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Primary care behavioral health

Amy M Kilbourne, Michelle M Barbaresso, Zongshan Lai, Kristina M Nord, Margretta Bramlet, David E Goodrich, Edward P Post, Daniel Almirall, Mark S Bauer
OBJECTIVE: Persons with chronic mental disorders are disproportionately burdened with physical health conditions. We determined whether Life Goals Collaborative Care compared to usual care improves physical health in patients with mental disorders within 12 months. METHODS: This single-blind randomized controlled effectiveness study of a collaborative care model was conducted at a midwestern Veterans Affairs urban outpatient mental health clinic. Patients (N = 293 out of 474 eligible approached) with an ICD-9-CM diagnosis of schizophrenia, bipolar disorder, or major depressive disorder and at least 1 cardiovascular disease risk factor provided informed consent and were randomized (February 24, 2010, to April 29, 2015) to Life Goals (n = 146) or usual care (n = 147)...
October 25, 2016: Journal of Clinical Psychiatry
Oni J Blackstock, Brent A Moore, Gail V Berkenblit, Sarah K Calabrese, Chinazo O Cunningham, David A Fiellin, Viraj V Patel, Karran A Phillips, Jeanette M Tetrault, Minesh Shah, E Jennifer Edelman
BACKGROUND: Among health care providers, prescription of HIV pre-exposure prophylaxis (PrEP) has been low. Little is known specifically about primary care physicians (PCPs) with regard to PrEP awareness and adoption (i.e., prescription or referral), and factors associated with adoption. OBJECTIVE: To assess PrEP awareness, PrEP adoption, and factors associated with adoption among PCPs. DESIGN: Cross-sectional online survey conducted in April and May 2015...
October 24, 2016: Journal of General Internal Medicine
Lori J Stark, Stephanie Spear Filigno, Christopher Bolling, Megan B Ratcliff, Jessica C Kichler, Shannon L Robson, Stacey L Simon, Mary Beth McCullough, Lisa M Clifford, Cathleen O Stough, Cynthia Zion, Richard F Ittenbach
Obesity affects nearly 2 million preschool age children in the United States and is not abating. However, research on interventions for already obese preschoolers is limited. To address this significant gap in the literature, we developed an intervention targeting obesity reduction in 2 to 5year olds, Learning about Activity and Understanding Nutrition for Child Health (LAUNCH). This paper describes the rationale, design, participant enrollment, and implementation of a 3-arm randomized, parallel-group clinical trial comparing LAUNCH to a motivational-interviewing intervention (MI) and standard care (STC), respectively...
October 21, 2016: Contemporary Clinical Trials
Katja Krug, Katharina I Kraus, Kathrin Herrmann, Stefanie Joos
BACKGROUND: In Germany, complementary and alternative medicine (CAM) in primary health care is offered by general practitioners (GPs) and by natural health practitioners, so called 'Heilpraktiker' (HPs). Considering the steadily growing number of unregulated HPs, the aim of the study was to assess characteristics of patients consulting HPs in comparison to patients consulting GPs. METHODS: In a cross-sectional study, patients of randomly selected GPs and HPs were asked to complete a questionnaire about their health care status, health care behavior, and symptoms rated on the Measure Yourself Medical Outcome Profile (MYMOP-D)...
October 24, 2016: BMC Complementary and Alternative Medicine
Karen D Hidalgo, Grégore I Mielke, Diana C Parra, Felipe Lobelo, Eduardo J Simões, Grace O Gomes, Alex A Florindo, Mário Bracco, Lenildo Moura, Ross C Brownson, Michael Pratt, Luiz R Ramos, Pedro C Hallal
BACKGROUND: This study was conducted to examine the lifestyle behaviors and health promoting practices of physicians, nurses, and community health workers in Brazil. METHODS: A random sample of primary health care units in Brazil was selected, and a pretested questionnaire was administered via phone interviews, in 2011, to 182 physicians, 347 nurses, and 269 community health workers, totaling 798 health professionals. The total initial sample included 1600 eligible health professionals...
October 24, 2016: BMC Public Health
Gregory P Beehler, Kaitlin R Lilienthal
The Primary Care Behavioral Health (PCBH) model of integrated primary care is challenging to implement with high fidelity. The Primary Care Behavioral Health Provider Adherence Questionnaire (PPAQ) was designed to assess provider adherence to essential model components and has recently been adapted into a quality improvement toolkit. The aim of this pilot project was to gather preliminary feedback on providers' perceptions of the acceptability and utility of the PPAQ toolkit for making beneficial practice changes...
