Journal of Primary Care and Community Health最新文献

{"title":"An Association Between State Laws Limiting Local Control and Community Smoke-Free Indoor Air in the United States.","authors":"Sunday Azagba, Todd Ebling, Alperen Korkmaz, Jessica King Jensen, Fares Qeadan, Mark Hall","doi":"10.1177/21501319241280905","DOIUrl":"https://doi.org/10.1177/21501319241280905","url":null,"abstract":"<p><p>This study examines the association between state laws limiting local control (preemption laws) and local smoke-free policies. We utilized policy data from the American Nonsmokers' Rights Foundation. The primary outcome variable is the presence of a \"100% smoke-free policy,\" across any of 4 indoor settings: workplaces, restaurants, bars, and gaming venues. We employed generalized structural equation modeling to investigate the relationship between state laws pre-empting smoke-free indoor air regulation and local adoption of policies requiring smoke-free air in any public venues, or for specific venues, adjusting for sociodemographic characteristics. Our findings reveal a significant association between state preemption laws and the presence of a local 100% smoke-free indoor policy as of 2023. In states with preemption laws, cities were less likely to have a 100% smoke-free indoor policy at any venue than cities in states without preemption laws (OR = 0.07, 95% CI = 0.05-0.10). When considering specific smoke-free venues, cities in states with preemption laws were less likely to have a 100% smoke-free indoor policy covering workplaces (OR = 0.05, 95% CI = 0.03-0.09), restaurants (OR = 0.04, 95% CI = 0.02-0.07), bars (OR = 0.04, 95% CI = 0.03-0.08), and gaming venues (OR = 0.03, 95% CI = 0.01-0.09) compared to cities in states without preemption laws. Our study suggests that state preemption laws limit local decision-making and the implementation of public health policies focused on tobacco harms.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241280905"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11403690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298420","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":"Motivation and Use of Telehealth Among People with Depression in the United States.","authors":"Soumitra S Bhuyan, Saurabh Kalra, Asos Mahmood, Akasha Rai, Kahuwa Bordoloi, Urmi Basu, Elizabeth O'Callaghan, Marilyn Gardner","doi":"10.1177/21501319241266515","DOIUrl":"https://doi.org/10.1177/21501319241266515","url":null,"abstract":"<p><strong>Introduction: </strong>The global mental health crisis, compounded by the challenges of the COVID-19 pandemic, underscores the urgent need for accessible mental health care solutions. Telehealth services have emerged as a promising technology to address barriers to access mental health services. However, population-based studies examining telehealth utilization among individuals with depression are limited.</p><p><strong>Methods: </strong>Using data from the National Cancer Institute's Health Information National Trends Survey (HINTS) of 2022 (n = 4502), we investigated telehealth utilization among individuals diagnosed with depression in the United States. We employed multivariable logistic regression analysis to assess the association, adjusting for demographics, health behaviors, health status, trust in the medical system, and access to transportation. We also studied the factors that motivated the use of telehealth among individuals diagnosed with depression.</p><p><strong>Results: </strong>In the multivariable adjusted logistic regression models, individuals diagnosed with depression (AOR 2.59, 95% CI 1.96-3.42) were significantly more likely to use telehealth services relative to individuals with no depression diagnosis. Other factors associated with increased telehealth use included women (AOR 1.36, 95% CI 1.07-1.72), Hispanic ethnicity (AOR 1.78, 95% CI 1.28-2.48), being married or living with a partner (AOR 1.30, 95% CI 1.05-1.62), frequent healthcare visits (AOR 2.31, 95% CI 1.71-3.11), health insurance coverage (AOR 1.86, 95% CI 1.04-3.34), confidence in self-care (AOR 1.38, 95% CI 1.07-1.78), and lack of reliable transportation (AOR 1.57, 95% CI 1.01-2.42). Major motivation factors that influenced telehealth use among individuals with depression primarily included convenience, such as reduced travel times, as well as clinicians' recommendations.</p><p><strong>Conclusion: </strong>Telehealth is a promising option for accessing mental health care, particularly for those with depression. Further research is needed to understand how well telehealth works and how it can be combined with traditional care, ensuring fair costs and keeping information safe.