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Julia B Nath, Shaughnessy Costigan, Feng Lin, Eric Vittinghoff, Renee Y Hsia
OBJECTIVE: To determine whether increasing access to federally qualified health centers (FQHCs) in California was associated with decreased rates of emergency department (ED) use by children without insurance or insured by Medicaid. METHODS: We combined several data sets to longitudinally analyze 58 California counties between 2005 and 2013. We defined access to FQHCs by county using 2 measures: FQHC sites per 100 square miles between 2005 and 2012 and percentage of Medicaid-insured and uninsured children served by FQHCs from 2008 to 2013...
September 22, 2016: Pediatrics
Monica Bidwal, Kajua Lor, Junhua Yu, Eric Ip
BACKGROUND: Adherence with asthma medications is less than optimal, measuring approximately 30-50%. Several factors have been shown to contribute to medication non-adherence including low-socioeconomic status, low literacy, medication cost, access to care, and language barriers. Community Health Clinic Ole has attempted to reduce medication adherence barriers associated with cost, access to care, and language by 1) allowing medications to be obtained from the clinic at a reduced cost via the 340B drug pricing program and patient assistance programs, and 2) providing one-on-one consultations from bilingual Spanish-speaking clinicians...
August 3, 2016: Research in Social & Administrative Pharmacy: RSAP
Anita Ravi, Linda Prine, Gabrielle deFiebre, Susan E Rubin
PURPOSE: To describe rates of and reasons for follow-up among adolescents and adults receiving contraceptive implants in a Federally Qualified Health Center (FQHC). METHODS: Retrospective comparison of patient-initiated implant-related contacts during the 6 months postinsertion among adolescents (110) and adults (154) who had implants placed at a FQHC network. RESULTS: Forty percent of adolescents and 26% of adults initiated follow-up (P = ...
September 1, 2016: Journal of Primary Care & Community Health
Maia Ingram, Nicole Marrone, Daisey Thalia Sanchez, Alicia Sander, Cecilia Navarro, Jill Guernsey de Zapien, Sonia Colina, Frances Harris
UNLABELLED: Hearing loss is associated with cognitive decline and impairment in daily living activities. Access to hearing health care has broad implications for healthy aging of the U.S. POPULATION: This qualitative study investigated factors related to the socio-ecological domains of hearing health in a U.S.-Mexico border community experiencing disparities in access to care. A multidisciplinary research team partnered with community health workers (CHWs) from a Federally Qualified Health Center (FQHC) in designing the study...
2016: Frontiers in Public Health
Mykell Barnacle, Mark A Strand, Amy Werremeyer, Brody Maack, Natasha Petry
PURPOSE: Evidence-based guidelines recommend regular depression screening among individuals with type 2 diabetes mellitus (T2DM). The purpose of this study is to examine depression screening patterns among a primary care population with T2DM, through use of the Patient Health Questionnaire-9 (PHQ-9). METHODS: In total, 1817 patients with T2DM were analyzed through a retrospective observational study at 2 sites, a regional health center and a federally qualified health center (FQHC)...
October 2016: Diabetes Educator
Shiraz I Mishra, Andrew L Sussman, Ambroshia M Murrietta, Christina M Getrich, Robert Rhyne, Richard E Crowell, Kathryn L Taylor, Ellen J Reifler, Pamela H Wescott, Ali I Saeed, Richard M Hoffman
INTRODUCTION: National guidelines call for annual lung cancer screening for high-risk smokers using low-dose computed tomography (LDCT). The objective of our study was to characterize patient knowledge and attitudes about lung cancer screening, smoking cessation, and shared decision making by patient and health care provider. METHODS: We conducted semistructured qualitative interviews with patients with histories of heavy smoking who received care at a Federally Qualified Health Center (FQHC Clinic) and at a comprehensive cancer center-affiliated chest clinic (Chest Clinic) in Albuquerque, New Mexico...
2016: Preventing Chronic Disease
Vivian Colón-López, Lizbeth M Toro-Mejías, Alexandra Conde-Toro, Michelle J Serra-Rivera, Tania M Martínez, Verónica Rodríguez, Ana M Ríos, Luis Berdiel, Héctor Villanueva
OBJECTIVE: The purpose of this study was to understand through a quantitative assessment, the views of HPV and HPV vaccination among parents of sons from a FQHC in PR. METHODS: A self-administered questionnaire was given to a convenience sample of 200 parents of sons 9-17 years old. RESULTS: Nearly 30% of the parents reported that their sons had initiated the HPV vaccine regimen. Health care provider recommendation was significantly associated with vaccine initiation...
