Use of quality circles for primary care providers in 24 European countries: an online survey of European Society for Quality and Safety in family practice delegates

Abstract Objectives Neck pain remains highly prevalent and costly worldwide. Although reassurance has been recommended as a first line of treatment, specific advice on the best ways to provide reassurance has not been provided due to lack of evidence. Pain symptoms and experiences differ between patients with whiplash-associated disorder (WAD) and those with nontraumatic neck pain (NTNP). The aims of this study were to 1) identify and compare the concerns, fears, and worries of patients with WAD and NTNP; and 2) determine if patients believe their concerns are addressed by primary care providers. Methods These questions were investigated through an online survey, with a convenience sample of 30 participants with NTNP and 20 with WAD. Results A thematic analysis of survey responses resulted in the following seven themes related to common concerns, and two regarding how well concerns were addressed. Common concerns expressed by both groups shared four themes: 1) further structural damage, 2) psychological distress, 3) concerns about the future, and 4) hardships that eventuate. Theme 5), pain/disability is long term, was specific to WAD. Themes 6), pain is current or reoccurring, and 7), interference with daily life, were specific to NTNP. Regarding how well patient concerns were addressed, two overarching themes were common to both conditions: 1) concerns were addressed, with both groups sharing the subthemes “successful treatment,” “reassurance,” and “trust”; and 2) concerns were not addressed, where all subthemes were shared with the exception of two unique to NTNP. Conclusions This detailed comparison provides information about neck pain patients’ concerns and fears, while providing health practitioners support for selecting strategies to promote reassurance appropriately for individual patient needs. Our findings from patients’ perspectives enhance the understanding for providing reassurance for neck pain as proposed by our analysis.

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Strategies in Primary Care to Face the SARS-CoV-2 / COVID-19 Pandemic: An Online Survey

Frontiers in Medicine ◽

10.3389/fmed.2021.613537 ◽

2021 ◽

Vol 8 ◽

Author(s):

Marion Eisele ◽

Nadine Janis Pohontsch ◽

Martin Scherer

Keyword(s):

Primary Care ◽

General Practitioners ◽

Health Care Providers ◽

Online Survey ◽

Qualitative Content Analysis ◽

Primary Care Providers ◽

Care Providers ◽

Sources Of Information ◽

Pandemic Preparedness ◽

Team Meetings

Background: Primary care plays a key role in pandemics like the SARS-CoV-2 pandemic in 2020. We aimed to investigate the challenges faced and the solutions implemented in primary care.Methods: One hundred and twenty-one general practitioners in Germany completed the online survey. We used open questions to examine challenges experienced and solutions implemented during the early pandemic and chose qualitative content analysis to extract and describe the meaning of the answers. We derived deductive categories from the research questions and formed inductive categories during the material reviews.Results: Main challenges were: insufficient information, lack of protective equipment, need to restructure practice procedures and insufficient individual and structural pandemic preparedness, resulting in secondary challenges: fear of infection, impaired patient care, aggravated steering of patients, difficult cooperation with external entities and a not viable hygiene concept advised by authorities. Strategies to address these challenges included establishing regular team-meetings to develop new solutions, focusing on few reliable sources of information, working in alternating shifts, increasing telemedicine, establishing window and open-air practices and building networks with other health care providers. Respondents criticized the lack of consideration of their experiences in planning pandemic measures within primary care.Conclusions: General practitioners successfully applied pragmatic and creative strategies in their practices during the early phase of the pandemic. Among these, communication within and between practices emerged as a key strategy. These strategies should be provided with pandemic preparedness plans. The lacking consideration of the primary care providers' experiences in planning and implementing pandemic measures needs to be addressed by stakeholders.

