The impact of training future optometrists in community health centers

The Advisor ◽  
2021 ◽  
Vol 41 (4) ◽  
Author(s):  
Amy Moy ◽  
Jennifer Reilly ◽  
Jonathon Jimmerson
Keyword(s):  
Cultural Diversity ◽  
Career Choice ◽  
Community Health ◽  
Community Health Centers ◽  
Underserved Populations ◽  
Health Centers ◽  
Care Providers ◽  
Eye Care ◽  
Healthcare Equity ◽  
The Impact

Abstract Community health centers are a rewarding and rich career choice for future optometrists. As primary eye care providers, optometrists in these multi-disciplinary settings have the potential to make significant and lasting impacts on patients of underserved populations, to increase awareness surrounding cultural diversity and impact on healthcare, and to advocate for healthcare equity. This article discusses why community health centers can be a career destination for current and prospective optometry students, and provides examples of making an impact as a health center optometrist.

Impact of a tobacco cessation intervention on adherence to tobacco use treatment guidelines among village health workers in Vietnam

2019 ◽  
Vol 27 (3) ◽  
pp. 24-33
Author(s):  
Nam Nguyen ◽  
Trang Nguyen ◽  
Van Truong ◽  
Kim Dang ◽  
Nina Siman ◽  
...  
Keyword(s):  
Community Health ◽  
Tobacco Use ◽  
Self Efficacy ◽  
Community Health Centers ◽  
Treatment Guidelines ◽  
Health Workers ◽  
Health Centers ◽  
Care Providers ◽  
Village Health Workers ◽  
Village Health

Community health workers (in Vietnam referred to as village health workers) have the potential to play a key role in expanding access to evidence-based tobacco use treatment. We conducted a cluster randomized controlled trial in community health centers in Vietnam that compared the effect of provider advice and cessation assistance (i.e. brief counseling and patient education materials) (BC) vs. BC + three sessions of in-person counseling delivered by a village health worker (BC+R) on providers’ and village health workers’ adherence to tobacco use treatment guidelines. All village health workers and health care providers received training. This paper presents data on the effect of the intervention on village health workers’ adherence to tobacco use treatment guidelines, including asking about tobacco use, advising smokers to quit, offering assistance and their attitude, norms, and self-efficacy related to tobacco use treatment. We examined changes in adherence to tobacco use treatment guidelines before and 12 months after the intervention among 89 village health workers working in the 13 community health centers enrolled in the BC+R study condition. Village health workers’ adherence to tobacco use treatment guidelines increased significantly. Village health workers were more likely to ask about tobacco use (3.4% at baseline, 32.6% at 12 months), offer advice to quit (4.5% to 48.3%) and offer assistance (1.1% to 38.2%). Perceived barriers to treating tobacco use decreased significantly. Self-efficacy and attitudes towards treating tobacco use improved significantly. Increased adherence to tobacco use treatment guidelines was associated with positive attitudes towards their role in delivering tobacco use treatment and increasing awareness of the community health center smoke-free policy. The findings suggest that, with training and support systems, village health workers can extend their role to include smoking cessation services. This workforce could represent a sustainable resource for supporting smokers who wish to quit.

scholarly journals Provision of Social Services and Health Care Quality in US Community Health Centers, 2017

2020 ◽  
Vol 110 (4) ◽  
pp. 567-573 ◽  
Author(s):  
Ashley M. Kranz ◽  
Ammarah Mahmud ◽  
Denis Agniel ◽  
Cheryl Damberg ◽  
Justin W. Timbie
Keyword(s):  
Health Care ◽  
Community Health ◽  
Social Services ◽  
Health Care Quality ◽  
Community Health Centers ◽  
Care Quality ◽  
Social Needs ◽  
Health Centers ◽  
Care Providers ◽  
Provision Of Services

Objectives. To describe the types of social services provided at community health centers (CHCs), characteristics of CHCs providing these services, and the association between on-site provision and health care quality. Methods. We surveyed CHCs in 12 US states and the District of Columbia during summer 2017 (n = 208) to identify referral to and provision of services to address 8 social needs. Regression models estimated factors associated with the provision of social services by CHCs and the association between providing services and health care quality (an 8-item composite). Results. CHCs most often offered on-site assistance for needs related to food or nutrition (43%), interpersonal violence (32%), and housing (30%). Participation in projects with community-based organizations was associated with providing services on-site (odds ratio = 2.48; P = .018). On-site provision was associated with better performance on measures of health care quality (e.g., each additional social service was associated with a 4.3 percentage point increase in colorectal cancer screenings). Conclusions. Some CHCs provide social services on-site, and this was associated with better performance on measures of health care quality. Public Health Implications. Health care providers are increasingly seeking to identify and address patients’ unmet social needs, and on-site provision of services is 1 strategy to consider.

