Impact of the CAPTURE COPD Screening Tool in US Primary Care: A Cluster Randomized Trial.

The impact of COPD screening on US primary care clinician behavior and patient outcomes is unclear. Assess the impact of receiving CAPTURE (COPD Assessment in Primary Care to Identify Undiagnosed Respiratory Disease and Exacerbation Risk) screening scores on clinical and patient outcomes. Cluster randomized trial included 49 usual care (COPD education only) and 51 intervention (COPD and CAPTURE education plus screening scores) primary care practices.

Discriminative Accuracy of the CAPTURE Tool for Identifying Chronic Obstructive Pulmonary Disease in US Primary Care Settings.

Importance: Chronic obstructive pulmonary disease (COPD) is underdiagnosed in primary care.

Objective: To evaluate the operating characteristics of the CAPTURE (COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk) screening tool for identifying US primary care patients with undiagnosed, clinically significant COPD.

Design, Setting, And Participants: In this cross-sectional study, 4679 primary care patients aged 45 years to 80 years without a prior COPD diagnosis were enrolled by 7 primary care practice-based research networks across the US between October 12, 2018, and April 1, 2022.

Protocol Summary of the COPD Assessment in Primary Care To Identify Undiagnosed Respiratory Disease and Exacerbation Risk (CAPTURE) Validation in Primary Care Study.

Chronic obstructive pulmonary disease (COPD) often remains undiagnosed and untreated. To date, COPD screening/case finding has not been designed to identify , disease ready for therapies beyond smoking cessation. Herein, we describe the ongoing prospective, pragmatic cluster-randomized controlled trial to assess specificity and sensitivity of the OPD ssessment in rimary Care o Identify ndiagnosed espiratory Disease and xacerbation Risk (CAPTURE) tool consisting of 5 questions and peak expiratory flow.

An evaluation of the spread and scale of PatientToc™ from primary care to community pharmacy practice for the collection of patient-reported outcomes: A study protocol.

Background: Medication non-adherence is a problem of critical importance, affecting approximately 50% of all persons taking at least one regularly scheduled prescription medication and costing the United States more than $100 billion annually. Traditional data sources for identifying and resolving medication non-adherence in community pharmacies include prescription fill histories. However, medication possession does not necessarily mean patients are taking their medications as prescribed.

Experiences Applying Technology to Overcome Common Challenges in Pharmacy Practice-Based Research in the United States.

Despite the importance of pharmacy practice-based research in generating knowledge that results in better outcomes for patients, health systems and society alike, common challenges to PPBR persist. Herein, we authors describe PPBR challenges our research teams have encountered, and our experiences using technology-driven solutions to overcome such challenges. Notably, limited financial resources reduce the time available for clinicians and researchers to participate in study activities; therefore, resource allocation must be optimized.

What Peer Mentoring Adds to Already Good Patient Care: Implementing the Carpeta Roja Peer Mentoring Program in a Well-Resourced Health Care System.

Purpose: The purpose of this study was to evaluate the impact of a peer support program on the health outcomes of patients already receiving well-organized, comprehensive diabetes care.

Methods: We used a mixed-methods, nonrandomized, control-group design to evaluate the impact of a peer-mentoring program on the health outcomes and self-management behaviors of adults with type 2 diabetes in 15 primary care practices in San Antonio. Propensity score analysis, t-tests, and multivariable repeated analyses were used to evaluate impact.

The Recovery-Oriented Care Collaborative: A Practice-Based Research Network to Improve Care for People With Serious Mental Illnesses.

Practice-based research networks (PBRNs) create continuous collaborations among academic researchers and practitioners. Most PBRNs have operated in primary care, and less than 5% of federally registered PBRNs include mental health practitioners. In 2012 the first PBRN in the nation focused on individuals with serious mental illnesses-the Recovery-Oriented Care Collaborative-was established in Los Angeles.

A cross-sectional study of provider and patient characteristics associated with outpatient disclosures of dietary supplement use.

Objective: Explore patterns in patients' disclosures of supplement use and identify provider and patient characteristics associated with disclosures.