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Personal Sun Protection and Counseling Patterns among Primary Care Providers

10.21203/rs.2.15928/v1 ◽

2019 ◽

Author(s):

Daniel Alexander Nadelman ◽

Joel J. Heidelbaugh

Keyword(s):

Primary Care ◽

Online Survey ◽

Formal Education ◽

Medical Training ◽

Primary Care Providers ◽

Sun Protection ◽

Training Methods ◽

Care Providers ◽

Patient Counseling ◽

The Relationship

Abstract Background: Personal sun protection and patient counseling patterns among primary care providers is an important topic that has not previously been studied in great detail. Our report evaluates the relationship between sun protection habits among providers, patterns in discussions with patients about sun protection, and prior education on this topic during medical training. Methods: An online survey was sent to family medicine faculty and house officers. Four survey questions about personal sun protection and patient counseling habits were provided. Participants were then asked whether they had received formal education concerning sun protection during their medical training. Results: Our results suggest that providers who received formal education on sun protection during their medical training were more likely to personally use adequate protection and counsel their patients on this topic. Conclusions: This study highlights the importance of sun protection education among primary care providers. Our findings suggest that improving education on this topic among physicians may lead to increased awareness among both patients and providers. Productive discussions about sun protection in the primary care setting has the potential to improve sun protective habits among patients, which can in turn decrease the incidence of skin cancer.

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Perceptions of primary care providers on TB care for migrants: a mixed methods study in Portugal

European Journal of Public Health ◽

10.1093/eurpub/ckz186.073 ◽

2019 ◽

Vol 29 (Supplement_4) ◽

Author(s):

A M Tavares ◽

A C Garcia ◽

A Gama ◽

A B Abecasis ◽

M Viveiros ◽

...

Keyword(s):

Primary Care ◽

Low Socioeconomic Status ◽

Online Survey ◽

Social Protection ◽

Close Contact ◽

Healthcare Providers ◽

Primary Care Providers ◽

Care Providers ◽

Foreign Born ◽

Structured Interviews

Abstract Background Tuberculosis (TB) is one of the main causes of death worldwide. In 2017, the proportion of TB cases among foreign-born individuals in Portugal was of 19%, and this proportion has been increasing. TB control among migrant populations largely depends on the role of the healthcare providers and their close contact with the patients. We aimed to explore the perspectives of primary care providers on the provision of TB care for migrant patients in Portugal. Methods An online survey and semi-structured interviews were conducted with healthcare providers from primary care settings in Portugal. Overall, 120 participated in the survey, and 17 were interviewed. Data from the survey and interviews were analysed using descriptive statistics and thematic analysis, respectively. Results Many participants (36.9%) considered that migrants arrive at an advanced stage of TB disease, and the main reason referred was migrants’ unawareness of the disease and its symptoms. Moreover, half (50.0%) of the providers considered that migrants frequently interrupt treatment, mainly due to their mobility, which causes difficulties in follow-up, and their social isolation that hampers social support. Overall, three main barriers for migrants’ access and use of TB care were mentioned: migrants’ low socioeconomic status, great bureaucracy required to register at services, and obstacles to benefit from social protection. Providers also suggested more training to improve their cultural competence and updating training on TB care. Conclusions Our study have shown social and economic factors that must be addressed to improve migrants’ access and use of TB care. In addition, increased health literacy for migrants and more training initiatives for providers can also contribute to improve TB care for migrants. Key messages Perspectives from primary care providers in Portugal highlighted social, economic, and administrative obstacles hampering the provision of TB care for migrants. With this work we expected to contribute with evidence to improve TB care for migrant patients in Portugal.

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The Other Parent: An Exploratory Survey of Providers’ Engagement of Fathers in Pediatric Primary Care

Clinical Pediatrics ◽

10.1177/0009922819829032 ◽

2019 ◽

Vol 58 (5) ◽

pp. 555-563 ◽

Cited By ~ 3

Author(s):

Brandon S. Allport ◽

Barry S. Solomon ◽

Sara B. Johnson

Keyword(s):

