J Am Board Fam Med
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Randomized Controlled Trial
Developing Patient-Refined Messaging for a Mailed Colorectal Cancer Screening Program in a Latino-Based Community Health Center.
Colon cancer is the second leading cause of cancer death in the United States, and screening rates are disproportionately low among Latinos. One factor thought to contribute to the low screening rate is the difficulty Latinos encounter in understanding health information, and therefore in taking appropriate health action. Therefore, we used Boot Camp Translation (BCT), a patient engagement approach, to engage Latino stakeholders (ie, patients, clinic staff) in refining the messages and format of colon cancer screening reminders for a clinic-based direct mail fecal immunochemical testing (FIT) program. ⋯ Using BCT, we successfully incorporated participant feedback to adapt culturally relevant health messages to promote FIT testing among Latino patients served by community clinics. Materials will be tested in the larger Participatory Research to Advance Colon Cancer Prevention (PROMPT) trial.
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Primary care physicians (PCPs) are increasing their role in the fight against the Hepatitis C Virus (HCV). Approximately 3.5 million Americans currently live with chronic HCV with rising incidence among young persons, especially those affected by the opioid epidemic. ⋯ Although treatment with new Direct Acting Antiviral agents ensure cure rates that routinely exceed 95%, as well as cause fewer adverse effects than previously available interferon-based regimens, some states still restrict access to HCV treatment, including by mandating which providers can prescribe and treat HCV. This special communication reviews HCV treatment resources, discusses data demonstrating similar cure rates between PCPs and specialists, and argues that capacity-building among PCPs will be necessary to control the HCV epidemic.
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Imaging tests are a widely used tool in primary care with many known benefits. Without an understanding of which outcomes matter the most to patients, clinicians are challenged to balance the benefits and harms of imaging tests. This study aimed to explore the perceived impacts imaging tests have on patients from the perspective of the primary care providers (PCPs) and determine PCPs' understanding of patient-centered outcomes (PCOs) from imaging tests. ⋯ PCPs recognize different outcomes of imaging tests that they consider important for patients. While providers are perceptive to patient outcomes there remains a challenge to how patient outcomes are used to improve care. Communication with patients and improving provider knowledge are needed to incorporate identified PCOs.
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Comparative Study
Does Ownership Make a Difference in Primary Care Practice?
We assessed differences in structural characteristics, quality improvement processes, and cardiovascular preventive care by ownership type among 989 small to medium primary care practices. ⋯ Primary care practice ownership was associated with differences in quality improvement process measures, with FQHCs reporting the highest use of such quality-improvement strategies. ABCS were mostly unrelated to ownership, suggesting a complex path between quality improvement strategies and outcomes.
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Routine HIV testing is not adequately occurring in primary care. One reason is that physicians perceive that patients do not want to discuss HIV testing and would prefer that patients initiate the discussion. A patient-centered text message campaign may prompt patients to discuss HIV testing with their physicians, thereby increasing HIV testing. ⋯ Our proof-of-concept study suggests an HIV text message campaign may increase HIV testing by encouraging patients to initiate discussion with their physicians. This intervention may increase HIV testing among low-income populations. A larger study is needed to confirm these findings.