Nutrition for the Healthy Adult

2018 ◽  
Author(s):  
Marijane G. Staniec
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Weight Gain ◽  
Chronic Diseases ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Healthy Adults ◽  
Dietary Guidelines ◽  
Care Providers ◽  
Added Sugars

Many of today’s healthy adults will be plagued by chronic diseases, such as obesity, hypertension, heart disease, and diabetes, and be robbed of the quality of life they desire. According to the 2015–2020 Dietary Guidelines for Americans, about half of all American adults have one or more diet-related chronic diseases. The question, “What should healthy adults eat to stay healthy?” may seem simple. However, many primary care providers feel vulnerable answering questions about nutrition. This review serves as a summary of the most up-to-date guidelines about added sugars, sodium, types of fat, and cholesterol for healthy adults and a refresher for health care providers caring for them. Other important related issues, such as the latest recommendations for physical activity, the problem of adult weight gain, the need for adiposity screening, the powerful role of the primary care provider, and suggestions nutrition-focused primary care, are discussed. This review contains 5 Figures, 5 Tables and 137 references Key words: weight gain, cholesterol, Dietary Guidelines, sugar-sweetened beverages, adiposity, added sugar, hydrogenated oils, physical activity, waist-to-height ratio, nutrition-focused, Primary Care

Lamotrigine and lithium in primary care psychiatric consultation: adoption and adverse effects

2020 ◽  
Author(s):  
James R Phelps ◽  
Olivia R Pipitone ◽  
Kenneth Squires ◽  
Jonathan D Bale
Keyword(s):  
Primary Care ◽  
Weight Gain ◽  
Adverse Effects ◽  
Collaborative Care ◽  
Bipolar Depression ◽  
Care Program ◽  
Primary Care Providers ◽  
Thyroid Stimulating Hormone ◽  
Care Providers ◽  
Psychiatric Consultation

Abstract Background The Collaborative Care Model of psychiatric consultation in primary care has improved outcomes for unipolar depression, but bipolar depressions are challenging for providers and consultants. Although lamotrigine and lithium are both first line medications for bipolar depression, their use in primary care has been declining over the last decade. Objective Our project aimed to quantify the frequency of and adoption of recommendations for lamotrigine and lithium, and their adverse effects, in a Collaborative Care program. Methods Chart review. Results For 620 depressed adult patients (Public Health Questionnaire, 9-item ≥10), lamotrigine and lithium were recommended by psychiatric consultant for 35% and 26% of patients, respectively; and when recommended, were prescribed by primary care providers 50% and 32% of the time, respectively. Eighty-four percent of lithium dosages were 600 mg or less; average serum level 0.32 mEq/l. In follow-up up to 6 months, lithium was associated with no more weight gain than lamotrigine; but 12% of patients receiving lithium had thyroid stimulating hormone increases exceeding the upper limit of normal, occurring in an average of 32 days after the initial prescription. Conclusions (i) In a Collaborative Care program of psychiatric consultation, recommendations for lamotrigine and lithium were very frequent. (ii) Adoption of these recommendations is variable, warranting further investigation. (iii) Like higher doses, low doses of lithium induced hypothyroidism (rapidly)—but not weight gain.

scholarly journals Reducing Alcohol and Opioid Use Among Youth in Rural Counties: An Innovative Training Protocol for Primary Health Care Providers and School Personnel

10.2196/21015 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e21015
Author(s):  
Erica Francis ◽  
Kara Shifler Bowers ◽  
Glenn Buchberger ◽  
Sheryl Ryan ◽  
William Milchak ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Health Care Providers ◽  
School Personnel ◽  
Primary Care Providers ◽  
School Nurses ◽  
Care Providers ◽  
Opioid Use

