Journal of Primary Care and Community Health最新文献

{"title":"Clinical Outcomes of Switching U-100 Intermediate or Basal Insulin to U-200 Insulin Degludec or U-300 Insulin Glargine.","authors":"Natalie Rosario, Cami Hunger, Allison Pettijohn, K'bria Whaley, Andrea Pabon, Valeria Hohl, Bernadette Asias-Dinh, Jodie Gee, Joshua Wollen","doi":"10.1177/21501319251327318","DOIUrl":"10.1177/21501319251327318","url":null,"abstract":"<p><strong>Introduction: </strong>Basal and intermediate insulin is available as U-100 (glargine, determir, NPH) or ultra-long-acting (ULA) U-200 (degludec) or U-300 (glargine). Insulins may be substituted with other insulin formulations based on financial factors, formulary preferences, patient preference, and patient response.</p><p><strong>Objective: </strong>Evaluate the impact on total daily dose of insulin when switching from an intermediate or basal U-100 to a ULA insulin.</p><p><strong>Methods: </strong>A single-center retrospective chart review was performed at a federally qualified health center. Patients switched from a U-100 intermediate or basal insulin to a U-200 degludec or U-300 glargine ULA insulin from 2019 to March 2024 were assessed. Clinical measures assessed were initial intermediate or basal insulin total daily dose, ULA insulin total daily dose at time of switch, at 1, 3, and 6 months, and change in HgbA1c, BMI, and weight.</p><p><strong>Results: </strong>When switched from a U-100 to a U-200 or U-300 insulin (<i>n</i> = 53), basal insulin total daily dose decreased by 13.1 units at 6 months (<i>P</i> < .05). At the 6-month mark after ULA switch, HgbA1c decreased (<i>P</i> < .001), but BMI (<i>P</i> = .161) and weight (<i>P</i> = .076) were similar. HgbA1c, BMI, weight, and total daily insulin dose were not significantly different between patients assigned U-200 and U-300 insulins.</p><p><strong>Conclusion: </strong>Patients switched from a U-100 basal insulin may utilize a lower total daily dose of a ULA insulin and experience reductions in HgbA1c, BMI, and weight.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251327318"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11960159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755223","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":"Socioeconomic Factors Associated With the Use of Telehealth in Primary Care Services During the COVID-19 Pandemic.","authors":"Carlota Quintal, Aida I Tavares, Inês Ribeiro, Victor Raposo, Pedro L Ferreira","doi":"10.1177/21501319241312564","DOIUrl":"10.1177/21501319241312564","url":null,"abstract":"<p><strong>Introduction: </strong>The main objective of this study was to assess whether socioeconomic factors were associated with the use of telehealth in primary care services in Portugal during the COVID-19.</p><p><strong>Methods: </strong>A questionnaire was administered to patients in primary healthcare units during the pandemic. The set of variables used in this study was part of a larger patient satisfaction questionnaire. A descriptive statistical analysis was performed, and a multiple logistic regression analysis was estimated to assess factors associated with using remote consultation.ResultsThe use of a remote consultation was reported by 38.2% of respondents (N = 7008), and the main reason for telehealth use was prescription renewal. Among non-users of telehealth, 40% did not know they could contact their family doctor by email. Factors positively associated with telehealth use were: older age, women, married, filled questionnaire without help, consumption of OTC and prescribed drugs, unmet healthcare needs, and registered with family doctor. The evidence suggests a negative association between education and telehealth use.</p><p><strong>Conclusions: </strong>No clear pattern emerged regarding the digital divide. The evidence shows a relevant lack of awareness regarding the possibility of using telehealth. If more complex forms of telehealth are adopted in primary care services, the digital divide might come to the surface.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319241312564"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12246532/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144585247","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 Influence of Sociocultural Determinants on the Number of Diagnosed Chronic Illness Reported by Indigenous Peoples in Canada and the United States During SARS-CoV2.","authors":"Mary G Jessome, Kimberly R Huyser, Katherine A Collins, Tom Einhorn, Tamara Chavez, Nicole Dawydiuk, Michelle Johnson-Jennings","doi":"10.1177/21501319251354833","DOIUrl":"10.1177/21501319251354833","url":null,"abstract":"<p><strong>Objectives: </strong>To determine the influence of cultural, including land-based, factors on the reported number of diagnosed chronic illnesses among Indigenous individuals living in Canada and the United States during SARS-CoV-2 (COVID-19).