Comparative Efficacy of Exercise Training and Conventional Psychotherapies for Adult Depression: A Network Meta-Analysis.

Objective: An estimated 3.8% of the global population experiences depression, according to the [2019] WHO report. Evidence supports the efficacy of exercise training (EX) for depression; however, its comparative efficacy to conventional, evidence-supported psychotherapies remains understudied.

Patient and provider prediabetes knowledge, attitudes, and behavior in a large urban family medicine practice.

Context: One-third of American adults have prediabetes. However, only 11% are aware of their condition, and they often do not receive prediabetes education or management. Prior studies have indicated knowledge gaps among primary care providers and patients on prediabetes management.

The association between food insecurity and physical activity in adults with serious mental illness living in supportive housing.

Rates of food insecurity are high among adults with serious mental illness (SMI); this population also engages in less physical activity than the general population. However, the relationship between food insecurity and physical activity in this group has not been explored. We examined food insecurity prevalence and its association with physical activity in 314 adults with SMI living in supportive housing in New York City and Philadelphia and enrolled in an institutional review board-approved randomized controlled trial of a Peer Group Lifestyle Balance (PGLB) program.

Patient and Provider Prediabetes Knowledge, Attitudes, and Behaviors in a Large Urban Family Medicine Practice.

One-third of U.S. adults have prediabetes, but only 11% are aware of their condition.

Transitioning from In-Person to Telemedicine Within Primary Care Behavioral Health During COVID-19.

The COVID-19 pandemic created significant mental stressors among patients, which had the potential to impede access to primary care behavioral health (PCBH) services through rapid unplanned shifts to telehealth. The authors utilized retrospective administrative data and patient surveys to assess the feasibility, acceptability, and clinical outcomes of Jefferson Health PCBH pre- and post-COVID pandemic onset (Cohort 1 in person-only visits and Cohort 2 telemedicine-only visits). Using a retrospective cohort comparison study, outcomes included number of patients receiving PCBH in both cohorts, frequency of visits, no-show and cancellation rates, change in mean PHQ-9 and GAD-7 scores for patients, changes in the levels of depression and anxiety severity using established severity levels, and patient satisfaction with telehealth (Cohort 2 only).

Development and evaluation of employee wellness sessions in response to COVID-19.

Introduction: The COVID-19 pandemic has led to widespread mental health distress. Few COVID-19 employee wellness initiatives have been evaluated and have primarily focused on frontline health care workers. This study described the feasibility and utilization of, and participant satisfaction for virtual COVID-19 employee wellness sessions at a large university and health system.

Third-Year Medical Students' Self-perceived Knowledge About Health Disparities and Community Medicine.

Introduction: Medical providers' attitudes about caring for vulnerable populations have significant implications for persistent health disparities. Therefore, assessing medical students' self-perceived knowledge about community-based medicine and care for underserved populations can provide insights for improving health care delivery to achieve health equity. We evaluated third-year medical students' perceptions of their knowledge and attitudes about community medicine, and addressing health care needs of vulnerable populations.

What we learned in the development of a third-year medical student curricular project.

The application of continuous systems improvement in medical education can provide actionable information for curriculum development, improvement, and future planning (as reported by Bowe and Armstrong, Acad Med 92:585-92, 2017). After receiving a medical education grant, we developed a curriculum to teach medical students how to use quality improvement (QI) to address health disparities in vulnerable populations. During the process of developing and implementing this curriculum, we learned several lessons.

"It's a place that gives me hope": A qualitative evaluation of a buprenorphine-naloxone group visit program in an urban federally qualified health center.

Medication for opioid use disorder (MOUD) with buprenorphine is effective in treating opioid use disorder yet remains underutilized. Scant research has examined the experience of patients, clinic staff, and providers in a "low-threshold" group-based MOUD program. This study evaluates a "low-threshold" MOUD program at a federally qualified health center (FQHC) in Philadelphia, Pennsylvania through the perspectives of its key stakeholders.