2016: Journal of Health Care for the Poor and Underserved
Adesuwa Olomu, William Hart-Davidson, Zhehui Luo, Karen Kelly-Blake, Margaret Holmes-Rovner
BACKGROUND: Use of Shared Decision-Making (SDM) and Decision Aids (DAs) has been encouraged but is not regularly implemented in primary care. The Office-Guidelines Applied to Practice (Office-GAP) intervention is an application of a previous model revised to address guidelines based care for low-income populations with diabetes and coronary heart disease (CHD). OBJECTIVE: To evaluate Office-GAP Program feasibility and preliminary efficacy on medication use, patient satisfaction with physician communication and confidence in decision in low-income population with diabetes and coronary heart disease (CHD) in a Federally Qualified Healthcare Center (FQHC)...
2016: BMC Health Services Research
James J Crall, Jackie Illum, Ana Martinez, Nadereh Pourat
Despite the high rate of untreated tooth decay, many young children in California under six years of age have never been to a dentist. Numerous and complex barriers to access to oral health care for young children exist, and a multifaceted approach is required to improve receipt of preventive and treatment services that could improve the oral health of this population. This policy brief describes the UCLA-First 5 LA 21st Century Dental Homes Project, which was designed to improve oral health care for young children in 12 Federally Qualified Health Center (FQHC) clinic sites with co-located dental and primary care services and its accessibility in their service areas throughout Los Angeles County...
June 2016: Policy Brief
Andrew J Potter, Amal N Trivedi, Brad Wright
OBJECTIVE: To determine whether younger dual-eligibles receiving care at federally qualified health centers (FQHCs) have lower rates of ambulatory care sensitive (ACS) hospitalization and emergency department (ED) visits. DATA SOURCES: We used the 100% Medicare Part A and Part B institutional claims from 2007 to 2010 for dual-eligibles younger than 65 years, enrolled in traditional fee-for-service Medicare, who received care at an FQHC or lived in a primary care service area with an FQHC...
July 1, 2016: Journal of Primary Care & Community Health
Chiang-Hua Chang, Valerie A Lewis, Ellen Meara, Jon D Lurie, Julie P W Bynum
BACKGROUND: Federally Qualified Health Centers (FQHCs) provide primary care for millions of Americans, but little is known about Medicare beneficiaries who use FQHCs. OBJECTIVE: To compare patient characteristics and health care service use among Medicare beneficiaries stratified by FQHC use. RESEARCH DESIGN: Cross-sectional analysis of 2011 Medicare fee-for-service beneficiaries aged 65 years and older. SUBJECTS: Subjects included beneficiaries with at least 1 evaluation and management (E&M) visit in 2011, categorized as FQHC users (≥1 E&M visit to FQHCs) or nonusers living in the same primary care service areas as FQHC users...
August 2016: Medical Care
Priya P Mehta, Juan E Santiago-Torres, C Ellis Wisely, Katherine Hartmann, Frini A Makadia, Mary Jo Welker, Diane L Habash
INTRODUCTION: There are a number of well-established barriers to accessing primary care. The LINKED Study set out to improve primary care usage through 1-on-1 counseling and referrals for patients with diabetes being treated at local free clinics. We hypothesized that this educational intervention paired with expedited referral would increase the use of federally qualified health centers (FQHCs) as a source of health care and ultimately lead to improved diabetic health. METHODS: Medical student volunteers counseled participants on the importance of primary care...
May 2016: Journal of the American Board of Family Medicine: JABFM
Yamile Molina, Jesse J Plascak, Donald L Patrick, Sonia Bishop, Gloria D Coronado, Shirley A A Beresford
BACKGROUND: Little is known about how neighborhood factors are associated with Latinas' barriers to cancer screening, including mammography. To address this gap, we examined barriers to mammography by neighborhood racial/ethnic composition and socioeconomic status among a federally qualified health center (FQHC)-based sample of non-adherent Latinas in Western Washington State. METHODS: Baseline data were drawn from a larger intervention study (n = 536 Latinas)...