Methods: Cross-sectional study of 61 outpatient primary care, integrative medicine, and complementary medicine providers, and 603 of their patients. Primary outcomes were supplement disclosures (based on audio recorded office visits, post-visit patient surveys and medical record abstractions for the day of the visits).

Leveraging practice-based research networks to accelerate implementation and diffusion of chronic kidney disease guidelines in primary care practices: a prospective cohort study.

Background: Four practice-based research networks (PBRNs) participated in a study to determine whether networks could increase dissemination, implementation, and diffusion of evidence-based treatment guidelines for chronic kidney disease by leveraging early adopter practices.

Methods: Motivated practices from four PBRNs received baseline and periodic performance feedback, academic detailing, and weekly practice facilitation for 6 months during wave I of the study. Each wave I practice then recruited two additional practices (wave II), which received performance feedback and academic detailing and participated in monthly local learning collaboratives led by the wave I clinicians.

A pilot randomized trial of community-based parent training for immigrant Latina mothers.

This paper reports on the development and piloting of the Madres a Madres (Mothers to Mothers) program, a new, community-based parent training program designed for immigrant Latina mothers and their children. Promotoras, or female community health workers of Latina background, delivered the program in a home visitation format. A total of 194 mothers and 194 focal children (87 male, 107 female) ages 7-12 were randomized to the intervention (113 mother-child dyads) or wait-list control condition (81 mother-child dyads) over the study period.

An overview of practice facilitation programs in Canada: current perspectives and future directions.

Practice facilitation has proven to be effective in improving the quality of primary care. A practice facilitator is a health professional, usually external to the practice, who regularly visits the practice to provide support in change management that targets improvements in the delivery of care. Our environmental scan shows that several initiatives across Canada utilize practice facilitation as a quality improvement method; however, many are conducted in isolation as there is a lack of coordinated effort, knowledge translation and dissemination in this field across the country.

Practice-based research networks (PBRNs): meeting the challenges of the future.

Practice-based research networks (PBRNs) are useful tools for conducting studies in the busy primary care setting, but their continued existence is threatened by a range of challenges. PBRNs must position themselves now to be prepared to face the challenges ahead. For example, experience with the Clinical Translational Science Awards has placed PBRNs at the center of university efforts toward greater community engagement.

Quality improvement as a tool for translating evidence based interventions into practice: what the youth violence prevention community can learn from healthcare.

Health care has been working for the past 2 decades to improve the translation of evidence based practice (EBPs) into care. The strategies used to facilitate this, and lessons learned, can provide useful models for similar work taking place in youth violence prevention. This article discusses the history of evidence translation in health care, reviews key strategies used to support translation of evidence based practice into care, and suggests lessons learned that may be useful to similar efforts in youth violence prevention and intervention services.

Preventing children's aggression in immigrant Latino families: a mixed methods evaluation of the Families and Schools Together program.

The effectiveness of the evidence based program, Families and Schools Together (FAST), was examined in two inter-related studies with immigrant Latino (Mexican) families in the U.S. In Study 1, we reported findings from pre-test, 3-month post-test, and 12-month follow-up surveys of parents and children participating in the FAST program.

Field test results of a new ambulatory care Medication Error and Adverse Drug Event Reporting System--MEADERS.

Purpose: In this study, we developed and field tested the Medication Error and Adverse Drug Event Reporting System (MEADERS)-an easy-to-use, Web-based reporting system designed for busy office practices.

Methods: We conducted a 10-week field test of MEADERS in which 220 physicians and office staff from 24 practices reported medication errors and adverse drug events they observed during usual clinical care. The main outcomes were (1) use and acceptability of MEADERS measured with a postreporting survey and interviews with office managers and lead physicians, and (2) distributions of characteristics of the medication event reports.

Impact of immigration on complementary and alternative medicine use in Hispanic patients.

Background: Although previous research has demonstrated frequent complementary and alternative medicine (CAM) use by Hispanic patients, it remains unclear whether the status of immigration plays a role in the frequency and reasons for use.

