Journal of Primary Care and Community Health最新文献

{"title":"Fluoride Knowledge, Attitudes, and Behaviors: Adults in Rural Alabama.","authors":"Alex Harper, Steven M Levy, Wei Shi","doi":"10.1177/21501319251350921","DOIUrl":"10.1177/21501319251350921","url":null,"abstract":"<p><strong>Introduction: </strong>Despite strong evidence supporting the benefits of water fluoridation in preventing dental caries, limited research exists on U.S. adults' knowledge, attitudes, and behaviors regarding fluoride and tap water intake. This study examined the knowledge, attitudes, and behaviors regarding fluoride and tap water intake of Green Hill, Alabama adults.</p><p><strong>Methods: </strong>A convenience sample of 291 adults was surveyed concerning their knowledge, attitudes, and behaviors about fluoride in water and toothpaste, and water consumption preferences.</p><p><strong>Results: </strong>There was a high level of knowledge about fluoride's role in cavity prevention, with 92.4% correctly identifying its benefits. However, 18.3% were unaware that fluoride does not help maintain healthy gums. Regarding attitudes, 14.5% strongly agreed and 28.3% agreed that fluoride in drinking water was beneficial, while 29.1% strongly supported and 53.5% supported its inclusion in toothpaste. A preference for bottled water over tap water was noted by 84.4% of participants, with 36.9% citing distrust of tap water quality as a primary reason. Bivariate analysis found a positive perception of fluoride in tap water correlated with better knowledge, while education level and fluoride awareness influenced attitudes.</p><p><strong>Conclusion: </strong>Additional research is necessary to explore reasons underlying adults' water consumption habits and fluoride perceptions.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251350921"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12188084/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144486556","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":"Digital Platforms in Primary Care: Leveraging Asynchronous Consultations to Support Management of Cardiometabolic Diseases and Risk Factors.","authors":"Mohammad S Razai, Hajira Dambha-Miller, Simon Griffin","doi":"10.1177/21501319251345721","DOIUrl":"10.1177/21501319251345721","url":null,"abstract":"","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251345721"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12126685/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144188268","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":"Sanitation and Menstrual Health Challenges Among Pandharpur Women Pilgrims: An Exploratory Study With Recommendations.","authors":"Manisha Gore, Avinash Patwardhan","doi":"10.1177/21501319251359136","DOIUrl":"10.1177/21501319251359136","url":null,"abstract":"<p><strong>Background: </strong>In the state of Maharashtra in India, a pilgrimage called \"Pandharpur Wari\" attracts half a million pilgrims annually. Orthodox Hindu culture is generally resistant to allowing women to participate in religious functions during their menstruation. With a significant female presence, ensuring adequate Water Sanitation and Hygiene (WASH) facilities and Menstrual Health and Hygiene (MHH) is crucial. Due to scant reliable quantitative data, a qualitative study was conducted to investigate first-hand accounts of experiences of WASH facilities and MHH practices of women pilgrims during 2023 pilgrimage.</p><p><strong>Methods: </strong>This study employed a qualitative design with convenience sampling, selecting 100 women pilgrims (aged 18-45 years) from the pilgrimage across 3 sites. Data were collected through semi-structured interviews. Descriptive and thematic analyses were conducted to examine experiences, challenges, and suggestions.</p><p><strong>Results: </strong>Over half (53%) were aged 32 to 41 years while (18%) were between 22 and 31 years. Most had studied up to secondary level (77%) and were married (95%). Thirty-four percent were farmers and a few had some other day job (7%). A large majority (97%) faced difficulties accessing toilets and bathing facilities, with some resorting to open defecation (36%). About (2%) used oral contraceptive to delay periods and (7%) experienced menstruation during pilgrimage. Lack of facilities for bathing and toilets along the pilgrimage route was one prominent challenge. Other challenges were, needing to bathe in the open, lack of gender-segregated facilities, and scanty sanitary facilities along the route. Women were found to be resilient in managing menstruation amidst systemic gaps. It was also found that cultural beliefs shaped pilgrimage participation while in menses and how it was hard to manage menstruation during pilgrimage without adequate infrastructure.</p><p><strong>Conclusion: </strong>The pilgrimage poses logistical, sanitation challenges for the pilgrims. Strategic planning, including mobile toilets, private bathing, menstrual hygiene support can improve the experience.