Journal of the American Board of Family Medicine最新文献

{"title":"Re: Prevalence and Associated Factors of Fluoride Varnish Application.","authors":"Angel Ogbeide, Awilda Murphy, Sienna Brown","doi":"10.3122/jabfm.2025.250169R0","DOIUrl":"10.3122/jabfm.2025.250169R0","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907073","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}

{"title":"Women's Health, Social Issues, and Quality of Care in Family Medicine.","authors":"Marjorie A Bowman, Caroline K Tietbohl, Dean A Seehusen, Christy J W Ledford","doi":"10.3122/jabfm.2025.250333R0","DOIUrl":"10.3122/jabfm.2025.250333R0","url":null,"abstract":"<p><p>This issue includes information gathered from multiple health systems, covers many chronic health conditions and risk factors, and gives estimates of patient panel size. Women's health articles cover period poverty, contraception and prenatal care. Other articles tackle the complex goal of improving care for at-risk patients and those with multiple chronic and behavioral health conditions, plus the potentially sensitive question of screening for potential firearm violence exposure.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-01-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145907136","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}

{"title":"Patient E-Message Character Limit Impact on Primary Care Clinician Burnout.","authors":"Christopher R Davis, Timothy D Riley, Benjamin N Fogel, Kathryn A Risher, Katherine E Shedlock, Makayla B Lagerman, Terrah M Keck-Kester, Matthew L Silvis","doi":"10.3122/jabfm.2025.250229R1","DOIUrl":"10.3122/jabfm.2025.250229R1","url":null,"abstract":"<p><strong>Introduction: </strong>Burnout is prevalent among primary care (PC) clinicians. One driver of this is asynchronous work, an important component of which is electronic messages (e-messages) between patients and clinicians in the electronic medical record (EMR). Studies have shown mixed results regarding the EMR's impact on clinician burnout and patient care, though none have been identified that investigate the impact of limiting the size of e-messages on PC clinicians.</p><p><strong>Methods: </strong>Our institution limited patient-initiated e-message length to 1000 characters across one health system. Impact on e-message burden and clinician burnout was assessed using anonymous, electronic, Likert scale-based questionnaires which were distributed to family medicine and general pediatrics PC clinicians before and after the character count limit implementation.</p><p><strong>Results: </strong>Approximately 150 clinicians were invited to participate, and about 54% and 48% completed the pre-/post-intervention surveys, respectively. There were no significant sociodemographic differences between respondents in the pre-/post-intervention surveys and there were no significant differences in Mini Z burnout scores or measures of e-message burden before and after the intervention.</p><p><strong>Discussion: </strong>These findings highlight that primary care provider burnout is a complex issue, and limiting e-message character counts alone may not be enough to make an impact.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292082/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934811","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Association Between HPV Vaccination and Neighborhood-Level Social Deprivation Among Latinos by Nativity.","authors":"Jennifer A Lucas, Miguel Marino, Cirila Estela Vasquez Guzman, Wyatt P Bensken, Kristin Lyon-Scott, Beverly B Green, Roopradha Datta, John Heintzman","doi":"10.3122/jabfm.2025.250274R1","DOIUrl":"10.3122/jabfm.2025.250274R1","url":null,"abstract":"<p><strong>Introduction: </strong>Latino community members have increased risk for human papillomavirus (HPV)-related cancers. HPV vaccination may be influenced by neighborhood-level social determinants of health and nativity. We examined differences in HPV vaccine coverage by social deprivation index (SDI) and nativity among Latino patients receiving care in community health centers (CHCs).</p><p><strong>Methods: </strong>We used electronic health record data for Latino patients aged 9-26 who received care in a multistate CHC network from 2012-2022 (n=212,611) to examine differences in HPV vaccine initiation and completion by SDI score tertile and nativity status, and by country of birth among those with country documented. Logistic regression was used to estimate covariate-adjusted odds ratios and prevalences.</p><p><strong>Results: </strong>While those living in higher social deprivation areas had higher prevalence of vaccine coverage, this was not consistent across all groups. Initiation was highest among foreign-born Latinos living in areas with medium deprivation (52.7%, 95% CI: 47.6-57.8%), but was similar for all US-born and foreign-born Latinos, and by SDI tertile. Completion was highest among US-born Latinos living in the areas with the highest deprivation (40.6%, 95% CI: 37.8-43.3%).</p><p><strong>Conclusion: </strong>In this multistate CHC sample of Latino patients, we observed more vaccination among those with a documented country of birth compared to those without that data, with low variation by neighborhood SDI and by country of birth. The lack of difference by SDI could be due to the CHC setting and suggests that interventions to increase HPV vaccination targeting Latinos overall, rather than by neighborhood social determinants, may be most effective.