Inquiry-The Journal of Health Care Organization Provision and Financing最新文献

{"title":"Health Poverty Reduction Policies and Effectiveness Evaluation in China Since 2015: A Narrative Review.","authors":"Junlong Li, Tiancheng Zhao, Zhiling Liu, Li Chen, Xiuli Wang, Jay Pan","doi":"10.1177/00469580251337232","DOIUrl":"10.1177/00469580251337232","url":null,"abstract":"<p><p>Poverty eradication and good health and well-being are at the core of Sustainable Development Goals (SDGs) concerns. As illness greatly contributes to poverty, addressing health poverty is crucial to combat the broader issue. Global poverty reduction (PR) efforts currently face significant challenges. Remarkably, China accelerated its poverty alleviation efforts in 2015 with the implementation of the Health Poverty Alleviation Project. However, existing knowledge about China's health PR policies is scattered across the literature, which impedes a comprehensive understanding among researchers and practitioners. This study seeks to bridge knowledge gap as input for further research by synthesizing relevant policies and literature. It reviews China's 12 policies on health PR since 2015, analyzes the governance logic and key governance initiatives for health PR, and assesses the effectiveness of governance in this area by reviewing 27 pieces of literature. Most studies show that China's policies to alleviate health poverty have enhanced PR. China initially established a nationwide, systematic, and coordinated health poverty governance system, which demonstrated good PR effects. These insights offer valuable lessons for the global poverty reduction agenda, such as accurate identification of the poor, systematic implementation of health PR, and sustained promotion of health PR. We hope that these efforts will help some nations or regions optimize their PR initiatives and advance the cause of eradicating poverty worldwide.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251337232"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12084708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144082151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician Health Literacy Competencies: A Qualitative Study Using Focus Groups.","authors":"Chia-Chen Chang, Hsiang-Ru Lai, Pei-Ling Tseng, Chun-Cheng Liu, Jin-Lain Ming, Chen-Yin Tung","doi":"10.1177/00469580251351455","DOIUrl":"10.1177/00469580251351455","url":null,"abstract":"<p><p>Health literacy is crucial for effective physician-patient communication, shared decision-making, and adherence to medical recommendations. This study aims to identify health literacy competencies required for physicians based on insights from physicians, medical interns, and patients. This qualitative study explored physicians' health literacy competencies through focus group discussions with 21 physicians, medical interns, and patients in Taiwan. Data were analyzed using content analysis to identify key themes and competency domains. Four key physician health literacy competency domains were identified: (1) assessing patients' health literacy, (2) strengthening physician-patient relationships, (3) facilitating shared decision-making, and (4) Teach-Back and confirmation of patient adherence. These findings highlight essential physician competencies in health literacy, emphasizing the importance of communication, trust, patient-centered decision-making, and structured feedback mechanisms to improve healthcare interactions and outcomes. Strengthening physician's health literacy competency is essential for improving patient engagement and adherence. Integrating health literacy training into medical education and promoting patient-centered communication can enhance healthcare outcomes.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251351455"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12205193/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144509515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Design of Pay-for-Performance Programs Affects Clinical Staff Perceptions of HPV Vaccine Incentives: Evidence from a US Survey.","authors":"Justin G Trogdon, Kathryn Brignole, Tara Licciardello Queen","doi":"10.1177/00469580251353406","DOIUrl":"10.1177/00469580251353406","url":null,"abstract":"<p><p>This study reports how 3 design features (size of incentive, who is responsible, and target goal) affect clinical staff perceptions of pay-for-performance (P4P) for HPV vaccination. We conducted a national survey of clinical staff in 2022 (N = 2527; response rate = 57%). Respondents worked in pediatrics, family medicine, or general medicine specialties in the United States and had a role in HPV vaccination for children ages 9 through 12 years. Respondents were randomized to 1 of 8 P4P scenarios representing 3 design features with 2 levels each. We used ordered logistic regression to model respondents' agreement with each of 11 statements about the P4P scenario. Statements represented domains of the Theory of Planned Behavior (attitudes, perceived behavioral control, and norms) plus 2 equity items. Relative to a $1000 incentive, a $5000 incentive was associated with favorable perceptions in 8/11 items: 5/5 attitude items and 1/2 items for each of control, norms, and equity. Incentives based on an individual provider's patients, rather than the entire clinic's patients, were associated with more agreement for 1 attitude item and 1 perceived behavioral control item. Relative to an absolute goal of 80%, a goal of 5% relative increase in HPV vaccination rates was associated with favorable perceptions for 3/5 attitude items and 1 equity item. Clinical staff perceptions of P4P for HPV vaccination were more favorable the larger the size of the incentive, when it was focused on a provider's own patients, and when the goal was a relative, rather than absolute, target.