Journal of the American Board of Family Medicine最新文献_第9页

Prevalence and Associated Factors of Fluoride Varnish Application. 氟化物清漆应用的流行及相关因素。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-09-01 DOI: 10.3122/jabfm.2024.240066R1

Mary C Tandon, John J Warren, Jeanette M Daly

{"title":"Prevalence and Associated Factors of Fluoride Varnish Application.","authors":"Mary C Tandon, John J Warren, Jeanette M Daly","doi":"10.3122/jabfm.2024.240066R1","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240066R1","url":null,"abstract":"Objectives: To determine rates of fluoride varnish (FV) application at a tertiary care center between 2018 and 2021 and factors associated with receipt of FV application in the medical setting.Design: A retrospective chart review and case-control study, matching children who had received FV application and those who had not during a well-child examination, were conducted.Measures: Current Procedural and Dental Terminology and International Classification of Diseases codes from an electronic medical record were used to determine the rates of FV application.Analytic strategy: Bivariate and multivariable analyses were conducted to determine factors associated with FV application.Results: The rate of fluoride applications was low but increased significantly from 0.1% in 2018 to 1.6% in 2020 (P < .0001). Among White, Black, and Hispanic subjects, 39.5%, 65.2%, and 68.9%, respectively, received FV application during well-child exams. Advanced registered nurse practitioners (ARNPs) and physician assistants (PAs) provided 0.05% of FV applications. Multivariable results for 788 patients identified \"Black, Hispanic, or other\" race and ethnicity or Medicaid insurance type as factors positively associated with receipt of medical FV.Discussion: This study showed an increase in FV application rates, which may be attributed to a quality improvement project and provider advocates. The prevalence was low and analyses show race and ethnicity and insurance factors associated with the receipt of FV application.Conclusion: The associated factors suggest medical clinicians may evaluate race and ethnicity or insurance type to determine FV recipients. The results showed ARNPs and PAs may be underutilized clinicians for this preventive treatment.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 5","pages":"826-832"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469663","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

Building a Primary Care Research Agenda for Latino Populations in the Setting of the Latino Paradox: A Report from the 2023 Latino Primary Care Summit. 在拉丁裔悖论的背景下为拉丁裔人口建立初级保健研究议程：来自2023年拉丁裔初级保健峰会的报告。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-09-01 DOI: 10.3122/jabfm.2024.240078R1

Miguel Marino, Ana F Abraído-Lanza, Benjamin Aceves, Elizur Bello, Sandra E Echeverría, Karen R Flórez, Eva Galvez, Carlos R Jaén, Daniel F López-Cevallos, Jennifer A Lucas, Cynthia M Mojica, Carlos J Rodriguez, Maria Rodriguez, Cirila Estela Vasquez Guzman, John Heintzman

{"title":"Building a Primary Care Research Agenda for Latino Populations in the Setting of the Latino Paradox: A Report from the 2023 Latino Primary Care Summit.","authors":"Miguel Marino, Ana F Abraído-Lanza, Benjamin Aceves, Elizur Bello, Sandra E Echeverría, Karen R Flórez, Eva Galvez, Carlos R Jaén, Daniel F López-Cevallos, Jennifer A Lucas, Cynthia M Mojica, Carlos J Rodriguez, Maria Rodriguez, Cirila Estela Vasquez Guzman, John Heintzman","doi":"10.3122/jabfm.2024.240078R1","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240078R1","url":null,"abstract":"Latinos represent almost 20% of the US population and face significant health and health care inequities. When compared with socioeconomically similar comparators, they demonstrate better all-cause mortality, a long-observed epidemiologic phenomenon known as the \"Latino paradox.\" In May 2023, we convened the inaugural Latino Primary Care Summit, focused on the theme, \"Immigrant Paradox: Primary Care Roles, Implications and Future,\" with the goal of helping to define a research agenda and recommendations for Latino primary care equity within the context of the Latino paradox. The Summit consisted of 8 expert presentations, including breakout discussion groups and report-outs to the entire Summit group. Six themes were identified from presentation content, and recommendations were drawn from these to better inform a primary care research agenda for Latino health equity. The 6 themes were organized into the following categories: 1) Latino Paradox Considerations, Limitations, and Implications (proper standardization and contextualization). 2) Data Issues (accurate and ethical categorization). 3) Bridging Clinic and Community (understanding partnership development and maintenance). 4) Primary Care Challenges (specific issues related to day-to-day delivery of primary care to Latino patients). 5) Social Needs (implementation and evaluation of social needs screening to Latino patients. 6) Workforce/Academics, Representation Inequities, and Innovation (research training, workforce diversity, and innovation approaches).","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 5","pages":"948-954"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469815","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