scholarly journals Community Health Centers and Access to Care Among Underserved Populations: A Synthesis Review

2019 ◽  
Vol 77 (1) ◽  
pp. 3-18 ◽  
Author(s):  
Brendan Saloner ◽  
Adam S. Wilk ◽  
Jonathan Levin
Keyword(s):  
Access To Care ◽  
Community Health ◽  
Low Income ◽  
Community Health Centers ◽  
Underserved Populations ◽  
Health Centers ◽  
Access Cost ◽  
Medicaid Eligibility ◽  
Quasi Experimental ◽  
Medicaid Expansions

Community health centers (CHCs) deliver affordable health services to underserved populations, especially uninsured and Medicaid enrollees. Since the early 2000s, CHCs have grown because of federal investments in CHC capacity and expansions of Medicaid eligibility. We review 24 relevant studies from 2000 to 2017 to evaluate the relationship between CHCs, policies that invest in services for low-income individuals, and access to care. Most included studies use quasi-experimental designs. Greater spending on CHCs improves access to care, especially for low-income and minority individuals. Medicaid expansions also increase CHC use. Some studies indicate that CHC investments complement Medicaid expansions to increase access cost-effectively. Further research should explore patient preferences and patterns of CHC utilization versus other sites of care and population subgroups for which expanding CHC capacity improves access to care most. Researchers should endeavor to use measures and sample definitions that facilitate comparisons with other estimates in the literature.

Impact of dermoscopy-aided pediatric teledermatology program on the accessibility and efficiency of dermatology care at community health centers

2021 ◽  
pp. 1357633X2110682
Author(s):  
Rebecca Calafiore ◽  
Aziz Khan ◽  
Daren Anderson ◽  
Zhao Helen Wu ◽  
Jun Lu
Keyword(s):  
Community Health ◽  
Community Health Centers ◽  
Large Scale ◽  
Pediatric Population ◽  
Adult Population ◽  
Health Centers ◽  
Referral System ◽  
Pediatric Dermatology ◽  
Store And Forward ◽  
The Impact

Background There are few studies focusing on pediatric teledermatology, and the impact of a large-scale pediatric teledermatology program on the accessibility and efficiency of dermatology care remains unclear. This study evaluated the impact of a state-wide implementation of a store-and-forward teledermatology program augmented by the incorporation of dermoscopy in pediatric patients visiting community health centers. Methods It was a descriptive, retrospective cohort study of 876 pediatric dermatology referrals. Results In the traditional referral system, only 60 patients (17.6%) were seen by dermatologists with average waiting times of 75 days due to limited access. In comparison, with an implementation of dermoscopy-aided teledermatology, all 536 teledermatology referrals received dermatological care within 24 h, of which only 64 (12%) patients requires face-to-face (F2F) consultation. Patients referred for F2F consultation via eConsults had a much lower no-show rate as compared to the traditional referral system (39% vs. 71%). Side by side comparison between general population and pediatric population has demonstrated shared features in efficiency and access improvement but revealed specific characteristics of pediatric teledermatology in terms of diagnosis and treatment. Conclusion Coordinated store-and-forward teledermatology platform with incorporation of dermoscopy between large community care network and dermatology provider can greatly improve access to pediatric dermatology care especially in underserved population. The efficiency of teledermatology in access improvement for pediatric population is comparable with adult population in eConsults. There are also unique features and challenges in pediatric teledermatology that require further research.

scholarly journals Excess Clinical Comorbidity Among HIV-Infected Patients Accessing Primary Care in US Community Health Centers

2017 ◽  
Vol 133 (1) ◽  
pp. 109-118 ◽  
Author(s):  
Kenneth H. Mayer ◽  
Stephanie Loo ◽  
Phillip M. Crawford ◽  
Heidi M. Crane ◽  
Michael Leo ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Community Health ◽  
Community Health Centers ◽  
Primary Care Providers ◽  
Health Centers ◽  
Research Network ◽  
People Living With Hiv ◽  
Care Providers