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251353406"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12217558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144546253","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Outcomes Evidence Must Keep Up with the Implementation of the 4Ms Framework to Ensure Age-Friendly Health System Transformation.","authors":"James D Harrison, Stephanie E Rogers, Benjamin Rosner, Estelle Martin, Sunny C Lin, Jarmin Yeh, Julia Adler-Milstein","doi":"10.1177/00469580251334511","DOIUrl":"10.1177/00469580251334511","url":null,"abstract":"<p><p>The Age-Friendly Health System (AFHS) movement was conceptualized as a transformative solution to reliably deliver evidence-based care to older adults. Guided by the 4Ms framework: What Matters, Mobility, Mentation, and Medication, AFHS healthcare systems have been given the flexibility to tailor 4Ms interventions and care processes to their context, preferences and populations. This flexibility has facilitated the widespread adoption of 4Ms care. However, as our understanding of 4Ms implementation grows, evidence of the impact of 4Ms care on outcomes must keep up with implementation to ensure AFHS transformation. It is only through assessing the 4Ms as a whole and understanding the interplay between the Ms in relationship to outcomes that we can understand: (1) value-generation to-date, (2) how variation in 4Ms implementation can maximize equitable value realization, and (3) if, and how, to expand the framework most effectively. We propose seven strategies to catalyze the generation and dissemination of robust evidence to support AFHS transformation. These strategies are organized around activities that individual healthcare delivery organizations, researchers and evaluators, and other key informants can pursue. Expanding evidence generation and disseminating findings using these proposed strategies will support the 4Ms framework as an effective vehicle for improving health outcomes for older adults.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251334511"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12033401/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144053694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Construction Level of Health Literate Health Organizations and Its Impact on Patients' Health Literacy: Based on Self-Determination Theory and Structural Equation Modeling.","authors":"Renjie Lu, Jing Zhou, Jiaying Ge, Xiyang Xia, Chao Lei, Shenyu Zhao, Dan Shen, Xiaoyu Wang, Jiaqian Chang, Yang Chen, Lingmin Hu","doi":"10.1177/00469580251351178","DOIUrl":"10.1177/00469580251351178","url":null,"abstract":"<p><p>This study aims to develop a scale for patient evaluation of health literate health care organizations (PEHLHO) tailored to the Chinese context, addressing deficiencies in existing tools. It also examines the relationships between PEHLHO, communicative health literacy (CHL), and enhancement of perceived health literacy (EPHL) in major Chinese cities. This includes their correlation with perceived service quality (PSQ) and perceived a community with shared future for doctor-patient (PCSF) to improve healthcare service quality and patient experiences in China. A PEHLHO Scale was developed using focus group discussions and the Delphi method, with other scales adapted from existing instruments. This cross-sectional study was conducted through an online survey administered in major cities from February 17, 2024, to March 4, 2024, which included Shanghai, Chengdu, Guangzhou, Beijing, Wuhan, Xuzhou, Nanjing, Suzhou across China. A total of 6411 questionnaires were collected. Following quality control standards, the remaining sample of 5206 valid responses met the minimum recommended size for structural equation modeling. Data analysis was performed using SPSS and AMOS software. Exploratory factor analysis of the PEHLHO Scale revealed 3 factors: health education, involvement in diagnosis and treatment, and convenient services. All scales showed good validity and reliability. Informing patients about service fees received the lowest score. A Structural-Process-Outcome model confirmed that PEHLHO positively influences PCSF and PSQ, with CHL and EPHL as mediators. This model was validated in additional cities, demonstrating good generalizability. Enhancing patient health literacy should focus on systemic changes. Establishing health literate health organizations (HLHOs) can improve CHL, doctor-patient communication, and patient health literacy, ultimately optimizing healthcare service quality and doctor-patient relationships. Promoting (HLHOs) in China has significant potential and importance.