Primary Care Research: Primary care providers miss opportunities during office visits for adult preventive care

2005 ◽  
Keyword(s):  
Primary Care ◽  
Preventive Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Office Visits ◽  
Primary Care Research ◽  
Care Research

scholarly journals Semistructured interviewing in primary care research: a balance of relationship and rigour

2019 ◽  
Vol 7 (2) ◽  
pp. e000057 ◽  
Author(s):  
Melissa DeJonckheere ◽  
Lisa M Vaughn
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Data Collection ◽  
Health Services ◽  
Family Physicians ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Care Research ◽  
Care Research ◽  
Semistructured Interviews

Semistructured in-depth interviews are commonly used in qualitative research and are the most frequent qualitative data source in health services research. This method typically consists of a dialogue between researcher and participant, guided by a flexible interview protocol and supplemented by follow-up questions, probes and comments. The method allows the researcher to collect open-ended data, to explore participant thoughts, feelings and beliefs about a particular topic and to delve deeply into personal and sometimes sensitive issues. The purpose of this article was to identify and describe the essential skills to designing and conducting semistructured interviews in family medicine and primary care research settings. We reviewed the literature on semistructured interviewing to identify key skills and components for using this method in family medicine and primary care research settings. Overall, semistructured interviewing requires both a relational focus and practice in the skills of facilitation. Skills include: (1) determining the purpose and scope of the study; (2) identifying participants; (3) considering ethical issues; (4) planning logistical aspects; (5) developing the interview guide; (6) establishing trust and rapport; (7) conducting the interview; (8) memoing and reflection; (9) analysing the data; (10) demonstrating the trustworthiness of the research; and (11) presenting findings in a paper or report. Semistructured interviews provide an effective and feasible research method for family physicians to conduct in primary care research settings. Researchers using semistructured interviews for data collection should take on a relational focus and consider the skills of interviewing to ensure quality. Semistructured interviewing can be a powerful tool for family physicians, primary care providers and other health services researchers to use to understand the thoughts, beliefs and experiences of individuals. Despite the utility, semistructured interviews can be intimidating and challenging for researchers not familiar with qualitative approaches. In order to elucidate this method, we provide practical guidance for researchers, including novice researchers and those with few resources, to use semistructured interviewing as a data collection strategy. We provide recommendations for the essential steps to follow in order to best implement semistructured interviews in family medicine and primary care research settings.

scholarly journals What matters most to patients about primary healthcare: mixed-methods patient priority setting exercises within the PREFeR (PRioritiEs For Research) project

BMJ Open ◽  
2019 ◽  
Vol 9 (7) ◽  
pp. e025954 ◽  
Author(s):  
Louisa Edwards ◽  
Melody Monro ◽  
Yaron Butterfield ◽  
Ravin Johl ◽  
Kent Cadogan Loftsgard ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mixed Methods ◽  
Priority Setting ◽  
Primary Healthcare ◽  
Health Resources ◽  
Primary Care Providers ◽  
Care Providers ◽  
Online Surveys ◽  
Care Research

ObjectivesTo identify patient-generated priority topics for future primary care research in British Columbia (BC), Canada within a diverse patient population.DesignMixed-methods priority setting exercises framed by the dialogue model, using the nominal group technique (rank-ordered scoring) and province-wide online surveys capturing importance ratings of the top 10 primary healthcare topics from patients and primary care providers.SettingBC, Canada.ParticipantsTopic identification was completed by 10 patient partners (7 female, 3 male) from the BC Primary Health Care Research Network Patient Advisory; online surveys were completed by 464 patients and 173 primary care providers.ResultsThe 10 members recruited to the patient advisory provided over 80 experiences of what stood out for them in BC primary care, which were grouped thematically into 18 topics, 10 of which were retained in province-wide surveys. Top-rated survey topics for both patients (n=464) and providers (n=173) included being unable to find a regular family doctor/other primary healthcare provider, support for living with chronic conditions, mental health resources and information sharing, including electronic medical records. However, all 10 topics were rated important, on average, by both groups.ConclusionsThe current project activities demonstrate the feasibility of including patients in priority setting exercises for primary healthcare in general, rather than focusing on a condition-specific population or disease area. There was considerable overlap between patient-generated topics and topics previously identified by other stakeholders, but patients identified two additional topics (mental health resources, improve and strengthen patient–provider communication). More similarities than differences in topic importance between patients and providers emerged in the online surveys. The project activities that follow (rapid literature reviews, multistakeholder dialogue) will highlight under-researched topics and inform the development of specific research questions.