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241266515"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409303/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298439","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 Healthcare Providers' Activities in Linking Patients With Chronic Diseases to Community Organizations: A Scoping Review.","authors":"Nevena Grgurevic, Maud-Christine Chouinard, Édith Ellefsen, Émilie Hudon, Catherine Hudon","doi":"10.1177/21501319241257374","DOIUrl":"10.1177/21501319241257374","url":null,"abstract":"<p><strong>Context: </strong>Aging and increasing comorbidities in the population are leading to more complex care for patients and primary healthcare providers. Community organizations (COs) may play a role in the services offered to support patients with chronic diseases (PCDs) but there are currently no clear guidelines to support primary healthcare providers in linking patients to COs.</p><p><strong>Objectives: </strong>The aim of this study was to describe the role of primary healthcare providers regarding linking PCDs to COs by: (1) describing linking activities; and (2) identifying the main facilitators and barriers associated with these activities.</p><p><strong>Methods: </strong>This scoping review was based on the Arksey and O'Malley method, completed by Levac, Colquhoun, and O'Brien. Related keywords were used in 7 databases to search relevant studies. After the initial screening, 135 full texts were assessed for eligibility by 2 reviewers using inclusion/exclusion criteria. Empirical studies describing activities performed by primary healthcare providers in linking PCDs to COs or describing facilitators or barriers to linking activities were included. Studies describing activities linking to other services than COs or located in emergency departments were excluded.</p><p><strong>Results: </strong>In total, 28 studies were included. Information reported in the studies was classified into 8 main linking activities: capacity development, patient identification, assessment, information, planning, referral, follow-up, and collaboration. Facilitators and barriers to these activities were related to intrapersonal characteristics of providers and patients, professional practice, work environment, relationships, and external influences. Healthcare providers' involvement was often adapted according to their field of practice.</p><p><strong>Conclusion: </strong>This scoping review details the role of primary healthcare providers when linking PCDs to COs in a collaborative and interdisciplinary context, which can be adapted to clinical practice by providers, experts, or stakeholders to support improvement in chronic care management.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241257374"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11437569/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298457","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":"Fear of Crime During Years of Street Violence Is Associated With Worsening Cardiovascular Health Status.","authors":"Oscar H Del Brutto, Robertino M Mera, Victor J Del Brutto, Denisse A Rumbea, Emilio E Arias, Mark J Sedler","doi":"10.1177/21501319241305951","DOIUrl":"10.1177/21501319241305951","url":null,"abstract":"<p><strong>Background: </strong>Street violence has detrimental effects on cardiovascular health (CVH). However, the significance of these consequences have not been systematically evaluated. In this study, we aimed to assess the impact of fear of crime on CVH status among community-dwellers aged ≥40 years living in a rural village stricken by violence.</p><p><strong>Methods: </strong>Participants were selected from individuals enrolled in the Atahualpa Project Cohort, a population-based longitudinal study that aims to reduce the burden of cardiovascular risk factors and diseases in rural Ecuador. Fear of crime was evaluated using a structured scale. The Life's Simple 7 construct of the American Heart Association was employed to assess CVH before the escalation of violence and crime in the village (2019) and at the end of the study (2024). Multivariate logistic regression models were fitted to examine the association between the exposure and outcomes.</p><p><strong>Results: </strong>A total of 648 individuals (mean age = 57.4 ± 11.7 years; 56% women) were included. At the end of the follow-up, significant association between fear of crime levels and worsening CVH status was noted. Participants allocated to the second and third tertiles of fear of crime were 3.27 (95% CI = 2.07-5.19) and 5.46 (95% CI = 3.14-9.48) times more likely to have worsening CVH status at follow-up compared to baseline determinations, respectively.</p><p><strong>Conclusion: </strong>This study shows an aggravating impact of fear of crime on the CVH status and identifies interventional targets that may help to reduce the risk of CVH status worsening in community-dwellers living in rural settings afflicted by violence.