scholarly journals Clinician and Staff Perceptions of Barriers to Providing Contraception in Primary Care

PRiMER ◽  
2019 ◽  
Vol 3 ◽  
Author(s):  
Lauren Cowen ◽  
Scott G. Hartman ◽  
Elizabeth Loomis ◽  
Sukanya Srinivasan ◽  
Christina Gasbarro ◽  
...  
Keyword(s):  
Primary Care ◽  
New York ◽  
Family Medicine ◽  
The United States ◽  
Perceived Barriers ◽  
Care Staff ◽  
Contraceptive Methods ◽  
Staff Perceptions ◽  
Contraceptive Services ◽  
Primary Care Clinicians

Introduction: Short interpregnancy periods increase the likelihood of preterm delivery and low birth weight,1 both of which are significant causes of infant morbidity and mortality.2 Since nearly half of pregnancies in the United States are unplanned,3 opportunities exist to better understand barriers to contraceptive services. Studying these barriers as perceived by clinical staff can better guide programs to improve interpregnancy spacing. Methods: Between September and November 2017, 76 staff and 95 primary care clinicians from two family medicine residency practices (Highland Family Medicine (HFM) in Rochester, New York and St Margaret Family Medicine (SM) in Pittsburgh, Pennsylvania) completed surveys. Questions assessed perceived barriers to providing contraceptive services, contraception knowledge, and opportunities for improvement. Survey-based analysis focused on comparative descriptive statistics between staff and provider responses. Results: Clinicians ranked side effects and patient lack of awareness and misconceptions about contraceptive methods more highly than staff (P=0.0073 and P=0.0001, respectively). Staff identified childcare and work absence as more significant barriers (P=0.0114 and P=0.0380, respectively). Providers felt appointment timing was the largest constraint to contraceptive care. Staff perceived financial limitations and scheduling to be the top barriers. Nonclinician staff exhibited significant knowledge gaps regarding contraception. Conclusions: Numerous modifiable barriers contribute to difficulty providing contraceptive services. Providers and staff largely agree on the perceived barriers, but there is a significant gap in nonclinician staff knowledge of contraception. Education can address one of the leading concerns, but improvement efforts should also address areas such as availability of devices, scheduling issues, and resident supervision.

Essay I Primary Care and Public Health

2015 ◽  
pp. 26-27
Author(s):  
Julie K. Wood
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Professionals ◽  
The United States ◽  
Federal Agencies ◽  
Community Members ◽  
Policy Makers ◽  
Public Health Professionals ◽  
Primary Care Clinicians ◽  
The Right

Drawing on the experiences of hundreds of public health and primary care clinicians from across the United States, this book explains why population health is receiving so much attention from policy makers in states and federal agencies, the practical steps that clinicians and public health professionals can take to work together to meet the needs of their community, signs that you are on the right track (or not) and how to sustain successes to the benefit of patients, community members, and the health care and public health teams that care for them.

Data and the Future of Public Health

2015 ◽  
pp. 305-310
Author(s):  
Jeffrey Engel
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Professionals ◽  
The United States ◽  
Federal Agencies ◽  
Community Members ◽  
Policy Makers ◽  
Public Health Professionals ◽  
Primary Care Clinicians ◽  
The Right

Drawing on the experiences of hundreds of public health and primary care clinicians from across the United States, this book explains why population health is receiving so much attention from policy makers in states and federal agencies, the practical steps that clinicians and public health professionals can take to work together to meet the needs of their community, signs that you are on the right track (or not) and how to sustain successes to the benefit of patients, community members, and the health care and public health teams that care for them.