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251359136"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12280537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676142","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":"Acquired Angioedema as the First Sign of Lymphoproliferative Disorder: Case Report and Review of Literature.","authors":"Juan Carlos Cardenas Rosales, Ahmad Ridwan, Carlos Ruiz-Orasma, Santiago F Galeano-Lovera, Fernando Gil Lopez, Jhonny Perusina, Jacqueline D Squire, Liuyan Jiang, Muhamad Alhaj Moustafa, Dana M Harris, Salma Iftikhar, Bala Munipalli","doi":"10.1177/21501319251360500","DOIUrl":"10.1177/21501319251360500","url":null,"abstract":"<p><p>Acquired angioedema due to C1-inhibitor deficiency (AAE-C1INH) is a rare condition characterized by the localized swelling of the deeper skin layers and mucous membranes, especially the face, lips, tongue, throat, and gastrointestinal tract. AAE-C1INH is strongly associated with lymphoproliferative disorders, although it can also be linked to autoimmune conditions, solid tumors, infections, or even occur without an identifiable cause. We present the case of a 45-year-old female patient with complaints of recurrent abdominal pain, bloating, and joint swelling. Laboratory testing showed decreased C1q and C4 complement levels, and C1 esterase inhibitor levels, indicative of AAE-C1INH. Further work up confirmed a diagnosis of extranodal marginal zone lymphoma with involvement of the bone marrow and spleen. Treatment with rituximab led to resolution of angioedema symptoms and almost complete remission of underlying lymphoma. This case underscores the importance of evaluating an underlying lymphoproliferative disorder in AAE-C1INH. Therefore, the early participation of a multidisciplinary team including specialists in immunology, hematology, and oncology is necessary for appropriate management.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251360500"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317231/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754806","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":"Bridging the Gaps: Strengthening Patient Engagement and Interprofessional Telehealth in Primary Care: Response to Your Insightful Commentary on Our Scoping Review.","authors":"Monica McGraw, Anaëlle Morin, Vanessa Tremblay-Vaillancourt, Marie-Eve Poitras, Yves Couturier, Pre Isabelle Gaboury, Marie-Dominique Poirier","doi":"10.1177/21501319251362656","DOIUrl":"10.1177/21501319251362656","url":null,"abstract":"","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251362656"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317225/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754809","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":"Healthcare Providers' Oral Health Practices Participating in a Regional Oral Health Intervention.","authors":"Patricia A Braun, Kimberly T Wiggins, Cherith Flowerday, Andrew Bienstock, L Miriam Dickinson","doi":"10.1177/21501319251360952","DOIUrl":"10.1177/21501319251360952","url":null,"abstract":"<p><strong>Objective: </strong>Evaluate healthcare providers' and staffs' knowledge, self-reported abilities, activities, and barriers to providing preventive oral health services (POHS) at primary care medical visits before and after participation in the Rocky Mountain Network of Oral Health (RoMoNOH) project.</p><p><strong>Methods: </strong>The RoMoNOH project integrated POHS into primary care medical visits of young children at 22 community health centers (CHCs) in Arizona, Colorado, Montana, and Wyoming by medical team members and/or by embedded dental hygienists (DHs). Twelve CHCs embedded DHs onto their teams. In an observational pre/post evaluation, a convenience sample of healthcare providers' characteristics were surveyed at baseline and 3 years across 4 oral health domains: knowledge, self-reported abilities, behaviors, and barriers. Each domain was scored from 0% to 100%, with 100% being optimal. Differences between pre- and post-project domain scores were assessed using chi-square, t-tests, and linear and logistic regression adjusting for providers' age.</p><p><strong>Results: </strong>Embedding DHs into CHCs and staff turnover impacted pre/post survey participants. The final analytic cohort included 213 (pre-survey response rate: 71%) and 165 (post-survey response rate: 52%) healthcare providers who worked with children < age 3. Participants were female (pre: 81%, post: 81%) and aged >35 years (pre: 39%, post: 41%). Unadjusted mean differences across surveys improved across all oral health domains (pre/post): knowledge: 65%/81%, <i>P</i> < .001; self-reported ability: 52%/71%, <i>P</i> < .001; activities: 32%/57%, <i>P</i> < .001; barriers: 27%/21%, <i>P</i> = .011. After adjustment for age, these improvements remained significant (all <i>P</i> ≤ .011).