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241305951"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11624535/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142792658","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":"Feasibility and Acceptability of a Mobile-Assisted Screening and Brief Intervention for Multiple Health Behaviors in Medical Settings.","authors":"Camille Forcier, Aymery Constant, Florine Grisard, Elise Clair, David Val-Laillet, Ronan Thibault, Romain Moirand","doi":"10.1177/21501319241303604","DOIUrl":"10.1177/21501319241303604","url":null,"abstract":"<p><strong>Introduction: </strong>Leveraging every interaction between patients and healthcare professionals constitutes an opportunity to foster behavior change. We developed a mobile Screening and Brief Intervention (mSBI) designed to screen for and intervene with multiple health behaviors, based on a personalized feedback. The objectives of the present study were to assess its feasibility during consultations for chronic conditions, collect users' opinions, and to investigate patients' behaviors and intention to change.</p><p><strong>Methods: </strong>Research counselors provided the mSBI to patients from 2 departments at University Hospital. Socio-demographic, behavioral, and acceptability data were collected from patients together with feasibility data from counselors' reporting.</p><p><strong>Results: </strong>A total of 259 participants were analyzed, aged 51 ± 17 years, with a majority of women (53%). The m-SBI averaged 20 min and most patients (92%) could complete the screening with minimal assistance. Medical doctors' involvement facilitated referral to and uptake of the m-SBI, and limited adverse events. On average, patients adhered to 11 of the 18 guidelines screened. A majority of patients rated the personalized feedback as comprehensible and useful. Nearly half of them intended to change behavior.</p><p><strong>Conclusions: </strong>The m-SBI seems well-accepted and useful, but doctor referral, adapting the screening tool to patients with low health literacy, and app's ability to send the feedback to patients/doctors are essential for feasibility.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241303604"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663265/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142873250","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":"Evaluating the Scope of Services and Monetary Impact of Charity Medical Clinics in North Texas.","authors":"Logan G Mills, Barbara Newsom, Abigail Lewis, Alexandra Pottorff, Ashley Wallace Wu, Erika Castro, Kelsi Morgan, Lawrence Wu, Bau P Tran, Katherine Lake, Mina Guirguis, James M Wagner, Nora Gimpel, Tiffany B Kindratt","doi":"10.1177/21501319241304143","DOIUrl":"10.1177/21501319241304143","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>The cost of medical services is a major barrier to healthcare accessibility for underserved populations in the United States. Community charity medical clinics help address this disparity by providing free or reduced-cost care for the medically underinsured; however, their economic and public health contributions are unknown. The objective of this study was to evaluate the scope of services and monetary impact of 4 community charity medical clinics in North Texas, with one of the largest medically underinsured populations in the United States.</p><p><strong>Methods: </strong>A cross-sectional study was conducted using electronic health records from 4 clinics serving adults and children in North Texas. Encounters from June 1 to December 31, 2018 completed by with sufficient documentation to assign a level of service were reviewed. There were 3942 encounters identified and 2148 (54.5%) audited. Centers for Medicare and Medicaid Services Evaluation and Management Standards were used to identify level of service provided for each encounter, and their subsequent value was determined based on CMS fee-for-service schedules at the time service was provided. Common conditions managed during these encounters were identified using ICD-10 codes documented with each encounter.</p><p><strong>Results: </strong>The most prevalent diagnoses encountered were hypertension, diabetes, hyperlipidemia, and major depressive disorder. We estimate the total value of services and medications provided for 1 year is between $840 278.30 to $845 737.41.</p><p><strong>Conclusions: </strong>The charity clinics in North Texas provide a significant economic impact through a high level of charity care and a broad scope of services for a vulnerable patient population. The results may be used in the development and implementation of future services to meet the needs of the medically underinsured.