Primary Care ◽

American Academy ◽

Online Survey ◽

Primary Care Providers ◽

Pediatric Care ◽

Pediatric Primary Care ◽

Care Providers ◽

Father Engagement ◽

Effective Strategies ◽

American Academy Of Pediatrics

Although father engagement in pediatric care is associated with positive child health outcomes, pediatric primary care providers (PCPs) often focus on the mother-child dyad. This study sought to characterize pediatric PCPs’ engagement of fathers in care. Pediatric PCPs affiliated with an academic health system were invited to complete an online survey. The primary outcome was the proportion of providers who routinely implement American Academy of Pediatrics recommendations for father engagement. There were 100 respondents. Of the 23 recommended practices for engaging fathers, 18 were routinely implemented by <50% of respondents. The least routinely implemented practices were parenting skills support (4%) and perinatal depression screening (5%). The most commonly endorsed barriers included lack of father attendance at visits (91%) and time constraints (75%). Despite the American Academy of Pediatrics recommendations, pediatric PCPs do not routinely engage fathers in care. Effective strategies are needed to reduce barriers and improve father engagement among pediatric providers.

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Changes to telehealth practices in primary care in New Brunswick (Canada): A comparative study pre and during the COVID-19 pandemic

PLoS ONE ◽

10.1371/journal.pone.0258839 ◽

2021 ◽

Vol 16 (11) ◽

pp. e0258839

Author(s):

Claire Johnson ◽

Jérémie B. Dupuis ◽

Pierre Goguen ◽

Gabrielle Grenier

Keyword(s):

Primary Care ◽

Comparative Study ◽

New Brunswick ◽

Nurse Practitioners ◽

Online Survey ◽

Primary Care Providers ◽

Care Providers ◽

Timely Access ◽

Access To Primary Care

Background During the COVID-19 pandemic, telehealth technologies were used in the primary health care setting in New Brunswick as a means to continue providing care to patients while following public health guidelines. This study aimed to measure these changes and examine if they improved timely access to primary care. A secondary goal was to identify which telehealth technologies were deemed sustainable by primary care providers. Methods This was a comparative study on the use of telehealth technology before and during the COVID-19 pandemic. Between April 2020 and November 2020, 114 active primary care providers (family physicians or nurse practitioners) responded to the online survey. Results The findings illustrated an increase in the use of telehealth technologies. The use of phone consultations increased by 122%, from 43.9% pre-pandemic to 97.6% during the pandemic (p < 0.001). The use of virtual consultation (19.3% pre-pandemic vs. 41.2% during the pandemic, p < 0.001), emails and texts also increased during the pandemic. Whereas the more structural organizational tools (electronic medical charts and reservation systems) remained stable. However, those changes did not coincide with a significant improvement to timely access to care during the pandemic. Many participants (40.1%) wanted to keep phone consultations, and 21.9% of participants wanted to keep virtual consultations as part of their long-term practice. Interpretation The observed increase in the use of telehealth technologies may be sustainable, but it has not significantly improved timely access to primary care in New Brunswick.

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Experiences with Primary Care in the State of Utah for Gender Diverse People: Surveying the Difficulties in Accessing Healthcare

10.1101/2020.12.28.20248879 ◽

2021 ◽

Author(s):

Bita Tristani-Firouzi ◽

Joanne Rolls ◽

Nicole L Mihalopoulos ◽

Cori A Agarwal

Keyword(s):

