Strategies to Address Racial and Ethnic Disparities in Health and Health Care for Chronic Conditions : An Evidence Map of Research From 2017 to 2024.

Background: Racial and ethnic disparities in health and health care persist in the United States, adversely affecting outcomes in prevention and treatment of chronic conditions among adults.

Purpose: To map interventions aimed at reducing racial and ethnic disparities and improving health outcomes in the prevention and treatment of chronic conditions in adults.

Data Sources: Searches of MEDLINE, CINAHL, and Scopus from January 2017 to April 2024, supplemented with gray literature.

Development and acceptability of PETS-Now, an electronic point-of-care tool to monitor treatment burden in patients with multiple chronic conditions: a multi-method study.

Background: The aim of this study was to develop a web-based tool for patients with multiple chronic conditions (MCC) to communicate concerns about treatment burden to their healthcare providers.

Methods: Patients and providers from primary-care clinics participated. We conducted focus groups to identify content for a prototype clinical tool to screen for treatment burden by reviewing domains and items from a previously validated measure, the Patient Experience with Treatment and Self-management (PETS).

Association of Burnout With Primary Care Clinician Perception of Team-Based Scheduling Support.

Introduction: Primary care clinician burnout is pervasive and detrimental. How components of teamwork and clinic culture might contribute to burnout remains unsettled.

Objective: To examine associations between primary care clinician perceptions of specific components of teamwork and of organizational culture, and perceived stress and burnout.

Longitudinal trajectories of treatment burden: A prospective survey study of adults living with multiple chronic conditions in the midwestern United States.

Objectives: Determine whether there are different longitudinal patterns of treatment burden in people living with multiple chronic conditions (MCC) and, if so, explore predictors that might reveal potential routes of intervention.

Methods: We analyzed data from a prospective mailed survey study of 396 adults living with MCC in southeastern Minnesota, USA. Participants completed a measure of treatment burden, the Patient Experience with Treatment and Self-management (PETS), and valid measures of health-related and psycho-social concepts at baseline, 6, 12, and 24 months.

Treatment Burden in People with Hypertension is Correlated with Patient Experience with Self-Management.

Introduction: New hypertension guidelines in the United States may require more people to take multiple medications or implement lifestyle changes. Increased treatment burden may be an unintended consequence and lead to worse health outcomes. Our study examined whether treatment burden is associated with factors related to self-management in those with hypertension.

Super fragmented: a nationally representative cross-sectional study exploring the fragmentation of inpatient care among super-utilizers.

Background: Super-utilizers with 4 or more admissions per year frequently receive low-quality care and disproportionately contribute to healthcare costs. Inpatient care fragmentation (admission to multiple different hospitals) in this population has not been well described.

Objective: To determine the prevalence of super-utilizers who receive fragmented care across different hospitals and to describe associated risks, costs, and health outcomes.

Health system interventions for adults with type 2 diabetes in low- and middle-income countries: A systematic review and meta-analysis.

Background: Effective health system interventions may help address the disproportionate burden of diabetes in low- and middle-income countries (LMICs). We assessed the impact of health system interventions to improve outcomes for adults with type 2 diabetes in LMICs.

Methods And Findings: We searched Ovid MEDLINE, Cochrane Library, EMBASE, African Index Medicus, LILACS, and Global Index Medicus from inception of each database through February 24, 2020.

Deriving and validating a brief measure of treatment burden to assess person-centered healthcare quality in primary care: a multi-method study.

Background: In primary care there is a need for more quality measures of person-centered outcomes, especially ones applicable to patients with multiple chronic conditions (MCCs). The aim of this study was to derive and validate a short-form version of the Patient Experience with Treatment and Self-management (PETS), an established measure of treatment burden, to help fill the gap in quality measurement.

Methods: Patient interviews (30) and provider surveys (30) were used to winnow items from the PETS (60 items) to a subset targeting person-centered care quality.

Factors Associated with Reported Colorectal Cancer Screening Among Lao-American Immigrants in Minnesota.

Colorectal Cancer (CRC) is common in Lao Americans, but screening is suboptimal. To investigate CRC screening rates of Lao Americans in Minnesota, and how predisposing characteristics, enabling resources, and perceived need are associated with screening. We conducted a convenience-sample cross-sectional survey of 50-75-year-old Lao Americans, using step-wise multivariate logistic regression to identify factors associated with ever being screened.

Integrating Community Health Workers Into Medical Homes.

Purpose: Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMHs), few PCMHs in Minnesota have incorporated these health workers into their care teams. We undertook a qualitative study to (1) identify facilitators and barriers to utilizing a CHW model among PCMHs in Minnesota, and (2) define roles played by this workforce within the PCMH team.

Methods: We conducted 51 semistructured, key-informant interviews of clinic leaders, clinicians, care coordinators, CHWs, and staff from 9 clinics (5 with community health workers, 4 without).

Validating the Patient Experience with Treatment and Self-Management (PETS), a patient-reported measure of treatment burden, in people with diabetes.

Aims: To validate a comprehensive general measure of treatment burden, the Patient Experience with Treatment and Self-Management (PETS), in people with diabetes.

