Journal of Primary Care and Community Health最新文献

{"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}

{"title":"SNAP and/or WIC Participation and Diet Quality in Mother-Child Dyads living in Greater Boston after Pandemic: A Mixed-Method Study.","authors":"Thanit Vinitchagoon, Fang Fang Zhang, Rebecca C Fauth, Erin Hennessy, Ana G Maafs, Emma M Browning, Christina D Economos","doi":"10.1177/21501319251317334","DOIUrl":"10.1177/21501319251317334","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Since the COVID-19 pandemic, few studies have examined how participation in Supplemental Nutrition Assistance Program (SNAP) and/or Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) impacts diet quality in families with young children. This study aims to explore the association between SNAP and/or WIC participation and diet quality in mother-child dyads in Greater Boston, MA.</p><p><strong>Methods: </strong>A mixed-method approach involving cross-sectional surveys and in-depth interviews were utilized. Participants included 69 mother-child dyads for quantitative and 18 mothers for qualitative data collection. Analysis of covariance using generalized linear models was employed to compare differences in Healthy Eating Index-2015 (HEI-2015) scores based on SNAP and/or WIC participation, and thematic analysis was used for coding themes.</p><p><strong>Results: </strong>Mothers who participated in SNAP and/or WIC were more from lower socioeconomic backgrounds. After adjusting for age, race/ethnicity, and education, no significant differences in diet quality were found for both mothers and their children. However, qualitative results showed that mothers prioritized their children's nutrition, used benefits to buy fruits and vegetables, and experienced stress that impacted their own diet quality.</p><p><strong>Conclusions: </strong>Since the pandemic, SNAP and WIC appeared to support families experiencing socioeconomic disadvantage (e.g., lower income and educational attainment) to improve diet quality, particularly through increased access to fruits and vegetables. However, these programs have not fully eliminated persistent disparities in diet quality, which seems to continue even the pandemic's immediate effects have subsided.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251317334"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11800251/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143190796","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":"An Innovative Clinic-Based Intervention to Improve Adolescent Access to Sexual and Mental Health Services: The Total Teen Program.","authors":"Whitney Garney, Gan Han, Christi Esquivel, Kristen Garcia, Kobi V Ajayi, Kelly Wilson","doi":"10.1177/21501319251315307","DOIUrl":"10.1177/21501319251315307","url":null,"abstract":"<p><strong>Objective: </strong>Adolescents encounter numerous healthcare access barriers, leading to poor health outcomes. Researchers developed the Total Teen (TT) program to improve access to sexual and reproductive health (SRH) and mental health (MH) services in settings providing adolescents and young adults (12-25) health services. This pilot study assessed the TT's impact on care across three settings: school-based health clinics, a federally qualified health center, and an adolescent health clinic for 12 weeks.</p><p><strong>Methods: </strong>Sociodemographic data, including age, race/ethnicity, gender, and insurance status, were collected. MH was assessed using patient health questionnaire (PHQ)-9 and generalized anxiety disorder (GAD)-2 scales, and sexual health was evaluated based on CDC guidelines and additional evidence-based questions. One-on-one time, confidential consultations, SRH and MH micro visits, and referrals measured access. Descriptive statistics, Pearson Chi-square tests, and Kruskal-Wallis tests compared site outcomes, while logistic regression models adjusted for age, gender, race, and site.</p><p><strong>Results: </strong>Four hundred and fifty-one participated in the TT program across the three sites. Concerning micro visits and referrals, being male was associated with lower depression rates (<i>P</i> = .0003) and generalized anxiety disorder (<i>P</i> = .0099). Being males also predicted micro visit receipt (<i>P</i> = .0199). Concerning SRH micro visits, higher sexual behavior scores (<i>P</i> < .0001) were significantly associated with a greater likelihood of utilizing SRH micro visits.</p><p><strong>Conclusions: </strong>Results indicate that TT improves access to SRH and MH services and referrals for at-risk adolescents. Findings underscore the importance of integrating SRH and MH services into routine adolescent care and involving health organizations and providers as key stakeholders in enhancing preventive healthcare access.