Association of Prediabetes Status Awareness With Behaviors and Perception of Health.

Introduction: Lifestyle modification can significantly reduce the risk of developing diabetes. However, the effect of prediabetes status awareness on perceptions of health and health behaviors are mixed. We used the 2015 to 2016 National Health and Nutrition Examination Survey (NHANES) data to evaluate the association of prediabetes status awareness with self-reported perception of health and health behaviors.

Differences in Persistently Elevated Hemoglobin A1c for African American and White Patients and the Role of Provider-Level Variation.

African Americans with type 2 diabetes (T2D) have higher average A1c levels than White patients. However, few studies have examined racial disparities in diabetes management in primary care, particularly provider-level variability. Study goals were to analyze racial differences for patients with any/2 or more elevated A1cs, explore patterns of visits/providers seen in patients with ≥1 elevated A1c, and explore the contributions of provider variability in patient A1c.

Breast Cancer Screening Shared Decision-Making in Older African-American Women.

Background: Discussions about whether to continue breast cancer screening in older women are complex, particularly for African American women. Decision aids may be helpful in guiding these conversations; however, little is known about the feasibility and acceptability of using breast cancer decision aids in older African American women. This study explored African American women's knowledge of breast cancer screening guidelines in older adults, prior conversations with providers regarding continuation of screening, and their understanding/willingness to engage in discussions about individualized breast cancer screening decision-making using two versions of tested decision aids.

Retention of Patients With Multiple Vulnerabilities in a Federally Qualified Health Center Buprenorphine Program: Pennsylvania, 2017-2018.

To describe and report initial outcomes of a low-threshold, group-based primary care medication for opioid use disorder (OUD) program in a federally qualified health center. We performed a retrospective chart review of patients enrolled in the program from October 4, 2017, to October 3, 2018, in Philadelphia, Pennsylvania. The main outcome measure was time retained in treatment, defined as time from treatment initiation to unplanned treatment termination.

Attitudes Surrounding a Community-Based Fitness Intervention at an Urban FQHC.

Background And Objectives: The population surrounding an urban federally qualified health center (FQHC) in Philadelphia has poorer health than Philadelphia overall. Community residents identified aerobics and dance classes as very important services or programs that an FQHC might provide. We sought to measure the impact of participation in a resident physician-led, patient-centered fitness and nutrition class on participants' attitudes, knowledge, and self-efficacy regarding their health.

An exploratory look at comorbidities, utilization, and quality of care among obese and nonobese children in academic family medicine practice.

Background: Obesity is one of the least addressed comorbidities among children who attend family medicine clinics. The aim of this study was to apply a population health framework to understand the differences between obese and nonobese pediatric patients in academic family medicine practice with regard to general demographics, comorbidities, and quality measures.

Methods: Exploratory retrospective chart reviews were conducted among obese children aged 2-17 years and a random sample of age-matched nonobese children in 2015.

Primary Care Providers' Attitudes and Practices Regarding Cancer Screening in Older Adults.

Cancer screening decisions for older adults should be individualized. However, conducting such complex shared decisions may be challenging for primary care providers (PCPs). Additionally, there is little information about how PCPs make these decisions.

The Effect of Primary Care Team Realignment on Point-of-Care Screening.

Reporting primary care quality measures is an essential component of value-based care delivery and is part of the strategy to bend the health care cost curve. As primary care physicians are increasingly pressed for time, incorporating ancillary staff screening into pre-visit workflows can increase screening rates, but can pose a challenge in large practice settings. The objective was to improve screening rates for depression and falls risk at a large, urban primary care practice.

Policy, System, and Environment Strategies to Promote Physical Activity and Healthy Food Sources to Address Guam's Disparate Non-Communicable Disease Burden.

In 2013, the Guam Non-Communicable Disease (NCD) Consortium, Department of Public Health and Social Services, and University of Hawaii collaborated to address Guam's NCD burden. This field report describes their efforts to implement policy, system, and environmental interventions through the worksite wellness and community garden programs.