The Reproductive Health Care of Transgender Young People: A Guide for Primary Care Providers

Abstract Introduction Past epidemiological research indicates that insomnia and depression are both highly prevalent and tend to co-occur in the general population. The present study further assesses this association by estimating: (1) the concurrence rates of insomnia and depression in outpatients referred by their primary care providers for mental health care; and (2) whether the association between depression and insomnia varies by insomnia subtype (initial, middle, and late). Methods Data were collected from 3,174 patients (mean age=42.7; 74% women; 50% Black) who were referred to the integrated care program for assessment of mental health symptoms (2018–2020). All patients completed an Insomnia Severity Index (ISI) and a Patient Health Questionnaire (PHQ-9) during their evaluations. Total scores for the ISI and PHQ-9 were computed. These scores were used to categorize patients into diagnostic groups for insomnia (no-insomnia [ISI < 8], subthreshold-insomnia [ISI 8–14], and clinically-significant-insomnia [ISI>14]) and depression (no-depression [PHQ-914]). Items 1–3 of the ISI were also used to assess the association between depression and subtypes of insomnia. Results Rates of insomnia were as follows: 34.6% for subthreshold-insomnia, 35.5% for clinically-significant insomnia, and 28.9% for mild-depression and 26.9% for clinically-significant-depression. 92% of patients with clinically significant depression reported at least subthreshold levels of insomnia. While the majority of patients with clinical depression reported having insomnia, the proportion of patients that endorsed these symptoms were comparable across insomnia subtypes (percent by subtype: initial insomnia 63%; middle insomnia 61%; late insomnia 59%). Conclusion According to these data, the proportion of outpatients referred for mental health evaluations that endorse treatable levels of insomnia is very high (approximately 70%). This naturally gives rise to at least two questions: how will such symptomatology be addressed (within primary or specialty care) and what affect might targeted treatment for insomnia have on health were it a focus of treatment in general? Support (if any) Vargas: K23HL141581; Perlis: K24AG055602

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What methods and challenges for taking account of context when transferring complex interventions?

European Journal of Public Health ◽

10.1093/eurpub/ckaa165.1071 ◽

2020 ◽

Vol 30 (Supplement_5) ◽

Author(s):

S Villadsen ◽

S Dias

Keyword(s):

Public Health ◽

Health Care ◽

Reproductive Health ◽

Health Care Providers ◽

Complex Interventions ◽

Health Interventions ◽

Care Providers ◽

Public Health Interventions ◽

Reproductive Health Care

Abstract For complex public health interventions to be effective their implementation needs to adapt to the situation of those implementing and those receiving the intervention. While context matter for intervention implementation and effect, we still insist on learning from cross-country comparison of implementation. Next methodological challenges include how to increase learning from implementation of complex public health interventions from various context. The interventions presented in this workshop all aims to improve quality of reproductive health care for immigrants, however with different focus: contraceptive care in Sweden, group based antenatal care in France, and management of pregnancy complications in Denmark. What does these interventions have in common and are there cross cutting themes that help us to identify the larger challenges of reproductive health care for immigrant women in Europe? Issues shared across the interventions relate to improved interactional dynamics between women and the health care system, and theory around a woman-centered approach and cultural competence of health care providers and systems might enlighten shared learnings across the different interventions and context. Could the mechanisms of change be understood using theoretical underpinnings that allow us to better generalize the finding across context? What adaption would for example be needed, if the Swedish contraceptive intervention should work in a different European setting? Should we distinguish between adaption of function and form, where the latter might be less important for intervention fidelity? These issues will shortly be introduced during this presentation using insights from the three intervention presentations and thereafter we will open up for discussion with the audience.