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147934872","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing Content Weights for the 2026 Sports Medicine Blueprint.","authors":"Ting Wang, Thomas R O'Neill, Bradley G Changstrom, Prasad Chodavarapu, James C Puffer, Warren P Newton","doi":"10.3122/jabfm.2025.250293R1","DOIUrl":"10.3122/jabfm.2025.250293R1","url":null,"abstract":"<p><strong>Introduction: </strong>The Certificate of Added Qualification in Sports Medicine is administered by the American Board of Family Medicine (ABFM) and cosponsored by the American Board of Emergency Medicine (ABEM), the American Board of Pediatrics (ABP), and the American Board of Physical Medicine and Rehabilitation (ABPMR). This article reviews the methodology used to determine the weighting of CAQSM assessments across five content domains.</p><p><strong>Methods: </strong>A survey was comprised of 231 sports medicine clinical activities asking respondents to rate how often they perform a clinical activity (the Frequency Index- FI) and to rate the level of risk to the patient if the condition is misdiagnosed or not managed properly (the Index of Harm-IoH). A random sample of 800 diplomates representing Sports Medicine Diplomates from five member boards was selected to participate. Rasch modeling was employed to analyze the survey results. The sports medicine advisory committee voted to equally balance FI+IoH survey results to weight the content domains.</p><p><strong>Results: </strong>The survey response rate was 42.2%. Survey respondents were demographically representative of the overall sampling frame across key variables, except for primary certifying board. Weights for the content domains were as follows: Musculoskeletal Conditions (32.1%), Medical Conditions (30.2%), Care of Emergency Conditions (22.4%) and Preventive Aspects of Sports Medicine (10.4%).</p><p><strong>Discussion: </strong>This is the first nationally representative survey of sports medicine clinical activities performed in the United States. This survey data was used to develop a new sports medicine blueprint. In the future, this data may be used to develop curriculum or assessments.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274940/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057931","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Primary Care Intervention to Improve Melanoma Detection and Management.","authors":"Alexandra Verdieck, Elizabeth Berry, Heather Holderness, Adeeb Haroon, Maria N Danna, Jeremy Erroba, Sancy Leachman, Talia Hodes, Emile Latour, Elizabeth Stoos, Deborah Cohen, Sue Flocke","doi":"10.3122/jabfm.2025.250110R2","DOIUrl":"10.3122/jabfm.2025.250110R2","url":null,"abstract":"<p><strong>Background: </strong>The incidence of cutaneous melanoma is increasing while access to dermatology care remains limited. Primary care clinicians are poised to identify and triage melanomas. However, barriers exist, including clinician knowledge and confidence. We tested the feasibility of an educational intervention to improve melanoma identification and management in primary care.</p><p><strong>Methods: </strong>We conducted a mixed-methods pilot feasibility study in two Pacific Northwest primary care clinics caring for underserved populations. Clinicians were invited to participate in educational sessions on skin cancer screening and dermoscopy device use. Qualitative interviews with participating clinicians assessed training experiences. Outcomes measured intervention feasibility, knowledge scores, use of dermatology e-consults, referrals and biopsy rates.</p><p><strong>Results: </strong>Clinicians exposed to the training (n=15) had significant gains in overall knowledge, with primary improvement in lesion identification and biopsy literacy. Referrals for in-person dermatology evaluation significantly decreased for the training-exposed clinicians (16.9 vs. 11.4 per 1000 visits pre, post respectively) whereas the comparison group (n=29) had a small increase (13.8 vs. 14.0 per 1000 visits). General skin check referrals decreased for the exposed group and increased for the comparison group, (p<0.01). Lesion-specific e-consults increased more in the intervention group but did not reach significance (p=0.05). Biopsy rates did not differ significantly. Qualitative findings highlighted training utility, especially image identification review and dermoscopy use.</p><p><strong>Conclusions: </strong>Melanoma education increased the specificity of primary care clinicians' e-consults without increasing in-person dermatology referrals or unnecessary biopsies. While this intervention has promise for improving skin cancer care in primary care, efforts are needed to increase clinician engagement in this education.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13322414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Career Family Physicians Continue to Provide Maternity Care and Deliver Babies.","authors":"Aerial Petty, Wendy B Barr, Zachary J Morgan, Andrew Bazemore","doi":"10.3122/jabfm.2025.250078R1","DOIUrl":"10.3122/jabfm.2025.250078R1","url":null,"abstract":"<p><p>While the proportion of all family physicians (FPs) delivering babies has declined, the proportion of early career FPs delivering babies declined at a much slower rate between 2016 and 2023 from 13.1% to 10.2%, and the proportion providing maternity care over this period has slightly increased from 25.0% to 28.9%. As maternal mortality rises, supporting FPs in maternity care is crucial for workforce sustainability and health equity.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274937/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057994","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From the Federal Government to the Front Lines of Primary Care: Lessons Learned in the Fight to Strengthen the Foundation of Healthcare.","authors":"Katherine A Gergen Barnett, Judith L Steinberg","doi":"10.3122/jabfm.2025.250174R2","DOIUrl":"10.3122/jabfm.2025.250174R2","url":null,"abstract":"<p><p>From the rise of chronic diseases to crushing medical debt, the American healthcare system is on life support. Primary care - the only medical specialty that has unambiguous evidence of improving overall health, lowering mortality, preventing disease, and reducing health care expenditures- is a critical resource in building towards the future of a healthy America. However, despite primary care being a bi-partisan issue that affects every American, prioritizing and strengthening primary care has been challenging and, as a specialty, it remains undervalued and underfunded. In our 50 plus years of collective service to primary care, we have learned both hard-earned and valuable lessons along the way and it is our hope that in sharing them they might be of service to those working to advance primary care through policy solutions.