Partnering With Medicaid, Medicare, Public Health, and Primary Care to Improve Health Outcomes

2015 ◽  
pp. 195-206
Author(s):  
Sharon G. Moffatt ◽  
Monica Valdes Lupi ◽  
Kathleen Nolan
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Professionals ◽  
The United States ◽  
Federal Agencies ◽  
Community Members ◽  
Policy Makers ◽  
Public Health Professionals ◽  
Primary Care Clinicians ◽  
The Right

Drawing on the experiences of hundreds of public health and primary care clinicians from across the United States, this book explains why population health is receiving so much attention from policy makers in states and federal agencies, the practical steps that clinicians and public health professionals can take to work together to meet the needs of their community, signs that you are on the right track (or not) and how to sustain successes to the benefit of patients, community members, and the health care and public health teams that care for them.

scholarly journals Title VII and the Development and Promotion of National Initiatives in Training Primary Care Clinicians in the United States

2008 ◽  
Vol 83 (11) ◽  
pp. 1021-1029 ◽  
Author(s):  
Ardis K. Davis ◽  
P Preston Reynolds ◽  
Norman B. Kahn ◽  
Roger A. Sherwood ◽  
John M. Pascoe ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
The United States ◽  
Title Vii ◽  
National Initiatives ◽  
Primary Care Clinicians

scholarly journals The Role of Primary Care Physicians (DLP) in Community Care

2018 ◽  
Vol 1 (1) ◽  
pp. 3
Author(s):  
Dhanasari Vidiawati Trisna Sanyoto ◽  
Nur Afrainin Syah
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Primary Care Physicians ◽  
Medical Training ◽  
The United States ◽  
Care Physician ◽  
Main Body ◽  
Family Doctors ◽  
Postgraduate Medical Training ◽  
Care Services

Dokter Layanan Primer (DLP) or Primary Care Physician (PCP) is a newly introduced term by the Indonesian government in 2013 since the enforcement of Medical Education Law 20/2013. DLP is a physician who solidifies his/ her education and career in primary care. They have postgraduate medical training in primary care and are experts in this field. In most countries, to be a generalist physician practising at primary care facilities such as health centres and primary care clinics, medical school graduates have to take postgraduate medical training to be proficient in terms of knowledge and skills in primary care services. Family medicine is the main body of knowledge of the primary care postgraduate training program in those countries even though their graduates are called differently among countries. These physicians are called family doctors or family physicians in the United States of America (USA), general practitioners (GPs) in Commonwealth countries, huisarts in the Netherlands. In Indonesia, where social, economic, and cultural diversity is very high in various regions, in addition to Family Medicine, Community Medicine and Public Health....

scholarly journals Working With Data

2015 ◽  
pp. 243-256
Author(s):  
Mina Silberberg ◽  
Denise Koo ◽  
Raymond J. King
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Health Professionals ◽  
The United States ◽  
Federal Agencies ◽  
Community Members ◽  
Policy Makers ◽  
Public Health Professionals ◽  
Primary Care Clinicians ◽  
The Right

Drawing on the experiences of hundreds of public health and primary care clinicians from across the United States, this book explains why population health is receiving so much attention from policy makers in states and federal agencies, the practical steps that clinicians and public health professionals can take to work together to meet the needs of their community, signs that you are on the right track (or not) and how to sustain successes to the benefit of patients, community members, and the health care and public health teams that care for them.

scholarly journals Electronic Consultation in Primary Care Between Providers and Patients: Systematic Review

10.2196/13042 ◽  
2019 ◽  
Vol 7 (4) ◽  
pp. e13042 ◽  
Author(s):  
Freda Mold ◽  
Jane Hendy ◽  
Yi-Ling Lai ◽  
Simon de Lusignan
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Health Care ◽  
The United States ◽  
Care Staff ◽  
Cochrane Library ◽  
Small Scale ◽  
Care Providers ◽  
Long Term Conditions ◽  
Electronic Consultation