Background Given that youth alcohol use is more common in rural communities, such communities can play a key role in preventing alcohol use among adolescents. Guidelines recommend primary care providers incorporate screening, brief intervention, and referral to treatment (SBIRT) into routine care. Objective The aim is to train primary care providers and school nurses within a rural 10-county catchment area in Pennsylvania to use SBIRT and facilitate collaboration with community organizations to better coordinate substance use prevention efforts. Methods To build capacity to address underage drinking and opioid use among youth aged 9-20 years, this project uses telehealth, specifically Project ECHO (Extension for Community Healthcare Outcomes), to train primary care providers and school nurses to address substance use with SBIRT. Our project will provide 120 primary care providers and allied health professionals as well as 20 school nurses with SBIRT training. Community-based providers will participate in weekly virtual ECHO sessions with a multidisciplinary team from Penn State College of Medicine that will provide SBIRT training and facilitate case discussions among participants. Results To date, we have launched one SBIRT ECHO project with school personnel, enrolling 34 participants. ECHO participants are from both rural (n=17) and urban (n=17) counties and include school nurses (n=15), school counselors (n=8), teachers (n=5), administrators (n=3), and social workers (n=3). Before the study began, only 2/13 (15.5%) of schools were screening for alcohol use. Conclusions This project teaches primary care clinics and schools to use SBIRT to prevent the onset and reduce the progression of substance use disorders, reduce problems associated with substance use disorders, and strengthen communities’ prevention capacity. Ours is an innovative model to improve rural adolescent health by reducing alcohol and opioid use. International Registered Report Identifier (IRRID) DERR1-10.2196/21015

scholarly journals Knowledge and Awareness Regarding T1DM in Primary Health care Providers

2019 ◽  
Vol 1 (2) ◽  
pp. 21-25
Author(s):  
Saira Yousaf ◽  
Rozina Arshad ◽  
Muhammad Waqeel ◽  
Maria Javaid ◽  
Hafiza Rabia Naeem ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Mechanism Of Action ◽  
Correct Answer ◽  
General Medicine ◽  
Primary Care Providers ◽  
Cross Sectional Study ◽  
Diabetic Patients ◽  
Care Providers ◽  
Cross Sectional

Background: Diabetes is one of the commonest non-communicable diseases in the world. Type 1 Diabetes Mellitus (T1DM) is relatively less common but it is associated with greater morbidity and mortality. It is important to have the knowledge and awareness of T1DM especially in primary care providers (PCPs) to save the lives of children and young adults with T1DM. Methods: A cross sectional study was performed by distributing questionnaires amongst the doctors belonging to the field of General Medicine working at the primary care level with practices comprising approximately 10% of diabetic patients. Responses were recorded on a questionnaire and the data was analyzed by SPSS versions 20. Results: Only 62% doctors were aware about the correct pathogenesis of T1DM. Regarding the most important and fatal complications of T1DM i.e. diabetic ketoacidosis (DKA), 88.9% came up with correct answer. However when asked about the mortality related to T1DM only 22% PCPs gave the right answer. Only 40% of the PCPs could give correct answer regarding the mechanism of action of insulin. 55.6% PCPs were aware of the variation in blood glucose levels and had knowledge how to adjust them. Only 55.6% doctors were aware of cause of hypoglycemia. Conclusion: Most of the PCPs had suboptimal knowledge regarding T1DM, its pathogenesis, complications and mechanism of action of insulin. This study had identified the need for further improvement in PCPs practices for treating and educating diabetes and recommended that awareness and educational programs are necessary to update the PCPs on screening, effective treatment of T1DM, and prevention of its complications.

scholarly journals Physical Activity Types and Programs Recommended by Primary Care Providers Treating Adults With Arthritis, DocStyles 2018

2021 ◽  
Vol 18 ◽  
Author(s):  
Dana Guglielmo ◽  
Kristina A. Theis ◽  
Louise B. Murphy ◽  
Michael A. Boring ◽  
Charles G. Helmick ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Activity Types

scholarly journals Online Health Promotion to Reduce Cancer Risk: Lessons From Learning With Alaska’s Tribal Primary Care Providers