</p><p><strong>Conclusions: </strong>Healthcare providers' oral health practices improved over a multi-year oral health integration project aimed at increasing delivery of POHS at medical visits.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251360952"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12317247/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144754838","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 Mixed-Methods Evaluation of a Primary Care Remote Blood Pressure Monitoring Quality Improvement Pilot.","authors":"Hossein Bakhshandeh, Sana Tehal, Oluseyi Fayanju, Sai Priyanka Kodam, Jesse Rokicki-Parashar, Margaret Seaton, Yingjie Weng, Anuradha Phadke","doi":"10.1177/21501319251358000","DOIUrl":"10.1177/21501319251358000","url":null,"abstract":"<p><strong>Introduction: </strong>Remote blood pressure monitoring (RBPM) programs are increasingly utilized to improve hypertension care. Rigorous analysis of program outcomes including clinical effectiveness and participant experience can inform future initiatives.</p><p><strong>Methods: </strong>During year 1 of the COVID-19 pandemic, we implemented a RBPM program for patients who: (1) received primary care in a single academic medical network, (2) were part of an accountable care financial arrangement, and (3) had uncontrolled hypertension. Evaluation combined a 6-month prospective cohort observational study (assessing the program's association with hypertension control and remote blood pressure [RBP] reporting) with surveys (assessing patient and care team experience.)Results:A total of 150 patients (mean age 57 years, 65% male) enrolled across 10 clinics, of whom 121/150 contributed remote blood pressure data. Among the patients who contributed data, we observed an adjusted reduction in systolic blood pressure by 1.08 mm Hg/month (95% CI = -1.24 to -0.91) and diastolic blood pressure by 0.88 mm Hg/month (95% CI = -0.99 to -0.77) associated with our intervention. The number of patients contributing to RBPM data declined from 121 to 22 from inception to the end of the 6-month study. Among the 61 patient survey respondents (40% response rate), 80% reported high program satisfaction and likelihood to recommend. Survey respondents noted improvements in weight loss (14%), medication compliance (16%), diet (29%), and exercise (35%). Qualitative survey analysis identified themes of patient convenience and increased self-efficacy in blood pressure (BP) management. Quantitative and qualitative patient and care team survey analysis showed technology linkage challenges.</p><p><strong>Conclusion: </strong>Overall, our primary care RPBM program was associated with improved blood pressure control among participants and favorable patient and care team experience but experienced challenges of significant decline in blood pressure reporting over time. For future institutional RBPM implementations, we aim to retain the high quality of blood pressure management guidance that participants received while increasing technology connectivity and longitudinal reporting support.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251358000"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144691984","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":"Intrinsic Capacity of Chinese Community-Dwelling Older Adults Using WHO Integrated Care for Older People (ICOPE) Framework: Structural Equation Model Analysis.","authors":"Junjun Sun, Kwanjai Amnatsatsue, Patsri Srisuwan, Patcharaporn Kerdmongkol, Dechavudh Nityasuddhi","doi":"10.1177/21501319251346433","DOIUrl":"10.1177/21501319251346433","url":null,"abstract":"<p><strong>Objective: </strong>This study aimed to examine the intrinsic capacity in Chinese older adults and its determinants (sociodemographic, lifestyle-related, environmental, and health-related factors) based on the WHO Integrated Care for Older People (ICOPE) framework.</p><p><strong>Methods: </strong>A cross-sectional community-based study was conducted among 485 community-dwelling older adults recruited from 4 community health service centers in Xinxiang City, Henan Province between August 2024 and February 2025. Intrinsic capacity was assessed across 5 domains: locomotion, cognition, vitality, psychology, and sensory capacity (hearing and vision). Structural equation model (SEM) was used to examine relationships among intrinsic capacity, sociodemographic factors, lifestyle, family support, social participation, healthcare access, and health conditions.</p><p><strong>Results: </strong>More than a half of subjects were female (61.2%), married (84.7%), having less than high school education (52%), with a mean age of 73.7 years (SD = 5.5). About 55.9% showed intrinsic capacity impairment, with most impairment of cognition (49.9%), followed by vision (44.9%), hearing (23.7%), locomotion (22.5%), vitality (18.1%), and psychological capacity (13%). The SEM demonstrated good fit and explained 83% of the variance in intrinsic capacity. Significant determinants, ranked by effect size, included dietary habits (β = .544), age (β = -.303), pain (β = -.240), handgrip strength (β = .205), social participation (β = .181), access to healthcare services (β = .138), hospitalization (β = -.10), and physical exercise (β = .089). All paths in the model were statistically significant ( <i>p</i> ' 0.05).