life Satisfaction Among Diverse Participants.","authors":"Razel Bacuetes Milo, Maria Luisa B Ramira, Nicole Martinez","doi":"10.1177/21501319241277574","DOIUrl":"https://doi.org/10.1177/21501319241277574","url":null,"abstract":"<p><strong>Introduction: </strong>Mental health (MH) conditions are among the most common chronic health conditions in the United States. Previous studies suggested decreased in life satisfaction post-COVID-19 in other populations outside the United States. This study explored the correlations between life satisfaction and MH among diverse community post-COVID-19 pandemic.</p><p><strong>Methods: </strong>A cross-sectional, non-experimental, retrospective study. The primary outcome was the Satisfaction with Life Scale total score (SWLS_TS) and the characteristics of the cases from self-reported information. Statistical software SPSS was used for descriptive and inferential analyses.</p><p><strong>Results: </strong>About 218 cases were included for analysis. Many of the cases were Asian Americans (n = 185, 84.1%). The multiple linear regression model significantly predicted 5.2% of the variance in SWLS_TS. Three out of 6 predictors significantly contributed to the model (age β = .172, t = 2.42, P = .017, ethnicity β = .148, <i>t</i> = 2.07, <i>P</i> = .039, and no history of MH β = .248, t = 3.31, P = .001).</p><p><strong>Conclusion: </strong>A diverse population was examined post-COVID-19 pandemic, and the findings suggest a positive correlation with age, ethnicity, and no history of MH with SWLS_TS.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241277574"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403679/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pro Inflammatory Cytokines Profiles of Patients With Long COVID Differ Between Variant Epochs.","authors":"Ravindra Ganesh, Siddhant Yadav, Ryan T Hurt, Michael R Mueller, Christopher A Aakre, Elizabeth A Gilman, Stephanie L Grach, Joshua Overgaard, Melissa R Snyder, Nerissa M Collins, Ivana T Croghan, Andrew D Badley, Raymund R Razonable, Bradley R Salonen","doi":"10.1177/21501319241254751","DOIUrl":"10.1177/21501319241254751","url":null,"abstract":"<p><strong>Background: </strong>Over 30% of patients with COVID-19 have persistent symptoms that last beyond 30 days and referred to as Long COVID. Long COVID has been associated with a persistent elevation in peripheral cytokines including interleukin-6, interleukin-1β, and tumor necrosis factor-α. This study reports cytokine profiles of patients in our clinic across SARS-COV-2 variant epochs.</p><p><strong>Methods: </strong>The clinical cytokine panel was analyzed in patients with Long COVID during periods that were stratified according to variant epoch. The 4 variant epochs were defined as: (1) wild-type through alpha, (2) alpha/beta/gamma, (3) delta, and (4) omicron variants.</p><p><strong>Results: </strong>A total of 390 patients had the clinical cytokine panel performed; the median age was 48 years (IQR 38-59) and 62% were female. Distribution by variant was wild-type and alpha, 50% (n = 196); alpha/beta/gamma, 7.9% (n = 31); delta, 18% (n = 72); and omicron, 23% (n = 91). Time to cytokine panel testing was significantly longer for the earlier epochs. Tumor necrosis factor-α (<i>P</i> < .001) and interleukin 1β (<i>P</i> < .001) were significantly more elevated in the earlier epochs (median of 558 days in wild-type through Alpha epoch vs 263 days in omicron epoch, <i>P</i> < .001)). Nucleocapsid antibodies were consistently detected across epochs.</p><p><strong>Discussion: </strong>When stratified by variant epoch, patients with early epoch Long COVID had persistently elevated peripheral pro-inflammatory cytokine levels when compared to later epoch Long COVID. Patients with Long COVID have similar clusters of symptoms across epochs, suggesting that the underlying pathology is independent of the peripheral cytokine signature.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241254751"},"PeriodicalIF":3.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11138192/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141162843","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Post-Stroke Depression and Suicidal Ideations: Relationship with Gender and Marital Status: A Cross Sectional Study.","authors":"Mgbeojedo Ukamaka Gloria, Osiri Emmanuel Jonah, Akosile Christopher Olusanjo, Okoye Emmanuel Chiebuka, John Jeneviv Nene, Akobundu Uzoamaka Nwakego, Anyaene Chiamaka Chinyere","doi":"10.1177/21501319241233172","DOIUrl":"10.1177/21501319241233172","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the prevalence and contributing factors of depression and suicidal ideations among stroke survivors in Nigeria.