Journal of Primary Care and Community Health最新文献

{"title":"Exploring Men's Experiences of Engagement With General Practice: A Qualitative Study.","authors":"Ruth Mursa, Christopher Patterson, Gemma McErlean, Elizabeth Halcomb","doi":"10.1177/21501319251318447","DOIUrl":"10.1177/21501319251318447","url":null,"abstract":"<p><strong>Introduction: </strong>As males are less engaged with healthcare than females, they often present when a condition is more advanced, reducing the potential for early intervention. Little is known about why men are less engaged and what influences them to be more proactive. This study sought to explore men's experiences of engagement with general practice.</p><p><strong>Methods: </strong>A qualitative descriptive study was nested within a sequential mixed-methods project. Semi-structured interviews were undertaken with 17 male staff and volunteers of the New South Wales Rural Fire Service about their experiences, attitudes, and preferences for general practice engagement. Thematic analysis was used to analyze data.</p><p><strong>Results: </strong>Five sub-themes emerged about men's engagement with general practice. \"Reasons for engagement\" revealed motivations for seeking healthcare. \"Seeking validation\" explained how social influences impacted engagement. The \"importance of relationships\" highlighted the value men place on trust with the healthcare provider/team, and how this impacts engagement. \"Interpersonal communication\" addressed preferences for direct and authentic communication. Finally, \"barriers to engagement\" revealed the challenges in accessing care.</p><p><strong>Conclusions: </strong>Awareness of the barriers and facilitators to men's engagement with general practice can inform strategies to improve care. This study suggests that health professionals play a crucial role in building therapeutic relationships with men and partnering with them in their healthcare journey to improve engagement and health outcomes.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251318447"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803725/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143256548","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 2-Year Retrospective Clinical Evaluation of a Novel Virtual Ward Model.","authors":"Juliana Pugmire, Abdul Ashish, Alison Chadwick, Matt Wilkes, Daniel Meekin, Ben Zaniello, Nicole Zahradka","doi":"10.1177/21501319251326750","DOIUrl":"10.1177/21501319251326750","url":null,"abstract":"<p><strong>Objective: </strong>The Wrightington, Wigan, and Leigh NHS Teaching Hospitals Foundation Trust (WWL) developed a novel virtual ward (VW) service that integrated with community and primary care, supported healthcare throughout a patient's journey, and had a clinical workflow that could step-up or step-down care as needed. We described their VW and evaluated clinical outcomes, adherence, safety, and patient satisfaction.</p><p><strong>Methods: </strong>Retrospective, single-center study of patients admitted to the WWL VW service from January 14, 2022 to January 31, 2024. Clinical data collected by WWL in their database for patients admitted to the VW, were matched to data captured automatically by the Current Health (CH) platform linked to the CH remote monitoring kits assigned to patients on the VW. The CH kits enabled the VW care at WWL and included a wearable device for continuous vital signs monitoring, a blood pressure cuff, and tablet. Evaluation metrics included clinical scope, clinical outcomes, adherence, safety, and patient satisfaction.</p><p><strong>Results: </strong>There were 1835 admissions and a 93% match rate between the clinical and CH databases. About 38% of referrals were step-up (31% ambulatory care and 7% primary care) and 62% of referrals were step-down (100% inpatients). Most specialty referrals were from thoracic and acute medicine (77%). The median length of stay on the VW was 8 days [IQR 5-13], 209 (12%) admissions were escalated to the hospital, 179 (11%) escalated to the emergency department out of hours, and 29 (2%) signposted to urgent medical services. Adherence to the wearable device was 92%. There were 38 minor safety incidents (typically hypersensitivity reactions or administrative errors) and 17 expected deaths. About 94% of admissions rated the VW experience as \"excellent\" or \"good.\" Results were similar between step-up and step-down referrals.</p><p><strong>Conclusion: </strong>We have shown the VW service yielded acceptable clinical outcomes, was safe with no serious adverse events or negative impact on mortality rate. Patient adherence to the technology and satisfaction with the VW service were high. The VW service was innovative in its acceptance of a broad range of patients, expanding services beyond respiratory medicine, and in developing a step-up pathway, preventing some patients from ever taking up an acute bed in the hospital.