Journal of general internal medicine
-
Rural America faces an alarming obesity crisis, with residents experiencing significantly higher rates of obesity due to socioeconomic disparities, limited access to healthcare, and structural challenges such as food deserts and insufficient healthcare infrastructure. This perspective addresses these pressing issues by proposing targeted, evidence-based interventions to reduce obesity in rural communities. ⋯ R. 1577, the Treat and Reduce Obesity Act, to alleviate financial barriers to treatment, including intensive behavioral therapy and pharmacotherapy; and (3) leveraging community-based programs, including the National Rural Obesity and Chronic Disease Initiative, the CDC's High Obesity Program, and the Delta Body and Soul initiative, to improve access to healthy foods and promote physical activity through local collaborations, education, and infrastructure enhancements. By implementing these comprehensive strategies, we aim to make obesity treatments and healthy lifestyle choices more accessible, ultimately reducing obesity rates, improving health outcomes, and enhancing the overall quality of life for rural residents across the USA.
-
The 1984 National Organ Transplant Act (NOTA) saw to the establishment of a national Organ Procurement and Transplantation Network (OPTN). As envisaged by the law's congressional sponsors, the Secretary of the US Department of Health and Human Services (HHS) was to institute a "central registry linking donors and potential recipients." In addition, the Secretary was to see to the institution of a "scientific registry of organ recipients" as well as "designate and maintain an identifiable unit in the Public Health Service to coordinate Federal organ transplant programs and policies." Forty years later, over 103,000 patients remain on the organ transplant waiting list for an average of 3-5 years during which time 17 die every day. ⋯ A Health Resources & Services Administration (HRSA) Modernization Initiative followed suit in March 2023. In this Perspective, we review the state of OPTN, discuss its recent oversight by the SCF, and describe its future reform as conceived and enunciated by HRSA.
-
Multitarget stool DNA (mt-sDNA) is an increasingly utilized noninvasive option for colorectal cancer screening; however, its impact is limited by imperfect test adherence. Tailored patient navigation (TPN) improves adherence for other cancer screening tests, but its role in mt-sDNA is not known. ⋯ Tailored patient navigation was associated with improved rates of mt-sDNA completion and SCNBP results despite built-in navigation services provided by the manufacturer. TPN for mt-sDNA is a promising strategy for enhancing colorectal cancer screening uptake.
-
We measured physicians' (1) perceived importance of having access to social determinants of health (SDOH) data received from external providers in the electronic health record (EHR); (2) internal SDOH documentation practices in the EHR, including whether physicians document SDOH in a structured format that may facilitate use; and (3) use of EHR SDOH data to identify community resources and make referrals on behalf of patients. ⋯ In 2022, most physicians documented SDOH data in their EHR, yet fewer used structured methods, limiting data exchange opportunities to address patients' social needs. Under half of physicians considered access to external SDOH data to be "very" important, suggesting greater reliance on data collected internally and missed opportunities to identify patients who need support. Variation in perceived importance of SDOH data access and SDOH documentation by physician characteristics indicate opportunities to support adoption of structured documentation tools facilitating SDOH data capture and exchange to improve patient-centered care.
-
The ethical responsibilities of healthcare professionals amidst geopolitical conflict, particularly regarding their impact on patient care and healthcare delivery, present a significant challenge, especially during current strife. With the rise of national and international discord and debate, and the close relationship between war and healthcare, healthcare organizations are increasingly pressured to comment, which can reflect societal engagement, but also pose demands for maintaining professionalism. ⋯ While the premise of this paper was prompted by geopolitical conflict, the principles emphasized are broadly applicable to an array of controversial issues. By fostering a culture of inclusivity and respect, healthcare professionals can mitigate the risks associated with politicization and ensure a commitment to the fundamental principle of "do no harm."