J Am Board Fam Med
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Randomized Controlled Trial
Families' Perspectives on Social Services Navigation After Pediatric Urgent Care.
Interest is growing in clinic-based programs that screen for and intervene on patients' social risk factors, including housing, food, and transportation. Though several studies suggest these programs can positively impact health, few examine the mechanisms underlying these effects. This study explores pathways through which identifying and intervening on social risks can impact families' health. ⋯ Social care programs may impact health through multiple potential pathways. Program impacts seem to be mediated by the extent to which programs increase knowledge of and access to social and health care services and support positive relationships between families and program personnel.
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Randomized Controlled Trial
Smoking Cessation Support in the Context of Other Social and Behavioral Needs in Community Health Centers.
Cigarette smoking rates remain disproportionately high among low income populations with unmet social and behavioral health needs. To address this problem, we sought to develop and evaluate the feasibility, acceptability, and preliminary effectiveness of a novel smoking cessation program for community health centers that serve these populations. ⋯ Lessons learned from this pilot study may inform the development of effective smoking cessation programs for CHCs that combine elements of both interventions.
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Randomized Controlled Trial
Empowering Low-Income Patients with Home Blood Pressure Monitors to Improve Hypertension Control.
Effective management of hypertension (HTN) is a priority in primary care. With telehealth now considered a staple care delivery method, uninsured and low-income patients without home blood pressure (BP) monitors may need additional attention and resources to achieve successful HTN control. ⋯ The provision of free home BP monitors to low-income patients may feasibly and effectively improve BP control and therapy adherence.
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Randomized Controlled Trial
Self-Management Support Improves Diabetes Outcomes Without Exacerbating Inequities.
Previous research has found an association between low health literacy and poor clinical outcomes in type 2 Diabetes Mellitus (T2DM) patients. We sought to determine if this association can be mitigated by a self-management support (SMS) program provided by trained health workers using a technology assisted menu driven program, called Connection to Health (CTH). ⋯ The study found that implementing the CTH program in 2 versions via a randomized clinical trial improved HbA1c concentrations without increasing disparities between participants with high and low health literacy. This suggests CTH-like programs can enhance diabetes outcomes in community health centers without exacerbating inequities for those with low health literacy.
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Randomized Controlled Trial Comparative Study
A Mixed-Methods Comparison of Interventions to Increase Advance Care Planning.
Although interventions can increase advance care planning (ACP) engagement, it remains unclear which interventions to choose in primary care settings. This study compares a passive intervention (mailed materials) to an interactive intervention (group visits) on participant ACP engagement and experiences. ⋯ While primary care patients may benefit from mailed ACP materials, patients reported increased readiness after ACP group visits. Group visits emphasized the value of upstream preparation, ongoing conversations, and increased knowledge about ACP.