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241304143"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11607747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142755623","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":"Vaccine Hesitancy Affecting Pneumococcal Vaccine Refusal in Older Adults with Morbidities.","authors":"Woothikrai Chitaree, Nida Buawangpong, Thanachat Yotruangsri, Wichuda Jiraporncharoen, Kanokporn Pinyopornpanish","doi":"10.1177/21501319241303568","DOIUrl":"10.1177/21501319241303568","url":null,"abstract":"<p><strong>Introduction: </strong>Pneumonia is a leading cause of mortality worldwide, with Streptococcus pneumoniae being the most common cause. Older adults are particularly at risk. However, vaccination rates in Thailand remain low.</p><p><strong>Objective: </strong>This study aims to examine the prevalence of vaccine refusal and its association with factors outlined in the 5C model (Confidence, Complacency, Constraints, Calculation, and Collective Responsibility) among older patients with morbidities.</p><p><strong>Setting: </strong>Study was conducted at outpatient clinic of the Department of Family Medicine, Chiang Mai University.</p><p><strong>Methods: </strong>An observational cross-sectional study. The data was collected via a self-administered questionnaire including demographic data, questionnaire in 5C model, and intention to received pneumococcal vaccine. Comparison of characteristic between vaccine refuser and non-refuser was performed by using Chi-square or a <i>T</i>-test. To explore the association between factors in 5C model and vaccine refusal, multiple logistic regression was performed with an adjustment for confounders.</p><p><strong>Results: </strong>From a total of 150 participants, the mean age was 69.8 ± 5.6 years old. Most of the patients were female (60.7%). The study found that 18% of the participants refused the pneumococcal vaccine. After adjusted for the confounders, the lower collective responsibility and confidence were significantly associated with vaccine refusal (Odds ratio 0.22 (95% confidence interval [CI] 0.06-0.74, <i>P</i> = .015) and Odds ratio 0.43 (95% CI 0.20-0.89, <i>P</i> = .024), respectively.</p><p><strong>Conclusion: </strong>Strategies to enhance confidence and address complacency about vaccines are essential for improving pneumococcal vaccination coverage. This insight can be used as a guideline and policies can be formulated which are aimed at reducing pneumococcal vaccine refusal in the older adults by enhancing communication about the benefits, efficacy, and risks of vaccines.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241303568"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11605742/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142751921","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":"Cross-Cultural Adaptation and Validation of the Perception of the Doctor-Patient Relationship (PREMEPA) Questionnaire in Chronic Multi-Pathological Patients.","authors":"María Zarza-Arribas, Juan Francisco Menárguez Puche, Rosario Morales López, Josep Xavier Barber Valles, Domingo Luis Orozco Beltrán","doi":"10.1177/21501319241241198","DOIUrl":"10.1177/21501319241241198","url":null,"abstract":"<p><strong>Objective: </strong>To conduct a cross-cultural adaptation and validation in Primary Care of the PREMEPA doctor-patient relationship perception questionnaire.</p><p><strong>Design: </strong>Descriptive, cross-sectional study, using self-administered questionnaires. Qualitative validation: an adapted version of the original questionnaire, was adapted to our culture. The process consisted of the evaluation, cross-cultural adaptation and consensus of a group of experts. The questionnaire was piloted on a sample of 32 patients diagnosed with at least 2 chronic pathologies.</p><p><strong>Measures: </strong>Cognitive piloting, comprehensibility assessment, content validation and internal consistency analysis using Cronbach's alpha coefficient. Quantitative validation: the internal consistency, construct validity and validity of the questionnaire were studied by means of a confirmatory factor analysis developed in a multicenter study, randomly selecting 202 patients with at least 2 chronic pathologies.</p><p><strong>Results: </strong>Content validity of the new Spanish version was confirmed to be adequate. Comprehensibility and internal consistency (Cronbach's α coefficient = 0.78) were adequate. The confirmatory factor analysis showed good dimensionality, factor relationship and internal consistency, as well as acceptable construct validity. The final result was a 13-item questionnaire consisting of 2 dimensions, which explain 58.5% of the variance: participation in decision-making (accounting for 45.2% of the variance) and person-centered communication (encompassing courtesy, empathy, humanity, and trust).</p><p><strong>Conclusions: </strong>This adapted version of the PREMEPA questionnaire can be considered valid for use in the Spanish population with a history of chronic pathology. This version of PREMEPA provides a new instrument to understand and improve chronic patient care, which can improve the doctor-patient relationship, encouraging adherence to treatment and enhancing health outcomes.