Low-Intensity Physical Activity Promotion in Primary Care. 促进初级保健中的低强度身体活动。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-09-01 DOI: 10.3122/jabfm.2024.240134R0

Apichai Wattanapisit, Sanhapan Wattanapisit

引用次数: 0

Family Medicine Residents Intentions to Provide Gender Affirming Care. 家庭医学住院医师提供性别肯定护理的意向。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-09-01 DOI: 10.3122/jabfm.2024.240077R1

Wendy B Barr, Sarah Fleischer, Lars E Peterson

引用次数: 0

Screening and Diagnosis of Type 2 Diabetes in Sickle Cell Disease. 2型糖尿病镰状细胞病的筛查和诊断。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-09-01 DOI: 10.3122/jabfm.2024.240042R1

Bria Carrithers, Rachel Klein, Fernando Ovalle, Julie Kanter

{"title":"Screening and Diagnosis of Type 2 Diabetes in Sickle Cell Disease.","authors":"Bria Carrithers, Rachel Klein, Fernando Ovalle, Julie Kanter","doi":"10.3122/jabfm.2024.240042R1","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240042R1","url":null,"abstract":"Background: Diagnosing type 2 diabetes mellitus (T2DM) in people with sickle cell disease (SCD) is complicated due to hemoglobin A variance in affected individuals. Accurate screening assessments are needed to prevent excessive morbidity and mortality. Primary care physicians need recommendations for screening and diagnosis in this unique population.Purpose: To synthesize recommendations regarding medical diagnosis criteria for T2DM in SCD.Data sources: PubMed, Standards of Medical Care in Diabetes, US Preventative Services Task Force, National Institute of Diabetes and Digestive and Kidney Diseases, searched on December 28, 2022.Study selection: One reviewer searched each database to select applicable studies pertaining to \"sickle cell disease,\" \"type 2 diabetes,\" \"HbA1c,\" and \"fructosamine\" from December 28, 2022, to March 15, 2023.Data extraction and quality assessment: A comprehensive literature review was done to extract current data/facts and assess certainty of evidence.Data synthesis: This review reviews 5 articles that met inclusion criteria to outline outpatient screening and diagnosis of T2DM in SCD. Based on these findings, we recommend fasting plasma glucose as the standard screening starting at age 35 based on USPSTF guidelines. We do not recommend using HbA1c, fructosamine, or glycated albumin for screening or diagnosis of T2DM in individuals with SCD; the latter entities have limited implications in their use.Limitations: There are limited studies available for diagnosis of T2DM in SCD.Conclusions: Fasting plasma glucose is the standard screening for T2DM for SCD to ensure early diagnosis and prevent worsening macro and microvascular complications from both comorbid conditions.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 5","pages":"919-922"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469676","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

Relationship Between Social Risks and Diabetes Metrics in a US Health System. 美国卫生系统中社会风险与糖尿病指标的关系

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-09-01 DOI: 10.3122/jabfm.2023.230498R2

Jessica L Sosso, Karen M Fischer, Michelle A Lampman, Gregory M Garrison, Stephen K Stacey, Matthew E Bernard, Randy M Foss, Dominika A Jegen, Summer V Allen, Tom D Thacher

