scholarly journals A Pilot Study Describing Knowledge and Practices in the Health Care of Men Who Have Sex With Men by U.S. Air Force Primary Care Providers

2013 ◽  
Vol 178 (2) ◽  
pp. e248-e254 ◽  
Author(s):  
Robert L. Tong ◽  
Jason Lane ◽  
Patrick McCleskey ◽  
Brian Montenegro ◽  
Katherine Mansalis
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Pilot Study ◽  
Air Force ◽  
Primary Care Providers ◽  
Care Providers ◽  
Sex With Men

754 Insomnia and Depression Symptoms in Primary Care Patients Referred for Mental Health Care

SLEEP ◽  
2021 ◽  
Vol 44 (Supplement_2) ◽  
pp. A294-A294
Author(s):  
Ivan Vargas ◽  
Alexandria Muench ◽  
Mark Seewald ◽  
Cecilia Livesey ◽  
Matthew Press ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Mental Health Care ◽  
Primary Care Providers ◽  
Depression Symptoms ◽  
Care Providers ◽  
Mild Depression ◽  
Significant Depression ◽  
Clinically Significant

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

scholarly journals 1542. Provider Uptake of Extragenital Screening for Gonorrhea and Chlamydia in Active Duty Air Force Members with Incident HIV Diagnosis

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S770-S771
Author(s):  
Christian C Lamb ◽  
Joseph Yabes ◽  
Shilpa Hakre ◽  
Jason Okulicz
Keyword(s):  
Primary Care ◽  
Hiv Infection ◽  
Air Force ◽  
Clinical Laboratory ◽  
Medical Center ◽  
Previous History ◽  
Primary Care Providers ◽  
Care Providers ◽  
National Guidelines ◽  
Hiv Diagnosis

Abstract Background The prevalence of Neisseria gonorrhea (GC) and Chlamydia trachomatis (CT) is much higher at extragenital anatomic sites among men who have sex with men (MSM) with HIV infection. National guidelines recommend that all MSM with HIV infection undergo screening for extragenital sexually transmitted infections (EG-STIs), however uptake is low in many primary care settings. We evaluated EG-STI screening by primary care providers (PCPs) for US Air Force (USAF) members with incident HIV infection. Methods All USAF members newly diagnosed with HIV infection who received initial HIV specialty care with Infectious Disease (ID) providers at Brooke Army Medical Center from 2016-2018 (n=98) were included. A retrospective chart review was conducted to evaluate STI screening performed by PCPs within 1 week of HIV diagnosis compared to screening at entry into ID care. Demographic, clinical, laboratory and behavioral risk data were collected. STI screening included GC/CT EG-STIs, urethral GC/CT, syphilis, and hepatitis B and C. Results Patients were predominantly male (97.9%) with a median age of 26 (IQR 23, 32) years at HIV diagnosis (Table 1). A previous history of STIs was reported in 53 (54.1%) patients and the majority of males self-identified as MSM (66.3%) or bisexual (22.5%). The median time from HIV diagnosis to ID evaluation was 26 days (IQR 9, 33). PCPs performed any STI screening in 61 (62.2%) patients (Table 2). EG-STI screening was conducted in 3 (3.1%) patients overall and in (3.4%) MSM/bisexuals. A total of 31 (31.6%) patients had missed STIs; the majority due to EG-STIs of the rectum (71%) and pharynx (21.9%). All EG-STIs would have been missed by urethral GC/CT screening alone. Table 1 Table 2 Conclusion EG-STI screening uptake was low among PCPs evaluating USAF members with incident HIV infection. Underutilization of EG-STI screening can result in missed infections and forward transmission of GC/CT. Barriers to low uptake need to be explored. Continued education and training of PCPs may be necessary to improve uptake of EG-STI screening. Disclosures All Authors: No reported disclosures

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

2015 ◽  
Vol 34 (2) ◽  
pp. 63-72 ◽  
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.

The Experience of Primary Care Providers With an Integrated Mental Health Care Program in Safety-Net Clinics

2015 ◽  
Vol 38 (2) ◽  
pp. 158-168 ◽  
Author(s):  
Wayne D. Bentham ◽  
Anna Ratzliff ◽  
David Harrison ◽  
Ya-Fen Chan ◽  
Steven Vannoy ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Care Program ◽  
Primary Care Providers ◽  
Safety Net ◽  
Care Providers ◽  
Health Care Program ◽  
Safety Net Clinics ◽  
Integrated Mental Health

Is the Far West Mental Health Integration Project Making a Difference? The General Practitioner Perspective

2005 ◽  
Vol 11 (3) ◽  
pp. 32 ◽  
Author(s):  
David Perkins ◽  
David Lyle
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Health Care ◽  
Primary Care Providers ◽  
Care Staff ◽  
Care Providers ◽  
Community Based ◽  
Mental Health Integration ◽  
Integration Project ◽  
The Impact

This paper reports on the evaluation of an Australian Government and NSW State funded Mental Health Integration Project in remote far western NSW. The project was part of the Mental Health Integration Program, developed from the Second National Mental Health Plan. The project implemented a model of community-based mental health services and used innovative financing arrangements to allow the provision of community-based specialist mental health teams to remote communities and to recruit visiting psychiatrists to support the local primary care providers. The evaluation strategy included a survey of general practitioners (GPs) in the Upper Western Sector and Broken Hill, designed to investigate their level and type of contact with psychiatrists and community-based specialist mental health care teams, their perceptions about the impact of the new services, and their interest in further professional development in mental health care.The project has shown that visiting specialists can be deployed in a primary care setting with a focus on meeting the needs of local GPs, primary health care staff and their patients.

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