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251326750"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11926843/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143665068","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":"Community-Engaged Mental Health and Wellbeing Initiatives in Under-Resourced Settings: A Scoping Review of Primary Studies.","authors":"Muhammad Chutiyami, Natalie Cutler, Sopin Sangon, Tusana Thaweekoon, Patcharin Nintachan, Wilai Napa, Phachongchit Kraithaworn, Jo River","doi":"10.1177/21501319251332723","DOIUrl":"10.1177/21501319251332723","url":null,"abstract":"<p><strong>Introduction: </strong>Community-engaged initiatives are identified as promising to improve the health of communities with limited resources. This review aims to examine community-engaged mental health/wellbeing initiatives across Low- and Middle-Income Countries (LMIC) and under-resourced settings of High-Income Countries (HIC).</p><p><strong>Methods: </strong>We searched CINAHL, Embase, MEDLINE, PsycINFO, and Scopus databases to identify eligible primary studies until August 2024. Studies conducted in English language, involving community members in the initiatives' design or implementation and targeting 1 or more mental health/wellbeing outcomes, were included.</p><p><strong>Results: </strong>About 35 studies (n = 35) reporting 29 mental health/wellbeing initiatives across LMIC-(n = 24) and HIC-(n = 11) were included. Programmes with high community engagement, including community-led initiatives, consistently reported positive mental health and well-being outcomes, including reduced clinical symptoms and enhanced personal recovery and wellbeing. However, mixed outcomes on initiatives' impact on quality of life and diagnosed mental health conditions were evident. Various challenges, including cultural barriers, were noted, as was a lack of involvement of people with lived experience of mental health challenges.</p><p><strong>Conclusion: </strong>Community-engaged mental health and wellbeing initiatives in under-resourced settings have shown the potential to improve mental health outcomes and well-being when actively involving community members. Future work should focus on scalable initiatives and active inclusion of people with lived experience of mental health challenges.Review protocol registration at https://doi.org/10.17605/OSF.IO/367BK.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251332723"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12035253/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053803","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":"High Social Risk and Biomarkers of Systemic Inflammation: A Population-Based Study in Middle-Aged and Older Adults Living in Rural Communities.","authors":"Oscar H Del Brutto, Denisse A Rumbea, Emilio E Arias, Kleber Arriaga, Robertino M Mera","doi":"10.1177/21501319251344427","DOIUrl":"10.1177/21501319251344427","url":null,"abstract":"<p><strong>Background: </strong>The association between social risk and biomarkers of inflammation remains underexplored in low-resource communities, where social risk and levels of inflammation differ from those in industrialized urban centers. This study aims to assess the association between levels of social risk and biomarkers of inflammation in adults residing in remote rural settings.</p><p><strong>Methods: </strong>This population-based, cross-sectional study involved 1392 community-dwellers aged ≥40 years. Social risk was assessed using the social determinants of health (SDH) included in Gijon's Social Familial Evaluation Scale (SFES). Biomarkers of inflammation were measured through the Systemic Immune-Inflammation Index (SII) and the C-Reactive Protein (CRP)/albumin ratio. Both unadjusted and multivariate models were fitted to determine the independent association between SDH and biomarkers of inflammation, treated as dependent variables.</p><p><strong>Results: </strong>The mean (±SD) age of 1392 study participants was 53.8 ± 11.5 years (59% women). The mean Gijon's SFES score was 10.1 ± 2.6 points, the mean SII was 451.6 ± 240.5 × 10⁹ L, and the mean CRP/albumin ratio was 0.13 ± 0.29. Unadjusted generalized linear regression models demonstrated direct significant associations between SDH scores and both dependent variables, including SII (β: 6.12; 95% CI: 1.35-10.89) and the CRP/albumin ratio (β: 0.03; 95% CI: 0.01-0.05). These associations remained significant after adjusting for demographics, level of education, and cardiovascular risk factors for both, the SII (β: 7.24; 95% CI: 2.08-12.41) and the CRP/albumin ratio (β: 0.03; 95% CI: 0.01-0.05).