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Federally qualified health centers

Nan Tracy Zheng, Susan Haber, Sonja Hoover, Zhanlian Feng
STUDY OBJECTIVES: Medicaid programs are not required to pay the full Medicare coinsurance and deductibles for Medicare-Medicaid dually eligible beneficiaries. We examined the association between the percentage of Medicare cost sharing paid by Medicaid and the likelihood that a dually eligible beneficiary used evaluation and management (E&M) services and safety net provider services. DATA SOURCES: Medicare and Medicaid Analytic eXtract enrollment and claims data for 2009...
October 21, 2016: Health Services Research
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
Nooshin Razani, Michael A Kohn, Nancy M Wells, Doug Thompson, Hanna Hamilton Flores, George W Rutherford
BACKGROUND: Contact with nature improves human health; stress reduction is a mediating pathway. Stay Healthy in Nature Everyday (SHINE) is a stress reduction and health promotion intervention for low-income families at an urban Federally Qualified Health Center. We plan to evaluate two service-delivery models for SHINE and present here the intervention design and evaluation protocol. METHODS: Behavioral change theory and environmental education literature informed the intervention...
September 29, 2016: Contemporary Clinical Trials
Karen McKoy, Nina M Antoniotti, April Armstrong, Rashid Bashshur, Jordana Bernard, Daniel Bernstein, Anne Burdick, Karen Edison, Mark Goldyne, Carrie Kovarik, Elizabeth A Krupinski, Joseph Kvedar, Jim Larkey, Ivy Lee-Keltner, Jules B Lipoff, Dennis H Oh, Hon Pak, Mark P Seraly, Daniel Siegel, Trilokraj Tejasvi, John Whited
Previous American Telemedicine Association (ATA) Teledermatology Practice Guidelines were issued in 2007. This updated version reflects new knowledge in the field, new technologies, and the need to incorporate teledermatology practice in a variety of settings, including hospitals, urgent care centers, Federally Qualified Health Centers, school-based clinics, public health facilities, and patient homes.
September 30, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
Marie-Louise Mares, David H Gustafson, Joseph E Glass, Andrew Quanbeck, Helene McDowell, Fiona McTavish, Amy K Atwood, Lisa A Marsch, Chantelle Thomas, Dhavan Shah, Randall Brown, Andrew Isham, Mary Jane Nealon, Victoria Ward
BACKGROUND: Millions of Americans need but don't receive treatment for substance use, and evidence suggests that addiction-focused interventions on smart phones could support their recovery. There is little research on implementation of addiction-related interventions in primary care, particularly in Federally Qualified Health Centers (FQHCs) that provide primary care to underserved populations. We used mixed methods to examine three FQHCs' implementation of Seva, a smart-phone app that offers patients online support/discussion, health-tracking, and tools for coping with cravings, and offers clinicians information about patients' health tracking and relapses...
September 29, 2016: BMC Medical Informatics and Decision Making
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
Benjamin G Druss, Silke A von Esenwein, Gretl E Glick, Emily Deubler, Cathy Lally, Martha C Ward, Kimberly J Rask
OBJECTIVE: Behavioral health homes provide primary care health services to patients with serious mental illness treated in community mental health settings. The objective of this study was to compare quality and outcomes of care between an integrated behavioral health home and usual care. METHOD: The study was a randomized trial of a behavioral health home developed as a partnership between a community mental health center and a Federally Qualified Health Center...
September 15, 2016: American Journal of Psychiatry
Robert S Nocon, Sang Mee Lee, Ravi Sharma, Quyen Ngo-Metzger, Dana B Mukamel, Yue Gao, Laura M White, Leiyu Shi, Marshall H Chin, Neda Laiteerapong, Elbert S Huang
OBJECTIVES: To compare health care use and spending of Medicaid enrollees seen at federally qualified health centers versus non-health center settings in a context of significant growth. METHODS: Using fee-for-service Medicaid claims from 13 states in 2009, we compared patients receiving the majority of their primary care in federally qualified health centers with propensity score-matched comparison groups receiving primary care in other settings. RESULTS: We found that health center patients had lower use and spending than did non-health center patients across all services, with 22% fewer visits and 33% lower spending on specialty care and 25% fewer admissions and 27% lower spending on inpatient care...