2018 ◽  
Vol 4 (Supplement 2) ◽  
pp. 16s-16s
Author(s):  
K. Cueva ◽  
M. Cueva ◽  
L. Revels ◽  
M. Hensel ◽  
M. Dignan
Keyword(s):  
Primary Care ◽  
Online Learning ◽  
Cancer Risk ◽  
Online Education ◽  
Health Care Providers ◽  
Primary Care Providers ◽  
Cancer Information ◽  
Advisory Group ◽  
Care Providers ◽  
Community Based

Background: Alaska's tribal primary care providers in rural Alaska - community health aides and practitioners (CHA/Ps) - requested online education about cancer for themselves and their communities. Aim: A research team at the Alaska Native Tribal Health Consortium engaged in community-based participatory action research to develop culturally respectful online cancer education to support CHA/Ps to increase their knowledge, reduce their own cancer risk, and share cancer information. Methods: This project created ten online learning modules, a semester-long online course that combined the modules with synchronous conversations, and a supplemental webinar series. All modules were community-based and collaboratively developed with input from a community advisory group of CHA/Ps, content experts, and interested partners. Learners completed an evaluation survey at the end of each module and webinar. Course participants completed a precourse assessment, and evaluations at the end of each module, at the end of the course, two-months postcourse, and six-months postcourse. Results: While evaluation is ongoing, as of March 2018, 194 unique individuals, including 27 course participants, had completed 1,288 module evaluation surveys. Learners reported an increase in cancer knowledge, and intentions to reduce their personal cancer risk and share cancer information as a result of the online learning. On 98% of completed surveys, learners shared that they planned to change their interactions with patients as a result of the learning, including talking more about cancer screening, cutting down/quitting tobacco, being more physically active, and eating healthy. A total of 88% of unique learners planned to reduce their personal cancer risk as a result of the learning, including by quitting tobacco, having recommended cancer screenings, exercising, and eating healthier. Comparison of pre and postcourse survey responses showed CHA/Ps’ had changed to eat more fruits and vegetables and exercise more, as well as felt more knowledgeable about cancer, and more comfortable both with finding medically-accurate cancer information online and talking to their patients, families, and communities about cancer. Conclusion: This culturally respectful education strategy may be adaptable to other populations to support primary care providers and their communities to reduce cancer risk. This intervention may be of particular interest to health care providers, public health professionals, and those interested in health systems in rural and remote regions and in areas with limited medical infrastructure.

Physical Activity Assessment and Recommendation for Adults With Arthritis by Primary Care Providers—DocStyles, 2018

2020 ◽  
pp. 089011712098137
Author(s):  
Dana Guglielmo ◽  
Louise B. Murphy ◽  
Kristina A. Theis ◽  
Charles G. Helmick ◽  
John D. Omura ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
Nurse Practitioners ◽  
High Volume ◽  
Primary Care Providers ◽  
Physical Activity Assessment ◽  
Care Providers ◽  
Provider Education ◽  
Cross Sectional ◽  
Activity Assessment

Purpose: To examine primary care providers' (PCPs) physical activity assessment and recommendation behaviors for adults with arthritis. Design: Cross-sectional. Setting: 2018 DocStyles online national market research survey of US physicians and nurse practitioners. Sample: 1,389 PCPs seeing adults with arthritis. Measures: 2 independent behaviors (assessment and recommendation) as 3 non-mutually exclusive groups: “always assesses,” “always recommends,” and “both” (“always assesses and recommends”). Analysis: Calculated percentages of each group (overall and by PCP characteristics), and multivariable-adjusted prevalence ratios (PRs) using binary logistic regression. Results: Among PCPs, 49.2% always assessed and 57.7% always recommended physical activity; 39.7% did both. Across all 3 groups, percentages were highest for seeing ≥20 adults with arthritis weekly (“both”: 56.4%; “always assesses”: 66.7%; “always recommends”: 71.3%) and lowest among obstetrician/gynecologists (“both”: 26.9%; “always assesses”: 36.8%; “always recommends”: 40.7%). Multivariable-adjusted associations were strongest for seeing ≥20 adults with arthritis weekly (referent: 1-9 adults) and each of “always assesses” (PR = 1.5 [95% confidence interval (CI): 1.3−1.8] and “both” (PR = 1.6 [95% CI: 1.4−1.9]). Conclusions: Approximately 40% of PCPs sampled always engaged in both behaviors (assessing and recommending physical activity) with adults with arthritis; seeing a high volume of adults with arthritis was consistently related to engaging in each behavior. Evidence-based approaches to support PCP counseling include offering provider education and training, raising awareness of available resources, and using health system supports.

