Storylines of family medicine II: foundational building blocks-context, community and health.

is a 12-part series of thematically linked mini-essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'II: foundational building blocks-context, community and health', authors address the following themes: 'Context-grounding family medicine in time, place and being', 'Recentring community', 'Community-oriented primary care', 'Embeddedness in practice', 'The meaning of health', 'Disease, illness and sickness-core concepts', 'The biopsychosocial model', 'The biopsychosocial approach' and 'Family medicine as social medicine.' May readers grasp new implications for medical education and practice in these essays.

Addressing the Social Determinants of Health in Undergraduate Medical Education Curricula: A Survey Report.

Purpose: Social determinants of health (SDH) are recognized as important factors that affect health and well-being. Medical schools are encouraged to incorporate the teaching of SDH. This study investigated the level of commitment to teaching SDH; learning objectives/goals regarding student knowledge, skills, and attitudes; location in the curriculum and teaching strategies; and perceived barriers to teaching SDH.

The Role of Cultural Psychiatry in Improving the Policy Response to Central America's Unaccompanied Minors at the American Border: Local and Global Implications.

Since 2014, children from El Salvador, Guatemala, and Honduras unaccompanied by their parents have fled in large numbers to the United States to escape violent crime and social disadvantage. Current mental health policies in the U.S.

GAP-REACH: a checklist to assess comprehensive reporting of race, ethnicity, and culture in psychiatric publications.

Growing awareness of health and health care disparities highlights the importance of including information about race, ethnicity, and culture (REC) in health research. Reporting of REC factors in research publications, however, is notoriously imprecise and unsystematic. This article describes the development of a checklist to assess the comprehensiveness and the applicability of REC factor reporting in psychiatric research publications.

Educating clinicians about cultural competence and disparities in health and health care.

An extensive body of literature has documented significant racial and ethnic disparities in health and health care. Cultural competency interventions, including the training of physicians and other health care professionals, have been proposed as a key strategy for helping to reduce these disparities. The continuing medical education (CME) profession can play an important role in addressing this need by improving the quality and assessing the outcomes of multicultural education programs.

Improving depression care for ethnic and racial minorities: a concept for an intervention that integrates CME planning with improvement strategies.

Depression is one of the most common reasons that individuals seek treatment in the primary care setting. Research in the past 15 years has shown that dramatic improvement in the management of patients with depression is possible. Advances in pharmacotherapy and delivery of depression care have been reported, but few currently benefit members of ethnic and racial minorities.

Addressing disparities in diagnosing and treating depression: a promising role for continuing medical education.

Depression is a very common reason that individuals seek treatment in the primary care setting. However, advances in depression management are often not integrated into care for ethnic and racial minorities. This supplement summarizes evidence in six key areas--current practices in diagnosis and treatment, disparities, treatment in managed care settings, quality improvement, physician learning, and community-based participatory research--used to develop an intervention concept described in the concluding article.

Caring for diverse populations: do academic family medicine practices have CLAS?

Background And Objectives: The Future of Family Medicine Final Report calls for greater emphasis on training physicians to provide culturally proficient and effective quality care to an increasingly diverse population. It remains unclear, however, how prepared academic family medicine practices are to address this need.

Methods: We carried out a qualitative sub-study (as part of a larger research study) using depth and focus group interviews at two urban family medicine centers to understand the challenges and opportunities involved in meeting the Department of Health and Human Services Office of Minority Health's National Standards for Culturally and Linguistically Appropriate Services (CLAS) in Health Care.

Antecedents to effective treatment of hypertension in Hispanic populations.

Hypertension is a common medical disorder affecting >50 million people. It is a primary modifiable risk factor to cardiovascular disease and a leading cause of death in black and Hispanic groups. This article focuses on patient-specific and physician-specific barriers that contribute to underdiagnosis, undertreatment, access issues, and poor adherence to therapy.

The relationship between ataque de nervios and unexplained neurological symptoms: a preliminary analysis.

Within somatization, unexplained neurological symptoms (UNSs) have been shown to mark a distinct subgroup with greater clinical severity. However, some UNSs resemble ataque de nervios somatic symptoms. This raises questions about cultural factors related to Hispanics with somatization characterized by UNSs.

The ETHNIC(S) mnemonic: a clinical tool for ethnogeriatric education.

Geriatrics healthcare providers need to be aware of the effect that culture has on establishing treatment priorities, influencing adherence, and addressing end-of-life care issues for older patients and their caregivers. The mnemonic ETHNIC(S) (Explanation, Treatment, Healers, Negotiate, Intervention, Collaborate, Spirituality/Seniors) presented in this article provides a framework that practitioners can use in providing culturally appropriate geriatric care. ETHNIC(S) can serve as a clinically applicable tool for eliciting and negotiating cultural issues during healthcare encounters and as a new instructional strategy to be incorporated into ethnogeriatric curricula for all healthcare disciplines.

Multicultural curricula in family practice residencies.

Background And Objectives: In 1985, results from a national survey indicated that 25% of family practice residencies taught about multicultural issues in their programs. Our current study identified the current status and content of the curricula and determined facilitating and impeding factors to multicultural curricula.

Methods: In 1998, the Society of Teachers of Family Medicine's Group on Multicultural Health Care and Education conducted a cross-sectional mail survey of all 476 family practice residency programs.

Primary care case management: a family physician's perspective.

"By working closely with other social and human services case managers, primary care physicians have the potential to play an important role in improving the delivery of needed biomedical and psychosocial services."

Reading and interpreting genograms: a systematic approach.

Family physicians continue to struggle with the problem of how to make optimal use of family information in everyday clinical practice. One important task in addressing this problem is describing systematically the categories of family information that are incorporated into the usual clinical problem-solving process used by physicians. In this article the usefulness of the genogram as a data-gathering and assessment tool is reexamined, and six information categories that can be used for generating and testing clinical hypotheses are outlined.

Display of small-area variation in health-related data: a methodology using resistant statistics.

Health care planning requires characterization of the population to be served. Examination of available demographic and epidemiologic data is one early step in this process. However, aggregate data for the entire geographic area of concern often fail to reveal important differences among geographically defined sub-populations--differences that influence the form an effective delivery system should take.

Patient satisfaction with the clinical encounter: social psychological determinants.

Patient-practitioner transactions in the ambulatory setting have become an increasingly important focus for research in recent years. In particular, there is growing interest in providing empirical support for our anecdotal, 'common-sense' notions that clinical encounter experiences are a major determinant of outcomes such as the patient's satisfaction with the encounter. The present study was designed to look at this issue and addressed the following two research questions: Is there a relationship between fulfillment of patient requests for services and patient satisfaction with the clinical encounter? and What degree of satisfaction is explained by the qualities of the encounter as compared to the characteristics of the patient, physician, and system of health care? Four newly-developed instruments were administered to a convenience sample of 144 adult patients and their physicians prior to and following actual visits to a University Family Practice Center.

Patient requests in family practice: a focal point for clinical negotiations.

A growing body of literature has stressed the importance of eliciting the patient's views on the management of health and illness. In particular, it is recognized that patients frequently enter into clinical encounters with specific requests for services, that is ideas about how they hope to be helped. The present investigation examined the following two questions: what kinds of requests do adult patients coming to a family practice center have prior to seeing the doctor; and will factor analysis of a 25-item patient request questionnaire provide evidence of the basic or most common dimensions of patient requests in this population? Two newly-developed instruments were administered to a sample of 144 adult patients before their visit to the doctor.