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13274943/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148057948","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comorbidities, Utilization, and Quality of Care as Predictors of Diabetes Complications.","authors":"Winston Liaw, Omolola E Adepoju, Carlos G Fuentes, Jiangtao Luo, Bill Glasheen, Ben King, Ioannis Kakadiaris, Todd Prewitt, Pete Womack, Jess Dobbins, LeChauncy Woodard","doi":"10.3122/jabfm.2025.250185R1","DOIUrl":"10.3122/jabfm.2025.250185R1","url":null,"abstract":"<p><strong>Objective: </strong>To determine factors associated with diabetes complications, measured by the Diabetes Complications Severity Index (DCSI).</p><p><strong>Research design and methods: </strong>This longitudinal analysis used insurer data (2016 - 2020) and included Medicare Advantage beneficiaries aged 65 and older with type 2 diabetes. The dependent variable was DCSI. Independent variables included year, demographics (age, sex, race/ethnicity, language, dual eligibility, rurality), comorbidities (Charlson (CCI) and Functional Comorbidity Indexes (FCI)), utilization (risk adjustment scores, emergency department, urgent care, outpatient, physician, inpatient, and pharmacy claims), and quality measures (hemoglobin A1c and blood pressure control). Four multilevel mixed-effects models were developed: demographics (model 1), comorbidities (model 2), utilization (model 3), and quality measures (model 4).</p><p><strong>Results: </strong>We included 49,843 individuals. Model 1 showed a relationship between year (IRR=1.32, p<0.001, 2020 vs. 2016), sex (IRR=0.86, p<0.001, female vs. male), race/ethnicity (IRR=1.06, p<0.001, Black vs. white), dual eligibility (IRR=1.26, p<0.001 yes vs. no), and rurality (IRR=0.90, p<0.001, yes vs. no). CCI (IRR=1.18, p<0.001) and FCI (IRR=1.08, p<0.001), which share overlapping and distinct comorbidities with DCSI, were associated with higher DCSI. Emergency department visits (IRR=1.01, p<0.05) and physician visits (IRR=1.003, p< 0.05) were associated with higher DCSI. Not meeting the blood pressure quality measure was linked to higher DCSI (IRR=1.10, p<0.05), while hemoglobin A1c control was not.</p><p><strong>Conclusions: </strong>Year, male sex, race/ethnicity, non-rural status, comorbidities, emergency department visits, and not meeting the blood pressure measure were linked to higher DCSI. Future research should develop strategies for high-risk groups in primary care settings.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197141/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787615","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emerging and Off-Label Uses Of Glucagon-Like Peptide-1 Receptor Agonists (GLP1-RA) and Dual GIP/GLP1-RAs.","authors":"Candis M Morello, Christina L Mnatzaganian, Nathan A Painter","doi":"10.3122/jabfm.2025.250158R1","DOIUrl":"10.3122/jabfm.2025.250158R1","url":null,"abstract":"<p><strong>Background: </strong>Glucagon-like peptide-1 receptor agonists (GLP1-RAs) and the glucagon-dependent insulinotropic polypeptide (GIP)/GLP1-RA are approved for type 2 diabetes (T2D) and obesity given their profound impact on glycemic weight management. Additional indications include reducing cardiovascular disease risk and progression of chronic kidney disease (CKD) in T2D as well as obstructive sleep apnea in patients with obesity. These enhanced effects are likely due to their pleiotropic effects, leading to decreased inflammation and other benefits. This review explored emerging evidence for uses of GLP1-RAs and GIP/GLP1-RA that have been researched but not yet approved. Clinicians may use this information to guide treatment decisions.</p><p><strong>Review process: </strong>PubMed and Embase literature searches were conducted using Medical Subject Heading terms. Studies referencing GLP1-RAs and GIP/GLP1-RA were included if they were published in approximately the last decade, included adults, and were either a randomized controlled trial, meta-analysis, or observational study. Of 319 articles reviewed, 27 met inclusion criteria.</p><p><strong>Emerging and compelling uses: </strong>Initial positive impacts have been noted for the following conditions: liver disease/liver transplant, CKD/kidney transplant, Alzheimer's disease, Parkinson's disease, substance use disorders, osteoarthritis, rheumatoid arthritis, psoriasis, COVID-19 virus, asthma, chronic obstructive pulmonary disorder, polycystic ovarian syndrome, and short bowel syndrome.</p><p><strong>Considerations: </strong>Large randomized controlled trials may lead to approvals of these conditions and are encouraged. Safety and adverse effects of these medications must be assessed when initiating or modifying doses.</p><p><strong>Conclusion: </strong>GLP1-RAs and GIP/GLP1-RA have demonstrated early benefits to several conditions beyond their current approved indications. Clinicians can use this information to determine treatment options for patients, particularly in those with T2D, cardiovascular disease, and/or obesity.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"39 1","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13197145/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147787587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}