Journal of the American Board of Family Medicine最新文献

Care Coordination: How Is It Implemented and Is It Different If a Social Worker Is on the Team?

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2025-01-30 DOI: 10.3122/jabfm.2024.240010R1

Leif I Solberg, Meghan M JaKa, Gregory S Knowlton, Jeanette Y Ziegenfuss, Anna R Bergdall, Robin R Whitebird, Joan M Kindt, Steven P Dehmer

{"title":"Care Coordination: How Is It Implemented and Is It Different If a Social Worker Is on the Team?","authors":"Leif I Solberg, Meghan M JaKa, Gregory S Knowlton, Jeanette Y Ziegenfuss, Anna R Bergdall, Robin R Whitebird, Joan M Kindt, Steven P Dehmer","doi":"10.3122/jabfm.2024.240010R1","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240010R1","url":null,"abstract":"Objective: To understand how primary care clinics coordinate services for complex patients and whether clinics with an integrated social worker do it differently.Methods: Cross-sectional survey of the 213 most experienced care coordinators for each of the 317 participating clinics.The survey asks about staffing, communications, care model (nursing vs integrated social worker), resources, support, services, how services are available and delivered, payment approach, and satisfaction. Clinics using the integrated model include the social worker as part of the care team, responsible for assessing and coordinating services for social needs, and communicating directly with both patients and clinicians.Results: Out of 317 clinics from 42 diverse care systems, 139 had an integrated social worker and 178 did not. Care coordinators in the integrated social worker clinics had somewhat larger patient panels and worked with almost twice as many clinicians. These care coordinators were also less likely to be on site and more likely to communicate with patients and clinicians by telephone rather than in person. Care coordinators in the integrated social worker clinics were 10 to 30% more likely to assess patients' social needs, provide a broader range of services, and to be more engaged in the process of referral for community services.Conclusion: Clinics with an integrated social worker seem to differ in the frequency and approach to care coordination as well as in how social needs are addressed from those that use a nursing model while providing most medical/nursing services at similar or higher rates.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Examining the Construct Stability of the Family Medicine Certification Scale Between One-Day Exam and Longitudinal Assessment.

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2025-01-30 DOI: 10.3122/jabfm.2023.230443R1

Thomas R O'Neill, Keith Stelter, Ting Wang

{"title":"Examining the Construct Stability of the Family Medicine Certification Scale Between One-Day Exam and Longitudinal Assessment.","authors":"Thomas R O'Neill, Keith Stelter, Ting Wang","doi":"10.3122/jabfm.2023.230443R1","DOIUrl":"https://doi.org/10.3122/jabfm.2023.230443R1","url":null,"abstract":"Purpose: To determine whether the construct of family medicine clinical decision making ability was invariant across modes of administration, the 1-day examination and the longitudinal assessment. We attempted to identify item characteristics associated with differences in difficulty across modes of administration.Methods: The data were item difficulty calibrations based on examinee responses to the 1-day examination and the longitudinal assessment. A repeated measures design was employed to identify question calibration differences across modes of administration, so that the stability of the question difficulty across modes of administration could be assessed. A qualitative review of the flagged questions was conducted to identify characteristics associated with questions becoming easier or more difficult.Results: The correlation between the pairs of calibrations was moderately positive r(298) = 0.558, P < .001 suggesting that the questions are functioning somewhat similarly across the different modes of administration; however, the scatterplot demonstrates that many of the questions became easier. Of the 298 repeated measures t test, 37% (110) did not show a significant difference, 43% (128) became easier on the longitudinal assessment, and 20% (60) became more difficult.Conclusions: This study suggests that changes in item difficulty do occur when extra time and the use of external resources are permitted. Usually the questions get easier, but in some cases the question becomes more difficult. Possible reasons for this are presented, and a method to adjust the item difficulty in a way to maintain a single construct is presented.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069033","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Minority Tax: Stories from Family Physicians.