April 8, 2016: Journal of Racial and Ethnic Health Disparities
Hannah L Maxey, Connor W Norwood, Ziyue Liu
OBJECTIVES: To determine whether and to what extent the state policy environment for the dental hygiene workforce affects the availability of dental services at Federally Qualified Health Centers (FQHCs). METHODS: We examined data drawn from the Uniform Data System on 1,135 unique FQHC grantees receiving community health center funding from the U.S. Health Center program between 2004 and 2012. The Dental Hygiene Professional Practice Index was used to quantify variations in state policy environment...
April 1, 2016: Journal of Public Health Dentistry
Brent A Moore, Daren Anderson, Lindsey Dorflinger, Ianita Zlateva, Allison Lee, Wesley Gilliam, Terrence Tian, Khushbu Khatri, Christopher B Ruser, Robert D Kerns
Successful organizational improvement processes depend on application of reliable metrics to establish targets and to monitor progress. This study examined the utility of the Pain Care Quality (PCQ) extraction tool in evaluating implementation of the Stepped Care Model for Pain Management at one Veterans Health Administration (VHA) healthcare system over 4 yr and in a non-VHA Federally qualified health center (FQHC) over 2 yr. Two hundred progress notes per year from VHA and 150 notes per year from FQHC primary care prescribers of long-term opioid therapy (>90 consecutive days) were randomly sampled...
2016: Journal of Rehabilitation Research and Development
Ellen Christiansen, Michelle DeCoux Hampton, Meghan Sullivan
PROBLEM: In some Federally-Qualified Community Health Centers (FQHCs), patients do not have a designated primary care provider (PCP). Patients see any provider who is available. This leads to fragmented care, poorer outcomes, and higher costs. DESIGN: Patients were empaneled to a designated PCP. Continuity, quality, and efficiency measures were collected at baseline, 6-, and 12-months postempanelment. BACKGROUND AND SETTING: Three rural FQHCs on the coast of Northern California performing about 18,000 patient visits annually...
August 2016: Journal of the American Association of Nurse Practitioners
Jacob Warren, Bryant Smalley, Nikki Barefoot
OBJECTIVE: To examine the relationship between race/ethnicity and motivation for weight loss and motivation for exercise among patients with chronic disease. DESIGN: Cross-sectional. SETTING: Our study took place within a network of federally qualified health centers (FQHCs) in the rural southern United States. PATIENTS OR PARTICIPANTS: 463 active FQHC patients with diabetes and/or hypertension identifying as African American, White Hispanic, or non-Hispanic White participated in our study...
2016: Ethnicity & Disease
Patricia M Herman, Maia Ingram, Charles E Cunningham, Heather Rimas, Lucy Murrieta, Kenneth Schachter, Jill Guernsey de Zapien, Scott C Carvajal
BACKGROUND: Consideration of patient preferences regarding delivery of mental health services within primary care may greatly improve access and quality of care for the many who could benefit from those services. OBJECTIVES: This project evaluated the feasibility and usefulness of adding a consumer-products design method to qualitative methods implemented within a community-based participatory research (CBPR) framework. RESEARCH DESIGN: Discrete-choice conjoint experiment (DCE) added to systematic focus group data collection and analysis...
August 2016: Patient
Kassandra A Alia, Darcy A Freedman, Heather M Brandt, Patricia Gibson-Haigler, Daniela B Friedman
BACKGROUND: Well-designed evaluation is necessary to document the impact of farmers' markets (FMs) on health, economic, and community outcomes. However, the complex nature of FMs poses challenges for evaluation. OBJECTIVE: Our goal is to describe a participatory, multilevel framework used to evaluate a FM implemented at a federally qualified health center (FQHC) in a rural community in the Southeastern United States. METHODS: An iterative, collaborative process involving three feedback loops was used to engage community stakeholders in the development, implementation, and utilization of the multilevel evaluation plan...
2015: Progress in Community Health Partnerships: Research, Education, and Action
Allison M Cole, Andrea Esplin, Laura-Mae Baldwin
INTRODUCTION: Federally Qualified Health Centers (FQHCs) provide primary care to low-income and uninsured patients in the United States. FQHCs are required to report annual measurements and provide evidence of improvement for quality measures; effective methods to improve quality in FQHCs are needed. Systems of Support (SOS) is a proactive, mail-based, colorectal cancer screening program that was developed and tested in an integrated health care system. The objective of this study was to adapt SOS for use in an FQHC system, guided by the Consolidated Framework for Implementation Research (CFIR)...
December 3, 2015: Preventing Chronic Disease
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