</p><p><strong>Conclusions: </strong>Social risk is directly associated with biomarkers of inflammation in the study population, suggesting that inflammation may be associated with adverse health outcomes in individuals with high social risk. Study results demonstrate that this association is not only evident in high-income regions but in underserved rural communities as well.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251344427"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12102551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144129132","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":"Neighborhood Disadvantage and Genetic Testing Use Among a Nationally Representative Sample of US Adults.","authors":"Jemar R Bather, Melody S Goodman, Kimberly A Kaphingst","doi":"10.1177/21501319251342102","DOIUrl":"10.1177/21501319251342102","url":null,"abstract":"<p><strong>Introduction: </strong>Genetic testing helps individuals with disease management, family planning, and medical decision-making. Identifying individual-level factors related to the use of genetic services is essential but may only partially explain differential genetic service usage. To address this knowledge gap, we analyzed data on a national sample of US adults to evaluate whether higher neighborhood vulnerability is significantly associated with lower genetic testing utilization, controlling for sociodemographic and health characteristics.</p><p><strong>Methods: </strong>A 2024 nationally representative cross-sectional survey of 631 US adults recruited using NORC's probability-based AmeriSpeak panel. Genetic testing uptake was measured as self-reported ever use of ancestry, personal trait, specific disease, or prenatal genetic carrier testing. Secondary outcomes were indicator variables for each genetic testing type. Neighborhood vulnerability (low versus high) was measured by the Social Vulnerability Index, capturing socioeconomic factors affecting community resilience to natural hazards and disasters.</p><p><strong>Results: </strong>Forty-eight percent of the weighted sample used genetic testing services. Compared to those in low vulnerability areas, individuals in high vulnerability areas had 42% lower odds (adjusted OR: 0.58, 95% CI: 0.37-0.90) of using genetic testing services, controlling for individual-level characteristics. Secondary analyses showed no evidence of statistically significant relationships between neighborhood vulnerability and specific types of genetic testing services.</p><p><strong>Conclusion: </strong>Findings suggest that neighborhood vulnerability may contribute to differences in genetic testing uptake, which is crucial to increasing early detection of cancer susceptibility and reducing US cancer incidence. This study demonstrates the importance of going beyond examining individual characteristics to investigating structural factors negatively impacting genetic testing usage.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251342102"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12104606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144144131","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":"Comparing Health Outcomes in Patients with Hypertension Receiving Continuity of Care From Regular Family Physician With Care From Multiple Physicians: A Retrospective Cohort Study.","authors":"Galih Kunarso, Ngiap Chuan Tan","doi":"10.1177/21501319251346702","DOIUrl":"10.1177/21501319251346702","url":null,"abstract":"<p><strong>Background: </strong>Effective hypertension management requires long-term lifestyle and medication adherence facilitated by regular physician. Higher continuity of care (CoC) is postulated to lead to better outcomes.</p><p><strong>Objectives: </strong>This study compares health outcomes of patients with hypertension receiving CoC from single family physicians over 5-year period with those treated by multiple physicians.</p><p><strong>Methods: </strong>Retrospective cohort study was conducted using electronic medical records from multi-ethnic Asian adults with hypertension and other non-communicable diseases. Patients managed in Family Physician Clinic (FPC) across 7 Singapore public primary care polyclinics from 2015 to 2019 were propensity scores matched with those treated by multiple physicians in General Clinic (GC) of the same polyclinics. CoC Index (COCI), health outcomes including blood pressure (BP), LDL-Cholesterol (LDL-C), cardiovascular complications and preventive measures were compared until 2021.