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251351178"},"PeriodicalIF":1.7,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12277676/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144676611","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Exploratory Qualitative Study of Beverage Sweetening Practices in Middle Eastern Families.","authors":"Abir Abdel Rahman, Nada O F Kassem, Marc Edwards, Juliana Abboud, Bahia Abdallah","doi":"10.1177/00469580251359507","DOIUrl":"10.1177/00469580251359507","url":null,"abstract":"<p><p>Over the last 30 years, there has been a continuing global shift in eating patterns and associated behaviors toward the consumption of foods and beverages rich in refined sugars in developed and undeveloped countries. The behavior of adding sugar to milk and other beverages has been observed as a major underlying factor in developing countries, including the Eastern Mediterranean Region. This qualitative study fills a knowledge gap by exploring the \"adding sugar behavior\" in primary caregivers and the underlying factors behind this common practice. In this study, a total of 26 in-depth interviews were conducted with the mothers, fathers and grandmothers of students from 4 public schools in Lebanon and thematically analyzed. The adding sugar behavior was common among the participants. Primary caregivers reported adding sugar to milk and to other beverages. Only a few primary caregivers stated that sugar was harmful and should be avoided. A common theme that emerged was that adding sugar to milk and beverages was a habit and a social norm within a locality. Findings of this innovative study in a Middle Eastern setting showed that the adding sugar behavior was influenced by specific personal and cultural behavioral factors. Strategies in future health behavior modification programs should include the children's family and the behaviors and habits within the culture.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251359507"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12290353/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144692403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies and Outcomes of Age-Friendly Health System Implementation in Outpatient Settings: A Systematic Review.","authors":"Rebecca J Howe, Katherine Rieke, Thomas Bayer, Htun Ja Mai, Jennifer L Sullivan, Jane A Driver, Taylor Rickard, Thomas A Trikalinos, James Rudolph, Ellen McCreedy, Eric Jutkowitz","doi":"10.1177/00469580251318244","DOIUrl":"10.1177/00469580251318244","url":null,"abstract":"<p><p>The Age-Friendly Health System (AFHS) movement has spread widely in recent years, with nearly 5000 healthcare organizations across the country recognized as Age-Friendly. Despite this broad recognition, there is little focus on how AFHS are implemented and the impact of implementation. The objectives of this study were to describe the strategies employed to support AFHS implementation in outpatient settings and to identify the measures used to evaluate implementation and effectiveness. We conducted a systematic review of literature from multiple databases spanning 2015 to March 2024, identified eligible studies using predefined inclusion/exclusion criteria, and extracted key data (eg, study design, study population, implementation strategies, outcomes/measures). We identified ten eligible studies from primary care clinics (N = 8), convenient care clinics (N = 1) and a cancer center (N = 1). The studies employed over 65 implementation strategies and 98 outcomes or measures. The vast majority of measures mapped to components of the 4Ms (Mobility, Mentation, Medication, What Matters), with up to ten measures per M category. Five of ten studies had reporting discrepancies and four did not fully define outcomes. The ten included studies serve as clear examples for the need for more evidence to support AFHS implementation in outpatient settings. Existing research lacks strategy specification and standardization of measures. We present gaps and opportunities to advance from AFHS \"recognition\" to impact.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251318244"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826848/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143416301","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effective Validation of Primary Care Patient Triage Classification Via Tele-Ophthalmology With Optometrist Support.","authors":"Rafael Carrasco Solís, Mª Rosario Rodríguez Griñolo, Beatriz Ponte Zúñiga, Beatriz Mataix Albert, María Leticia Lledó de Villar, María José González Troncoso, Rocío Martínez de Pablos, Enrique Rodríguez de La Rúa Franch","doi":"10.1177/00469580251367231","DOIUrl":"https://doi.org/10.1177/00469580251367231","url":null,"abstract":"<p><p>The triage classification and diagnosis of eye diseases in primary care patients through teleophthalmology were performed by ophthalmologists, optometrists, and family physicians. The agreement in <i>triage classification</i> and diagnosis between observers, as well as the quality of referrals from primary care to ophthalmology, were evaluated. Study to compare methods using a non-inferiority method approach. The sample comprised 220 patients with suspected ocular problems evaluated by family physicians. These patients were examined by an optometrist <i>(observer 1</i>) using a Visionix VX650 multi-diagnostic platform. The optometrist provided a suspected diagnosis and a referral. The tests were forwarded electronically to an ophthalmologist (observer 2), who provided a diagnosis and referral. Subsequently, they were reviewed in person by an ophthalmologist (observer 3) who provided a diagnosis and referral. The observers worked independently and at different times, without knowledge of each other's evaluations, ensuring the objectivity of the analysis. We analyzed interobserver agreement in <i>triage referrals</i> and diagnosis using the Kappa index. The <i>triage classification</i> of patients by teleophthalmology coincides with that of in-person ophthalmology in 91.2% of the cases (Kappa = 0.819). The optician's <i>triage classification</i> coincided with in-person ophthalmology in 91.3% (Kappa = 0.858) and with teleophthalmology in 92.3% (Kappa = 0.851). The diagnostic categories, teleophthalmology and in-person ophthalmology coincided in 84.61% of the cases (Kappa = 0.80). The optician coincided with in-person ophthalmology in 90.65% (Kappa = 0.88) and with teleophthalmology in 90.9% of the diagnoses (Kappa = 0.87). There was a very high level interobserver agreement for both <i>triage classification</i> and diagnostic categories. This validates our teleophthalmology approach, conducted in a primary care setting by optometrists, family physicians, and ophthalmologists, for an effective triage classification of patients referred to ophthalmology services. This t<i>elemedicine</i> also accurately categorizes patients based on their conditions, optimizing resources, reducing waiting times and waiting lists.