Empowering Pharmacy Technicians as Vaccine Champions: A Pilot Study in Independent Community Pharmacies.

Background: Increasing vaccine uptake in communities has been essential, even before COVID-19. The use of "vaccine champions" or "VaxChamps" has shown promise. VaxChamps, who are often community members with specialized training but no special credentials, advocate for vaccination by sharing their experiences and knowledge.

A crisis of confidence? Intervening in vaccine hesitancy in North Dakota.

In November 2020, North Dakota reported a higher number of cases and deaths per capita from COVID-19 than any other state in the United States. Several months later, it reported one of the country's highest rates of vaccine hesitancy, leading to the development and implementation of the state-funded and physician-led "Vaccine Champion" ("VaxChamp") program. Glossing the primary problem as one of "provider confidence," the VaxChamp program emphasized a standardized, scalable intervention that targeted healthcare providers directly, and patients only indirectly.

Relationship between Loneliness and Mild Behavioral Impairment: Validation of the Japanese Version of the MBI Checklist and a Cross-Sectional Study.

Background: Mild behavioral impairment (MBI) and loneliness are associated with cognitive decline and an increased risk of dementia.

Objective: Our aim was to examine the validity of the Japanese version of the MBI checklist (MBI-C) and investigate the relationship between loneliness and MBI.

Methods: The participants in this cross-sectional study included 5 cognitively normal persons and 75 persons with mild cognitive impairment.

Using a rapid ethnographic assessment to explore vaccine hesitancy on a public university campus in the Upper Midwest.

This exploratory study examined campus attitudes toward vaccines to guide subsequent development of context-relevant interventions for increasing vaccine acceptance and uptake. We gathered ethnographic data on a convenience sample of campus community members (students, faculty, staff) at a public university over six weeks in spring 2022. Student researchers conducted a rapid ethnographic assessment across campus locations.

Primary care physicians' perspectives and challenges on managing multimorbidity for patients with dementia: a Japan-Michigan qualitative comparative study.

Background: Multimorbidity management can be extremely challenging in patients with dementia. This study aimed to elucidate the approaches of primary care physicians in Japan and the United States (US) in managing multimorbidity for patients with dementia and discuss the challenges involved.

Methods: This qualitative study was conducted through one-on-one semi-structured interviews among primary care physicians, 24 each from Japan and Michigan, US.

Preparedness for a pandemic: Independent community pharmacists' experiences delivering COVID-19 vaccines.

Objective: To identify the experiences and preparedness for independent community pharmacies to deliver COVID-19 vaccines.

Design: A mixed-methods study collected quantitative and qualitative data.

Setting And Participants: Every independent community pharmacy providing COVID-19 vaccines in North Dakota.

A Novel Mixed Methods Approach Combining Geospatial Mapping and Qualitative Inquiry to Identify Multilevel Policy Targets: The Focused Rapid Assessment Process (fRAP) Applied to Cancer Survivorship.

Multi-level perspectives across communities, medical systems and policy environments are needed, but few methods are available for health services researchers with limited resources. We developed a mixed method health policy approach, the , that is designed to uncover multi-level modifiable barriers and facilitators contributing to public health issues. We illustrate with a study applying fRAP to the issue of cancer survivorship care.

Substance use disorder approaches in US primary care clinics with national reputations as workforce innovators.

Background: Over the last decade, primary care clinics in the United States have responded both to national policies encouraging clinics to support substance use disorders (SUD) service expansion and to regulations aiming to curb the opioid epidemic.

Objective: To characterize approaches to SUD service expansion in primary care clinics with national reputations as workforce innovators.

Methods: Comparative case studies were conducted to characterize different approaches among 12 primary care clinics purposively and iteratively recruited from a national registry of workforce innovators.

Neural Correlates of Mild Behavioral Impairment: A Functional Brain Connectivity Study Using Resting-State Functional Magnetic Resonance Imaging.

Background: Mild behavioral impairment (MBI) is associated with accelerated cognitive decline and greater risk of dementia. However, the neural correlates of MBI have not been completely elucidated.

Objective: The study aimed to investigate the correlation between cognitively normal participants and participants with amnestic mild cognitive impairment (aMCI) using resting-state functional magnetic resonance imaging.

Cancer Survivorship Care Roles for Primary Care Physicians.

Purpose: Despite a burgeoning population of cancer survivors and pending shortages of oncology services, clear definitions and systematic approaches for engaging primary care in cancer survivorship are lacking. We sought to understand how primary care clinicians perceive their role in delivering care to cancer survivors.

Methods: We conducted digitally recorded interviews with 38 clinicians in 14 primary care practices that had national reputations as workforce innovators.

Understanding primary care-oncology relationships within a changing healthcare environment.

Background: Management of care transitions from primary care into and out of oncology is critical for optimal care of cancer patients and cancer survivors. There is limited understanding of existing primary care-oncology relationships within the context of the changing health care environment.

Methods: Through a comparative case study of 14 innovative primary care practices throughout the United States (U.

The 3 Cs of Content, Context, and Concepts: A Practical Approach to Recording Unstructured Field Observations.