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2025-01-30 DOI: 10.3122/jabfm.2023.230495R1

Zuleica Santiago-Delgado, Namita Bhardwaj, Winfred T Frazier, Ashley Collazo, N Ogechi Abara, Kendall M Campbell

{"title":"The Minority Tax: Stories from Family Physicians.","authors":"Zuleica Santiago-Delgado, Namita Bhardwaj, Winfred T Frazier, Ashley Collazo, N Ogechi Abara, Kendall M Campbell","doi":"10.3122/jabfm.2023.230495R1","DOIUrl":"https://doi.org/10.3122/jabfm.2023.230495R1","url":null,"abstract":"The minority tax has been defined as a set of disparities that those who are underrepresented in medicine face in addition to clinical care, education, and research responsibilities. These taxes include systemic racism, diversity efforts, clinical and promotion disparities, lack of faculty development, and isolation. Much has been added to the literature to better define and characterize the minority tax and propose suggestions for mitigations. This article builds on the existing literature that defines clinical efforts and diversity efforts disparities by exploring the intersections of these disparities through the experiences of family medicine faculty in the clinical environment. The authors, who are all academic family medicine physicians from minoritized communities, use their lived experiences to share how the diversity efforts disparity impacts patient care. Themes noted include health system wide challenges for patients whose preferred language is not English and the importance of racial and ethnic concordance between patients and the physician workforce.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069044","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The One Taboo Question.

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2025-01-30 DOI: 10.3122/jabfm.2023.230478R1

Jordan M Alpert, Heather McKee Hurwitz, Michael B Rothberg

引用次数: 0

Strategies for Implementing Integrated Behavioral Health into Health Centers.

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2025-01-30 DOI: 10.3122/jabfm.2023.230417R1

Ann M Nguyen, Rebecca A Klege, Theresa Menders, Charu Verma, Stephanie Marcello, Benjamin F Crabtree

{"title":"Strategies for Implementing Integrated Behavioral Health into Health Centers.","authors":"Ann M Nguyen, Rebecca A Klege, Theresa Menders, Charu Verma, Stephanie Marcello, Benjamin F Crabtree","doi":"10.3122/jabfm.2023.230417R1","DOIUrl":"https://doi.org/10.3122/jabfm.2023.230417R1","url":null,"abstract":"Background: Integrated behavioral health (IBH) is a promising approach which embeds behavioral health services into primary care. Yet, IBH has had limited implementation. Our objective was to identify strategies to successfully implement the \"Cherokee\" IBH model by examining a 2013 to 2019 IBH demonstration project in New Jersey that included Federally Qualified Health Centers (FQHCs) and Community Health Centers (CHCs).Methods: We conducted qualitative semistructured interviews of 18 primary care and behavioral health clinicians from 10 FQHCs/CHCs in 2022. Interview guide questions drew on the Proctor Implementation Outcomes Framework to capture strategies to optimize acceptability, appropriateness, feasibility, fidelity, penetration, and sustainability of IBH implementations. A template approach was used to code data and identify themes.Results: All participating FQHCs/CHCs were still offering IBH services 3 years after the demonstration project, suggesting that strategies were successful in implementing and sustaining IBH. Strategies these FQHCs/CHCs employed included: (1) select champions with experience leading organizational change; (2) provide training that emphasizes how brief behavioral health interventions differ from traditional therapy; (3) develop on-going IBH training procedures for new staff; (4) create physical spaces for behavioral health consultants; (5) establish scheduling systems; and (6) identify local IBH billing codes, policies, and procedures.Discussion: Change management approaches can help in the implementation of IBH; however, additional strategies unique to IBH may be needed to address the attitudinal, organizational, and financial challenges inherent to IBH.Conclusion: Future implementations should apply multi-faceted approaches that address persistent and seemingly intractable barriers that have inhibited IBH integration.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-01-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069040","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Training in Gender Affirming Care is Medically Necessary.

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2025-01-30 DOI: 10.3122/jabfm.2024.240266R1

K Fallin-Bennett, M Arterburn, S T Marks

引用次数: 0

Doxycycline Postexposure Prophylaxis for Sexually Transmitted Infection Prevention. 多西环素暴露后预防性传播感染。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2025-01-17 DOI: 10.3122/jabfm.2024.240056R0

Elizabeth Close, Alexander Jones, William Noggle

引用次数: 0

For Atrial Fibrillation, DOACs Outperform Warfarin in Patients with Reduced Kidney Function. 对于房颤，doac在肾功能降低患者中优于华法林。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2025-01-17 DOI: 10.3122/jabfm.2024.240155R0

Robert A Powell, Jessica S Coulter, Ariel L Hoffman

引用次数: 0

Keep on Keeping on - Mirena IUD for 8 Years. 继续坚持-使用了8年的宫内节育器。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2025-01-17 DOI: 10.3122/jabfm.2024.240037R0

Samuel Holt McNair, Carl Tunink, Laura Morris

引用次数: 0

Filtering Race Out of GFR Calculation. 在GFR计算中过滤竞态。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2025-01-17 DOI: 10.3122/jabfm.2024.240035R0

Winfred Frazier, Yufei Ge

引用次数: 0