Bipolar Depression in a Low-Income Primary Care Clinic

2005 ◽  
Vol 162 (11) ◽  
pp. 2146-2151 ◽  
Author(s):  
Mark Olfson ◽  
Amar K. Das ◽  
Marc J. Gameroff ◽  
Daniel Pilowsky ◽  
Adriana Feder ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Bipolar Depression ◽  
Primary Care Clinic ◽  
Care Clinic

Using Touch-Screen Technology to Assess Smoking in a Low-Income Primary Care Clinic: A Pilot Study

2011 ◽  
Vol 46 (14) ◽  
pp. 1750-1754 ◽  
Author(s):  
Philip H. Smith ◽  
Gregory G. Homish ◽  
Christopher Barrick ◽  
Nancy L. Grier
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Low Income ◽  
Primary Care Clinic ◽  
Touch Screen ◽  
Care Clinic

Pregnant Hispanic Women: A Mental Health Study

1992 ◽  
Vol 73 (9) ◽  
pp. 515-521 ◽  
Author(s):  
Luis H. Zayas ◽  
Nancy A. Busch-Rossnagel
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Low Income ◽  
Mental Health Problems ◽  
Hispanic Women ◽  
Primary Care Clinic ◽  
Health Study ◽  
Community Based ◽  
Care Clinic ◽  
Mental Health Study

By most accounts, pregnant Hispanic women are a population at risk for perinatal health and mental health problems. In this article, the authors report on a pilot study of the mental health status of 86 low-income, pregnant Hispanics. Three cases drawn from a community-based, primary care clinic demonstrate how Hispanic women may appear in the clinical setting and how interventions can be designed.

scholarly journals Experiences and Beliefs of Low‐Income Patients with Hypertension in Louisiana and Mississippi during the COVID‐19 Pandemic

2020 ◽  
Author(s):  
Katherine T. Mills ◽  
Erin Peacock ◽  
Jing Chen ◽  
Amanda Zimmerman ◽  
Hua He ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Primary Care Clinic ◽  
Treatment Strategies ◽  
Pressure Control ◽  
Healthcare Services ◽  
Poverty Level ◽  
Antihypertensive Medications ◽  
Patient Centered ◽  
Care Clinic

Abstract Background The coronavirus disease 2019 (COVID‐19) pandemic disproportionately affects individuals with hypertension and health disparities. Methods and Results We assessed experiences and beliefs of low‐income and minority patients with hypertension during the COVID‐19 pandemic. Participants (N=587) from the Implementation of Multifaceted Patient‐Centered Treatment Strategies for Intensive Blood Pressure Control (IMPACTS‐BP) study completed a telephone survey in May and June of 2020. Participants were 65.1% Black, 59.7% female, and 57.7% reported an income below the federal poverty level. Overall, 2.7% tested positive and 15.3% lost a family member or friend to COVID‐19. These experiences were significantly more common in Black (3.9% and 19.4%, respectively) than in non‐Black participants (0.5% and 7.8%, respectively). Further, 14.5% lost a job and 15.9% reported food shortages during the pandemic. Most participants complied with stay‐at‐home orders (98.3%), social distancing (97.8%), and always wearing a mask outside their home (74.6%). Participants also reported high access to needed healthcare (94.7%) and prescription medications (97.6%). Further, 95.7% of respondents reported that they continued to take their regular dosage of antihypertensive medications. Among the 44.5% of participants receiving a healthcare appointment by telehealth, 96.6% got the help they needed, and 80.8% reported that the appointment quality was as good as or better than in‐person visits. Finally, 88.9% were willing to return to their primary care clinic. Conclusions These data suggest that low‐income patients, especially Black patients, were negatively impacted by COVID‐19. However, most patients were able to access needed healthcare services and were willing to return to their primary care clinic for hypertension management.

Peer-led Group Sessions to Improve Healthful Eating and Physical Activity in a Low-income Primary Care Clinic Population

2018 ◽  
Author(s):  
Kristen A. Copeland ◽  
Courtney Brown ◽  
Zana Percy ◽  
Alisa Balestra ◽  
Robert Siegel ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Low Income ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
Group Sessions ◽  
Clinic Population

Determinants of adherence to antihypertensive treatment among patients attending a primary care clinic with limited medical armamentarium in Delhi, India: A qualitative study

2020 ◽  
pp. 174239532095941
Author(s):  
Saurav Basu ◽  
Kajok Engtipi ◽  
Rajesh Kumar
Keyword(s):  
Primary Care ◽  
Low Income ◽  
Care Center ◽  
Primary Care Clinic ◽  
Care Facility ◽  
Pressure Control ◽  
Organ Damage ◽  
Uncontrolled Hypertension ◽  
Primary Care Center ◽  
Care Clinic

Objective To determine perspectives on reasons for non-adherence to antihypertensive therapy and its socioeconomic determinants among patients attending a primary care center in a low-income area in Delhi, India. Methods We conducted in-depth interviews with a total of 30 patients having hypertension at a primary care facility located in a low-income urban area in Delhi. Results All the participants were aware that hypertension was a serious illness, and medication intake was necessary throughout life to prevent uncontrolled hypertension. All participants in varying quantities practiced salt restriction, but the consumption of fresh fruit and vegetables was low primarily due to economic reasons. The participants were unable to differentiate the concept of exercise from physical activity. Medication adherence was suboptimal, and significant reasons for non-adherence were forgetfulness, carelessness and running out of drug stocks. Blood pressure control was also suboptimal in a majority of the participants, but combination therapy was restricted due to limited medical armamentarium at the clinic. Laboratory investigations for monitoring target end-organ damage were either delayed or not conducted in most participants. Discussion Hypertensive patients undergoing treatment at primary care facilities often report suboptimal medical adherence and treatment outcomes, with socioeconomic causes being a major driver of non-adherence.