scholarly journals A Primary Care Provider’s Guide to Preventive Health After Spinal Cord Injury

2020 ◽  
Vol 26 (3) ◽  
pp. 209-219
Author(s):  
James Milligan ◽  
Stephen Burns ◽  
Suzanne Groah ◽  
Jeremy Howcroft
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Preventive Care ◽  
Primary Care Providers ◽  
Preventive Health ◽  
Care Providers ◽  
Health Maintenance ◽  
Cord Injury

Objective: Provide guidance for preventive health and health maintenance after spinal cord injury (SCI) for primary care providers (PCPs). Main message: Individuals with SCI may not receive the same preventive health care as the general population. Additionally, SCI-related secondary conditions may put their health at risk. SCI is considered a complex condition associated with many barriers to receiving quality primary care. Attention to routine preventive care and the unique health considerations of persons with SCI can improve health and quality of life and may prevent unnecessary health care utilization. Conclusion: PCPs are experts in preventive care and continuity of care, however individuals with SCI may not receive the same preventive care due to numerous barriers. This article serves as a quick reference for PCPs.

scholarly journals A Chronic Care Model Program Incorporating Group Office Visits for Obesity Treatment in Primary Care

2011 ◽  
Vol 4 (4) ◽  
pp. 87-98 ◽  
Author(s):  
Andrea C Ely ◽  
Christie A Befort ◽  
Angela Banitt Duncan ◽  
Jianghua He ◽  
Cheryl Gibson ◽  
...  
Keyword(s):  
Primary Care ◽  
Weight Change ◽  
Chronic Care Model ◽  
Chronic Care ◽  
Primary Care Providers ◽  
Obesity Treatment ◽  
Care Providers ◽  
Office Visits ◽  
Care Model ◽  
Weight Control Behaviors

Background. Obesity is a chronic disease of epidemic proportions. Primary care providers are on the front line of diagnosing and treating obesity and need better tools to deliver top-notch obesity care. Methods. A pilot randomized trial was conducted to test a chronic care model (CCM) program for obesity compared to usual care. Primary care patients, 18 years and older, with a body mass index (BMI) between 27 and 45 were enrolled. Sixteen weekly 90-minute group office visits were structured with the first 30 minutes encompassing individualized clinical assessments and the final 60 minutes containing the group-based standardized intensive lifestyle training. The primary outcome was weight change at 16 weeks. Secondary outcomes were weight change at 24 weeks, change in diet and physical activity behaviors, self-efficacy for weight control behaviors, and physiologic markers of cardiovascular risk at 16 and 24 weeks. Results. The participants (19 in the active arm and 10 in the control arm) were 49.8 ± 11.5 years old (mean ± SD), 97% women, 55% white, and 41% black. Weight change in the control arm at week 16 was 0.25+ 2.21 kg (mean + SD) and that for the active arm was -5.74 + 4.50 kg (n=16). The difference between the two arms was significant (p = 0.0002). Both the intent-to-treat analysis using the last observation carried forward approach and the analysis including completers only provided similar siginificant results. Conclusions. This study demonstrated that a CCM program incorporating group office visits was feasible and effective for obesity treatment in primary care settings.

Abstract TP389: Utilizing A Stroke Protocol to Improve Stroke Prevention Education

Stroke ◽  
2017 ◽  
Vol 48 (suppl_1) ◽  
Author(s):  
Allison Wells ◽  
Lisa Bellamy ◽  
Keyword(s):  
Risk Factors ◽  
Primary Care ◽  
Stroke Prevention ◽  
Primary Care Providers ◽  
Care Providers ◽  
Office Visits ◽  
Prevention Education ◽  
Prevention Protocol ◽  
Primary Care Office ◽  
Stroke Education

