Annals of family medicine
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Annals of family medicine · Jan 2023
Primary Care's Challenges and Responses in the Face of the COVID-19 Pandemic: Insights From AHRQ's Learning Community.
The COVID-19 pandemic dramatically disrupted health care systems and delivery in the United States. Despite emotional, psychological, logistical, and financial stress, primary care clinicians responded to the challenges that COVID-19 presented and continued to provide essential health services to their communities. As the lead federal agency for primary care research, the Agency for Healthcare Research and Quality (AHRQ) identified a need to engage and support primary care in responding to COVID-19. ⋯ We identified challenges, responses, and innovations that emerged through learning community engagement, information sharing, and dialog. We categorized these across 5 domains that reflect core areas integral to primary care delivery: patient-centeredness, clinician and practice, systems and infrastructure, and community and public health; health equity was crosscutting across all domains. The engagement of the community to identify real-time response and innovation in the context of a global pandemic has provided valuable insights to inform future research and policy, improve primary care delivery, and ensure that the community is better prepared to respond and contribute to ongoing and future health challenges.
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Annals of family medicine · Jan 2023
Understanding Indigenous Health Literacy Through Community-Led Engagement.
Context: This is the last in a four-part series that describes the outcome of a mixed-methods participatory social justice (MMPSJ) research project. A community engagement model was designed by participants as a synthesis of working with urban Indigenous peoples living on Treaty Six Territory and traditional homeland of the Metis in Saskatchewan, Canada. It responds to the Truth and Reconciliation Commissions calls to Action 10, 18-20. ⋯ Participants: Twelve Indigenous people representing four intergenerational families were invited to two Talking Circles to respond to questions derived from the Aboriginal Regional Health Surveys; as well as answer the following questions: What are the current connections between literacy and health within urban Indigenous families? What literacy issues continue to marginalize the community? How would you like this knowledge disseminated? This research was reviewed and approved by the University of Saskatchewan's Behavioural REB. Results/Findings: Knowledge of Treaty Six teachings was increased; participants described the social justice/transformative nature of this work an opportunity to be seen well and whole; and the Community Engagement Model evolved within the MMPSJ design. Conclusions: Community-based research can be transformed to being community-led through careful consideration of power and authentically engaging with the community at each step in the process.
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Annals of family medicine · Jan 2023
Observational StudyExploring Diagnostic Strategies for Streptococcal Throat Infection Remotely: A Feasibility Study.
Context: Acute sore throat is a common presentation in primary care and often results in antibiotic prescription. The Covid pandemic has driven changes in consultation with less face to face visits. Scoring tools are available to target antibiotics and widely used in the UK but it is not clear whether patient self assessment is feasible and sufficiently precise to enable remote use of scoring tools. ⋯ Photographs were of sufficient quality for clinical assessment less than half the time. Patients/parents/carers are very good at ruling out pus and inflammation, but have a tendency to overcall these findings, especially inflammation. Further implications for self assessment and future work will be described.