Suicide Safer Care: A Public Health Approach to Training Primary Care Providers in Addressing Suicide

ObjectivesHypertension and diabetes mellitus are important risk factors for cardiovascular diseases (CVDs). Once identified with these conditions, individuals need to be linked to primary healthcare system for initiation of lifestyle modifications, pharmacotherapy and maintenance of therapies to achieve optimal blood pressure and glycaemic control. In the current study, we evaluated predictors and barriers for non-linkage to primary-care public health facilities for CVD risk reduction.MethodsWe conducted a community-based longitudinal study in 16 urban slum clusters in central India. Community health workers (CHWs) in each urban slum cluster screened all adults, aged 30 years or more for hypertension and diabetes, and those positively screened were sought to be linked to urban primary health centres (UPHCs). We performed univariate and multivariate analysis to identify independent predictors for non-linkage to primary-care providers. We conducted in-depth assessment in 10% of all positively screened, to identify key barriers that potentially prevented linkages to primary-care facilities.ResultsOf 6174 individuals screened, 1451 (23.5%; 95% CI 22.5 to 24.6) were identified as high risk and required linkage to primary-care facilities. Out of these, 544 (37.5%) were linked to public primary-care facilities and 259 (17.8%) to private providers. Of the remaining, 506 (34.9%) did not get linked to any provider and 142 (9.8%) defaulted after initial linkages (treatment interrupters). On multivariate analysis, as compared with those linked to public primary-care facilities, those who were not linked had age less than 45 years (OR 2.2 (95% CI 1.3 to 3.5)), were in lowest wealth quintile (OR 1.8 (95% CI 1.1 to 2.9), resided beyond a kilometre from UPHC (OR 1.7 (95% CI 1.2 to 2.4) and were engaged late by CHWs (OR 2.6 (95% CI 1.8 to 3.7)). Despite having comparable knowledge level, denial about their risk status and lack of family support were key barriers in this group.ConclusionsThis study demonstrates feasibility of CHW-based strategy in promoting linkages to primary-care facilities.

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Public Health Detailing of Primary Care Providers: New York City’s Experience, 2003–2010

American Journal of Public Health ◽

10.2105/ajph.2011.300622 ◽

2012 ◽

Vol 102 (S3) ◽

pp. S342-S352 ◽

Cited By ~ 9

Author(s):

Michelle G. Dresser ◽

Leslie Short ◽

Laura Wedemeyer ◽

Victoria Lowerson Bredow ◽

Rachel Sacks ◽

...

Keyword(s):

Public Health ◽

Primary Care ◽

New York ◽

Primary Care Providers ◽

Care Providers

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Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

BioMed Research International ◽

10.1155/2015/137020 ◽

2015 ◽

Vol 2015 ◽

pp. 1-11 ◽

Cited By ~ 5

Author(s):

Jinhee Lee ◽

Thomas F. Kresina ◽

Melinda Campopiano ◽

Robert Lubran ◽

H. Westley Clark

Keyword(s):

Public Health ◽

Primary Care ◽

Substance Use ◽

Alcohol Use ◽

Opioid Dependence ◽

Alcohol Use Disorders ◽

Primary Care Providers ◽

Care Providers ◽

Addictive Disorders ◽

Care And Treatment

Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence.

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Fax Communication with Primary Care Providers During Public Health Emergencies Rhode Island Department of Health (2002)

PsycEXTRA Dataset ◽

10.1037/e311062004-001 ◽

2013 ◽

Author(s):

Keyword(s):

Public Health ◽

Primary Care ◽

Rhode Island ◽

Primary Care Providers ◽

Care Providers ◽

Public Health Emergencies ◽

Department Of Health

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Effect of a Digital Precision Public Health Intervention for Care Coordination During Covid-19 Pandemic in Australia: A Real World Study

10.21203/rs.3.rs-882615/v1 ◽

2021 ◽

Author(s):

Andre Q Andrade ◽

Jean-Pierre Calabretto ◽

Nicole L Pratt ◽

Lisa M Kalisch-Ellett ◽

Vanessa T LeBlanc ◽

...