Background: Although stroke is a preventable disease, it remains a leading cause of death and disability in the United States. Public knowledge of stroke prevention is relatively low. Stroke education is necessary to improve this knowledge deficit. Primary care providers play an important role in stroke education due to their ability to reach more patients and their ability to help manage the patient’s modifiable risk factors. The purpose of this project is twofold: to increase stroke knowledge in patients and to increase the amount of stroke education provided by the primary care provider. Methods: A stroke prevention protocol was created for primary care providers to utilize. The protocol helps the provider decide which patients benefit the most from stroke prevention education. If the patient has more than four stroke risk factors, the provider should initiate the stroke prevention protocol. The protocol assists the provider in delivering the stroke prevention education. Brochures were created for the provider to give to the patient. The goal of the project is to include five providers in Kentucky primary care offices. Each provider will complete an evaluation of the protocol after using it for a month. Results: Although the implementation is currently in progress, it is anticipated that the stroke protocol will improve stroke prevention education in the primary care office. Ultimately, practice will be changed by increasing the number of people who receive stroke prevention information by their primary care provider. Conclusion: Stroke education can be incorporated into primary care office visits to improve community awareness regarding stroke prevention. It is anticipated that the implementation of the stroke protocol will increase the amount of stroke education delivered to patients in the primary care setting. The evaluations completed by each healthcare provider are predicted to reflect an increase in the number of patients who receive stroke education. These evaluations will include the healthcare provider’s insight of the protocol which will assist in improving it for future use in primary care office visits.

scholarly journals Usual Source of Primary Care and Preventive Care Measures in a Pandemic: A Nationwide Study in Japan

2021 ◽  
Author(s):  
Takuya Aoki ◽  
Yasuki Fujinuma ◽  
Masato Matsushima
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Preventive Care ◽  
Short Form ◽  
Primary Care Providers ◽  
Sensitivity Analyses ◽  
Care Providers ◽  
Usual Source ◽  
Care Assessment ◽  
Care Performance

Objectives. In a pandemic when there are many barriers to providing preventive care by health care workers, it is unclear whether primary care contributes to the quality of preventive care and what type of preventive care delivery is a challenge for primary care providers. This study aimed to assess multiple preventive care measures and to examine their associations with having a usual source of primary care and primary care performance during the COVID-19 pandemic in Japan. Design. Nationwide cross-sectional study. Setting. Japanese general adult population. Participants. 1,757 adult residents. Primary outcome measures. Fourteen preventive care measures aggregated the overall, screening, immunization, and counseling composites. Results. Depression screening, zoster vaccination, and tetanus vaccination had low implementation rates even among participants with a usual source of primary care. After adjustment for possible confounders, having a usual source of primary care was positively associated with all preventive care composites. Primary care performance assessed by the Japanese version of Primary Care Assessment Tool Short Form was also dose-dependently associated with an increase in all composites. Results of the sensitivity analyses using a different calculation of preventive care composite were similar to those of the primary analyses. Conclusions. Receipt of primary care, particularly high-quality primary care, contributed to increased preventive care utilization even during the COVID-19 pandemic. However, the rate of mental health screening in primary care was at a very low level. Therefore, addressing mental health issues should be a major challenge for primary care providers during and after the pandemic.

Preventive Care of Liver Disease by Primary Care Providers

2009 ◽  
Vol 104 ◽  
pp. S153-S154
Author(s):  
Freddy Caldera ◽  
Maria Melguiz-Castro ◽  
Jeffrey Gilbert ◽  
Lisbeth Selby
Keyword(s):  
Primary Care ◽  
Liver Disease ◽  
Preventive Care ◽  
Primary Care Providers ◽  
Care Providers

scholarly journals Newborn Screening Long Term Follow-Up in the Medical Home

2019 ◽  
Vol 5 (3) ◽  
pp. 25
Author(s):  
Deborah Badawi ◽  
Katharine Bisordi ◽  
Marilyn J. Timmel ◽  
Scott Sorongon ◽  
Erin Strovel
Keyword(s):  
Primary Care ◽  
Newborn Screening ◽  
Clinical Outcomes ◽  
Data Sharing ◽  
Preventive Care ◽  
Medical Home ◽  
Primary Care Providers ◽  
Care Providers ◽  
Long Term Outcomes

This demonstration project explored the feasibility of utilizing data from pediatric primary care providers to evaluate the long-term outcomes of children with disorders identified by newborn screening (NBS). Compliance with national guidelines for care and the morbidity for this population was also examined. Primary care practices were recruited and patients with sickle cell disease or who were deaf/hard of hearing were given the opportunity to enroll in the study. Data were collected on the quality of the medical home with practice data compared to family responses. Clinical outcomes for each patient were assessed by review of medical records and patient surveys. These data sources were compared to determine accuracy of primary care data, morbidity, and receipt of preventive care. Electronic data sharing was explored through transmission of Clinical Document Architecture (CDA) files. Care coordination was a challenge, even in highly accredited medical homes. Providers did not have complete information regarding clinical outcomes and children were not consistently receiving recommended preventive care. Electronic data sharing with public health departments encountered interface challenges. Primary care providers in the USA should not currently be used as a sole source to evaluate long-term outcomes of children with disorders identified by NBS.

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