</p><p><strong>Conclusions: </strong>The SEM analysis demonstrated that dietary habits, handgrip strength, social participation, access to healthcare services, and physical exercise were positively associated with intrinsic capacity, while age, pain, and hospitalization showed negative associations. These findings suggest that primary care approaches focusing on multi-domain interventions, particularly health promotion, self-care, and early screening, may be promising areas for future public health initiatives. Community-based programs integrating these modifiable factors should be prioritized to promote intrinsic capacity and functional independence among Chinese community-dwelling older adults.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251346433"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227898/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561475","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":"Integrating Ambulatory Care Pharmacists Into Value-Based Primary Care: A Scalable Solution to Chronic Disease.","authors":"Alexander J Blood, Harry Saag, Adam Chesler, Dalia Ameripour, Max Gutierrez, Van Nguyen, Cassandra Richardson, Clive Fields, Jen Clair, Aaron Yao, Sashi Moodley","doi":"10.1177/21501319241312041","DOIUrl":"10.1177/21501319241312041","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Patients living with chronic diseases require more medical attention, including more visits to primary care. However, primary care providers are overburdened, and this specialty is attracting fewer new providers than before. Clinical pharmacists can augment these efforts by improving disease state control. In this cohort study, we aimed to demonstrate a retail pharmacy hired and trained clinical pharmacist within a value-based primary care clinic network can improve hypertension (HTN) and type 2 diabetes mellitus (T2DM) control.</p><p><strong>Methods: </strong>In this cohort study, a pharmacist, enabled by a collaborative drug therapy management agreement, prescribed and titrated therapies for HTN and T2DM. Primary outcomes were pre- to post-index changes in hemoglobinA1c, systolic, and diastolic blood pressure (BP) measures.</p><p><strong>Results: </strong>The HTN cohort consisted of 43 patients and the T2DM cohort consisted of 125 patients. The difference-in-differences (β) in the HTN group was -10.2 mmHg (<i>P</i> < .01) for systolic BP and -2.0 mmHg (<i>P</i> = .42) for diastolic BP. The β in the T2DM group was -1.16% (<i>P</i> < .001).</p><p><strong>Conclusions: </strong>Statistically significant reductions in systolic BP and hemoglobinA1c were observed in the pharmacist-managed group compared with matched controls. These results demonstrate that pharmacist integration into a value based primary care clinic may improve measures of chronic disease associated with morbidity and mortality.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319241312041"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11713977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956814","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":"Providers' Beliefs and Values: Understanding Their Approach to Gender-Affirming Care.","authors":"Ahona Shirin, Maya Daniello, Laura Stamm","doi":"10.1177/21501319241312574","DOIUrl":"10.1177/21501319241312574","url":null,"abstract":"<p><strong>Objectives: </strong>This qualitative study explored the beliefs and values influencing healthcare providers' delivery of gender-affirming care (GAC) to transgender and gender-diverse (TGD) youth amidst current social and political dynamics.</p><p><strong>Methods: </strong>The study PI conducted 43 semi-structured interviews with providers across states with varying GAC legislation. Responses from 41 providers were analyzed in this paper. A thematic approach to data analysis was employed using qualitative coding.</p><p><strong>Results: </strong>Key themes emerged: criteria for treatment, ethical and moral considerations, and professional and personal responsibility. Providers widely endorsed GAC as evidence-based and essential for alleviating distress and promoting autonomy. They emphasized the importance of respecting patients' gender identities and viewing GAC as life-saving.</p><p><strong>Conclusion: </strong>Despite legislative challenges, the study highlights a strong consensus among providers on the medical necessity of GAC for TGD youth.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319241312574"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11700393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142928381","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}