Objectives: As the life expectancy of people infected with human immunodeficiency virus (HIV) infection has increased, the spectrum of illness has evolved. We evaluated whether people living with HIV accessing primary care in US community health centers had higher morbidity compared with HIV-uninfected patients receiving care at the same sites. Methods: We compared data from electronic health records for 12 837 HIV-infected and 227 012 HIV-uninfected patients to evaluate the relative prevalence of diabetes mellitus, hypertension, chronic kidney disease, dyslipidemia, and malignancies by HIV serostatus. We used multivariable logistic regression to evaluate differences. Participants were patients aged ≥18 who were followed for ≥3 years (from January 2006 to December 2016) in 1 of 17 community health centers belonging to the Community Health Applied Research Network. Results: Nearly two-thirds of HIV-infected and HIV-uninfected patients lived in poverty. Compared with HIV-uninfected patients, HIV-infected patients were significantly more likely to be diagnosed and/or treated for diabetes (odds ratio [OR] = 1.18; 95% confidence interval [CI], 1.22-1.41), hypertension (OR = 1.38; 95% CI, 1.31-1.46), dyslipidemia (OR = 2.30; 95% CI, 2.17-2.43), chronic kidney disease (OR = 4.75; 95% CI, 4.23-5.34), lymphomas (OR = 4.02; 95% CI, 2.86-5.67), cancers related to human papillomavirus (OR = 5.05; 95% CI, 3.77-6.78), or other cancers (OR = 1.25; 95% CI, 1.10-1.42). The prevalence of stroke was higher among HIV-infected patients (OR = 1.32; 95% CI, 1.06-1.63) than among HIV-uninfected patients, but the prevalence of myocardial infarction or coronary artery disease did not differ between the 2 groups. Conclusions: As HIV-infected patients live longer, the increasing burden of noncommunicable diseases may complicate their clinical management, requiring primary care providers to be trained in chronic disease management for this population.

scholarly journals Patient-Centered Practices for Engaging Transgender and Gender Diverse Patients in Clinical Research Studies

2020 ◽  
Author(s):  
Andrew Asquith ◽  
Lauren Sava ◽  
Alexander B. Harris ◽  
Asa E. Radix ◽  
Dana J. Pardee ◽  
...  
Keyword(s):  
New York ◽  
Clinical Research ◽  
Community Health ◽  
Community Health Centers ◽  
Underserved Populations ◽  
Health Centers ◽  
Barriers And Facilitators ◽  
Community Research ◽  
Gender Diverse ◽  
And Gender

Abstract Background: The purpose of this formative study was to assess barriers and facilitators to participation of transgender and gender diverse (TGD) patients in clinical research to solicit specific feedback on perceived acceptability and feasibility of research methods to inform creation of a multisite longitudinal cohort of primary care patients engaged in care at two community health centers.Method: Between September-November 2018, four focus groups (FGs) were convened at two community health centers in Boston, MA and New York, NY (N=28 participants across all 4 groups; 11 in Boston and 17 in New York). FG guides asked about patient outreach, acceptability of study methods and measures, and ideas for study retention. FGs were facilitated by TGD study staff, lasted approximately 90 min in duration, were audio recorded, and then transcribed verbatim by a professional transcription service. Thematic analyses were conducted by two independent analysts applying a constant comparison method. Consistency and consensus were achieved across code creation and application aided by Dedoose software.Results: Participants were a mean age of 33.9 years (SD 12.3; Range 18-66). Participants varied in gender identity with 4 (14.3%) male, 3 (10.7%) female, 8 (28.6%) transgender male, 10 (35.7%) transgender female, and 3 (10.7%) nonbinary. Eight (26.6%) were Latinx, 5 (17.9%) Black, 3 (10.7%) Asian, 3 (10.7%) another race, and 5 (17.9%) multiracial. Motivators and facilitators to participation were: research creating community, research led by TGD staff, compensation, research integrated into healthcare, research applicable to TGD and non-TGD people, and research helping TGD communities. Barriers were: being research/healthcare averse, not identifying as TGD, overlooking questioning individuals, research coming from a ‘cisgender lens”, distrust of how the research will be used, research not being accessible to TGD people, and research being exploitative.Conclusion: Though similarities emerged between the perspectives of TGD people and research citing perspectives of other underserved populations, there are barriers and facilitators to research which are unique to TGD populations. It is important for TGD people to be involved as collaborators in all aspects of research that concerns them.

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