</p><p><strong>Methods: </strong>557 Indigenous individuals completed the <i>Hearing Indigenous Voices</i> survey (HIS) in 2021. Data from HIS respondents living with at least one chronic illness was used to conduct a Poisson regression. This equation estimated the effect of change in ancestral land use, participation in cultural activities, and demographic characteristics on the number of diagnosed chronic illnesses reported by Indigenous individuals.</p><p><strong>Results: </strong>Results demonstrate that the number of chronic illnesses reported by Indigenous individuals during COVID-19 was positively correlated with 2 cultural factors. The first is spending a different amount of time on ancestral territories compared to before the pandemic (<i>P</i> < .01). Participating in beading, traditional arts and crafts, or Indigenous storytelling (<i>P</i> < .001) is the second. However, this relationship was moderated by age (<i>P</i> < .01) and socio-economic status (<i>P</i> < .001), with positive and negative associations respectively found for each demographic factor.</p><p><strong>Discussion: </strong>Cultural practices, including accessing ancestral territories, often positively contribute to Indigenous Peoples' health. The increased number of diagnosed chronic illnesses among respondents who participate in cultural activities suggests that those living with chronic illness may not gain the same benefits from culture during pandemics because of the multitude of barriers they face during emergencies.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251354833"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12227905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144561476","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":"Impact of a Housing and Health Focused Residency Curriculum on Community Health Worker Utilization for Unmet Housing Needs.","authors":"Marc Shi, Samuel Woo, Samantha Levano, Kevin Fiori, Shwetha Iyer","doi":"10.1177/21501319251340818","DOIUrl":"10.1177/21501319251340818","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Stable housing is a well-recognized health-related social need (HRSN) with little attention in medical training. This study examined the efficacy of a resident housing curriculum on referrals to a Community Health Worker (CHW) intervention to assist patients with unmet housing needs.</p><p><strong>Methods: </strong>This was a retrospective cohort study conducted on Internal Medicine residents at a large urban residency program in Bronx, NY. We utilized multivariate mixed-effects logistic regression to determine whether clinician curriculum exposure increased CHW referrals among patients who self-reported housing needs in a HRSN screening tool between July 2021 and August 2024.</p><p><strong>Results: </strong>Nine hundred six unique patients screened positive for unmet housing needs, and 303 (33.4%) patients were referred to CHWs by eligible clinicians (n = 118). Clinician exposure to the curriculum was not a significant predictor of CHW referrals (aOR = 1.03, 95% CI = 0.69-1.54), adjusting for covariates. Patient age (aOR = 0.98, 95% CI = 0.97-0.99), Spanish language (aOR = 1.65, 95% CI = 1.09-2.51), and Medicaid coverage (aOR = 1.61, 95% CI = 1.03-2.51) were associated with likelihood of referral.</p><p><strong>Conclusions: </strong>Our findings demonstrate that the curriculum did not increase CHW referrals. Multimodal educational and systemic interventions that support the use of existing workflows may be needed to increase uptake of interventions to address HRSNs.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251340818"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12166233/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144289694","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":"Embedding Health-Related Social Needs Screening and Resource Navigation in a U.S. Forensic Asylum Clinic: A Pilot Intervention.","authors":"Allison Arteaga Argumedo, Manami T Uechi, Matthew G Gartland, Altaf Saadi","doi":"10.1177/21501319251348065","DOIUrl":"10.1177/21501319251348065","url":null,"abstract":"<p><strong>Background: </strong>Despite increased focus on social determinants of health, little is known about screening and intervention for asylum seekers, a highly marginalized group. We present the feasibility of a pilot social needs screening and resource navigation program at the Massachusetts General Hospital (MGH) Asylum Clinic in Boston, Massachusetts.