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241241198"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10981856/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140330217","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 Impact of Biological and Social Factors on Mortality in Older Adults Living in Rural Communities.","authors":"Oscar H Del Brutto, Robertino M Mera, Denisse A Rumbea, Mark J Sedler","doi":"10.1177/21501319241228123","DOIUrl":"10.1177/21501319241228123","url":null,"abstract":"<p><strong>Background: </strong>Information on factors that increase mortality in remote settings is limited. This study aims to estimate the independent and joint role of several factors on mortality risk among older adults living in rural Ecuador.</p><p><strong>Methods: </strong>Participants were selected from community-dwelling older adults who were included in previous studies targeting mortality risk factors in the study population. Generalized structural equation modeling (GSEM) was utilized to evaluate prior causal assumptions, to redraw causal links, and to introduce latent variables that may help to explain how the independently significant variables are associated with mortality.</p><p><strong>Results: </strong>The study included 590 individuals (mean age: 67.9 ± 7.3 years; 57% women), followed for a median of 8.2 years. Mortality rate was 3.4 per 100 person-years. Prior work on separate multivariate Poisson and Cox models was used to build a tentative causal construct. A GSEM containing all variables showed that age, symptoms of depression, high social risk, high fasting glucose, a history of overt stroke, and neck circumference were directly associated with mortality. Two latent variables were introduced, 1 representing the impact of biological factors and another, the impact of social factors on mortality. The social variable significantly influenced the biological variable which carried most of the direct effect on mortality.</p><p><strong>Conclusions: </strong>Several factors contributed to mortality risk in the study population, the most significant being biological factors which are highly influenced by social factors. High social risk interact with biological variables and play an important role in mortality risk.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241228123"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10807323/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139541813","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 Role of an Early Childhood Community Health Worker in Addressing Psycho-Social Needs in the Perinatal and Early Childhood Period.","authors":"Sahar Moheize, Mandy Hsu, Luz Adriana Matiz, Patricia Peretz, Kristy Medina, Amanda Esteves, Dodi Meyer, Beth Maletz, Lucie Pineda, Evelyn Berger-Jenkins","doi":"10.1177/21501319241234478","DOIUrl":"10.1177/21501319241234478","url":null,"abstract":"<p><strong>Objective: </strong>Addressing family psychosocial and mental health needs in the perinatal and early childhood period has a significant impact on long-term maternal and child health and is key to achieving health equity. We aimed to (1) describe and evaluate the role of an Early Childhood Community Health Worker (EC-CHW) to address psychosocial needs and improve psychosocial well-being for families in the perinatal period, and (2) examine factors associated with completion of goals.</p><p><strong>Methods: </strong>An EC-CHW program was modeled after an existing hospital CHW program for children with special healthcare needs and chronic disease. An evaluation was conducted using repeated measures to assess improvements in psychosocial outcomes such as family stress and protective factors after participating in the EC-CHW program. Linear regression was also used to assess factors associated with completion of goals.</p><p><strong>Results: </strong>Over a 21-month period (January 2019-September 2020), 161 families were referred to the EC-CHW. The most common reasons for referral included social needs and navigating systems for child developmental and behavioral concerns. There were high rates of family engagement in services (87%). After 6 months, families demonstrated statistically significant improvements in protective factors including positive parenting knowledge and social support. Only 1 key predictor variable, maternal depression, showed significant associations with completion of goals in the multivariable analysis.</p><p><strong>Conclusions: </strong>This study demonstrated the need for, and potential impact of an EC-CHW in addressing psychosocial and mental health needs in the perinatal period, and in a primary care setting. Impacts on protective factors are promising.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241234478"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10916458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040645","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}