scholarly journals Family Medicine Resident Knowledge of Adverse Childhood Experiences

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Kimberly Collins ◽  
Carolin Spice ◽  
Bailey C. Ingraham ◽  
Morhaf Al Achkar
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Adverse Childhood Experiences ◽  
Primary Care Providers ◽  
Comfort Level ◽  
Care Providers ◽  
Childhood Experiences ◽  
Knowledge And Attitudes ◽  
Adverse Childhood ◽  
Family Medicine Residents

Introduction: Exposure to adverse childhood experiences (ACEs) has been associated with poor health in adulthood. Primary care providers can provide more appropriate medical care and intervene if they ask patients about ACEs. The purpose of this study is to determine existing knowledge and attitudes about ACEs among family medicine residents within the Washington, Wyoming, Alaska, Montana, and Idaho (WWAMI) region. Methods: Researchers developed a nine-question survey to assess family medicine residents’ knowledge and attitudes about ACEs, and their comfort level in addressing ACEs. The survey was distributed to 540 residents in 22 family medicine residency programs in the WWAMI region. Results: Most residents reported they had some (32%) or moderate (35%) knowledge of the ACEs study. However, 30% reported no knowledge of the ACEs study, and very few (3%) reported significant knowledge. Of 117 respondents reporting at least some prior knowledge of ACEs, 42% had first heard about ACEs during residency. The ACEs topics that respondents felt least comfortable addressing during a patient encounter were a patient’s personal history of sexual abuse (75%) and witnessing physical abuse (47%). Most residents (84%) indicated that they would like to see ACEs integrated into their residency curriculum. Discussion: This study demonstrates a gap in residency training on the topic of ACEs in family medicine residencies within the WWAMI region. Residents are uncomfortable addressing ACEs with patients but are receptive to learning about this topic. More teaching about ACEs can increase residents’ comfort level with addressing these topics in the primary care setting.

Streamlining primary care screening for adverse childhood experiences

2021 ◽  
Author(s):  
Lindsay A. Thompson ◽  
Stephanie L. Filipp ◽  
Rebeccah E. Mercado ◽  
Matthew J. Gurka
Keyword(s):  
Primary Care ◽  
Adverse Childhood Experiences ◽  
Childhood Experiences ◽  
Adverse Childhood

scholarly journals New Zealand among global social media initiative leaders for primary care advocacy

2016 ◽  
Vol 8 (2) ◽  
pp. 94 ◽  
Author(s):  
Kyle Hoedebecke ◽  
Joseph Scott-Jones ◽  
Luís Pinho-Costa
Keyword(s):  
Primary Care ◽  
Social Media ◽  
New Zealand ◽  
Family Medicine ◽  
Family Doctor ◽  
Primary Care Providers ◽  
Care Providers ◽  
Family Doctors ◽  
Medicine Community ◽  
World Organisation

Abstract The international ‘#1WordforFamilyMedicine’ initiative explores the identity of General Practitioners (GPs) and Family Physicians (FPs) by allowing the international Family Medicine community to collaborate on advocating for the discipline via social media. The New Zealand version attracted 83 responses on social media. Thematic analysis was performed on the responses and a ‘word cloud’ image was created based on an image identifying the country around the world - that of the silver fern. The ‘#1WorldforFamilyMedicine’ project was promoted by WONCA (World Organisation of Family Doctors) globally to help celebrate World Family Doctor Day on 19 May 2015. To date, over 80 images have been created in 60 different countries on six continents. The images represent GPs’ love for their profession and the community they serve. We hope that this initiative will help inspire current and future Family Medicine and Primary Care providers.

scholarly journals Understanding primary care providers’ perceptions of cancer prevention and screening in a predominantly rural healthcare system in the upper Midwest

2019 ◽  
Vol 19 (1) ◽  
Author(s):  
Daniel M. Saman ◽  
Kayla M. Walton ◽  
Melissa L. Harry ◽  
Stephen E. Asche ◽  
Anjali R. Truitt ◽  
...  
Keyword(s):  
United States ◽  
Primary Care ◽  
Cancer Screening ◽  
Cancer Risk ◽  
Cancer Prevention ◽  
Primary Care Providers ◽  
The United States ◽  
Comfort Level ◽  
Care Providers ◽  
Cancer Prevention And Screening

