scholarly journals Injury Prevention Education in the Waiting Room of an Underserved Pediatric Primary Care Clinic

2018 ◽  
Vol 58 (1) ◽  
pp. 73-78 ◽  
Author(s):  
Nikita Habermehl ◽  
Elizabeth Diekroger ◽  
Rina Lazebnik ◽  
Grace Kim
Keyword(s):  
Primary Care ◽  
Injury Prevention ◽  
Primary Care Clinic ◽  
The United States ◽  
Childhood Mortality ◽  
Pediatric Primary Care ◽  
Waiting Room ◽  
Care Clinic ◽  
Prevention Education

Unintentional injuries are the leading cause of childhood mortality in the United States. Study aims included educating families about injury prevention and improving satisfaction with the waiting room experience. Two hundred caregivers with young children in the waiting room of an underserved pediatric primary care clinic participated in brief individual education sessions and received a toolkit containing small safety items and content highlighting age-appropriate safety topics. Participants completed 2 follow-up surveys, and most caregivers (94%) reported learning new information about injury prevention and thought that the intervention resulted in a better waiting room experience (91%). Of those who completed the 2-week follow-up survey (84%), 93.5% made changes at home and 42.7% bought new safety equipment. Injury prevention education can be effectively provided in the waiting room of a pediatric primary care clinic by improving reported caregiver safety knowledge and behaviors as well as satisfaction with the waiting room experience.

Parasitology Screening of Latin American Children in a Primary Care Clinic

PEDIATRICS ◽  
1992 ◽  
Vol 89 (2) ◽  
pp. 279-283
Author(s):  
Joel L. Bass ◽  
Kishor A. Mehta ◽  
Bonnie Eppes
Keyword(s):  
Primary Care ◽  
Latin American ◽  
Primary Care Physicians ◽  
Screening Program ◽  
Primary Care Clinic ◽  
The United States ◽  
Common Finding ◽  
Parasitic Infections ◽  
Screening Process ◽  
Care Clinic

A screening program based in a Massachusetts community hospital primary care clinic, which included 124 children from 12 different Latin American countries, demonstrated that nearly 35% were carriers of pathogenic parasites. The large majority (83.7%) of these children were asymptomatic at the time of the examination. Although there may be considerable variation based on country of origin, the present results, as well as a review of the literature, suggest this is likely to be a common finding among children born in most regions of Latin America. Compliance with the screening process was significantly higher in groups with higher infection rates and the successive yield in those patients who submitted two or more stool samples revealed that most pathogens were identified in the first sample. Schoolage children were found to have the highest risk for both roundworm infections and multiple parasitic infections. For those children with identified pathogens, nearly 90% received treatment. Current trends in immigration, international adoptions, and special circumstances including day care, family shelters, and increasing numbers of human immunodeficiency virus-infected children have made an appreciation of the extent of parasitosis, and awareness of possible management approaches, an important consideration for primary care physicians in the United States.

Opportunities for and Barriers to Using Smartphones for Health Education Among Families at an Urban Primary Care Clinic

2018 ◽  
Vol 57 (11) ◽  
pp. 1281-1285 ◽  
Author(s):  
Francis J. Real ◽  
Dominick DeBlasio ◽  
Cesarina Rounce ◽  
Adrienne W. Henize ◽  
Andrew F. Beck ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Education ◽  
Mobile Devices ◽  
Mobile Technology ◽  
Primary Care Clinic ◽  
Pediatric Primary Care ◽  
Care Clinic ◽  
Primary Care Clinics ◽  
Survey Questions

Mobile technology is omnipresent in society. Though studies suggest increased rates of smartphone accessibility, current access and barriers to smartphone usage at urban primary care clinics remains unclear. A self-administered survey was distributed to families presenting to an urban, underserved pediatric primary care clinic in spring 2017. Survey questions related to smartphone ownership and barriers to usage. A total of 273 parents completed the survey. Ninety-five percent of participants owned a smartphone. Fifty-eight percent of participants identified no barriers to smartphone usage. Among those who identified one or more barriers (n = 108), difficulties were primarily related to Wi-Fi access (46%), available phone memory (45%), existing phone data (28%), and discomfort with technology (11%). The majority of parents (59%) were interested in using a smartphone to learn about their child’s health. In conclusion, there is opportunity to transform health education utilizing mobile devices, though disparities to usage should be considered.