</p><p><strong>Methods: </strong>This was a cross-sectional study comprising 75 consenting stroke survivors who were purposively recruited from 2 tertiary hospitals. Suicidal ideations and depression were measured using standard questionnaires. Obtained data was analyzed with appropriate statistical tools.</p><p><strong>Results: </strong>9.3% of the participants had depression while 4% reported suicidal ideations. Significant correlation existed between suicidal ideations and depression (ρ = .31, <i>P</i> = .01), and levels of depression and suicidal ideations (χ² = 85.76; <i>P</i> < .01). Depression had a significant relationship with gender and marital status, while suicidal ideations had a significant relationship with marital status. Females were significantly more depressed than their male counterparts (<i>U</i> = 512.50, <i>P</i> = .04) and also had a higher score on suicidal ideations. The widowed/divorced recorded the highest scores on depression (χ² = 8.77, <i>P</i> = .01) and suicidal ideations (χ² = 6.62; <i>P</i> = .04).</p><p><strong>Conclusion: </strong>A worrisome prevalence of depression was reported among the study participants. The level of suicidal ideations was quite low. Depression and suicidal ideations were higher among females and those who lost their life partners (either by divorce or death).</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241233172"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10878211/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139900631","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescent Healthcare Access: A Qualitative Study of Provider Perspectives.","authors":"Whitney R Garney, Sara A Flores, Kristen M Garcia, Sonya Panjwani, Kelly L Wilson","doi":"10.1177/21501319241234586","DOIUrl":"10.1177/21501319241234586","url":null,"abstract":"<p><strong>Introduction: </strong>Adolescent access to quality healthcare is key to prevention and early intervention for health risk behaviors. This paper provides a healthcare provider perspective on barriers and facilitators to youth accessing care.</p><p><strong>Methods: </strong>Five focus groups were conducted from November to December 2020 with providers from a variety of healthcare settings. Participants were asked to describe their respective adolescent patient populations, adolescent-specific health concerns, and organizational accommodations specific for youth services. Transcripts were analyzed using Inductive Thematic Analysis and themes were grouped using a social-ecological framework.</p><p><strong>Results: </strong>At an individual level, providers noted that an adolescent's knowledge and ability to navigate services varied greatly across settings. Providers identified provider trust and parent/guardian support as key interpersonal factors that support adolescents' access to services. Organizational factors included bureaucratic barriers and the clinic's reputation among youth. Community factors centered on mistrust within healthcare systems and stigmatization of seeking certain types of services. Participants also described how state-level policies influence parent/guardian consent requirements, which can limit adolescents' access to care.</p><p><strong>Conclusion: </strong>Adolescent access to and utilization of healthcare in the United States is a complex problem requiring systems-level change. Healthcare organizations and providers have the opportunity and capacity to positively influence adolescents' healthcare access and experiences, however a lack of standardized, clinic-level priorities and guidelines can limit adolescent-centered care.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241234586"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10901052/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139984171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to MAT: Participants' Experiences With Transportation, Non-Emergency Transportation, and Telehealth.","authors":"Jennifer Boyd, Martha Carter, Adam Baus","doi":"10.1177/21501319241233198","DOIUrl":"10.1177/21501319241233198","url":null,"abstract":"<p><strong>Introduction: </strong>Access to medication assisted treatment (MAT) for opioid use disorder (OUD) in the United States is a significant challenge for many individuals attempting to recover and improve their lives. Access to treatment is especially challenging in rural areas characterized by lack of programs, few prescribers, and transportation barriers. This study aims to better understand the roles that transportation, Medicaid-funded non-emergency medical transportation (NEMT), and telehealth play in facilitating access to MAT in West Virginia (WV).