Background Governments and health care providers are keen to find innovative ways to deliver care more efficiently. Interest in electronic consultation (e-consultation) has grown, but the evidence of benefit is uncertain. Objective This study aimed to assess the evidence of delivering e-consultation using secure email and messaging or video links in primary care. Methods A systematic review was conducted on the use and application of e-consultations in primary care. We searched 7 international databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, PsycINFO, EconLit, and Web of Science; 1999-2017), identifying 52 relevant studies. Papers were screened against a detailed inclusion and exclusion criteria. Independent dual data extraction was conducted and assessed for quality. The resulting evidence was synthesized using thematic analysis. Results This review included 57 studies from a range of countries, mainly the United States (n=30) and the United Kingdom (n=13). There were disparities in uptake and utilization toward more use by younger, employed adults. Patient responses to e-consultation were mixed. Patients reported satisfaction with services and improved self-care, communication, and engagement with clinicians. Evidence for the acceptability and ease of use was strong, especially for those with long-term conditions and patients located in remote regions. However, patients were concerned about the privacy and security of their data. For primary health care staff, e-consultation delivers challenges around time management, having the correct technological infrastructure, whether it offers a comparable standard of clinical quality, and whether it improves health outcomes. Conclusions E-consultations may improve aspects of care delivery, but the small scale of many of the studies and low adoption rates leave unanswered questions about usage, quality, cost, and sustainability. We need to improve e-consultation implementation, demonstrate how e-consultations will not increase disparities in access, provide better reassurance to patients about privacy, and incorporate e-consultation as part of a manageable clinical workflow.

scholarly journals An assessment of implementation of Community Oriented Primary Care in Kenyan family medicine postgraduate medical education programmes

2016 ◽  
Vol 8 (1) ◽  
Author(s):  
Ian J. Nelligan ◽  
Jacob Shabani ◽  
Stephanie Taché ◽  
Gulnaz Mohamoud ◽  
Megan Mahoney
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Focus Groups ◽  
Learning Outcomes ◽  
Care Delivery ◽  
The United States ◽  
Community Empowerment ◽  
Successful Implementation ◽  
Community Based ◽  
Postgraduate Students

Background and objectives: Family medicine postgraduate programmes in Kenya are examining the benefits of Community-Oriented Primary Care (COPC) curriculum, as a method to train residents in population-based approaches to health care delivery. Whilst COPC is an established part of family medicine training in the United States, little is known about its application in Kenya. We sought to conduct a qualitative study to explore the development and implementation of COPC curriculum in the first two family medicine postgraduate programmes in Kenya. Method: Semi-structured interviews of COPC educators, practitioners, and academic stakeholders and focus groups of postgraduate students were conducted with COPC educators, practitioners and academic stakeholders in two family medicine postgraduate programmes in Kenya. Discussions were transcribed, inductively coded and thematically analysed. Results: Two focus groups with eight family medicine postgraduate students and interviews with five faculty members at two universities were conducted. Two broad themes emerged from the analysis: expected learning outcomes and important community-based enablers. Three learning outcomes were (1) making a community diagnosis, (2) understanding social determinants of health and (3) training in participatory research. Three community-based enablers for sustainability of COPC were (1) partnerships with community health workers, (2) community empowerment and engagement and (3) institutional financial support. Conclusions: Our findings illustrate the expected learning outcomes and important communitybased enablers associated with the successful implementation of COPC projects in Kenya and will help to inform future curriculum development in Kenya.

Essay I Local Health Departments and a Primary Care Safety Net

2015 ◽  
pp. 216-221
Author(s):  
Robert M. Pestronk
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Safety Net ◽  
The United States ◽  
Local Health ◽  
Community Members ◽  
Policy Makers ◽  
Public Health Professionals ◽  
Primary Care Clinicians ◽  
The Right

Drawing on the experiences of hundreds of public health and primary care clinicians from across the United States, this book explains why population health is receiving so much attention from policy makers in states and federal agencies, the practical steps that clinicians and public health professionals can take to work together to meet the needs of their community, signs that you are on the right track (or not) and how to sustain successes to the benefit of patients, community members, and the health care and public health teams that care for them.

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