Encouraging Asian Immigrant Women to Disclose Intimate Partner Violence in Primary Care Settings

2020 ◽  
pp. 088626052095964
Author(s):  
Paula Tavrow ◽  
Danny Azucar ◽  
Dan Huynh ◽  
Caroline Yoo ◽  
Di Liang ◽  
...  
Keyword(s):  
Primary Care ◽  
Intimate Partner Violence ◽  
Partner Violence ◽  
Immigrant Women ◽  
Cultural Beliefs ◽  
Primary Care Clinic ◽  
The United States ◽  
Intimate Partner ◽  
Asian Immigrant ◽  
Care Clinic

Risks of intimate partner violence (IPV) often are higher among immigrant women, due to dependency, language barriers, deportation fears, cultural beliefs, and limited access to services. In the United States, Asian immigrant women experiencing IPV often are reluctant to disclose abuse. Viewing videos that depict IPV survivors who have successfully obtained help might encourage disclosure. After conducting formative research, we created brief videos in four Asian languages (Korean, Mandarin Chinese, Thai, and Vietnamese) for use in primary care clinic consultation rooms. We then conducted in-depth interviews with 60 Asian immigrant women in California to get their perspectives on how helpful the videos might be in achieving disclosure. Most participants believed the videos would promote disclosure in clinics, although those who had been abused seemed more skeptical. Many had stereotyped views of victims, who they felt needed to be emotive to be credible. Videos should be upbeat, highlighting the positive outcomes of escaping violence and showing clearly each step of the process. Various types of IPV should be described, so that women understand the violence is not exclusively physical. Victims would need reassurance that they will not be arrested, deported, or forced to leave their abusers. Discussing the benefits of escaping violence to children could be influential. Victims also must be convinced that providers are trustworthy, confidential, and want to help. To assist immigrant populations to disclose IPV to a health provider, videos need to be culturally relevant, explain various types of violence, allay fears, and show clear processes and benefits.

Implementation of a brief screening tool to identify needs of cancer survivors.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e23075-e23075 ◽  
Author(s):  
Allison L. McDonough ◽  
Yvonne Y. Lei ◽  
Dana Haggett ◽  
Rachel Jimenez ◽  
Katherine T. Johnston ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Primary Care ◽  
Cancer Survivors ◽  
Breast Cancer Survivors ◽  
Primary Care Clinic ◽  
Qualitative Assessment ◽  
Plain Language ◽  
Convenience Sample ◽  
Care Clinic

e23075 Background: Innovation in health care delivery is needed to improve care for cancer survivors. We report a pragmatic study intended to evaluate our experience with adopting screening guidelines from the National Comprehensive Cancer Network (NCCN) to the routine care of breast cancer survivors in primary care and oncology follow up. Methods: We adapted the NCCN recommended screening questions into a plain language self-administered 1 page intake questionnaire. The tool was administered to a convenience sample of female breast cancer survivors in routine follow-up at an oncology or primary care clinic from September through December 2018. Domains included symptoms, lifestyle concerns, and financial issues. Frequency of concerns was assessed as “never”, “rarely”, “sometimes”, “very frequently” and “always”. We dichotomized results and evaluated feasibility of administration, prevalence of reported symptoms and qualitative assessment of burden as well as utility of the tool among participating clinicians. Results: 165 out of 169 patients offered the questionnaire participated (98%). Office staff provided the questionnaire at routine visits without notable impact on clinic flow. Most commonly endorsed concerns (sometimes or more) were: desire to improve fitness or nutrition (80%), worry about cancer recurrence (72%), and problems with sleep (57%). A majority also reported feeling nervous or worried (55%) and aches or pains in limbs or joints (55%). Several issues known to be underreported in clinic visits were endorsed including lack of satisfaction with sexual function (30% sometimes or more, 12% very often or always) and difficulty remembering things (47% sometimes or more, 13% very often or always). Among 7 participating clinicians, the tool was deemed useful and not burdensome. Several noted that it led to discussing issues that may not otherwise have been addressed. Suggestions included systematically identifying resources and strategies to address common issues and incorporating the tool into the electronic health record to increase utility. Conclusions: Screening for individual needs among survivors is feasible and efficient and may identify prevalent issues that otherwise can be missed in routine survivorship care.

Pediatrician Interview Style and Mothers' Disclosure of Psychosocial Issues

PEDIATRICS ◽  
1994 ◽  
Vol 93 (2) ◽  
pp. 289-295
Author(s):  
Lawrence S. Wissow ◽  
Modena E.H. Wilson ◽  
Debra L. Roter
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Problems ◽  
Primary Care Clinic ◽  
Health Problems ◽  
Physical Punishment ◽  
Pediatric Primary Care ◽  
Psychosocial Issues ◽  
City Hospital ◽  
Care Clinic