</p><p><strong>Methods: </strong>Clinicians and staff referred patients who had a forensic evaluation in the clinic for screening. We screened across ten domains: (1) Housing and utilities, (2) Food security, (3) Access to healthcare, (4) Transportation, (5) Education/ Literacy, (6) Employment, (7) Childcare, (8) Disability/Disabling conditions, (9) Psychosocial well-being, and (10) Personal safety.</p><p><strong>Results: </strong>From April 2021 to June 2022, we evaluated 118 patients in the clinic. Twenty-eight (24%) completed screening. Their average age was 35.5 years (range = 18-67) and 50% were men. They came from 11 countries, with Uganda (25%), Cameroon (14%), El Salvador (14%), and Ecuador (14%) most represented. Most common needs were access to healthcare (86%), employment (46%), psychosocial wellbeing (43%), and education (43%). Applicants also typically screened positive for multiple domains (mean = 3.3, SD = 2.2, range = 1-8 domains).</p><p><strong>Conclusion: </strong>Our pilot social needs screening and resource navigation program in an academic asylum clinic demonstrates the model's feasibility. Future studies should explore patient experiences and outcomes following referral.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251348065"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12174709/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Primary Care Perspectives on a Pediatric Mental Healthcare Access (PMHCA) Program.","authors":"Susanna Ciccolari Micaldi, Rachel Brown, Sarah Krogman, Carolyn R Ahlers-Schmidt, Nicole Klaus, Polly Freeman, Ashley Hervey, Kari Harris","doi":"10.1177/21501319251372514","DOIUrl":"10.1177/21501319251372514","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>It is suggested that collaborative mental health models, like those used in pediatric mental health care access (PMHCA) programs, can enhance youth mental health care by boosting physicians' and other healthcare professionals' (PHCPs) confidence and skills in treating pediatric psychiatric disorders. This study assessed the impact of a PMHCA program on PHCPs by identifying key themes in semi-structured interviews.</p><p><strong>Methods: </strong>Semi-structured telephone interviews were conducted with PHCPs enrolled in KSKidsMAP between July 2019 and March 2022. Three researchers independently reviewed transcripts to identify themes with discrepancies resolved through consensus. Demographic data are presented as frequencies and percentages.</p><p><strong>Results: </strong>The 25 participants included physicians (<i>n</i> = 14; 56%), nurse practitioners (<i>n</i> = 8; 32%), and other mental healthcare clinicians (<i>n</i> = 3; 12%). Seven themes were identified: (1) Awareness and Education; (2) Resources and Access to Care; (3) Comfort and Confidence; (4) Visibility; (5) Collaboration; (6) Reimbursement and Financial Barriers; and (7) Holistic Care. Program benefits included enhancing PHCPs' skills and pediatric access to mental health care. Recommendations for improvement included expanding specialist services and increasing program visibility. Key areas to improve pediatric mental health care included better education, workforce expansion, interprofessional collaboration, and reimbursement reform.</p><p><strong>Conclusion: </strong>Data highlight the benefits of PMHCA programs in supporting PHCPs' provision of pediatric mental health care.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251372514"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12449635/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Access to Basic Needs and Healthcare by People Experiencing Unsheltered Homelessness.","authors":"Alexis Coulourides Kogan, Brett Feldman, Corinne T Feldman, Camilo Zaks, Jersey Chen, Jehni Robinson","doi":"10.1177/21501319251356768","DOIUrl":"10.1177/21501319251356768","url":null,"abstract":"<p><strong>Objective: </strong>To investigate the experience of people experiencing unsheltered homelessness (PEUH) in meeting their basic needs for food, drinking water, toilet, hygiene, and healthcare in Los Angeles County.</p><p><strong>Methods: </strong>Cross-sectional, in-person health assessment survey (modified HOUSED BEDS instrument) from 2022 to 2023 among PEUH age 18+ years and initiating care with street medicine (N = 665).