Abstract P077: Missed Opportunities for Behavioral Counseling by Primary Care Providers

Circulation ◽  
2016 ◽  
Vol 133 (suppl_1) ◽  
Author(s):  
John D Omura ◽  
Susan A Carlson ◽  
Prabasaj Paul ◽  
Kathleen B Watson ◽  
Fleetwood Loustalot ◽  
...  
Keyword(s):  
Physical Activity ◽  
Primary Care ◽  
At Risk ◽  
Primary Care Providers ◽  
Care Providers ◽  
Behavioral Counseling ◽  
The Metabolic Syndrome ◽  
Patients At Risk ◽  
Risk Patients ◽  
Counseling Practices

Background: In 2014, the US Preventive Services Task Force recommended adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors be offered or referred to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. Hypothesis: We hypothesized that primary care providers (PCPs) who discussed physical activity with most of their at risk patients would have a higher prevalence of offering select components than PCPs who discussed physical activity less frequently. Methods: DocStyles 2015, a Web-based panel survey of 1251 PCPs (response rate=76.8%), assessed physical activity counseling practices with patients at risk for CVD (overweight or obese and with hypertension, dyslipidemia, impaired fasting glucose, or the metabolic syndrome). Results: Overall, 55.9% (SE=1.4) of PCPs discussed physical activity with most of their patients at risk for CVD. Among respondents who discussed physical activity with any at risk patients (N=1244), the prevalence of components offered when they counseled ranged from 92.6% encouraging increased physical activity to 15.8% referring to intensive behavioral counseling (Table). PCPs who discussed physical activity with most at risk patients had a higher prevalence of offering all counseling components assessed than PCPs who discussed physical activity less frequently, except for referring to intensive behavioral counseling where no difference was found. Of all PCPs, 8.4% both discussed physical activity with most of their at risk patients and referred them to intensive behavioral counseling. Conclusion: Just over half of PCPs surveyed discussed physical activity with most patients at risk for CVD. These PCPs more frequently offered select components when they counseled with the exception of referral to intensive behavioral counseling. Both the low levels of counseling and referral to intensive behavioral counseling present important opportunities for improving counseling practices.

Abstract P379: Features to Increase Primary Care Provider Referrals to Intensive Behavioral Counseling for Cardiovascular Disease Prevention

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
John D Omura ◽  
Kathleen B Watson ◽  
Fleetwood V Loustalot ◽  
Janet E Fulton ◽  
Susan A Carlson
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
At Risk ◽  
Task Force ◽  
Primary Care Providers ◽  
Care Providers ◽  
Behavioral Counseling ◽  
Patients At Risk ◽  
Risk Patients