Objective. Primary care pediatricians play an important role in the detection, diagnosis, treatment, and referral of children with mental health problems. Some parents, however, are reluctant to discuss behavioral and emotional symptoms with their child's pediatrician. Studies of patient-physician communication suggest that specific aspects of pediatrician interview style (asking questions about psychosocial issues, making supportive statements, and listening attentively) increase disclosure of sensitive information. We hypothesized that disclosures of parent and child psychosocial problems would be more likely to occur during visits when pediatricians used these techniques. Design. Cross-sectional analysis of a systematic sample of pediatric primary care visits. Population. Two hundred thirty-four children ages 6 months to 14 years and their mothers or female guardians attending an inner-city hospital-based pediatric primary care clinic; 52 physicians in their second or third year of pediatric residency training. Methods. Visits audiotaped and dialogue coded using the Roter Interactional Analysis System. Independent variables included counts of pediatrician utterances in the following categories: (a) questions about psychosocial issues, (b) statements of support and reassurance, and (c) statements indicating sympathetic and attentive listening. Dependent variables were the disclosure of information about: (a) parental medical or emotional impairment, (b) family disruption, (c) use of physical punishment, and (d) aggressive or overactive child behavior. Results. Use of psychosocially oriented interviewing techniques was associated with a greater likelihood of disclosure for all four of the topic areas studied. Odds ratios for disclosure, adjusted for parental concerns and child age, ranged from 1.09 to 1.22 depending on the interview technique and outcome involved. Positive associations were observed both for topics raised primarily in response to pediatrician questions (family and parent problems) and for topics raised primarily by mothers (behavior and punishment). Conclusions. Three simple communication skills were associated with disclosure of specific concerns relevant to child mental health. Training pediatricians to use these skills would help to better detect and diagnose children's mental health problems.

377 Insomnia Treatment Practices of Primary Care Providers in Primary Care Settings

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A150-A150
Author(s):  
Cassandra Godzik ◽  
Adam Sorscher
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Primary Care Providers ◽  
Sleep Medicine ◽  
Quality Metrics ◽  
Care Providers ◽  
National Guidelines ◽  
Daytime Functioning ◽  
Care Clinic

Abstract Introduction Insomnia is highly prevalent in adult populations, with rates found to be between 10% and 40% as reported in a metanalysis conducted by Zhang et al. (2019). Insomnia is associated with worsened health outcomes and increased healthcare utilization. Primary care providers (PCPs) are the first point of contact for most people seeking treatment for insomnia. The American Academy of Sleep Medicine has proposed six quality metrics for the evaluation and treatment of insomnia (Edinger et al., 2015). In this study, we investigate how often primary care providers meet these quality metrics when they encounter a patient with a new complaint of insomnia. Methods We reviewed the charts of adult patients seen in our primary care clinic department with a new presenting complaint of insomnia between 2014–2016. The clinic notes were scored to see if any of the six metrics of quality care for insomnia as proposed by the AASM were addressed in the index appointment (T1) and in follow up appointments (T2) within three months. Results Demographic variables were analyzed (N=155; 48 males, 107 females); mean age 64 years (range 24–98). We found that PCPs documented the following: at T1, assessment of sleep quality (68%), evidence-based treatment provided (82%), daytime functioning assessed (19%), and adverse side effects assessed (11%). 29% of subjects returned for a follow up visit with 3 months. At T2, there was an assessment of sleep satisfaction/quality (40%), and of improved daytime functioning (87%). Conclusion Presently, evaluation and treatment of insomnia by PCPs is not standardized. By identifying how providers address insomnia in practice, we can develop interventions to help promote adherence to the national guidelines for treatment of insomnia in a non-sleep medicine healthcare setting. Support (if any) Dr. Cassandra M. Godzik’s Postdoctoral Research Fellowship: NIMH - T32 MH073553

Capitation Reimbursement for Pediatric Primary Care

PEDIATRICS ◽  
1986 ◽  
Vol 77 (1) ◽  
pp. 29-34
Author(s):  
Toby Gordon ◽  
Catherine DeAngelis ◽  
Ronald Peterson
Keyword(s):  
Primary Care ◽  
Private Insurance ◽  
Health Maintenance Organization ◽  
Primary Care Clinic ◽  
Pediatric Primary Care ◽  
Care Clinic ◽  
Health Maintenance ◽  
Close Supervision ◽  
Medicaid Population ◽  
Inpatient And Outpatient Care

A feasibility analysis of capitation reimbursement for a primarily Medicaid population in The Johns Hopkins Pediatric Primary Care Clinic was conducted. The utilization of all inpatient and outpatient care of 2,261 patients was monitored for a 6-month period. As a result, per capita rates based on charges were determined for each group of patients according to type of insurance. Blue Cross and private insurance patients had capitation rates three times that of the Medicaid patients and over ten times that of the self-pay patients. This variation in utilization was attributed to the selection of enrollees, the morbidity of the population, and the varying services covered by payor group. Administrative issues regarding establishing a pediatric health maintenance organization are also discussed. Close supervision of house staff in treating patients, including admissions, length of stay, and specialty referral is of utmost importance in containing costs in this clinic setting.

Dose Matters: A Smartphone Application to Improve Asthma Control Among Patients at an Urban Pediatric Primary Care Clinic

2019 ◽  
Vol 8 (5) ◽  
pp. 357-365 ◽  
Author(s):  
Francis J. Real ◽  
Andrew F. Beck ◽  
Dominick DeBlasio ◽  
Matthew Zackoff ◽  
Adrienne Henize ◽  
...  
Keyword(s):  
Primary Care ◽  
Asthma Control ◽  
Primary Care Clinic ◽  
Smartphone Application ◽  
Pediatric Primary Care ◽  
Care Clinic
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