October 24, 2016: Psychological Services
Prakash Chand Negi, Raman Chauhan, Vivek Rana, Vidyasagar, Kavinder Lal
BACKGROUND: There are no data available on the prevalence of non-communicable diseases (NCD) risk factors among the tribal population of hill state of Himachal Pradesh (HP). The epidemiological study of NCD risk factors was done in the tribal population of district Kinnaur of HP to estimate the burden of NCD risk factors and their risk determinants. METHODS: WHO STEP wise approach was used for screening of the core NCD risk indicators in 3582 randomly selected natives of Kinnaur aged 20-70 years by trained Health workers of the district health services...
September 2016: Indian Heart Journal
Andrew S Hwang, Steven J Atlas, Johan Hong, Jeffrey M Ashburner, Adrian H Zai, Richard W Grant, Clemens S Hong
BACKGROUND: A better understanding of the attributes of patients who require more effort to manage may improve risk adjustment approaches and lead to more efficient resource allocation, improved patient care and health outcomes, and reduced burnout in primary care clinicians. OBJECTIVE: To identify and characterize high-effort patients from the physician's perspective. DESIGN: Cohort study. PARTICIPANTS: Ninety-nine primary care physicians in an academic primary care network...
October 21, 2016: Journal of General Internal Medicine
Hanna F Skjåkødegård, Yngvild S Danielsen, Mette Morken, Sara-Rebekka F Linde, Rachel P Kolko, Katherine N Balantekin, Denise E Wilfley, Pétur B Júlíusson
BACKGROUND: The purpose of the FABO-study is to evaluate the effect of family-based behavioral social facilitation treatment (FBSFT), designed to target children's family and social support networks to enhance weight loss outcomes, compared to the standard treatment (treatment as usual, TAU) given to children and adolescents with obesity in a routine clinical practice. METHODS: Randomized controlled trial (RCT), in which families (n = 120) are recruited from the children and adolescents (ages 6-18 years) referred to the Obesity Outpatient Clinic (OOC), Haukeland University Hospital, Norway...
October 21, 2016: BMC Public Health
Wanjiku F M Njoroge, Cody A Hostutler, Billie S Schwartz, Jennifer A Mautone
There are multiple barriers to accessing high quality, evidence-based behavioral health care for children and adolescents, including stigma, family beliefs, and the significant paucity of child and adolescent psychiatrists. Although equal access continues to be an unmet need in the USA, there is growing recognition that integrated behavioral health services in pediatric primary care have the potential to reduce health disparities and improve service utilization. In a joint position paper, the American Academy of Pediatrics (AAP) and the American Academy of Child and Adolescent Psychiatry (AACAP) highlighted the multiple benefits of children receiving initial behavioral health screening, assessment, and evidence-based behavioral health treatments in the medical home...
December 2016: Current Psychiatry Reports
Denise Dion Hallfors, Bonita J Iritani, Lei Zhang, Shane Hartman, Winnie K Luseno, Elias Mpofu, Simbarashe Rusakaniko
This study examines the association between religious affiliation and reasons for marriage, perceived church attitudes, and reproductive health-seeking behaviors, including HIV testing, among young women in eastern rural Zimbabwe. The sample comprised women (N = 35) who had married by 2012 while participating in a larger randomized controlled trial (RCT) to test the effects of school support on HIV-related risk. The RCT sample was identified in 2007 as all female sixth graders in 25 rural eastern Zimbabwe primary schools whose parents, one or both, had died (N = 328)...
December 2016: SAHARA J: Journal of Social Aspects of HIV/AIDS Research Alliance
Andrew Silapaswan, Douglas Krakower, Kenneth H Mayer
Since FDA approval of HIV pre-exposure prophylaxis (PrEP) for HIV prevention, attention has been focused on PrEP implementation. The CDC estimates that 1.2 million U.S. adults might benefit from PrEP, but only a minority are using PrEP, so there is a significant unmet need to increase access for those at risk for HIV. Given the large numbers of individuals who have indications for PrEP, there are not enough practicing specialists to meet the growing need for providers trained in providing PrEP. Moreover, since PrEP is a preventive intervention for otherwise healthy individuals, primary care providers (PCPs) should be primary prescribers of PrEP...
October 19, 2016: Journal of General Internal Medicine
Karen E van den Hondel, Anne Linde Saaltink, Peter Paul M Bender
BACKGROUND: Forensic physicians are responsible for first-line medical care of detainees (individuals held in custody) in the police station. The Dutch police law contains a 'duty of care', which gives the police responsibility for the apparent mentally ill and/or confused people they encounter during their work. The police can ask a forensic physician to do a primary psychiatric assessment of any apparent mentally ill detainee. The forensic physician determines if the apparent mentally ill behavior of the detainee is due to a somatic illness, or has a psychiatric cause for which the detainee needs admission to a psychiatric hospital...
