A Multi-Modality Intervention Improves Obesity Bias among Medical Students.

: Obesity is linked to chronic diseases in adults and children. Its prevalence continues to grow in the United States, necessitating the need for healthcare provider training and presenting an opportunity for the education of future medical providers. Despite this need, effectively implementing obesity education into medical school curricula has been challenging.

Group Medical Visits for Addressing Weight and Blood Pressure in an Underserved Population.

The effect of group medical visits (GMV) compared to individual medical visits (IMV), on weight and blood pressure in a large primary care practice serving a predominantly underserved population, was assessed. The records of 304 patients attending a weight-loss program were analyzed using mixed-effects regression models. Patients in GMV lost an average of 11.

Gender, psychiatric disability, and dropout from peer support specialist training.

Although research indicates that the prevalence of psychiatric disability differs depending on gender, a paucity of information exists as to whether men and women with psychiatric disability also differ regarding service program outcomes. For a United States Southwest peer support specialist training program, this study examines whether gender moderates the association between psychiatric disability and a key outcome-training dropout. Data were collected for 78 men and 157 women with psychiatric disability and 137 men and 203 women with mental illness only.

Feasibility of a family-focused YMCA-based diabetes prevention program in youth: The E.P.I.C. Kids (Encourage, Practice, and Inspire Change) Study.

Efficacious lifestyle modification programs for children at risk of type 2 diabetes (T2D) have not been well established outside of clinical settings. In this study, the feasibility of a family-focused, YMCA-based prevention program for children at risk of T2D was evaluated between September 2015 and July 2016 in Tucson, Arizona. A 12-week YMCA-led lifestyle intervention was adapted for 9-12-year-old children and their families to encourage healthy eating, physical activity, and supportive home environments.

Artificially sweetened beverages, sugar-sweetened beverages, plain water, and incident diabetes mellitus in postmenopausal women: the prospective Women's Health Initiative observational study.

Sugar-sweetened beverages (SSBs) have been associated with an increased risk of diabetes mellitus (DM), whereas the association with artificially sweetened beverages (ASBs) is unclear. We aimed to evaluate the associations of ASB and SSB consumption with the risk of developing DM and the potential benefit of replacing SSBs with ASBs or water. The national Women's Health Initiative recruited a large prospective cohort of postmenopausal women between 1993 and 1998.

Relationship Between Marital Transitions, Health Behaviors, and Health Indicators of Postmenopausal Women: Results from the Women's Health Initiative.

Background: Historically, marital status has been associated with lower mortality and transitions into marriage were generally accompanied by improved health status. Conversely, divorce has been associated with increased mortality, possibly mediated by changes in health behaviors.

Methods: This study uses data from a prospective cohort of 79,094 postmenopausal women participating in the Women's Health Initiative Observational Study (WHI-OS) to examine the relationship between marital transition and health indicators (blood pressure, waist circumference, body mass index [BMI]) as well as health behaviors (diet pattern, alcohol use, physical activity, and smoking) in a sample of relatively healthy and employed women.

The EPIC Kids Study: a randomized family-focused YMCA-based intervention to prevent type 2 diabetes in at-risk youth.

Background: It is well established that behavioral lifestyle interventions resulting in modest weight reduction in adults can prevent or delay type 2 diabetes mellitus; however in children, successful weight management interventions are rarely found outside of controlled clinical settings. The lack of effective community-based programs is a barrier to reducing obesity prevalence and diabetes risk in children. The objective of our study is to develop and test a group-randomized family-centered community-based type 2 diabetes prevention intervention targeting at-risk children, 9- to 12-years-old.

Families United/Familias Unidas: family group office visits to reduce risk factors for type 2 diabetes.

Purpose: The purpose of the Families United/Familias Unidas study was to evaluate the feasibility and efficacy of group office visits on reducing diabetes risk in a multiethnic, primary care population.

Methods: Adults, ages 18 to 70 years, with any diabetes risk factor were recruited to attend 12 group office visits over 6 months. Each participant identified 1 support person, age 14 to 70 years, to accompany them.

Cultural competence education for practicing physicians: lessons in cultural humility, nonjudgmental behaviors, and health beliefs elicitation.

Introduction: Although numerous studies have examined cultural competence training, debate still exists about efficacious approaches to this training. Furthermore, little focus has been placed on training and evaluating practicing physicians.

Methods: A skills-based course on culturally competent diabetes care was developed and subsequently tested in a controlled trial of primary physicians caring for patients enrolled in one state's Medicaid program.

Assessing culturally competent diabetes care with unannounced standardized patients.

Background And Objectives: More effective diabetes care is desperately needed, especially for ethnic minority populations. Provider cultural competence promises to be an important means for reducing disparities in outcomes for patients with diabetes. The objectives of this study were to understand the role of cultural competence in the diabetes office visit.

Intervention in overweight children improves body mass index (BMI) and physical activity.

Background: Childhood obesity is a growing epidemic in family medicine with few clinical treatment options. We implemented and evaluated a group office-visit intervention by family physicians for overweight children and their parents, emphasizing nutrition and physical activity within a resiliency psychosocial model.

Methods: The intervention lasted for 3 months, with half of the children crossing over to intervention after 6 months in the study.