{"title":"Relationship Between Social Risks and Diabetes Metrics in a US Health System.","authors":"Jessica L Sosso, Karen M Fischer, Michelle A Lampman, Gregory M Garrison, Stephen K Stacey, Matthew E Bernard, Randy M Foss, Dominika A Jegen, Summer V Allen, Tom D Thacher","doi":"10.3122/jabfm.2023.230498R2","DOIUrl":"https://doi.org/10.3122/jabfm.2023.230498R2","url":null,"abstract":"Objective: The primary aim of this cross-sectional analysis was to evaluate the association of multiple social risk domains on the attainment of a composite quality metric in patients with diabetes in a large US regional practice.Research design and methods: The study population included adult patients with type 2 diabetes empaneled to a family medicine clinician in Mayo Clinic Rochester or Mayo Clinic Health System. Patients met the diabetes metric (D5) if: HgbA1c < 8, Blood pressure < 140/90, statin use unless contraindicated, avoidance of tobacco use, and aspirin use if coexisting vascular disease. The D5 metric, demographic, and social risks year end 2022 data were collected from the electronic health record (EHR). A multiple logistic regression model was calculated for each social risk domain, controlling for demographic factors.Results: Among 44,010 patients with type 2 diabetes, the D5 metric was less likely to be met in those who were younger, nonwhite, rural, lower visit utilizers, or who had commercial or unknown insurance. Patients who gave high-risk answers to social risk domains of housing risk, financial risk, food insecurity, and transportation needs were significantly less likely to meet the D5 metric.Conclusions: This data reinforces the important clinical impact social risk factors have for primary care patients and highlights the need for more interventional studies.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 5","pages":"939-947"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469669","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

Clinically Relevant Family Medicine Research: Board Certification Updates. 临床相关家庭医学研究：委员会认证更新。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-09-01 DOI: 10.3122/jabfm.2024.240352R0

Marjorie A Bowman, Dean A Seehusen, Jacqueline Britz, Christy J W Ledford

引用次数: 0

Non-Surgical Management of Urinary Incontinence. 尿失禁的非手术治疗。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-09-01 DOI: 10.3122/jabfm.2023.230471R1

Ranna Al-Dossari, Monica Kalra, Julie Adkison, Bich-May Nguyen

{"title":"Non-Surgical Management of Urinary Incontinence.","authors":"Ranna Al-Dossari, Monica Kalra, Julie Adkison, Bich-May Nguyen","doi":"10.3122/jabfm.2023.230471R1","DOIUrl":"https://doi.org/10.3122/jabfm.2023.230471R1","url":null,"abstract":"Urinary incontinence management varies depending on the type of incontinence and severity of symptoms. Types of incontinence include stress (SUI), urge or overactive bladder (OAB), mixed, neurogenic, and overflow incontinence. First-line treatment for OAB and SUI is nonpharmacologic management. Behavioral therapy is first-line treatment for urge incontinence. Vaginal mechanical devices (cones, pessaries, and urethral plugs), pelvic floor muscle training, and electroacupuncture are recommended as first-line treatment for women with SUI. Biofeedback and electric muscle stimulation can be adjunctive therapy for SUI. Antimuscarinics and β-3 agonists can be used as adjective therapy for those with OAB who do not improve with behavioral therapy. β-3 agonists have less anticholinergic side effects compared with antimuscarinics for OAB. Adverse medication effects can often lead to discontinuation due to poor tolerability. Third-line therapies are for those who fail conservative and pharmacologic therapies and lack high-grade evidence. Neuromodulation, neurotoxin injections, vaginal laser therapy, and acupuncture are third-line in OAB management. Pharmacologic management with α-1-blockers is recommended as first-line treatment for moderate to severe overflow incontinence from BPH. 5-α reductase inhibitors can be used as an adjunct medication in those with refractory overflow incontinence symptoms and a PSA ≥ 1.5 mg/dL. Clean intermittent catheterization is first-line therapy for neurogenic bladder but can increase risk of catheter-associated urinary tract infection. Clinicians should assess type of incontinence, patient goals, side effect profile, and tolerability to determine an individualized treatment plan for each patient.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 5","pages":"909-918"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469390","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

Initial Development of a Scale to Measure Patient Psychological Safety. 初步研制一种测量病人心理安全的量表。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-09-01 DOI: 10.3122/jabfm.2023.230465R1