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251315307"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775955/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061095","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":"Gender and Health in Asia: Toward Gender-Affirming Care in the ASEAN Region.","authors":"Rowalt Alibudbud","doi":"10.1177/21501319251316667","DOIUrl":"10.1177/21501319251316667","url":null,"abstract":"","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251316667"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11775968/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143061096","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":"The Mental Health Paradox of COVID-19 Prevention: Adherence, Fatigue, and Depression in a Longitudinal Perspective.","authors":"Jiahui Jin, Daniel W L Lai, Elsie Yan, Vincent W P Lee","doi":"10.1177/21501319251334207","DOIUrl":"https://doi.org/10.1177/21501319251334207","url":null,"abstract":"<p><strong>Objectives: </strong>The COVID-19 pandemic presented significant challenges, particularly the psychological impact of prolonged preventive measures. This study aimed to explore the longitudinal relationships among adherence, anti-pandemic fatigue, and depression, focusing on how these dynamics evolved.</p><p><strong>Methods: </strong>A prospective longitudinal survey was conducted among 627 adults in Hong Kong during the pandemic across 3 waves. Repeated measures ANOVA, cross-lagged path modeling, and mediation model were employed to assess temporal relationships among adherence, anti-pandemic fatigue, and depression.</p><p><strong>Results: </strong>Adherence at T3 significantly predicted T4's anti-pandemic fatigue (<i>B</i> = 0.196, SE = 0.055) and depression (<i>B</i> = 1.690, SE = 0.247), and anti-pandemic fatigue significantly predicted T4's depression (<i>B</i> = 0.684, SE = 0.260). These effects diminished at later waves, reflecting psychological relief as restrictions eased. Notably, adherence was found to increase anti-pandemic fatigue, which in turn exacerbated depressive symptoms.</p><p><strong>Conclusion: </strong>While relationships varied over the 3 time points, the longitudinal design has clarified the causal inference. The study highlights the mental toll of prolonged restrictions and emphasizes the importance of designing integrative strategies that support adherence while addressing fatigue and depression. These findings offer actionable insights for primary care and community health programs in managing future public health emergencies.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251334207"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033405/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024387","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":"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":"Intralesional Injection of Vitamin D3 for Treatment of Cutaneous Warts: A Randomized, Double-Blind, Placebo-Controlled Trial.","authors":"Stephen P Merry, David N Brennan, Michelle J Duvall, Joseph B Stanek, Erin K O'Dowd, Tom D Thacher","doi":"10.1177/21501319251365853","DOIUrl":"https://doi.org/10.1177/21501319251365853","url":null,"abstract":"<p><strong>Introduction: </strong>Treatment of cutaneous warts with intralesional vitamin D3 has demonstrated promising results in over 35 studies with methodological limitations.</p><p><strong>Methods: </strong>We conducted a randomized, double-blind, placebo-controlled trial in our primary care procedure clinic of intralesional vitamin D3 12 000 IU vs placebo in cutaneous warts every 4 weeks up to 3 times. Warts were assessed 4, 8, 12, and 24 weeks after the initial injection. The primary outcome was complete wart resolution. Reduction in wart size was a secondary outcome.</p><p><strong>Results: </strong>Between October 2020 and April 2023, we enrolled 77 participants with 1 or more cutaneous warts (41 and 36 in vitamin D3 and placebo groups, respectively) with untreated (32%) and recalcitrant (69%) warts. At 24 weeks, the index wart had resolved in 12 (30%) of vitamin D3 and 10 (31%) placebo participants. Treatment with vitamin D3 had no effect on wart surface area in an adjusted model nor wart resolution in analysis adjusted for baseline wart size, multiple warts, and the vehicle (OR 0.31 [95% CI] 0.01-10.3; <i>P</i> = 0.51).</p><p><strong>Conclusions: </strong>These results demonstrate a lack of benefit of intralesional vitamin D3 in cutaneous warts.(ClinicalTrials.gov number NCT04278573).</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251365853"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12375156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144973631","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}