</p><p><strong>Results: </strong>Analysis of 6520 patients (mean age 64.8 years, 56% female, 76% Chinese) showed FPC cohort had higher COCI (mean = 0.432 vs 0.073; <i>P</i> < .001). This was associated with further reduction in diastolic BP of 0.13 mmHg (<i>P</i> < .001) and LDL-C levels of 0.01 mmol/L (<i>P</i> = .001) per year faster than in GC, with higher proportion of patients meeting LDL-C targets (74.1% vs 68.0%; <i>P</i> < .001) in 2021. FPC cohort also showed greater influenza (OR = 2.88; <i>P</i> < .001) and pneumococcal (OR = 1.34; <i>P</i> < .001) vaccinations uptake. Subgroup analysis of patients with diabetes indicated better diabetic foot screening completion (OR = 1.34; <i>P</i> < .001). No significant improvement was found in systolic BP or cardiovascular complications.</p><p><strong>Conclusion: </strong>Higher CoC in FPC led to clinically relevant improvement in LDL-C and vaccination, but not BP or cardiovascular complication rates.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251346702"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310574","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":"Physician Uncertainty, Beliefs, and Practices on Peri- and Postmenopausal Bleeding Evaluation and the Impact on Risks for Black Patients at Risk for Endometrial Cancer.","authors":"Maya Gross, Patrice Williams, Whitney Robinson, Erica Marsh, Mollie Wood, Til Stürmer, Minerva Orellana, Kemi Doll","doi":"10.1177/21501319251346096","DOIUrl":"10.1177/21501319251346096","url":null,"abstract":"<p><strong>Objectives: </strong>Endometrial cancer incidence and mortality disproportionately affect Black patients, and delayed diagnosis is a contributor. Providers in multiple settings share the task of endometrial cancer diagnosis. The purpose of this study is to elicit physician perspectives on national guidelines for the diagnosis of endometrial cancer (EC), understanding of racial disparities in EC, and to explore physician receptivity to a risk-based, endometrial biopsy (EMB)-first approach of peri/postmenopausal bleeding.</p><p><strong>Methods: </strong>We performed semi-structured interviews with 12 U.S. physicians across multiple specialties. Interview structure was developed and refined using an iterative process. We used inductive reasoning to employ exploratory content analysis.</p><p><strong>Results: </strong>We interviewed OB/Gyn (n = 4), family medicine (n = 3), internal medicine n = 3), and emergency medicine (n = 2) physicians in all regions of the U.S. Slightly over half (58%) performed EMB. Most (58%) were uncertain about guidelines for diagnosis. Nearly half (42%) reported lack of knowledge regarding racial disparities in EC diagnosis and cancer outcomes. OB/Gyn physicians were skeptical of guideline efficacy in high-risk patients, including patients identifying as Black. Most (75%) physicians supported a risk-based, biopsy-first approach to diagnosis of EC.</p><p><strong>Conclusions: </strong>Physicians caring for patients at risk for EC lack knowledge of current guidelines and of racial disparities in endometrial cancer diagnosis and outcomes. A multi-pronged approach, incorporating changes to national guidelines and targeted provider education, is necessary to eliminate inequities in diagnosis of EC.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251346096"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310593","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":"From Trials to Practice: Implementing a Clinical Intervention in Community Settings.","authors":"Elizabeth M Vaughan, Xiaoying Yu, Victor J Cardenas, Craig A Johnston, Salim S Virani, Ashok Balasubramanyam, Christie M Ballantyne, Aanand D Naik","doi":"10.1177/21501319251339190","DOIUrl":"10.1177/21501319251339190","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Diabetes increases the risk of complications, especially for vulnerable populations. Our previous randomized clinical trial (RCT), TIME (<u>T</u>elehealth-supported, <u>I</u>ntegrated Community Health Workers (CHWs), <u>M</u>edication access, group visit <u>E</u>ducation), showed the efficacy of CHW-led diabetes care. This study aimed to gather data on transitioning TIME from clinical trials to practical implementation.</p><p><strong>Methods: </strong>We conducted a 12-month RCT at a nonprofit community clinic using the Consolidated Framework for Implementation Research (CFIR). Participants, Hispanic adults without insurance and with type 2 diabetes (N = 58; 29/arm), were randomized to TIME (intervention) or usual care (control). The intervention included monthly group visits and weekly CHW mHealth contact (6 months, Action Phase), followed by quarterly visits and bi-monthly mHealth contact (6 months, Maintenance Phase). The research team provided tele-mentoring to the clinic team throughout the intervention. Outcomes included implementation measures including acceptability, adoption, appropriateness, cost, feasibility, fidelity, satisfaction, and effectiveness.