November 2016: American Journal of Public Health
Michelle C Kegler, Regine Haardörfer, Iris Alcantara, Julie A Gazmararian, Alexandra Gemma, Pam Reynolds, Cecillia Morris
Ecologic models of physical activity identify multiple environmental domains that influence activity levels, including the home. This study examined aspects of the home environment associated with objective measures of physical activity in overweight and obese women. Study participants were recruited through three federally qualified health centers in rural southwest Georgia as part of a randomized controlled trial of a home-environment-focused weight gain prevention intervention. Data collected from February 2011 to December 2012 were from 301 participants who completed baseline interviews and wore accelerometers for 7 days...
September 12, 2016: Women & Health
Eve N Dexter, Scott Fields, Rebecca E Rdesinski, Bhavaya Sachdeva, Daisuke Yamashita, Miguel Marino
PURPOSE: Internet-based patient portals are increasingly being implemented throughout health care organizations to enhance health and optimize communication between patients and health professionals. The decision to adopt a patient portal requires careful examination of the advantages and disadvantages of implementation. This study aims to investigate 1 proposed advantage of implementation: alleviating some of the clinical workload faced by employees. METHODS: A retrospective time-series analysis of the correlation between the rate of electronic patient-to-provider messages-a common attribute of Internet-based patient portals-and incoming telephone calls...
September 2016: Journal of the American Board of Family Medicine: JABFM
Richard C Rapp, John Pascoe
PURPOSE: Given the importance of partnership in improving health care outcomes among children, there is a substantial need to understand better what partnership means to parents and physicians. The goal of this study was to develop a partnership survey that was based on parents' and pediatricians' opinions about the key concepts of partnership. METHODS: Parents of patients visiting an affluent suburban private practice and a federally qualified health center, and 2 groups of pediatricians, were asked to review 61 partnership concepts and identify those they considered as being important to partnership...
September 2016: Journal of the American Board of Family Medicine: JABFM
Emily M Mader, Chester H Fox, John W Epling, Gary J Noronha, Carlos M Swanger, Angela M Wisniewski, Karen Vitale, Amanda L Norton, Christopher P Morley
BACKGROUND: Despite the current evidence of preventive screening effectiveness, rates of breast, cervical, and colorectal cancer in the United States fall below national targets. We evaluated the efficacy and feasibility of combining practice facilitation and academic detailing quality improvement (QI) strategies to help primary care practices increase breast, cervical, and colorectal cancer screening among patients. METHODS: Practices received a 1-hour academic detailing session addressing current cancer screening guidelines and best practices, followed by 6 months of practice facilitation to implement evidence-based interventions aimed at increasing patient screening...
September 2016: Journal of the American Board of Family Medicine: JABFM
Lyndsay A Nelson, Lindsay S Mayberry, Kenneth Wallston, Sunil Kripalani, Erin M Bergner, Chandra Y Osborn
BACKGROUND: Among adults with type 2 diabetes mellitus (T2DM), adherence to recommended self-care activities is suboptimal, especially among racial and ethnic minorities with low income. Self-care nonadherence is associated with having worse glycemic control and diabetes complications. Text messaging interventions are improving the self-care of adults with T2DM, but few have been tested with disadvantaged populations. OBJECTIVE: To develop Rapid Education/Encouragement And Communications for Health (REACH), a tailored, text messaging intervention to support the self-care adherence of disadvantaged patients with T2DM, based on the Information-Motivation-Behavioral skills model...
September 8, 2016: JMIR Human Factors
Kelly Arnett, Rebecca L Sudore, David Nowels, Cindy X Feng, Cari R Levy, Hillary D Lum
BACKGROUND: Interprofessional health care team members consider advance care planning (ACP) to be important, yet gaps remain in systematic clinical routines to support ACP. A clearer understanding of the interprofessional team members' perspectives on ACP clinical routines in diverse settings is needed. METHODS: One hundred eighteen health care team members from community-based clinics, long-term care facilities, academic clinics, federally qualified health centers, and hospitals participated in a 35-question, cross-sectional online survey to assess clinical routines, workflow processes, and policies relating to ACP...
September 6, 2016: American Journal of Hospice & Palliative Care
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
Armando Valdez, Anna M Napoles, Susan L Stewart, Alvaro Garza
US Latina women experience disproportionately high cervical cancer incidence and mortality rates. These health disparities are largely preventable with routine pap tests and human papillomavirus (HPV) screening. This study tested the efficacy of a cervical cancer education intervention to improve risk factor knowledge, attitudes, self-efficacy, and self-reported behavior related to cervical cancer screening among low-income Latinas who had not been screened in the past 2 years, compared to a usual care control group...
August 30, 2016: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
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
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