Paul J Hershberger, Timothy N Crawford, Angie Castle, Sarah K Hiett, Roselle Bea P Almazan, Khadijah C Collins, Jared M Burkert, David G Fields, Sarah G Yu, Katharine Conway

{"title":"Initial Development of a Scale to Measure Patient Psychological Safety.","authors":"Paul J Hershberger, Timothy N Crawford, Angie Castle, Sarah K Hiett, Roselle Bea P Almazan, Khadijah C Collins, Jared M Burkert, David G Fields, Sarah G Yu, Katharine Conway","doi":"10.3122/jabfm.2023.230465R1","DOIUrl":"https://doi.org/10.3122/jabfm.2023.230465R1","url":null,"abstract":"Introduction: Psychological safety is the perception that it is safe to express oneself without fear of ridicule. Better patient outcomes are associated with health care teams that experience psychological safety. However, the psychological safety of the patient has largely been ignored, even though it may affect patient forthrightness and adherence. We developed an initial Patient Psychological Safety Scale (PPSS) to assess patients' experience of psychological safety.Methods: Thirteen items modified from team-focused measures of psychological safety comprised the initial version of the PPSS. To explore criterion validity, 8 items pertaining to nondisclosure of important information were used. A convenience sample of 100 patients from 4 primary care settings completed a survey comprised of the PPSS and nondisclosure questions.Results: A confirmatory factor analysis (CFA) indicated that the 13-item PPSS did not measure 1 factor. A subsequent exploratory factor analysis (EFA) identified 2 factors. A second CFA was conducted on a modified 9-item PPSS representing the 2 factors and retaining items with a factor loading of 0.40 or higher, and the results indicated a good fit. Internal reliability and validity for factors 1 (relationship comfort) (α = 0.95) and 2 (belonging) (α = 0.88) were strong. Although few respondents endorsed nondisclosure, there was a significant association between lower relationship comfort and nondisclosure of disagreement with clinician recommendation (median difference = 5.0, P = .001).Conclusions: Patients' experience of psychological safety may affect clinical outcomes. The PPSS provides a starting point for further study of this potentially important variable.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 5","pages":"809-815"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469328","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

Looking Back to Move Forward: Reflections of PBRN Directors. 回顾前进：PBRN董事的思考。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-09-01 DOI: 10.3122/jabfm.2023.230271R2

C J Peek, Frank M Reed, Ned Calonge, Paul A Nutting, John Hickner, Wilson D Pace, Jennifer Carroll, Linda Niebauer, Larry A Green

{"title":"Looking Back to Move Forward: Reflections of PBRN Directors.","authors":"C J Peek, Frank M Reed, Ned Calonge, Paul A Nutting, John Hickner, Wilson D Pace, Jennifer Carroll, Linda Niebauer, Larry A Green","doi":"10.3122/jabfm.2023.230271R2","DOIUrl":"https://doi.org/10.3122/jabfm.2023.230271R2","url":null,"abstract":"This article looks back on the story of the Ambulatory Sentinel Practice Network (ASPN) and its successor, the National Research Network (NRN), through the eyes of its leaders during the first 40 years. Facilitated conversations over 2 years iteratively coalesced key facts and patterns in this collective account of what they had observed. Time-durable patterns observed are distilled for interpretation and application by contemporary practice-based research network (PBRN) leaders as they move forward. Looking back is done via developmental eras. The ASPN was proposed in 1978 as a set of change strategies for primary care research, ASPN gathered momentum through efforts of individuals, institutions, and small grants that mobilized enthusiasm and commitment in the face of headwinds. The network expanded into the research mainstream from 1988, addressing large socially important questions with greater acceptance and volume of PBRN research. The ASPN is now in an era of scaling up and adapting to huge technological, organizational, and business shifts and a growing emphasis on patient and community engagement, safety, and disparities. Archetypal dilemmas and balances that emerged and reemerged across these eras are distilled, along with ways they were addressed at the time. The authors then project their 40-year experience to future vistas they believe the PBRN value proposition can be adapted and extended; what they regard as promising directions future leaders to take.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 5","pages":"955-968"},"PeriodicalIF":2.4,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143469263","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