Keyword(s):

Public Health ◽

Primary Care ◽

Continuity Of Care ◽

Care Coordination ◽

Real World ◽

Primary Care Providers ◽

Patient Specific ◽

Specific Information ◽

Care Providers ◽

Precision Public Health

Abstract Background: Emergencies disproportionally affect vulnerable populations. The COVID-19 pandemic affected older patients with co-morbidities both directly due to more severe infection and indirectly by affecting care provision. To promote continuity of care, public health professionals require tools to quickly and precisely coordinate with primary care providers. This study evaluated whether digital interventions powered by current existing infrastructure are more effective than conventional interventions in promoting primary care appointments during the COVID-19 pandemic. Methods: We developed a digital intervention delivered by secure messaging and compared it to a post delivered intervention to promote continuity of care for vulnerable veterans during COVID-19 in a real world, non-randomised, interventional study. The study was implemented as part of the Veterans’ MATES program, an Australian Government Department of Veterans’ Affairs program to promote improvements in health care for veterans. The intervention provided patient specific information to general practitioners (GPs) to support continuity of care, alongside mailed education to veterans. The intervention key messages were to maintain regular contact with care providers and to continue to adhere to health plans. The intervention took place in April 2020, during the first weeks of COVID-19 social distancing rules in Australia. The main outcome was time to first appointment with the primary general practitioner (GP) measured using a Cox proportional hazards model.Results: GPs received digital messaging for 51,052 veterans and post messaging for 26,859 veterans. The proportion of patients seeing their primary GP during the three months following intervention was higher in the digital group (77.8%) than the post group (61.5%) (p<0.01). Being in the digital group was associated with earlier appointments. Conclusion: Current infrastructure coupled with innovative solutions is effective in promoting care coordination at scale during national emergencies, opening up new perspectives for precision public health initiatives.

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Public health nurses' experience of collaboration with primary care providers in northern British Columbia

10.24124/2018/58872 ◽

2018 ◽

Author(s):

Sara Pyke

Keyword(s):

Public Health ◽

Primary Care ◽

British Columbia ◽

Primary Care Providers ◽

Public Health Nurses ◽

Care Providers

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Small Area Analysis of Diabetes Complications: Opportunities for Targeting Public Health and Health Services Interventions

Australian Journal of Primary Health ◽

10.1071/py05045 ◽

2005 ◽

Vol 11 (3) ◽

pp. 72 ◽

Cited By ~ 2

Author(s):

Z Ansari ◽

MJ Ackland ◽

NJ Carson ◽

BCK Choi

Keyword(s):

Public Health ◽

Primary Care ◽

Health Services ◽

Small Area ◽

Diabetes Complications ◽

Admission Rate ◽

Primary Care Providers ◽

Care Providers ◽

Admission Rates ◽

Rate Ratios

The objective of this paper is to present small area analyses of diabetes complications in Victoria, Australia, and to illustrate their importance for targeting public health and health services interventions. Local government areas in Victoria were aggregated into 32 Primary Care Partnerships (PCP), which are voluntary alliances of primary care providers. The 32 PCP areas were used as the basic geographic units for small area analyses. Admission rates for diabetes complications were age and sex standardised using the direct method and the 1996 Victorian population as the reference. Admission rate ratios were calculated using the Victorian admission rates as the reference. The 95 per cent confidence intervals for the standardised admission rate ratios were based on the Poisson distribution. There was a wide variation (almost fivefold) in admission rates for diabetes complications across the PCP catchments, with the lowest standardised rate ratio of 0.37 and the highest of 1.75. There were 11 PCPs (seven metropolitan, four rural) with admission rate ratios significantly higher than the Victorian average. The seven metropolitan PCPs contributed more than 43% of all admissions and bed days for diabetes complications in Victoria. Small area analyses of diabetes complications are an exciting new development aimed at stimulating an evidence-based dialogue between local area health service providers, planners and policy-makers. The purpose is to provide opportunities to target public health and health services interventions at the local level to improve the management of diabetes complications in the community.