</p><p><strong>Results: </strong>Few participants reported access to a toilet (23%), shower (44%), primary care (7%), and food (<i>x̅</i> = 8.3 meals per week ±5.7). Geographical area was associated with statistically significant differences in participant demographic characteristics, access to, and source type of basic resources.</p><p><strong>Conclusions: </strong>Key gaps in access to basic resources for survival for PEUH continue to exist in an urban county where state and local government entities have prioritized addressing homelessness by heavily investing in housing solutions.</p><p><strong>Policy implications: </strong>Pervasive unmet needs for basic resources among PEUH threatens wellbeing and holds important implications for public health, healthcare providers, and payers. Geographical differences in access to basic resources for PEUH suggests a need for heterogeneous services, resources, solutions, and policies to better support PEUH.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251356768"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450266/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145092669","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":"Enhancing Primary Care Capacity for Cardiovascular Disease Management Through the ECHO+ Model: A Multistate Rural Collaboration Among West Virginia, Arkansas, and Oklahoma.","authors":"Dru Ricci, Hannah Schmitt, Heidi Ngov, Tessa Collins, Amie Pollack, Kirsten Meisinger, Anne-Marie Anagnostopoulos, Adam Vascellaro, Brody Eaton, Janie Knotts, David Duong","doi":"10.1177/21501319251367831","DOIUrl":"10.1177/21501319251367831","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular diseases (CVD) are the leading cause of mortality in Arkansas, West Virginia, and Oklahoma, underscoring the need for approaches to build primary care capacity to address CVD in these states.</p><p><strong>Methods: </strong>The \"ECHO+\" model integrates a CVD-focused tele-education course with quality improvement (QI) training and coaching to empower rural primary care providers (PCPs) in diagnosing and managing CVD effectively.</p><p><strong>Results: </strong>41 clinicians participated in the program. 100% reported high satisfaction and intention to apply learnings in practice. CVD knowledge and confidence increased among participants immediately post-course, with sustained improvements at a 6-month follow-up. QI teams achieved measurable improvements in clinical metrics and evidence-based CVD care practices through Plan-Do-Study-Act (PDSA) cycles, including an increase in optimized statin therapy rates from 72% to 86%. The clinical course also increased statin prescribing, with participating providers prescribing significantly more statins in the 6 months following the course than the 6 months before. Patients of participating clinicians experienced improved health outcomes, as evidenced by reductions in systolic blood pressure.</p><p><strong>Conclusion: </strong>These findings illustrate the potential of academic medical centers collaborating with rural primary care clinics to address health disparities through the ECHO+ model, which combines tele-education and QI to enhance clinician capacity and improve population health outcomes.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251367831"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12414120/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145006630","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":"Psychometric Validation of the Cantonese Version of the Patient-Centered Primary Care Instrument for Multimorbid Patients in Hong Kong.","authors":"Jinglin Gan, Peipei Hu, Tak-Ka Tang, Cheuk Ling Lee, Chen-Wei Liu, Eliza Lai-Yi Wong, Francisco Tsz Tsun Lai, Benjamin Hon-Kei Yip","doi":"10.1177/21501319251368995","DOIUrl":"10.1177/21501319251368995","url":null,"abstract":"<p><strong>Introduction: </strong>Patient-centered care and assessing patient experience is essential for improving healthcare quality, particularly for individuals with multimorbidity, who require coordinated and personalized care. Despite its importance, no valid and reliable tool is currently available for measuring patient-centered care for the multimorbid population within the Cantonese cultural context, limiting local healthcare evaluations. This study recruited 500 multimorbid participants from a General Outpatient Clinic in Sha Tin, Hong Kong, to validate the translated and culturally adapted patient-centeredness assessment instrument.