Families United/Familias Unidas: development and implementation of a family-based group office visit model for the primary prevention of type 2 diabetes.

Purpose: The purpose of this study is to describe the development and implementation of a new diabetes prevention intervention that combines the benefits of family support with the group office model. Intensive lifestyle modification can effectively delay the onset of type 2 diabetes, yet health providers are challenged in translating these results to their patients. The group outpatient visit model can provide a means to address prevention issues in a financially sustainable manner.

Pilot study of impact of medical-legal partnership services on patients' perceived stress and wellbeing.

Unlabelled: Medical-legal partnerships (MLPs) bring legal services into health care settings to address patients' unmet legal needs. This pilot project examined whether MLP services impact patients' perceptions of stress and wellbeing.

Methods: Providers referred patients with legal concerns to the Tucson Family Advocacy Program (TFAP), an MLP within a family medicine clinic.

Concurrent and longitudinal predictors of self-esteem in elementary and middle school girls.

Background: The purpose of this study was to analyze the effects of factors related to self-esteem, both cross-sectionally and longitudinally, among 2 cohorts of girls over a period of 4 years, from elementary through middle school.

Methods: A multiethnic sample of 656 elementary school girls recruited from 13 schools in Hayward, CA, and Tucson, AZ, was evaluated annually over a 4-year period. The McKnight Risk Factor Survey IV was administered, which consists of 103 questions that assess self-esteem, appearance appraisal, effect of body changes, depressed mood, teasing, school performance, and other factors.

Teaching culturally effective diabetes care: results of a randomized controlled trial.

Background And Objectives: Increased cultural competence is a tool in the fight to eliminate health disparities in people with diabetes. However, questions remain regarding the best cultural competence teaching, evaluation, and dissemination methods. An Internet-based approach requires less facilitator time and provides greater ease of dissemination.

KnowPain-50: a tool for assessing physician pain management education.

Background: Despite a need for better physician pain management education, there are no widely accepted assessment or outcome measures to support this work.

Objective: Create a self-assessment tool to measure physician educational needs and the effectiveness of chronic pain educational programs.

Design: We used expert consensus to draft a 142-item survey that covered essential areas of chronic pain management.

The diverse functions of role models across primary care specialties.

Background And Objectives: This study investigated the relationship of role models to primary care specialty and gathered information on the attributes and functions of role models.

Methods: A questionnaire on medical school experiences and attitudes was administered to primary care graduates from 24 US medical schools.

Results: Questionnaires were completed by 1,457 physicians.

Family medicine specialty choice and interest in research.

Background And Objectives: This study investigated interest in research related to declining interest in family medicine by US medical school graduates.

Methods: Twenty-four schools were selected for study based on American Academy of Family Physicians data on the number of their graduates entering family medicine. Data for all graduates in 1997, 1998, and 1999 were obtained from the Association of American Medical Schools matriculation and graduation questionnaires for 23 of 24 schools.

A comparison of primary care graduates from schools with increasing production of family physicians to those from schools with decreasing production.

Background And Objectives: This study investigated factors related to declining interest in family medicine by US medical school graduates.

Methods: A questionnaire was sent to all physicians who graduated from 24 medical schools in 1997-1999, and who entered a family medicine residency, and a randomly selected equal number of graduates from the same years who entered other primary care specialties. Between 1997 and 1999, 12 of these schools had increases and 12 had decreases in the proportion of graduates choosing family medicine residencies.

Factors related to the choice of family medicine: a reassessment and literature review.

Background: Recent decreases in the number of students entering family medicine has prompted reconsideration of what is known about the factors affecting specialty choice.

Methods: Thirty-six articles on family medicine specialty choice published since 1993 were reviewed and rated for quality.

Results: Rural background related positively and parents' socioeconomic status relates negatively to choice of family medicine.

Which primary care specialty? Factors that relate to a choice of family medicine, internal medicine, combined internal medicine-pediatrics, or pediatrics.

Background And Objectives: This study was conducted to examine factors used by medical students to select a primary care specialty that may differentiate students who choose the primary care specialties of family medicine, internal medicine, pediatrics, and combined internal medicine-pediatrics.

Methods: A questionnaire was sent to all family physicians and an equal number of other primary care physicians graduating from one of 24 medical schools in 1997-1999. Twelve schools had increasing proportions of graduates choosing family medicine in this study period, and 12 had decreasing proportions.

Comments heard by US medical students about family practice.

Background And Objectives: This study was conducted to explore the hypothesis that negative comments from faculty and residents about family practice are related to the recent decline in student selection of this specialty.

Methods: A questionnaire was sent to all family physicians and an equal number of other primary care physicians who graduated from one of 24 medical schools in 1997-1999. Twelve schools had increasing proportions of graduates choosing family practice in the study period, and 12 had decreasing proportions.

Declining interest in family medicine: perspectives of department heads and faculty.

Background And Objectives: In 2003, US seniors filled 42% of family practice residency positions, the lowest percentage in the specialty's recent history. We hypothesized that institutional support, contact with family medicine faculty, and faculty satisfaction would be positively related to choice of family practice and that faculty satisfaction would be negatively affected by increasing pressure for clinical productivity.

Methods: We surveyed department heads and faculty at 24 US allopathic medical schools, selected by their rate of family medicine graduates from 1997 to 1999 and the size of the school.