American journal of preventive medicine
-
Effective patient-provider communication is a critical component of optimal patient care, but its potential impact on the delivery of healthcare services remains unclear. This study examines the association of patient-provider communication with access to care, healthcare utilization, and financial burden of care. ⋯ Encouraging effective patient-provider communication is essential for advancing patient-centered care and mitigating health inequities.
-
Herpes zoster increases stroke and myocardial infarction risk. The objective of this study is to evaluate the impact of live attenuated zoster vaccination on stroke and myocardial infarction risk in patients at risk of zoster, including those with hypertension, diabetes mellites, obesity, hypercholesterolemia, chronic kidney disease, chronic obstructive pulmonary disease, emphysema, asthma, and chronic liver disease. ⋯ Live attenuated zoster vaccination is associated with lower risk of stroke and myocardial infarction in adults with at-risk comorbidities, controlling for age and sex. Vaccination may provide cardiovascular benefits beyond zoster prevention.
-
Youth experience significant mental health (MH) needs, and gender- and racially/ethnically-diverse youth are less likely than peers to receive care. School-based health centers (SBHCs) are a healthcare delivery model that may decrease disparities. This study examined the role of SBHCs in reducing disparities in MH care receipt among SBHC clients. ⋯ SBHCs may reach youth who are traditionally less likely to seek care in other settings, including racially/ethnically- and gender-diverse youth. As in other settings, engaging males in healthcare is an area for improvement. These findings help to demonstrate the potential of SBHCs for decreasing disparities in mental health care.
-
Few studies have examined county-level hotspots of veteran suicide and associated place-based contributors, limiting development of targeted community-level prevention strategies. The objectives of this national spatial analysis of all veteran suicides were to identify areas of the United States with higher-than-expected veteran suicide rates and determine county-level social and economic characteristics associated with areas of higher risk. ⋯ This study contributes to a comprehensive public health approach to veteran suicide prevention by identifying where resources are needed most, and which place-based intervention targets have the largest potential for impact. Findings suggest that public health efforts to address suicide among veterans should address community-level firearm access and identify ways to alleviate deleterious effects of social fragmentation.
-
Successful delivery of the virtual Medicare Diabetes Prevention Program (MDPP) is influenced by a beneficiary's access to a computer and use of the Internet. ⋯ Approximately 30% of potentially MDPP-eligible beneficiaries (representing ∼6 million beneficiaries) lacked full digital access. Efforts to encourage enrollment in the virtual MDPP must address digital disparities for beneficiaries at-risk for type 2 diabetes.