Abstract Background Cancer is the leading cause of death in the United States, with the burden expected to rise in the coming decades, increasing the need for effective cancer prevention and screening options. The United States Preventive Services Task Force has suggested that a shared decision-making process be used when clinicians and patients discuss cancer screening. The electronic medical record (EMR) often provides only reminders or alerts to primary care providers (PCPs) when screenings are due, a strategy with limited efficacy. Methods We administered a cross-sectional electronic survey to PCPs (n = 165, 53% response rate) at 36 Essentia Health primary care clinics participating in a large, National Cancer Institute-funded study on a cancer prevention clinical decision support (CDS) tool. The survey assessed PCP demographics, perceptions of the EMR’s ability to help assess and manage patients’ cancer risk, and experience and comfort level discussing cancer screening and prevention with patients. Results In these predominantly rural clinics, only 49% of PCPs thought the EMR was well integrated to help assess and manage cancer risk. Both advanced care practitioners and physicians agreed that cancer screening and informed discussion of cancer risks are important; however, only 53% reported their patients gave cancer screening a high priority relative to other health issues. Conclusions The impact of EMR-linked CDS delivered to both patients and PCPs may improve cancer screening, but only if it is easy to use and saves PCPs time.

scholarly journals Semistructured interviewing in primary care research: a balance of relationship and rigour

2019 ◽  
Vol 7 (2) ◽  
pp. e000057 ◽  
Author(s):  
Melissa DeJonckheere ◽  
Lisa M Vaughn
Keyword(s):  
Primary Care ◽  
Family Medicine ◽  
Data Collection ◽  
Health Services ◽  
Family Physicians ◽  
Primary Care Providers ◽  
Care Providers ◽  
Primary Care Research ◽  
Care Research ◽  
Semistructured Interviews

Semistructured in-depth interviews are commonly used in qualitative research and are the most frequent qualitative data source in health services research. This method typically consists of a dialogue between researcher and participant, guided by a flexible interview protocol and supplemented by follow-up questions, probes and comments. The method allows the researcher to collect open-ended data, to explore participant thoughts, feelings and beliefs about a particular topic and to delve deeply into personal and sometimes sensitive issues. The purpose of this article was to identify and describe the essential skills to designing and conducting semistructured interviews in family medicine and primary care research settings. We reviewed the literature on semistructured interviewing to identify key skills and components for using this method in family medicine and primary care research settings. Overall, semistructured interviewing requires both a relational focus and practice in the skills of facilitation. Skills include: (1) determining the purpose and scope of the study; (2) identifying participants; (3) considering ethical issues; (4) planning logistical aspects; (5) developing the interview guide; (6) establishing trust and rapport; (7) conducting the interview; (8) memoing and reflection; (9) analysing the data; (10) demonstrating the trustworthiness of the research; and (11) presenting findings in a paper or report. Semistructured interviews provide an effective and feasible research method for family physicians to conduct in primary care research settings. Researchers using semistructured interviews for data collection should take on a relational focus and consider the skills of interviewing to ensure quality. Semistructured interviewing can be a powerful tool for family physicians, primary care providers and other health services researchers to use to understand the thoughts, beliefs and experiences of individuals. Despite the utility, semistructured interviews can be intimidating and challenging for researchers not familiar with qualitative approaches. In order to elucidate this method, we provide practical guidance for researchers, including novice researchers and those with few resources, to use semistructured interviewing as a data collection strategy. We provide recommendations for the essential steps to follow in order to best implement semistructured interviews in family medicine and primary care research settings.

scholarly journals Teaching Family Medicine Residents How to Identify and Address Social Determinants of Health

PRiMER ◽  
2021 ◽  
Vol 5 ◽  
Author(s):  
Lisa Schoenberger ◽  
Rajaa Mourabet ◽  
Binju Bose ◽  
Qian Gu ◽  
Benita Benjamin ◽  
...  
Keyword(s):  
Family Medicine ◽  
Social Determinants Of Health ◽  
Social Determinants ◽  
Screening Tool ◽  
Primary Care Providers ◽  
Practical Experience ◽  
Social Needs ◽  
Determinants Of Health ◽  
Care Providers ◽  
Family Medicine Residents

Introduction: This educational program aimed to teach family medicine residents how to address social determinants of health. The literature reviewed suggested that curricula addressing social needs of patients were sporadic and failed to provide residents with practical ways to apply the knowledge. The program objectives were to provide residents with a thorough understanding of social determinants of health and to provide a practical experience where they could address social needs. Methods: The program consisted of four didactic sessions in which the residents discussed why addressing social determinants of health is important, designed a screening tool, and were educated on how to assess and communicate with patients. As a longitudinal experience, the residents used the screening tool in their clinic and connected patients with resources. We performed a mixed-methods data analysis to determine if program goals were met. Results: Survey data showed a statistically significant change in the comfort, understanding, and consistency of addressing social determinants of health. Reflections showed similar results. Residents recognized the importance of being aware of social needs, having conversations with patients about their needs, and considering cost when they implement treatment plans.  Conclusions: Family medicine residents are the future primary care providers for our communities. Therefore, it is important to equip them with the knowledge and ability to address all of the factors affecting their patients’ health. Graduates will be able to apply this knowledge to their future patients, and educators can be assured family physicians have the skills to address social determinants of health.