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Needs assessment for gender sensitive reproductive health services for adolescents

International Journal of Adolescent Medicine and Health ◽

10.1515/ijamh-2017-0201 ◽

2020 ◽

Vol 0 (0) ◽

Cited By ~ 2

Author(s):

Fatemeh Rahmanian ◽

Soheila Nazarpour ◽

Masoumeh Simbar ◽

Ali Ramezankhani ◽

Farid Zayeri

Keyword(s):

Health Care ◽

Reproductive Health ◽

Health Services ◽

Health Care Providers ◽

Health Care Services ◽

Care Providers ◽

Reproductive Health Services ◽

Care Needs ◽

Reproductive Health Care ◽

Care Services

AbstractBackgroundA dimension of reproductive health services that should be gender sensitive is reproductive health services for adolescents.ObjectiveThis study aims to assess needs for gender sensitive reproductive health care services for adolescents.MethodsThis was a descriptive cross-sectional study on 341 of health care providers for adolescents in health centers and hospitals affiliated to Shiraz University of Medical Sciences in Iran in 2016. The subjects of the study were recruited using a convenience sampling method. The tools for data collection were: (1) a demographic information questionnaire and; (2) a valid and reliable questionnaire to Assess the Needs of Gender-Sensitive Adolescents Reproductive Health Care Services (ANQ-GSARHS) including three sections; process, structure and policy making for the services. Data were analyzed using SPSS 21.ResultsThree hundred and forty-one health providers with an average working experience of 8.77 ± 5.39 [mean ± standard deviation (SD)] years participated in the study. The results demonstrated the highest scores for educational needs (92.96% ± 11.49%), supportive policies (92.71% ± 11.70%) and then care needs (92.37% ± 14.34%) of the services.ConclusionsProviding gender sensitive reproductive health care services for adolescents needs to be reformed as regards processes, structure and policies of the services. However, the gender appropriate educational and care needs as well as supportive policies are the priorities for reform of the services.

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Primary Care Physicians’ Perceptions of Barriers To Preventive Reproductive Health Care In Rural Communities

Perspectives on Sexual and Reproductive Health ◽

10.1363/4407812 ◽

2012 ◽

Vol 44 (2) ◽

pp. 78-83 ◽

Cited By ~ 30

Author(s):

Cynthia H. Chuang ◽

Sandra W. Hwang ◽

Jennifer S. McCall-Hosenfeld ◽

Lara Rosenwasser ◽

Marianne M. Hillemeier ◽

...

Keyword(s):

Primary Care ◽

Health Care ◽

Rural Communities ◽

Reproductive Health ◽

Primary Care Physicians ◽

Reproductive Health Care

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Knowledgeability, attitude, and practice behaviors of primary care providers toward managing patients’ oral health care in medical practice

The Journal of the American Dental Association ◽

10.1016/j.adaj.2019.05.020 ◽

2019 ◽

Vol 150 (10) ◽

pp. 863-872

Author(s):

Neel Shimpi ◽

Ingrid Glurich ◽

Aloksagar Panny ◽

Amit Acharya

Keyword(s):

Primary Care ◽

Health Care ◽

Oral Health ◽

Medical Practice ◽

Primary Care Providers ◽

Oral Health Care ◽

Care Providers ◽

Practice Behaviors ◽

Attitude And Practice

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Introducing Shared Mental Health Care in Northwestern Ontario: An Analysis of Changing Referral Patterns of Primary Care Providers

Canadian Journal of Community Mental Health ◽

10.7870/cjcmh-2015-020 ◽

2015 ◽

Vol 34 (2) ◽

pp. 63-72 ◽

Cited By ~ 1

Author(s):

Graham Gaylord ◽

S. Kathleen Bailey ◽

John M. Haggarty

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Mental Health Services ◽

Health Services ◽

Mental Health Care ◽

Community Mental Health Services ◽

Primary Care Providers ◽

Care Providers ◽

Referral Patterns

This study describes a shared mental health care (SMHC) model introduced in Northern Ontario and examines how its introduction affected primary care provider (PCP) mental health referral patterns. A chart review examined referrals (N = 4,600) from 5 PCP sites to 5 outpatient community mental health services from January 2001 to December 2005. PCPs with access to SMHC made significantly more mental health referrals (p < 0.001). Two demographically similar PCPs were then compared, one co-located with SMHC. Referrals for depression to non-SMHC mental health services were 1.69 times more likely to be from the PCP not co-located with SMHC (p < 0.001). Findings suggest SMHC increases access to care and decreases demand on existing mental health services.

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