Primary Care ◽

Hormone Therapy ◽

Online Survey ◽

Primary Care Providers ◽

Insurance Companies ◽

Care Providers ◽

University Of Utah ◽

Trans Men ◽

Healthcare Needs ◽

Trans Women

Background: Transgender and non-binary communities continue to be underserved in healthcare. This study seeks to better understand the barriers and difficulties faced by transgender and non-binary patients in accessing primary care and hormone therapy in Utah. Methods: An online survey was developed for transgender and non-binary identifying adults and was advertised via social media and the University of Utah Hospital website. Results: There were 123 respondents from Utah including 39 trans women, 49 trans men, and 35 non-binary individuals. The age ranged from 18-67 (average 30 years), and 93% were Caucasian. The majority (84%) were insured, yet 67% of respondents reported difficulty accessing primary care. Fear of discrimination and being unable to find trans-friendly providers were reported as the two largest barriers. Non-binary respondents reported fear of discrimination as a barrier to primary care at the highest percentage (92%). Nearly 3 in 4 respondents who have hormone therapy reported difficulty paying for it. One in four trans women reported accessing hormones online or from a friend. Conclusion: Utah is currently drastically underequipped to provide for the healthcare needs of transgender and non-binary communities. There needs to be an increase in trans-friendly primary care providers to curb discrimination. More resources and efforts must go into training primary care providers with necessary knowledge to properly serve transgender and non-binary patients. Finally, clear anti-discrimination laws are needed for insurance companies to reduce the financial barrier to transgender health services in Utah.

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Aging through the time of COVID-19: a survey of self-reported healthcare access

BMC Health Services Research ◽

10.1186/s12913-021-07353-9 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Allie Peckham ◽

Keenan A. Pituch ◽

Molly Maxfield ◽

M. Aaron Guest ◽

Shalini Sivanandam ◽

...

Keyword(s):

Primary Care ◽

Healthcare Provider ◽

Chronic Conditions ◽

Online Survey ◽

Healthcare Access ◽

Primary Care Providers ◽

Care Providers ◽

Snowball Sampling ◽

Health Seeking ◽

The Impact

Abstract Background Chronic conditions are common and require ongoing continuous management and preventive measures. The COVID-19 pandemic may have affected the management of chronic conditions by delaying care. We sought to understand the impact of personal characteristics (i.e., age) and healthcare factors (i.e., access to a provider) on healthcare access in a sample of Americans 50 years of age or older during COVID-19. Method Participants completed an online survey at the start of the COVID-19 pandemic – the Aging in the Time of COVID Survey. Questions focused on health status, health care access, COVID-19 fear, and social connectedness. Participants were recruited through social media advertisements, list serves, and snowball sampling. Data collection started in early April 2020 and concluded in late May 2020. Logistic regression models examined the results of two key access points: healthcare provider/doctor (n = 481) and medication (n = 765), with 56 and 93% of participants reporting access to a provider and medications, respectively. Results Individuals with an established primary care provider were much more likely to obtain access to a healthcare provider, OR = 3.81 (95% CI: 1.69, 8.77), and to receive medication, OR = 4.48 (95% CI: 1.61, 11.48), during the time of COVID-19. In addition, access to medication was (a) higher for those who were older, OR = 1.05 (95% CI: 1.01, 1.09), had a higher income (greater than 100 k compared to less than 50 k, OR = 3.04 (95% CI: 1.11, 8.98), and (b) lower for those having caregiving responsibilities, OR = 0.41 (95% CI: 0.21, 0.78), or greater social isolation, OR = 0.93 (95% CI: 0.87, 0.98). Conclusions Although most participants had access to medication, just over half had access to a healthcare provider when needed. Notably, health-seeking behaviors for individuals who do not have an established primary care providers as well as those who provide unpaid care, are socially isolated, and younger may require more proactive approaches to care monitoring, management, and maintenance.

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Minnesota healthcare providers’ breast cancer screening practices at the extremes of age.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e13037 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e13037-e13037

Author(s):

Deanna Gek Koon Teoh ◽

Rachel Isaksson Vogel ◽

Alicia Allen ◽

Anne Hudson Blaes ◽

Susan Mason ◽

...

Keyword(s):

Breast Cancer ◽

Primary Care ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Online Survey ◽