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251367231"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12391710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979720","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community and System Advocate Perspectives on Extreme Risk Protection Order Implementation: Qualitative Lessons on Client Context, Professionalization, and Equity.","authors":"Kelsey M Conrick, Julie Kafka, Julia P Schleimer, V Kalei Kanuha, Christopher St Vil, Ali Rowhani-Rahbar, Megan Moore","doi":"10.1177/00469580251370929","DOIUrl":"10.1177/00469580251370929","url":null,"abstract":"<p><p>Community and system-based (eg, civil legal) advocates can play a critical role in the implementation of extreme risk protection orders (ERPO); however, the novelty of ERPO laws impedes understanding of their implementation in these settings. As most ERPO laws are based on Domestic Violence Protection Orders (DVPO), we explored how the implementation of DVPOs by system and community advocates can inform recommendations for advocate involvement in ERPO implementation. We conducted semi-structured interviews with 9 community and system-based advocates involved in DVPO implementation in the 1970s-1990s. We used narrative inquiry to identify strengths and concerns with DVPO implementation, then applied lessons learned to potential implications for ERPOs. Three lessons arose, with corresponding ERPO implications. First, advocates evaluated individual context before offering options, including protection orders. Participants suggested ERPO advocates should be prepared to offer wraparound services in addition to or instead of an ERPO, if contraindicated. Second, the \"professionalization\" of the role of advocates affected how they served clients. Participants recommended professional development opportunities for those with lived experience of firearm-related harm. Third, advocates were well-positioned to anticipate and identify inequities in DVPO implementation. Participants suggested an evaluation system be developed to monitor for any potential inequities in ERPO implementation. The insights from participants in this study, situated in historical context, offer ERPO researchers, implementers, and policymakers a unique opportunity to ensure that ERPO implementation aligns with its legislative intent of preventing firearm tragedies and proactively address and prevent potential unintended consequences of ERPOs.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251370929"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12399828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144979625","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Supporting Health Equity Through APRN Workforce Development: Strategies for Nursing Graduate Programs to Increase Access to Care in Underserved Areas.","authors":"Julie A Gordon, Amy Costner-Lark, Kimberly A Allen, Susan Dresser, Karina M Shreffler, Melissa Craft","doi":"10.1177/00469580251366933","DOIUrl":"https://doi.org/10.1177/00469580251366933","url":null,"abstract":"<p><p>Graduate nursing programs have an opportunity to support health equity, especially for people who live in rural communities and other health care provider shortage areas. The Advanced Practice Registered Nurse (APRN) bridges access to care gaps across a variety of care settings and populations, but the employment of APRNs is generally skewed toward urban areas. Institutions of higher education are uniquely positioned to address this imbalance. This article outlines the strategies, success, implications for current practice, and recommendations of a federally funded project launched in 2023 aimed at improving the distribution of APRNs in Oklahoma. Utilizing the social determinants of health model, the project employed 3 strategies: recruit from diverse backgrounds, support students with financial assistance and extracurricular courses, and help students engage through mentorship, preceptorship, and dissemination activities. A diverse group of students (n = 55) were selected for the scholarship based on a weighted application and disadvantaged background score. All students completed the extracurricular training in preparation for clinical rotation, and 10% attended and/presented their work at professional conferences, and approximately 75% of graduates reported working in rural or underserved communities. Graduate nursing programs can influence health equity and healthcare access in their regions by enhancing clinical rotation experiences through mentorship, preceptorships, and extracurricular education. Graduate nursing program directors can implement these strategies independent of extramural funding. Integrating these approaches across all programs will better prepare APRNs to serve diverse populations and improve placement in underserved areas.</p>","PeriodicalId":54976,"journal":{"name":"Inquiry-The Journal of Health Care Organization Provision and Financing","volume":"62 ","pages":"469580251366933"},"PeriodicalIF":2.3,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145126653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}