Methods: A survey of 164 patients from a federally qualified health center in South Central Los Angeles was used; the health center serves a predominantly Latino immigrant patient population. The study included the following variables: patient age; sex; place of birth; number of years living in the United States; CAM use within the last year; and, if positive CAM use, what type(s) and for what condition(s).

How culture impacts the dissemination and implementation of innovation: a case study of the Families and Schools Together program (FAST) for preventing violence with immigrant Latino youth.

We consider how culture impacts the translation of research into practice, focusing on the culture of the client and the culture of the agency implementing selected programs. We build on lessons learned from a pilot study of an evidence-based family-school partnership, Families and Schools Together (FAST), to prevent youth violence with low-income, immigrant Latino families in Southern California. We examine the impact of cultural characteristics on the translation of this innovation into practice at the community level, relying on an interactive systems framework developed recently by Wandersman and colleagues (2008, American Journal of Community Psychology, 41(3-4), in press) discussed in this issue.

A comparison of unsedated colonoscopy and flexible sigmoidoscopy in the family medicine setting: an LA Net study.

Background: Colonoscopy visualizes more of the colon than flexible sigmoidoscopy. This study compares the outcomes of an unsedated modified colon endoscopy (MCE) with flexible sigmoidoscopy (FS) in family medicine practice.

Methods: We conducted a retrospective chart review of existing clinical data to compare outcomes for 48 patients undergoing MCE and 35 patients undergoing FS at 3 family medicine practices in Los Angeles.

World Health Organization's TEACH-VIP: contributing to capacity building for youth violence prevention.

Youth violence is a major public health problem in every region of the world, yet it is especially prevalent in specific settings. Youth homicide rates exceeding 10.0/100,000 occur most often in countries that are low or middle income, or which are experiencing rapid economic or social change.

American Medical Association's Youth Violence Prevention Training and Outreach Guide.

This article describes the development and contents of a training and outreach guide Connecting the Dots to Prevent Youth Violence: A Training and Outreach Guide for Physicians and Other Health Professionals (the Guide) on youth violence prevention for healthcare providers developed by the American Medical Association. The Guide, was developed to help translate recommendations made by the Commission for the Prevention of Youth Violence in their 2000 report, Youth and Violence: Medicine, Nursing, and Public Health: Connecting the Dots to Prevent Violence, into healthcare practice. The Guide, which will also be available in Spanish in early 2006, is structured as a speaker's kit and includes prepared speeches, case studies, issue briefs, and copies of screening tools and patient education materials from a variety of sources appropriate for use in the clinical setting.

What health professionals should know: core competencies for effective practice in youth violence prevention.

Background: Youth violence has been identified as a critical health concern in the United States; however, few training resources are available for preparing health professionals to contribute to prevention efforts in their professional practices. Identification of core competencies for health professionals in youth violence prevention can be used to support the development of training resources in this area of professional practice.

Methods: In 2001, experts in youth violence, health care, and health professional education from eight of the ten Academic Centers of Excellence on Youth Violence Prevention met to develop a list of core competencies that health professionals need for effective practice in youth violence prevention.

The Trager approach in the treatment of chronic headache: a pilot study.

Context: Although the traditional treatment of headache has been pharmacological, there have been many attempts to treat headaches with other methods with mixed levels of success.

Objective: To obtain preliminary data on the efficacy of the Trager approach in the treatment of chronic headache.

Design: Small-scale randomized controlled clinical trial.

Slow progress: predoctoral education in family medicine in four Latin American countries.

Background: Many countries in Latin America are seeking to expand primary care services provided through their health care systems. Family physicians are an essential component of an effective primary care workforce, but we know little about the status of family practice training in Latin America. This study examines predoctoral training in family practice in four Latin American countries and identifies factors affecting its incorporation into medical training institutions.

[Common competencies for the prevention of violence among young people].

The high prevalence of violence in children and youth has been a great concern among diverse sectors of our society. Considered as a complex public health problem, the Centers of Disease Control and Prevention (CDC) of Atlanta, Georgia, has financed local and national projects geared to its prevention. This work describes the process in which the Developing Centers of Youth Violence Prevention from the University of Puerto Rico and the University of Southern California collaborated in the development of core competencies for health professionals in youth violence prevention.