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Public Health Detailing to Increase Routine HIV Screening in Baltimore, Maryland: Satisfaction, Feasibility, and Effectiveness

Public Health Reports ◽

10.1177/0033354917732333 ◽

2017 ◽

Vol 132 (6) ◽

pp. 609-616 ◽

Cited By ~ 4

Author(s):

Amelia Greiner Safi ◽

Jamie Perin ◽

Andrea Mantsios ◽

Christina Schumacher ◽

C. Patrick Chaulk ◽

...

Keyword(s):

Public Health ◽

Primary Care ◽

Hiv Testing ◽

Hiv Transmission ◽

Primary Care Providers ◽

Local Health ◽

Hiv Screening ◽

Care Providers ◽

Staff Members

The objective of this study was to evaluate the satisfaction with, and the feasibility and effectiveness of, a public health detailing project focused on increasing routine human immunodeficiency virus (HIV) screening of people aged 13-64 by primary care providers working in areas of Baltimore City, Maryland, with high rates of HIV transmission (defined as a mean geometric viral load of ≥1500 copies/mL per census tract). In public health detailing, trained public health professionals (ie, detailers) visit medical practice sites to meet with providers and site staff members, with the intention of influencing changes in clinical practice policy and/or behavior. During 2014, detailers made personal visits and gave HIV Testing Action Kits containing maps, educational and guideline documents, and resource lists to 166 providers and office managers at 85 primary care sites. At follow-up, 88 of 91 (96.7%) providers and 37 of 38 (97.4%) clinic managers were very satisfied or satisfied with the project. Of the 79 sites eligible at follow-up (ie, those that had not closed or merged with another practice), 76 (96.2%) had accepted at least 1 HIV Testing Action Kit, and 67 of 90 (74.4%) providers had increased their HIV screening. Public health detailing projects can be used to educate and support providers, establish relationships between providers and local health departments, and disseminate public health messages.

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Primary Care Medical Practices: Are Community Health Care Providers Ready for Disasters?

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2018.13 ◽

2018 ◽

Vol 13 (02) ◽

pp. 128-132 ◽

Cited By ~ 1

Author(s):

Rachel M. Peters ◽

Thomas J. Hipper ◽

Esther D. Chernak

Keyword(s):

Public Health ◽

Primary Care ◽

Health Care ◽

Primary Care Providers ◽

Special Health Care Needs ◽

Health Care Needs ◽

Care Providers ◽

Care Needs ◽

Special Health Care ◽

Special Health

AbstractObjectiveThis study seeks to determine the capacity of community primary care practices to meet the needs of patients during public health emergencies and to identify the barriers and resources necessary to participate in a coordinated response with public safety agencies.MethodsThe self-administered web-based survey was distributed in January 2014 via e-mail to primary care providers in Pennsylvania using the listservs of several professional societies.ResultsA total of 179 primary care providers participated in the survey. In total, 38% had practice continuity of operations plan in place and 26% reported that they had a plan for patient surge in the outpatient setting. Thirty percent reported that they were registered on the state Health Alert Network and 41% said they were able to communicate with patients during disasters. Only 8% of providers reported that they believed that their patients with special health care needs were prepared for a disaster, although over two-thirds of responding practices felt they could assist these patients with disaster preparedness. Providers indicated that more information regarding government agency plans and community resources, patient education materials, and more time to devote to counseling during patient encounters would improve their ability to prepare their patients with special health care needs for disasters. Providers also reported that they would benefit from partnerships to help the practice during emergencies and communications technology to reach large numbers of patients quickly.ConclusionsCommunity-based primary care practices can be useful partners during public health emergencies. Efforts to promote continuity of operations planning, improved coordination with government and community partners, as well as preparedness for patients with special health care needs, would augment their capabilities and contribute to community resilience. (Disaster Med Public Health Preparedness. 2019;13:128–132).

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