Primary Care Providers ◽

Screening Methods ◽

Average Risk ◽

Care Providers ◽

Screening Practices

e13037 Background: Breast cancer screening guidelines disagree on the age to initiate and discontinue screening. We sought to determine the age at which Minnesota providers initiate and discontinue breast cancer screening. Methods: A cross-sectional online survey of Minnesota primary care providers was conducted in 2016. The survey queried providers’ breast screening practices for average-risk women. Data were summarized using descriptive statistics and comparisons by professional characteristics were conducted using Chi-squared tests. Results: There were 805 respondents (8% of 10,392 invitees), of which 456 (56.7%) provided primary care to women and were included in the analysis. 316 (72%) were women, 193 (44%) were physicians, 50 (11%) were physician assistants (PAs), and 197 (45%) were advanced practice nurses (APNs). 85% practiced in a community setting. 38% had practiced > 20 years, and 27% had practiced < 10 years. Among respondents, 67%, 77% and 72% recommended screening mammography for women age 40-44, 45-49 and 70+ years, respectively. Compared to male providers, female providers were more likely to screen women age 40-44 years (73% vs. 49%; p < 0.0001) and 45-49 years (81% vs. 66%; p = 0.002), but there was no difference by gender for patients age 70+ years (72% vs. 74%; p = 0.89). Respondents reporting specialized interest in women’s health were more likely to screen women age 40-44 years (73% vs. 61%; p = 0.006), 45-49 years (83% vs 72%; p = 0.007) and older than age 70 years (77% vs. 69%; p = 0.04). Physicians were less likely to screen women age 40-44 and 45-49 years (57% and 71%, respectively; p = 0.001) than PAs (72%, 78%) and APNs (74%, 83%), but APNs were less likely to screen women age 70+ years (65% vs. physicians 79% vs. PAs 76%; p = 0.006). Number of years in practice was not associated with a difference in age at initiation of screening, however, increasing number of years in practice was associated with screening women age 70+ years (p = 0.02). Conclusions: Although breast cancer screening practices for average risk women vary by healthcare provider characteristics, a majority of Minnesota primary care providers initiate breast cancer screening between ages 40-49 years, and continue screening women age 70 years and older.

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590. Persisting COVID-19 vaccination hesitancy in the South Bronx

Open Forum Infectious Diseases ◽

10.1093/ofid/ofab466.788 ◽

2021 ◽

Vol 8 (Supplement_1) ◽

pp. S397-S398

Author(s):

Danelly Gomez D' Aza ◽

Masood A Shariff ◽

Israel Duran Santibanez ◽

Raquel Horowitz ◽

Hina Asad ◽

...

Keyword(s):

Primary Care ◽

Online Survey ◽

Minority Groups ◽

Mobile Apps ◽

Primary Care Providers ◽

Vaccine Hesitancy ◽

Care Providers ◽

The South ◽

South Bronx ◽

Cross Sectional

Abstract Background Minority groups have the lowest vaccination rates when compared to the overall population. We aim to study the attitudes and perceptions of COVID-19 vaccination, about six months after vaccine rollout in the South Bronx. Methods Cross-sectional anonymized online survey evaluating knowledge, attitude and perception about COVID-19 vaccination using SurveyMonkey™ was conducted in South Bronx community from April - June 2021. Results Of the 281 participants, 67% were Latinx and 16% were African American (AA); 69% (195) were fully vaccinated (FV) and 31% (86) with vaccine hesitancy (VH). The common reasons for hesitancy were “concerns about side effects” (38%), “vaccine is not safe” (27%) and “vaccine was approved too fast” (26%) (p< .001). VH were more likely to rely online/mobile apps (30%) and friends and family (23%) as compared to FV. VH were more likely to be AA, younger age (< 35 yrs), high school or lower education, single, unemployed, without comorbidities, not current on other eligible vaccines, and did not believe “vaccine is necessary to end the pandemic.” Majority of participants from both cohorts trusted their primary care providers. Mistrust with healthcare and pharmaceutical companies was higher in VH (p=0.009). Both groups preferred to continue wearing mask and practice social distancing despite vaccination status. Table 1b: COVID-19 Vaccine Survey Summary Table 1c: COVID-19 Vaccine Survey Participant Characteristics Conclusion Persisting vaccine hesitancy is concerning in minority communities. Identifying the target population and implementation of innovative methods to improve COVID-19 vaccination acceptance leveraging primary care providers would be a possible solution. Disclosures All Authors: No reported disclosures

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