Annals of family medicine
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Annals of family medicine · Jan 2023
Observational StudyImpact of the Affordable Care Act Medicaid Expansion on Weight Loss among Community Health Center Patients with Obesity.
Context: Obesity affects over 40% of the US population and is linked to multiple preventable health conditions which can cause premature morbidity and mortality. Weight loss of at least 5% in patients with obesity reduces their risk of comorbid conditions and leads to improvement in some conditions, such as diabetes. Patients with obesity from underserved populations are less likely to access primary and preventive care services. ⋯ Among newly insured patients, Hispanic (22%) and Black (29%) patients residing in expansion states, had larger proportion of patients with WL5+ than those in non-expansion states (20% and 18%, respectively). No differences were observed among non-Hispanic White patients (expansion 28% vs non-expansion 27%). Conclusions: The findings suggest greater improvement in weight management among patients residing in expansion states than those in non-expansion states, especially among racial and ethnic minorities receiving care in CHCs.
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Annals of family medicine · Jan 2023
Development and Design Needs of Mobile Health (mHealth) Apps for Adolescents.
Context: Adolescent obesity remains a significant public health issue within the United States. Application (app) technology growth and popularity offer new opportunities for research and health improvement. The development of a consolidated mobile health application (mHealth app) for adolescents on these platforms has the potential to improve health outcomes. ⋯ Outcomes: Adolescent stakeholder feedback is crucial in the successful development of an adolescent-targeted mHealth app. Adolescents prefer vibrant colors, modern, easy-to-use interface, gamification and rewards, customizable and personalized, simple, and mature graphics. Adolescents were especially motivated by gamification techniques in maintaining their interest in the application and their health behavior goals.
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Annals of family medicine · Jan 2023
Adaptation and Content Validation of a Patient-Reported Measure of Treatment Burden for use in Stroke Survivors (PETS-Stroke).
Context: Treatment burden is defined as the workload of healthcare for people with long-term conditions and the impact on wellbeing. Stroke survivors often live with considerable treatment burden because of high healthcare workload alongside deficiencies in care provision that can make navigating healthcare systems and managing health more difficult. Ways of measuring treatment burden after stroke are currently lacking. ⋯ The final PETS-stroke tool has 34-items, spanning 13 domains. It includes 10 items unchanged from PETS, 6 new and 18 amended. Conclusions: The development of a systematic method of quantifying treatment burden from the perspective of stroke survivors will allow for the identification of patients at high risk of treatment burden and will aid the design and testing of tailored interventions aimed at lessening treatment burden.
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Annals of family medicine · Jan 2023
Observational StudyPersonal Continuity and Prescribing Correctly: A Perfect Couple in Primary Care.
Context Personal continuity is a widely accepted core value of primary care. Previous studies suggest that personal continuity is associated with fewer Potentially Inappropriate Prescriptions (PIPs). However, this has not been studied in the primary care population. ⋯ Three of four continuity measures (BBI, HI and UPC) were positively and significantly associated with fewer potentially inappropriate prescriptions. Conclusions High personal continuity is associated with appropriate prescribing. Increasing personal continuity may improve quality of prescriptions and reduce harmful consequences.
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Annals of family medicine · Jan 2023
Clinical Outcomes of a Newly Instituted Hospital at Home Program During the COVID19 Pandemic.
Context: The COVID19 pandemic stressed U. S. health systems beyond their capacity and created worsening clinical outcomes. Hospital a Home (HaH) programs were utilized infrequently prior to pandemic. ⋯ HaH programs were associated with shorter inpatient length of stays, but longer total length of stays. In surge times, HaH programs could potentially reduce iLOS and increase bed capacity. Future studies should look to evaluate the economic impact of HaH programs and investigate the drivers of the increased tLOS.