</p><p><strong>Methods: </strong>We developed this survey using an exploratory sequential mixed methods approach following a review of current peer-reviewed literature plus information gained from 3 semi-structured interviews and follow-up discussions with 5 individuals with lived experience in MAT. Survey results from 225 individuals provided rich context on the influence of transportation in enrolling and remaining in treatment, use of NEMT, and experiences using telehealth. Data were collected from February through August 2021.</p><p><strong>Results: </strong>We found that transportation is a significant factor in entering into and remaining in treatment, with 170 (75.9%) respondents agreeing or strongly agreeing that having transportation was a factor in deciding to go into a MAT program, and 176 (71.1%) agreeing or strongly agreeing that having transportation helps them stay in treatment. NEMT was used by one-quarter (n = 52, 25.7%) of respondents. Only 13 (27.1%) noted that they were picked up on time and only 14 (29.2%) noted that it got them to their appointment on time. Two thirds of respondents (n = 134, 66.3%) had participated in MAT services via telehealth video or telephone visits. More preferred in-person visits to telehealth visits but a substantial number either preferred telehealth or reported no preference. However, 18 (13.6%) reported various challenges in using telehealth.</p><p><strong>Conclusions: </strong>This study confirms that transportation plays a significant role in many people's decisions to enter and remain in treatment for OUD in WV. Additionally, for those who rely on NEMT, services can be unreliable. Finally, findings demonstrate the need for individualized care and options for accessing treatment for OUD in both in-person and telehealth-based modalities. Programs and payers should examine all possible options to ensure access to care and recovery.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241233198"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10906046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139991484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association Between Alcohol Consumption and Blood Pressure Levels Among HIV Sero-Positive and Sero-Negative Cohorts: A Secondary Analysis of the Vukuzazzi Study.","authors":"Manasseh B Wireko, Jacobus Hendricks, Kweku Bedu-Addo, Marlise Van Staden, Emmanuel A Ntim, John A Larbi, Isaac K Owusu","doi":"10.1177/21501319241235594","DOIUrl":"10.1177/21501319241235594","url":null,"abstract":"<p><strong>Background: </strong>The effect of hypertension is aggravated by lifestyle factors such as alcohol consumption. This study sought to determine the association between alcohol consumption and the level of blood pressures among HIV seronegative and seropositive cohorts.</p><p><strong>Methods: </strong>This secondary analysis was performed on a cross-sectional survey data of 17 922 participants during the period between 2018 and 2020. A questionnaire was used to obtain participants' alcohol consumption history, which was categorized into non-alcohol consumers, non-heavy alcohol consumers, and heavy alcohol consumers. A linear regression model was used to establish relationships among participants with raised blood pressure (BP ≥ 140/90 mmHg).</p><p><strong>Results: </strong>Out of the total participants, 3553 (19.82%) were hypertensives. Almost 13% of the hypertensives (n = 458; 12.89%) were undiagnosed, and 12.44 % (442) had uncontrolled hypertension. About 14.52% of the hypertensives (3553) were not on any antihypertensive medication. Male non-consumers of alcohol had the highest systolic and diastolic BP; uncontrolled systolic BP (165.53 ± 20.87 mmHg), uncontrolled diastolic BP (102.28 ± 19.21mmHg). Adjusted for covariates, moderate alcohol consumption was associated with HTN among participants who were HIV seropositive [unadjusted (RR = 1.772, <i>P</i> = .006, 95% CI (1.178-2.665)], [RR = 1.772, <i>P</i> = .005, 95% CI (1.187-2.64)]. [unadjusted RR = 1.876, <i>P</i> = .036, 95% CI (1.043-3.378)], adjusted RR = 1.876, <i>P</i> = .041, 95% CI (1.024-3.437). Both moderate and heavy alcohol consumption were significantly related to hypertension among HIV sero-negative [unadjusted model, moderate consumption RR = 1.534 <i>P</i> = .003, 95% CI (1.152-2.044)], [adjusted model, moderate alcohol consumption RR = 1.535, <i>P</i> = .006, 95% CI (1.132-2.080)], [unadjusted model, heavy alcohol consumption, RR = 2.480, <i>P</i> = .030, 95% CI (1.091-5.638)], [adjusted model RR = 2.480, <i>P</i> = .034, 95% CI (1.072-5.738)].