scholarly journals Predictors of Alcohol Use in Safety-Net Primary Care: Classism, Religiosity, and Race

2020 ◽  
Vol 2020 ◽  
pp. 1-10
Author(s):  
Michael A. Trujillo ◽  
Erin R. Smith ◽  
Sarah Griffin ◽  
Allison B. Williams ◽  
Paul B. Perrin ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Racial Differences ◽  
Low Income ◽  
Primary Care Clinic ◽  
Safety Net ◽  
Direct Effects ◽  
Cross Sectional ◽  
Care Clinic ◽  
Problematic Drinking

Class-based discrimination may impact problematic drinking in low-income populations, which may be buffered by personal religiosity. However, little is known how race may impact this association. The purpose of this study was to examine racial differences in the effect of class-based discrimination on problematic drinking as moderated by comfort with God and determine if there were conditional direct effects of class-based discrimination on problematic drinking by race. In this cross-sectional study, participants (N = 189) were patients of an urban, safety-net primary care clinic who completed questionnaires assessing experiences of class-based discrimination, attitudes toward God, and alcohol use. Data were collected from 2015 to 2016 and analyzed using the Hayes PROCESS macro. There was a significant main effect for class-based discrimination predicting problematic drinking. Two-way interaction analyses identified a significant comfort with God by race interaction with greater comfort with God associated with less problematic drinking among white but not black respondents. Conditional direct effects showed that experiences of class-based discrimination were associated with problematic drinking at low and moderate but not high levels of comfort with God in black participants, whereas none were observed for white participants. This study provides insight on how personal religiosity, class-based discrimination, and race may intertwine to shape problematic alcohol use in primarily low-income, urban patients. Clinicians’ awareness of risk and protective factors, as well as how race tempers the effects of such factors, is vital in providing better care for this population.

scholarly journals Psychosocial Underpinnings of Pain and Sleep Disturbance in Safety-Net Primary Care Patients

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Sarah Griffin ◽  
Joseph Tan ◽  
Paul B. Perrin ◽  
Allison B. Williams ◽  
Erin R. Smith ◽  
...  
Keyword(s):  
Mental Health ◽  
Social Support ◽  
Primary Care ◽  
Sleep Disturbance ◽  
Psychosocial Factors ◽  
Low Income ◽  
Primary Care Clinic ◽  
Safety Net ◽  
Care Clinic ◽  
Cynical Hostility

Objective. The aim of this study was to uncover possible psychosocial underpinnings of pain and sleep disturbance in a safety-net primary care sample. Methods. Patients (n = 210) awaiting care in a safety-net primary care clinic waiting room completed measures of cynical hostility, social support, mental health, sleep disturbance, and pain. This study was cross-sectional and observational. Results. A structural equation model suggested that higher cynical hostility was associated with lower social support, which in turn was associated with poorer mental health, which then corresponded with higher pain and sleep disturbance. All possible indirect (mediational) effects within this model were statistically significant, suggesting a possible route through which cynical hostility may shape pain and sleep, two common presenting problems in primary care. Conclusions. These findings illustrate the interplay of psychosocial factors with chronic pain and sleep disturbance in a sample of low-income, predominantly African-American patients seeking care at a safety-net primary care clinic. The findings support integrated primary care as a way to target not only behavioral health issues but also the psychosocial factors entangled with physical health.

A Previsit Screening Checklist Improves Teamwork and Access to Preventive Services in a Medical Home Serving Low-Income Adolescent and Young Adult Patients

2017 ◽  
Vol 57 (7) ◽  
pp. 835-843
Author(s):  
Sophie H. Allende-Richter ◽  
Sydney T. Johnson ◽  
Mariam Maloyan ◽  
Patricia Glidden ◽  
Kerrilynn Rice ◽  
...  
Keyword(s):  
Primary Care ◽  
Young Adults ◽  
Low Income ◽  
Primary Care Clinic ◽  
Team Work ◽  
Adolescents And Young Adults ◽  
Care Clinic ◽  
Care Services ◽  
Primary Care Services ◽  
Publicly Insured

Publicly insured adolescents and young adults experience significant obstacles in accessing primary care services. As a result, they often present to their medical appointments with multiple unmet needs, adding time and complexity to the visit. The goal of this project was to optimize team work and access to primary care services among publicly insured adolescents and young adults attending an urban primary care clinic, using a previsit screening checklist to identify patient needs and delegate tasks within a care team to coordinate access to health services at the time of the visit. We conducted an interventional quality improvement initiative in a PDSA (Plan-Do-Study-Act) cycle format; 291 patients, 13 to 25 years old were included in the study over an 8-months period. The majority of patients were receptive to the previsit screening checklist; 85% of services requested were provided; nonclinician staff felt more involved in patient care; and providers’ satisfaction increased.

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