Methods: We conducted a secondary analysis of a cross-sectional survey study with 120 people diagnosed with type 1 or type 2 diabetes and at least one additional chronic illness. Surveys included established patient-reported outcome measures and a 48-item version of the PETS, a new measure comprised of multi-item scales assessing the burden of chronic illness treatment and self-care as it relates to nine domains: medical information, medications, medical appointments, monitoring health, interpersonal challenges, health care expenses, difficulty with health care services, role activity limitations, and physical/mental exhaustion from self-management.

Healthcare provider relational quality is associated with better self-management and less treatment burden in people with multiple chronic conditions.

Purpose: Having multiple chronic conditions (MCCs) can lead to appreciable treatment and self-management burden. Healthcare provider relational quality (HPRQ) - the communicative and interpersonal skill of the provider - may mitigate treatment burden and promote self-management. The objectives of this study were to 1) identify the associations between HPRQ, treatment burden, and psychosocial outcomes in adults with MCCs, and 2) determine if certain indicators of HPRQ are more strongly associated than others with these outcomes.

Engaging Minority Youth in Diabetes Prevention Efforts Through a Participatory, Spoken-Word Social Marketing Campaign.

Purpose: To examine the reach, efficacy, and adoption of The Bigger Picture, a type 2 diabetes (T2DM) social marketing campaign that uses spoken-word public service announcements (PSAs) to teach youth about socioenvironmental conditions influencing T2DM risk.

Design: A nonexperimental pilot dissemination evaluation through high school assemblies and a Web-based platform were used.

Setting: The study took place in San Francisco Bay Area high schools during 2013.

The panel management questionnaire: a tool to measure panel management capability.

Primary care practices are turning toward team-based strategies such as panel management, in which nonclinicians address routine preventive and chronic disease care tasks for a group of patients. No known validated instruments have been published for measuring panel management implementation. The authors developed the 12-item Panel Management Questionnaire (PMQ) measuring 4 domains.

Development and early implementation of the bigger picture, a youth-targeted public health literacy campaign to prevent type 2 diabetes.

The prevalence of type 2 diabetes is rapidly rising, especially among minority and low-income youth. There is an unmet need to engage youth in identifying solutions to reverse this trajectory. Social marketing campaigns and entertainment education are effective forms of health communication for engaging populations in health-promoting behaviors.

Diabetes peer coaching: do "better patients" make better coaches?

Purpose: The purpose of this study was to identify characteristics of peer coaches associated with improvement in diabetes control among low-income patients with type 2 diabetes.

Methods: Low-income patients with type 2 diabetes who spoke English or Spanish from 6 urban clinics in San Francisco, California, were invited to participate in the study. Twenty participants received training and provided peer coaching to 109 patients over a 6-month peer coaching intervention.

Pilus gene pool variation and the virulence of Corynebacterium diphtheriae clinical isolates during infection of a nematode.

Toxigenic Corynebacterium diphtheriae strains cause diphtheria in humans. The toxigenic C. diphtheriae isolate NCTC13129 produces three distinct heterotrimeric pili that contain SpaA, SpaD, and SpaH, making up the shaft structure.

Adhesion by pathogenic corynebacteria.

Pathogenic members of the genus Corynebacterium cause a wide range of serious infections in humans including diphtheria. Adhesion to host cells is a crucial step during infection. In Corynebacterium diphtheriae, adhesion is mediated primarily by filamentous structures called pili or fimbriae that are covalently attached to the bacterial cell wall.

The diguanylate cyclase, Rrp1, regulates critical steps in the enzootic cycle of the Lyme disease spirochetes.

Rrp1 is the sole c-di-GMP-producing protein (diguanylate cyclase) of Borrelia burgdorferi. To test the hypothesis that Rrp1 regulates critical processes involved in the transmission of spirochetes between ticks and mammals, an rrp1 deletion mutant (B31-Δrrp1) and a strain that constitutively produces elevated levels of Rrp1 (B31-OV) were constructed. The strains were assessed for progression through the enzootic cycle using an Ixodes tick/C3H-HeJ mouse model and tick immersion feeding methods.

Identification and molecular characterization of a cyclic-di-GMP effector protein, PlzA (BB0733): additional evidence for the existence of a functional cyclic-di-GMP regulatory network in the Lyme disease spirochete, Borrelia burgdorferi.

The Borrelia burgdorferi Rrp1 protein is a diguanylate cyclase that controls a regulon consisting of approximately 10% of the total genome. Because Rrp1 lacks a DNA-binding domain, its regulatory capability is most likely mediated through the production of bis-(3'-5')-cyclic dimeric GMP (c-di-GMP). C-di-GMP binds to and activates the regulatory activity of proteins that harbor a PilZ domain.

Comparative analysis of the properties and ligand binding characteristics of CspZ, a factor H binding protein, derived from Borrelia burgdorferi isolates of human origin.

Borrelia burgdorferi CspZ (BBH06/BbCRASP-2) binds the complement regulatory protein factor H (FH) and additional unidentified serum proteins. The goals of this study were to assess the ligand binding capability of CspZ orthologs derived from an extensive panel of human Lyme disease isolates and to further define the molecular basis of the interaction between FH and CspZ. While most B.