</p><p><strong>Conclusion: </strong>Alcohol consumption is significantly related to increase BP regardless of HIV infection.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241235594"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10938620/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140111840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards Improvement of Heatwave Warnings for Older Adults: The Case of Queensland Australia.","authors":"Mehak Oberai, Steven Baker, Aaron J E Bach, Connor Forbes, Ella Jackman, Sebastian Binnewies, Zhiwei Xu, Sarah Cunningham, Son Nghiem, Dung Phung, Shannon Rutherford","doi":"10.1177/21501319241286584","DOIUrl":"10.1177/21501319241286584","url":null,"abstract":"<p><strong>Background: </strong>Heatwave warnings provide crucial information about the nature of the event and the steps that can be taken to mitigate its impact. It is well known that heat events disproportionately impact the health of older adults. Therefore, it's critical that heatwave warnings reach this population. However, our current understanding of the effectiveness of heatwave warning messages among older Queenslanders is limited.</p><p><strong>Methods: </strong>A Queensland wide survey was conducted in 2022 among 547 older adults (≥65 years), aiming to collect information on their perception of heat-related health risk, their knowledge of the existing heatwave warnings, and if they had ever heard of a heatwave warning. Chi-square analysis followed by multinomial or binomial logistic regression was utilized to understand various socio-economic and personal factors that impact the heatwave warning reach to older Queenslanders.</p><p><strong>Results: </strong>Only 43% of the respondents had heard a heatwave warning and only 49% of those who heard a warning(s) changed their behavior as a result. The results showed 20% of respondents perceived themselves to be at heat-related health risk, and these individuals were 1.98 times more likely to have heard heatwave warnings. Further, individuals who perceived themselves to be at heat-related health risk were 3.62 times more likely to adopt adaptive measures in response to heatwave warnings.</p><p><strong>Implications: </strong>This study suggests that in older adults, higher knowledge and perception of heat-related health risk are associated with higher likelihoods of attention to heatwave warnings and adoption of cooling measures.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241286584"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11536501/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142569848","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Randomized Trial to Address Food Insecurity and Promote Smoking Cessation Among Low-Income Adults.","authors":"Jin E Kim-Mozeleski, Madeline C Castele, Pooja Nambiar, Kevin M Chagin, Stephanie Pike Moore, Patricia Hardy, Karen Cook, Ashwini R Sehgal","doi":"10.1177/21501319241245275","DOIUrl":"10.1177/21501319241245275","url":null,"abstract":"<p><p>Many low-income adults who smoke also have unmet social needs, such as food insecurity, which can serve as a barrier to smoking cessation. We developed a novel intervention to jointly address smoking cessation and food insecurity and assessed its feasibility, acceptability, and preliminary outcomes. We enrolled participants who screened for food insecurity, reported smoking daily, and were ready to quit. All participants received 3 months of resources navigation from a community health worker through monthly telephone calls for referrals and check-ins for smoking cessation and food access resources. Participants randomized to the intervention group received an economic intervention equivalent to the cost of 1 week of groceries/month for 3 months. We randomized 55 participants who were smoking on average 13 cigarettes/day. The trial was feasible and acceptable based on 3-month retention rates (80%) and end-of-study qualitative feedback (91% would recommend the study to others). At 3 months, participants in the intervention versus control group reported a longer length of abstinence from smoking and had a higher proportion of serious quit attempts. Results from this pilot study suggest the importance of attending to social needs, particularly food insecurity, as a strategy to promote smoking cessation among low-income adults who smoke.