Facilitators and Barriers to Implementing a Patient-Centered Oncology Care Model.

Purpose: Oncology practices often serve as the "medical home" for patients but may not have systems to support all aspects of patient-centered care. We piloted a new set of oncology medical home standards that call for accessible, continuous, coordinated, and team-based care. We examined how adoption of the standards varies across a variety of practices and compared practice self-report with external evaluation of implementation.

Health Quality Measures Addressing Disparities in Culturally and Linguistically Appropriate Services: What are Current Gaps?

Purpose: Disparities in health care persist among many at-risk groups. This study examines the current state of health quality measures addressing disparities and culturally and linguistically appropriate services (CLAS), and identifies important gaps in existing measures and their implementation.

Methods: We searched key quality reporting databases and websites to identify measures and structural program requirements addressing disparities or CLAS.

Lessons From Early Implementation of a Patient-Centered Care Model in Oncology.

Purpose: Oncology practices may serve as the primary health provider for patients with cancer and the so-called neighbor during periods of transition and survivorship. New standards for patient-centered oncology practice articulate expectations for the primary health provider and neighbor roles. We report the implementation experiences of five oncology practices participating in a pilot of these standards.

Overcoming challenges to teamwork in patient-centered medical homes: a qualitative study.

Background: There is emerging consensus that enhanced inter-professional teamwork is necessary for the effective and efficient delivery of primary care, but there is less practical information specific to primary care available to guide practices on how to better work as teams.

Objective: The purpose of this study was to describe how primary care practices have overcome challenges to providing team-based primary care and the implications for care delivery and policy.

Approach: Practices for this qualitative study were selected from those recognized as patient-centered medical homes (PCMHs) via the most recent National Committee for Quality Assurance PCMH tool, which included a domain on practice teamwork.

There's more than one way to build a medical home.

Objectives: The patient-centered medical home (PCMH) is a critical aspect of delivery system reform. The purpose of this study was to examine variations in achievement of PCMH requirements across different types of practices.

Study Design: We used data on the points awarded, by standard and element, to 2369 practices recognized by September 2013 under the National Committee for Quality Assurance PCMH program, 2011 version.

Context matters: the experience of 14 research teams in systematically reporting contextual factors important for practice change.

Purpose: We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors.

Methods: Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important to interpreting their findings (internal validity) and transporting or reinventing their findings in other settings/situations (external validity). Each team provided a table or list of important contextual factors and interpretive text included as appendices to the articles in this supplement.

Support and strategies for change among small patient-centered medical home practices.

Purpose: We aimed to determine the motivations and barriers facing small practices that seek to adopt the patient-centered medical home (PCMH) model, as well as the type of help and strategies they use.

Methods: We surveyed lead physicians at practices with fewer than 5 physicians, stratified by state and level of National Committee for Quality Assurance PCMH recognition, using a Web-based survey with telephone, fax, and mail follow-up. The response rate was 59%, yielding a total sample of 249 practices from 23 states.

South Asian American perspectives on overweight, obesity, and the relationship between weight and health.

Introduction: Compared with other racial groups, South Asian adults develop type 2 diabetes and cardiovascular disease at a lower body mass index (BMI). Perceptions of weight and the effect of weight on health can influence weight-loss attempts but are not well described in this population. The objective of this study was to examine perceptions of weight appropriateness and the effect of weight on health among South Asian Americans.

Classification of health plans based on relative resource use and quality of care.

Objective: To examine variation among commercial health plans in resource use and quality of care for patients with diabetes mellitus or cardiovascular disease.

Study Design: Cohort study using Healthcare Effectiveness Data and Information Set data submitted to the National Committee for Quality Assurance in 2008.

Methods: Composite measures were estimated for diabetes and cardiovascular disease resource use and quality of care.

Patient-centered medical homes in the United States.

The concept of a medical home is receiving increased attention as a potential means to improve care and reduce costs. This study describes the characteristics and capabilities of practices that have achieved recognition of National Committee for Quality Assurance as a "patient-centered medical home" (PCMH). Both small and large practices demonstrate capabilities related to the goals of PCMH of accessible, coordinated, and patient-centered care; however, practices affiliated with larger organizations achieve higher levels of PCMH recognition compared with unaffiliated small practices.

Explanatory models of coronary heart disease among South Asian immigrants.

Objective: This study investigated South Asians' explanatory models (EM) of CHD and compared them to the biomedical model as part of an effort to inform the development of culturally targeted CHD prevention messages.

Methods: We conducted in-depth, semi-structured interviews in English, Hindi and Urdu with 75 respondents from a federally qualified health center and at a community center for South Asian immigrants in Chicago, Illinois.

Results: While EMs of CHD included risk factors from the biomedical model, they also included psychosocial and spiritual risk factors.

Knowledge gaps and misconceptions about coronary heart disease among U.S. South Asians.

Background: Although South Asians are at higher risk for coronary heart disease (CHD) than most other U.S. racial/ethnic groups, very little research has addressed this disparity.

Explanatory models of health and disease among South Asian immigrants in Chicago.

To identify concepts of health and disease as part of a study on designing culturally-targeted heart disease prevention messages for South Asians. We conducted qualitative, semi-structured interviews in English, Hindi and Urdu with 75 respondents from a federally qualified health center and at a community center for South Asian immigrants in Chicago, Illinois. Age ranged from 20 to 70 years; 60% were women; 60% held advanced degrees; 70% migrated to the US in the last 10 years; and 60% of the interviews were in Hindi or Urdu.

Racial and ethnic differences in activities of daily living disability among the elderly: the case of Spanish speakers.

Objective: To compare incident disability patterns across racial and ethnic groups.

Design: Prospective cohort study with 6-year follow-up (1998-2004).

Setting: National probability sample.