Most primary care researchers lack a practical approach for including field observations in their studies, even though observations can offer important qualitative insights and provide a mechanism for documenting behaviors, events, and unexpected occurrences. We present an overview of unstructured field observations as a qualitative research method for analyzing material surroundings and social interactions. We then detail a practical approach to collecting and recording observational data through a "3 Cs" template of content, context, and concepts.

Shifting Implementation Science Theory to Empower Primary Care Practices.

Observers of the past 10 to 15 years have witnessed the simultaneous growth of dramatic changes in the practice of primary care and the emergence of a new field of dissemination and implementation science (D&I). Most current implementation science research in primary care assumes practices are not meeting externally derived standards and need external support to meet these demands. After a decade of initiatives, many stakeholders now question the return on their investments.

Impact of subjective vs. objective remission status on subjective cognitive impairments in depression.

Objective: The impact of subjective vs. objective illness severity on subjective cognitive impairment in patients with depression has not been addressed.

Methods: This study is a post-hoc analysis of our cross-sectional study in Japanese outpatients with depressive disorder (ICD-10) (Ozawa et al.

Foods and Drinks Available from Urban Food Pantries: Nutritional Quality by Item Type, Sourcing, and Distribution Method.

The overall nutritional quality of foods/drinks available at urban food pantries is not well established. In a study of 50 pantries listed as operating in the Bronx, NY, data on food/drink type (fresh, shelf-stable, refrigerated/frozen) came from direct observation. Data on food/drink sourcing (food bank or other) and distribution (prefilled bag vs.

Improving access to specialized care for first-episode psychosis: an ecological model.

Psychotic spectrum disorders are serious illnesses with symptoms that significantly impact functioning and quality of life. An accumulating body of literature has demonstrated that specialized treatments that are offered early after symptom onset are disproportionately more effective in managing symptoms and improving outcomes than when these same treatments are provided later in the course of illness. Specialized, multicomponent treatment packages are of particular importance, which are comprised of services offered as soon as possible after the onset of psychosis with the goal of addressing multiple care needs within a single care setting.

Extraordinary Care for Extraordinary Conditions: Constructing Parental Care for Serious Mental Illness in Japan.

This article presents an account of how Japanese parents in a family support group for mental illness constructed understandings of care for adult children with serious mental illness, primarily schizophrenia. I build from Janis H. Jenkins's research on the "extraordinary condition" of schizophrenia to discuss "extraordinary care," which parents practiced as a way to refute cultural and clinical beliefs about pathogenic families and degenerative diseases.

Unreliable and Difficult-to-Access Food for Those in Need: A Qualitative and Quantitative Study of Urban Food Pantries.

For individuals who are food insecure, food pantries can be a vital resource to improve access to adequate food. Access to adequate food may be conceptualized within five dimensions: availability (item variety), accessibility (e.g.

A mixed-methods analysis of the capacity of the Patient-Centered Medical Home to implement care coordination services for cancer survivors.

There are currently 15.5 million cancer survivors in USA who are increasingly relying on primary care providers for their care. Patient-Centered Medical Homes (PCMHs) have the potential to meet the unique needs of cancer survivors; but, few studies have examined PCMH attributes as potential resources for delivering survivorship care.

Cancer Survivorship Care in Advanced Primary Care Practices: A Qualitative Study of Challenges and Opportunities.

Importance: Despite a decade of effort by national stakeholders to bring cancer survivorship to the forefront of primary care, there is little evidence to suggest that primary care has begun to integrate comprehensive services to manage the care of long-term cancer survivors.

Objective: To explain why primary care has not begun to integrate comprehensive cancer survivorship services.

Design, Setting, And Participants: Comparative case study of 12 advanced primary care practices in the United States recruited from March 2015 to February 2017.

Resilience and spirituality in patients with depression and their family members: A cross-sectional study.

Objective: The degree and quality of resilience in patients with depression have never been investigated in the context of remission status, spirituality/religiosity, and family members' resilience levels, which was addressed in this study.

Methods: This cross-sectional study recruited Japanese outpatients with depressive disorder according to ICD-10 and cohabitant family members who were free from psychiatric diagnoses. Resilience was assessed using the 25-item Resilience Scale (RS).

Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care.

Purpose: This study describes the experiences of early implementers of primary care-focused cancer survivorship delivery models.

Methods: Snowball sampling was used to identify innovators. Twelve participants (five cancer survivorship primary care innovators and seven content experts) attended a working conference focused on cancer survivorship population strategies and primary care transformation.

Emplotting Hikikomori: Japanese Parents' Narratives of Social Withdrawal.

Hikikomori, often glossed as "social withdrawal," emerged as a sociomedical condition among Japanese youth at the end of the twentieth century, and it continues to fascinate and concern the public. Explanatory frameworks for hikikomori abound, with different stakeholders attributing it to individual psychopathology, poor parenting, and/or a lack of social support structures. This article takes an interpretive approach to hikikomori by exploring parents' narrative constructions of hikikomori children in support group meetings and in-depth interviews.