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241245275"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11003330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140855549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Care Providers' Experiences Treating Opioid Use Disorder Using Telehealth in the Height of the COVID-19 Pandemic.","authors":"Sarah Alexandra Marshall, Lachan E Siebenmorgen, Katherine Youngen, Tyrone Borders, Nickolas Zaller","doi":"10.1177/21501319241246359","DOIUrl":"10.1177/21501319241246359","url":null,"abstract":"<p><strong>Background: </strong>The COVID-19 pandemic catalyzed a rapid shift in healthcare delivery towards telehealth services, impacting patient care, including opioid use disorder (OUD) treatment. Regulatory changes eliminated the in-person evaluation requirement for buprenorphine treatment, encouraging adoption of telehealth. This study focused on understanding experiences of primary care providers in predominantly rural areas who used telehealth for OUD treatment during the pandemic.</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with 22 primary care providers. Participants practiced in 13 rural and 9 urban counties in Kentucky and Arkansas. Data were analyzed using conventional content analysis.</p><p><strong>Results: </strong>The pandemic significantly impacted healthcare delivery. While telehealth was integrated for behavioral health counseling, in-person visits remained crucial, especially for urine drug screenings. Telehealth experiences varied, with some facing technology issues, while others found it efficient. Telehealth proved valuable for behavioral health counseling and sustaining relationships with established patients. Patients with OUD faced unique challenges, including housing, internet, transportation, and counseling needs. Stigma surrounding OUD affected clinical relationships. Building strong patient-provider relationships emerged as a central theme, emphasizing the value of face-to-face interactions. Regarding buprenorphine training, most found waiver training helpful but lacked formal education.</p><p><strong>Conclusion: </strong>This research offers vital guidance for improving OUD treatment services, especially in rural areas during crises like the COVID-19 pandemic. It highlights telehealth's value as a tool while acknowledging its limitations. The study underscores the significance of strong patient-provider relationships, the importance of reducing stigma, and the potential for training programs to elevate quality of care in OUD treatment.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241246359"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11008087/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140865421","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting a Remotely Delivered Patient Navigation Program for Colorectal Cancer Screening in Primary Care: Important Considerations for Rural Contexts.","authors":"Brooke Ike, Gina A Keppel, Katie P Osterhage, Linda K Ko, Allison Cole","doi":"10.1177/21501319241288025","DOIUrl":"10.1177/21501319241288025","url":null,"abstract":"<p><strong>Introduction: </strong>Colonoscopy is a critical component of colorectal cancer (CRC) screening and patient navigation (PN) improves colonoscopy completion. A lay navigator remotely providing navigation across rural primary care organizations (PCOs) could increase PN access. In preparation for the Colonoscopy Outreach for Rural Communities (CORC) study, we examined partners' perspectives on contextual factors that could influence CORC program implementation, and adaptations to mitigate potential barriers.</p><p><strong>Methods: </strong>We interviewed 29 individuals from 6 partner PCOs and the community-based organization (CBO) delivering the PN program. An analysis approach informed by Miles, Huberman, and Saldana identified critical themes. Results are reported using the Framework for Reporting Adaptations and Modifications-Enhanced (FRAME).</p><p><strong>Results: </strong>Potential barriers included that rural patients are hard to reach remotely and might mistrust the navigator, and the CBO is unfamiliar with the patient communities and does not have patient care experience or pre-existing communication pathways with the PCOs. Program content and navigator training was adapted to mitigate these challenges.</p><p><strong>Conclusions: </strong>Our study highlights contextual factors to account for before implementing a remote, centralized patient navigation program serving rural communities. Gathering partner perspectives led to intervention adaptations intended to address potential barriers while leaving the core components of the evidence-based intervention intact.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241288025"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11526216/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142510196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}