</p><p><strong>Key results: </strong>The program showed high levels of fidelity (direct observation), adoption (CHW-participant contact: 844 successes of 957 attempts [88.2%]), and feasibility (3.4% attrition). The intervention's net savings was $16,435 ($566/participant). At 6 months, intervention participants had greater HbA1c reductions (-0.85% vs 0.35% [δ = 1.2%]; <i>P</i> = .004; effectiveness) compared to the control. At month 12, more intervention participants improved HbA1c (-0.52% vs 0.25% [δ = 0.8%], <i>P</i> = .062) and preventive care adherence (<i>P</i> < .0001) compared to the control. Surveys revealed high appropriateness (mean = 4.8/5.0 and 5.95/6.0), satisfaction (mean = 4.6/5.0), and acceptability (mean = 4.9/5.0) among providers, CHWs, participants, and stakeholders.</p><p><strong>Conclusions: </strong>TIME met key early implementation measures, including strong engagement at both clinic and participant levels, while demonstrating cost savings and significant clinical improvements. These results support the transition of TIME from efficacy trials to practical, community-based diabetes care. Larger studies are needed to further evaluate these findings.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251339190"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12106995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144151834","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":"Hiding in the Folds: Case Report Highlighting the Role of Imaging in Detecting Dermatofibrosarcoma Protuberans.","authors":"Carlie A Aurubin, Lorvens Decosma, Olayemi Sokumbi, Aneesah P Garrett, Cara C Prier","doi":"10.1177/21501319251314855","DOIUrl":"10.1177/21501319251314855","url":null,"abstract":"<p><p>Dermatofibrosarcoma protuberans (DFSP) is a rare slow-growing skin cancer with a great capacity for local destruction. DFSP can manifest in a myriad of ways. This case report aims to contribute to the literature by increasing awareness of this condition, along with common diagnostic practices and treatment regimens. We present a 52-year-old Filipino woman who was evaluated for dyspnea with an incidental finding of an indeterminate nodule on imaging. A comprehensive diagnostic workup confirmed dermatofibrosarcoma protuberans (DFSP), which was ultimately treated with surgical resection. Clinically, about 52% of patients are misdiagnosed, leading to poor outcomes. Therefore, awareness, early detection, multidisciplinary treatment, and lifelong screening are essential for optimal outcomes.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251314855"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11829286/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143426346","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":"Evaluation of a Learning Collaborative to Implement Postgraduate Nurse Practitioner (NP) and/or Physician Associate (PA) Residency or Fellowship Programs in a Community Health Center.","authors":"Meaghan Angers, Manjari Mishra, Amanda Schiessl, Margaret Flinter, Nicole Seagriff, Kerry Bamrick, Charise Corsino, May Oo","doi":"10.1177/21501319251329674","DOIUrl":"https://doi.org/10.1177/21501319251329674","url":null,"abstract":"<p><p>This paper presents findings from a study focused on establishing Postgraduate Nurse Practitioner (NP) and/or Physician Assistant (PA) Training Programs within federally funded health centers and look-alikes. The study aimed to identify facilitators and barriers encountered by participating health centers in the Health Resources and Services Administration (HRSA) funded Postgraduate NP and/or PA Training Programs Learning Collaborative. Of the 78 health centers that participated in the learning collaborative since 2016, 47.44% (n = 37) responded to the survey. The top facilitators for launching a program were leadership support, clinical support, and dedicated time for planning and implementation. The top barriers for not launching a program were lack of financial resources, competing priorities, and limited dedicated time for planning and implementation. Interviews echoed these findings, as well as highlighted additional facilitators of grant funding and mission-driven workforce pathway planning. Survey results from those that launched a training program revealed that 215 graduates have completed the program, with 86 employed within the health center. These findings provide valuable insights and guidance to support health centers in their journey towards building and launching a Postgraduate NP and/or PA Training Program, as well as informing future HRSA policies, programs, and funding.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251329674"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12062603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144054066","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}