</p><p><strong>Objectives: </strong>This study aimed to adapt and validate the Cantonese version of the Patient-Centered Primary Care instrument, originally developed by Cramm and Nieboer, for use among Hong Kong residents with multimorbidity.</p><p><strong>Methods: </strong>The 35-item Cantonese version of the Patient-Centered Primary Care instrument was translated into Cantonese using standard translation procedures. A cross-sectional telephone survey was conducted from August to November 2023, recruiting 500 middle-aged Hong Kong residents with multimorbidity (≥2 chronic conditions). Confirmatory factor analysis was conducted to test the 8-dimensional structure, while reliability (McDonald's Omega) and validity (discriminant, convergent, and criterion-related) were assessed.</p><p><strong>Results: </strong>Confirmatory factor analysis demonstrated marginally acceptable fit indices: SRMR = 0.073, RMSEA = 0.064, CFI = 0.871, and TLI = 0.856. The discriminant validity was supported (HTMT ratios <0.85). The total Omega value for the multidimensional scale was .91, with total Omega values for each dimension ranging from .79 to .95, demonstrating strong reliability. Convergent validity was confirmed via significant correlations with the Patient Enablement Instrument (PEI; <i>P</i> < .001). Criterion-related validity was not established, as no significant evidence supported.</p><p><strong>Conclusions: </strong>The Cantonese version of PCPC instrument demonstrates acceptable reliability and validity for assessing patient-centered care in Hong Kong's multimorbid population. This tool addresses the lack of relevant assessment measures, provides a practical solution for evaluating patient centeredness in this specific clinical context.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251368995"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12441288/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145070759","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 Utilization Unchanged in the Control Arm of a Randomized Clinical Trial.","authors":"Pratik Gongloor, Saad Nadeem, Xiaoying Yu, Mukaila Raji, Kristina D Mena, Elizabeth M Vaughan","doi":"10.1177/21501319251379740","DOIUrl":"10.1177/21501319251379740","url":null,"abstract":"<p><strong>Background: </strong>In low-income settings, clinical trial participation may influence participant behavior, including among control groups. Increased access to care and heightened health awareness during trial enrollment could lead to altered behaviors, a phenomenon known as the Hawthorne effect, which may obscure true intervention impacts; however, this effect remains poorly studied in low-income environments.</p><p><strong>Aim: </strong>To conduct a secondary exploratory analysis of healthcare utilization among control participants of a randomized clinical trial (RCT).</p><p><strong>Methods: </strong>We retrospectively analyzed electronic medical records from the control arm (n = 26) of an RCT involving low-income Hispanic adults with type 2 diabetes receiving care at a community clinic. Before randomization to a 12-month diabetes education intervention or usual care (control), participants underwent on-site measurements of HbA1c, blood pressure, and weight. Healthcare utilization among control participants was compared during the year before and throughout the study, including all types of exposures: provider visits and other services (eg, orders).</p><p><strong>Results: </strong>Total healthcare utilization was similar between the pre-period (11.9 exposures/year) and the study-period (11.4 exposures/year; <i>P</i> = .93), with no significant changes across visit types. There were no significant differences in fitted mean monthly visits between the pre- and study-periods (<i>P</i> = .93), nor over time (<i>P</i> = .89).</p><p><strong>Conclusions: </strong>This exploratory study found no evidence of a Hawthorne effect on healthcare utilization among control participants. While this may suggest consistent healthcare behaviors, it may also highlight an important public health concern: individuals in low-income settings may lack the resources to translate increased awareness into health-related action. Larger studies are needed to further elucidate behavioral patterns in low-income populations.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251379740"},"PeriodicalIF":2.5,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12476492/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145179373","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}