October 11, 2016: Journal of Forensic and Legal Medicine
Chun Chang, Qingqi Zeng, Ying Ji, Xinying Sun, Yuhui Shi, Yanlin Wang, Chengcheng Han, Xiuqin Wen
OBJECTIVE: To exam whether health literacy mediated the association between intervention and blood pressure control and to better understand the relationship between health literacy and health outcome for hypertensive. DESIGN AND METHOD: A before-after designed one-year community-based intervention program including patient education and patient-centered goal support were conducted in a primary care setting. A face-to-face interview were completed among 468 hypertensives before intervention and 406 after intervention...
September 2016: Journal of Hypertension
Curtis Bone, Lilian Gelberg, Mani Vahidi, Barbara Leake, Julia Yacenda-Murphy, Ronald M Andersen
OBJECTIVE: The Affordable Care Act encourages integration of behavioral health into primary care. We aim to estimate the level of under-reporting of drug use in federally qualified health centers (FQHCs) among self-reported risky drug users. METHODS: Adult patients in the waiting rooms of 4 FQHCs who self-reported risky drug use on the screening instrument World Health Organization's Alcohol, Smoking and Substance Involvement Screening Test (score 4-26), who participated in the "Quit Using Drugs Intervention Trial," submitted urine samples for drug testing...
October 6, 2016: Journal of Addiction Medicine
Chun Chao, Michael J Silverberg, Tracy A Becerra, Douglas A Corley, Christopher D Jensen, Qiaoling Chen, Virginia P Quinn
BACKGROUND: Human papillomavirus vaccination may result in lowered intention to be screened for cervical cancer, potentially leading to gaps in screening coverage and avoidable cervical cancer diagnoses. OBJECTIVE: To examine the association between human papillomavirus vaccination and subsequent cervical cancer screening initiation and adherence to recommended screening intervals to detect gaps in screening coverage and inform future prevention efforts. STUDY DESIGN: A retrospective cohort study was conducted in two distinct cohorts of female members of Kaiser Permanente Southern California, a large integrated healthcare delivery system...
October 13, 2016: American Journal of Obstetrics and Gynecology
Hani Raoul Khouzam
Trazodone is an antidepressant that is FDA-approved for the treatment of depression. It has been used by mental health and primary care providers for the treatment of multiple psychiatric and medical conditions .This review describes trazodone mechanism of action, formulation, dosage and adverse effects and then summarizes the beneficial effects of trazodone in the treatment of various psychiatric and medical conditions such as major depression, as well non-approved FDA indications such as insomnia,anxiety disorders, posttraumatic stress disorder, obsessive compulsive disorder, feeding and eating disorders, substance use disorders, behavioral disturbances associated with cognitive dysfunction, sexual dysfunction, certain pain conditions, and rehabilitation after acute ischemic stroke...
October 17, 2016: Postgraduate Medicine
Mina S Makary, Summit H Shah, Shantanu Warhadpande, Ivan G Vargas, James Sarbinoff, Joshua D Dowell
PURPOSE: The association of retrievable inferior vena cava filters (IVCFs) with adverse events has led to increased interest in prompt retrieval, particularly in younger patients given the progressive nature of these complications over time. This study takes a design-of-experiments (DOE) approach to investigate methods to best improve filter retrieval rates, with a particular focus on younger (<60 years) patients. METHODS: A DOE approach was executed in which combinations of variables were tested to best improve retrieval rates...
October 12, 2016: Journal of the American College of Radiology: JACR
Zhixin Liu, Rachael Moorin, John Worthington, Geoffrey Tofler, Mark Bartlett, Rabia Khan, Yeqin Zuo
BACKGROUND: The National Prescribing Service (NPS) MedicineWise Stroke Prevention Program, which was implemented nationally in 2009-2010 in Australia, sought to improve antithrombotic prescribing in stroke prevention using dedicated interventions that target general practitioners. This study evaluated the impact of the NPS MedicineWise Stroke Prevention Program on antithrombotic prescribing and primary stroke hospitalizations. METHOD AND RESULTS: This population-based time series study used administrative health data linked to 45 and Up Study participants with a high risk of cardiovascular disease (CVD) to assess the possible impact of the NPS MedicineWise program on first-time aspirin prescriptions and primary stroke-related hospitalizations...
October 13, 2016: Journal of the American Heart Association
C R Macchi, Rodger Kessler, Andrea Auxier, Juvena R Hitt, Daniel Mullin, Constance van Eeghen, Benjamin Littenberg
Insufficient knowledge exists regarding how to measure the presence and degree of integrated care. Prior estimates of integration levels are neither grounded in theory nor psychometrically validated. They provide scant guidance to inform improvement activities, compare integration efforts, discriminate among practices by degree of integration, measure the effect of integration on quadruple aim outcomes, or address the needs of clinicians, regulators, and policymakers seeking new models of health care delivery and funding...
October 13, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
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