scholarly journals Adverse childhood experiences and their Alcohol, and chat Consumption among school-going adolescents, Ethiopia: Cross-sectional study

2020 ◽  
Vol 4 (1) ◽  
pp. 076-083
Author(s):  
Tsehay Mekonnen ◽  
Necho Mogesie ◽  
Belete Asmare ◽  
Mekonnen Werkua
Keyword(s):  
Alcohol Use ◽  
Health Care Providers ◽  
Adverse Childhood Experiences ◽  
Educational Status ◽  
Cross Sectional Study ◽  
Care Providers ◽  
Sectional Study ◽  
Cross Sectional ◽  
Childhood Experiences ◽  
Adverse Childhood

Background: Alcohol and chat use during adolescence is associated with academic and health problems, including abuse or dependence in adulthood. The aim of the present study was to investigate associations between adverse childhood experiences (ACEs) and early initiation of alcohol and chat use among school-going adolescents. Methods: A cross-sectional study was performed with 546 school-going adolescents. The ACE International Questionnaire (ACE-IQ) was used to assess ACEs, Alcohol and chat use was assessed by questions prepared by the authors. Multiple logistic regression models were used to examine the associations between overall ACE score and alcohol use and the potential moderating effects of confounders. Results: prevalence of chat chewing behavior was 26.6% followed by alcohol use 20%. A total of 66.2% of participants reported at least one ACE, and 5.93% reported four or more ACEs. High/Multiple ACEs (ACEs=1-3 and above 3) were significantly associated with increased alcohol use behaviors (AOR=1.491(1.072-3.078) and (AOR=3.171(1.330-7.560) respectively and increased chat use behaviors by 4.92 times (AOR=4.92, 95%CI=2.640-8.432) and 11.022 times (AOR=11.022, 95%CI=1.230-25.560) respectively controlling other factors. Conclusion: ACEs were significantly associated with risk behaviors, alcohol and chat use may lead to poor health, and educational outcomes among adolescent students and numbers of ACEs have graded association. Social support, sex, residence, parent educational status, and current level of depressive symptoms were significant modulating factors, which parents, school teachers, psychologists, and adolescent health care providers should give the concern to decrease the effect on school-going adolescents.

scholarly journals 864. Adolescent Primary Care Provider Knowledge of HIV Pre-Exposure Prophylaxis (PrEP) and Universal Screening at a Midwest Academic Medical Center

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S523-S524
Author(s):  
Genevieve Allen ◽  
Jamie Riddell
Keyword(s):  
Internal Medicine ◽  
Primary Care ◽  
Family Medicine ◽  
Hiv Testing ◽  
Medical Center ◽  
Academic Medical Center ◽  
Primary Care Providers ◽  
Care Providers ◽  
Academic Medical ◽  
Exposure Prophylaxis

Abstract Background HIV remains a problem for adolescents with 21% of new infections in the United States in 2018 occurring in youth. In this study we attempted to assess the knowledge of and comfort with pre-exposure prophylaxis and universal HIV testing among adolescent primary care providers affiliated with one academic medical center. Methods We conducted a survey of internal medicine/pediatrics, pediatrics, and family medicine residents and attending physicians affiliated with an academic medical center. Data collected included provider prescribing and referring habits for PrEP and information on their universal HIV testing habits. A “test your knowledge” section followed the survey which asked participants to name PrEP medications and to correctly select laboratory monitoring required for PrEP. Correct answers and prescribing resources were provided on completion of the survey. Results 138 (76%) respondents were aware that PrEP is approved for adolescents. There was no significant difference across specialties or between residents and attendings. 44.8% of respondents felt uncomfortable prescribing PrEP and two thirds had never prescribed PrEP. Reasons for not prescribing PrEP included: not seeing adolescents who qualify (n=80), not having enough training (66), confidentiality concerns (22), forgetting to address PrEP (19), and concern incidence of HIV is too low to recommend PrEP (15). Pediatricians were the least likely to test for HIV with 11% of pediatrician, 32% of internal medicine/pediatric, and 38% of family medicine respondents reported universal HIV testing for patients 15 years and older (p < 0.05). Residents were more likely to test for HIV than attendings (33.3% versus 16%, p < 0.05). 111 participants completed the “test your knowledge” section. 31.5% correctly named two approved PrEP medications. There were 183 responses to the survey (49% response rate). Conclusion Adolescent primary care providers are aware that PrEP is FDA approved for adolescents but a gap in PrEP prescribing and HIV testing persists. There remain perceptions that HIV incidence is too low to discuss PrEP and that providers are not seeing patients who qualify. Next steps include developing an institutional PrEP guideline and creating an electronic medical record order set to facilitate PrEP prescribing. Disclosures All Authors: No reported disclosures

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