Background: The US Preventive Services Task Force recommends adults with certain cardiovascular disease (CVD) risk factors be offered or referred to intensive behavioral counseling to promote a healthful diet and physical activity for CVD prevention. However, only 1 in 12 primary care providers (PCPs) currently follow this recommendation. This study assessed system and programmatic features PCPs reported would increase their likelihood of referring patients at risk for CVD to intensive behavioral counseling and whether this varied by the percentage of at-risk patients with whom they discuss physical activity. Methods: DocStyles 2018, a web-based panel survey of PCPs, assessed the percentage of at-risk patients with whom PCPs discuss physical activity and the degree to which select features would increase their likelihood of referring to intensive behavioral counseling. Results: Overall, 60.8% of PCPs discussed physical activity with most of their at-risk patients; 21.8% did so with many and 17.4% with few or some. The proportion of PCPs identifying features as increasing their likelihood of referring to intensive behavioral counseling by a great extent ranged from 24.1% for an automated referral in electronic health records, 35.3% for patient progress reports, 41.5% for the program being accredited or evidence-based, to 67.2% for the program having no cost to the patient (Table). These proportions increased for each feature as the percentage of at-risk patients with whom they discuss physical activity increased. Conclusion: PCPs identified programmatic features (i.e. being accredited and of no cost) as having the greatest influence on their likelihood of referring patients at risk for CVD to intensive behavioral counseling, although this varied by the percentage of at-risk patients with whom they discuss physical activity. Findings suggest that the effectiveness of strategies to improve behavioral counseling referrals by PCPs may depend on their current physical activity counseling practices.

Shaping the Next Generation of Providers

2019 ◽  
pp. 457-464
Author(s):  
Gerri Mattson ◽  
Karen Remley
Keyword(s):  
Primary Care ◽  
Health Care Providers ◽  
Clinical Medicine ◽  
Collaborative Work ◽  
Well Being ◽  
Primary Care Providers ◽  
Care Providers ◽  
Health Community ◽  
Changing Role

This chapter is about the changing role of the primary carer in the health setting with a particular focus on the training of primary carers. Primary care providers are already increasingly called on to expand their practice beyond their traditional knowledge and skills in clinical medicine. The chapter looks at the population health competency of primary health carers. Primary care providers, once trained, in the community can serve as mentors for trainees, which can provide additional perspective and experience outside of the academic setting. The chapter goes on to argue that the health and well-being of the entire community are dependent on the collaborative work of health care providers, public health, community organizations, faith-based organizations, and the community itself. Understanding the myriad connections, competencies, and impacts of these partnerships allows clinicians to engage with the community early in their careers; to deepen their engagement, understanding, and ability over time; and to be effective advocates with and on behalf of the communities they serve.

Primary Care Providers’ Awareness of Physical Activity-Related Intensive Behavioral Counseling Services for Cardiovascular Disease Prevention

2018 ◽  
Vol 33 (2) ◽  
pp. 208-216 ◽  
Author(s):  
John D. Omura ◽  
Kathleen B. Watson ◽  
Fleetwood Loustalot ◽  
Janet E. Fulton ◽  
Susan A. Carlson
Keyword(s):  
Physical Activity ◽  
Cardiovascular Disease ◽  
Primary Care ◽  
At Risk ◽  
Primary Care Providers ◽  
The United States ◽  
Counseling Services ◽  
Care Providers ◽  
Behavioral Counseling ◽  
Local Services

Purpose: The US Preventive Services Task Force recommends that adults at risk for cardiovascular disease (CVD) be offered or referred to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. We assessed primary care providers’ (PCPs) awareness of local physical activity-related behavioral counseling services, whether this awareness was associated with referring eligible patients, and the types and locations of services to which they referred. Design: Cross-sectional survey. Setting: Primary care providers practicing in the United States. Subjects: 1256 respondents. Measures: DocStyles 2016 survey assessing PCPs’ awareness of and referral to physical activity-related behavioral counseling services. Analysis: Calculated prevalence and adjusted odds ratios (aORs). Results: Overall, 49.9% of PCPs were aware of local services. Only 12.6% referred many or most of their at-risk patients and referral was associated with awareness of local services (aOR = 2.81, [95% confidence interval: 1.85-4.25]). Among those referring patients, services ranged from a health-care worker within their practice or group (25.4%) to an organized program in a medical facility (41.2%). Primary care providers most often referred to services located outside their practice or group (58.1%). Conclusion: About half of PCPs were aware of local behavioral counseling services, and referral was associated with awareness. Establishing local resources and improving PCPs’ awareness of them, especially using community–clinical linkages, may help promote physical activity among adults at risk for CVD.

Sign in / Sign up

Export Citation Format

Share Document