Annals of family medicine
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Annals of family medicine · Apr 2022
Identifying health centers in areas with low COVID-19 vaccination rates & high rates of vaccine hesitancy.
Context: Large numbers of US adults are vaccinated, but COVID-19 vaccine hesitancy remains high. Health centers funded by the Health Resources and Services Administration (HRSA) have played a major role in COVID-19 vaccinations and have the potential to vaccinate even larger numbers of people. Objective: To identify U. ⋯ Conclusions: While almost one-half of US adults have been vaccinated, younger adults have much lower rates of vaccination and large numbers are still unvaccinated. Further, vaccine rates vary by race and ethnicity, with less than one-fifth of Hispanic and black adults having been vaccinated. Targeting areas with high rates of vaccine hesitancy and low vaccination rates supports strategic planning, optimizes finite resources, and better assists health centers in creating culturally competent outreach addressing vaccine hesitancy.
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Annals of family medicine · Apr 2022
Group-based nutrition interventions for community-dwelling older adults: a systematic review to inform community co-design.
Context: Many older adults fail to meet dietary recommendations for food quality and quantity, which is important to prevent disability and disease. Group and community-based nutrition interventions may help overcome psychosocial, environmental, and behavioural barriers to healthy eating. The EMBOLDEN project uses community co-design, integrating the best available evidence with local knowledge to develop a novel, group-based physical activity, system navigation, and nutrition intervention for older adults. ⋯ Results were shared with EMBOLDEN's Guiding Council of older adults and local health/social service providers to co-design the intervention. Conclusions: Although group-based interventions demonstrate promise in promoting healthier eating among community-dwelling older adults, the available evidence is relatively low quality. Our analysis highlights an opportunity for primary care researchers to advance the science of health promotion and disease prevention nutrition initiatives for older adults.
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Annals of family medicine · Apr 2022
More than cervical cancer: Understanding racial/ethnic disparities in oropharyngeal cancer outcomes among males by HPV status.
Context: Over the last two decades the incidence of male oropharyngeal cancers (OPCa) has increased rapidly in the United States, yet OPCa is mostly preventable. Differences in OPCa incidence and outcomes by race/ethnicity and human papillomavirus (HPV) status have not been previously studied. Objective: Examine racial/ethnic disparities in HPV-related and non-HPV related OPCa outcomes among males. ⋯ Adjusting for treatment eliminated the higher mortality among Hispanics, but not in Blacks. Conclusions: To decrease incidence rates of late stage OPCa, HPV vaccination and possibly, HPV OPCa screening should be advocated, especially in White males. Further research to explicate possible biologic mechanisms and behaviors or comorbidities contributing to the higher OPCa mortality among Black males is needed.
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Annals of family medicine · Apr 2022
Racial disparity in the occurrence of suicides among patients with background intimate partner violence.
The prevalence of Intimate Partner Violence (IPV) continues to increase in the USA. IPV is a major risk factor for suicide and inflicts a substantial economic burden on the United States in terms of health care costs and reduced productivity. The increased racial disparity has been explained in terms of higher prevalence of traditional risk factors of suicide in the white population. ⋯ The prevalence of IPV has continue to increase in the USA. The higher prevalence of suicides among whites with background IPV is independent of traditional risk factors.
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Annals of family medicine · Apr 2022
Randomized Controlled TrialRandomized controlled trial of an audit and feedback cycle to improve adherence to Choosing Wisely Canada recommendations.
Context: Choosing Wisely Canada (CWC) aims to engage healthcare providers to reduce unnecessary care. Reducing overuse of antimicrobials and antipsychotics in patients with dementia in primary care settings remains an ongoing challenge. Audit and Feedback (A&F) interventions can facilitate practice change but can be improved by understanding factors affecting the likelihood of uptake of the feedback. ⋯ There were no statistically significant provider characteristics when considering all providers with improved prescribing, but male, rural and fee for service providers were more likely to decrease prescribing greater than the mean. Conclusion: Both practice specific and generic A&F information sent directly to primary care providers by a trusted source reduced potentially unnecessary prescriptions. This supports ongoing engagement with primary care providers in practice-based research networks to improve care and promote sustained practice changes.