Real-World Massage Therapy Produces Meaningful Effectiveness Signal for Primary Care Patients with Chronic Low Back Pain: Results of a Repeated Measures Cohort Study.

Objective: While efficacy of massage and other nonpharmacological treatments for chronic low back pain is established, stakeholders have called for pragmatic studies of effectiveness in "real-world" primary health care. The Kentucky Pain Research and Outcomes Study evaluated massage impact on pain, disability, and health-related quality of life for primary care patients with chronic low back pain. We report effectiveness and feasibility results, and make comparisons with established minimal clinically important differences.

The Intersection of Massage Practice and Research: Community Massage Therapists as Research Personnel on an NIH-funded Effectiveness Study.

Introduction: Few NIH funded studies give community massage therapists the opportunity to become study personnel. A recent NIH/NCCAM-funded study investigating chronic low back pain (CLBP) recruited, trained, and utilized community massage practitioners (CMPs) as study personnel. This study's aim was to determine whether health-related outcomes for CLBP improve when patients are referred from primary care to select CAM modalities including massage therapy (MT).

Diabetes and cancer screening rates among Appalachian and non-Appalachian residents of Kentucky.

Background: Having diabetes may increase the odds of late-stage breast cancer. In Kentucky, the rates of late-stage disease are higher in rural than in urban areas, particularly in rural Appalachia. The objectives of the study were to examine the relationship between diabetes and cancer screening and to determine whether Appalachia residence modifies this association.

Colorectal cancer screening: patients' and physicians' perspectives on decision-making factors.

While patient barriers to colorectal cancer (CRC) screening have been identified, how well this knowledge is utilized during the patient-physician interaction is not fully understood. This study aims to assess among primary care physicians the degree of consensus between perceived and actual patients' CRC screening decision-making influential factors. During 2004-2006, 30 patients were interviewed to identify factors influencing screening decisions and 66 physicians were interviewed to understand what factors they thought were important to patients.

Cancer risk assessment by rural and Appalachian family medicine physicians.

Context: Challenges to the identification of hereditary cancer in primary care may be more pronounced in rural Appalachia, a medically underserved region.

Purpose: To examine primary care physicians' identification of hereditary cancers.

Methods: A cross-sectional survey was mailed to family physicians in the midwestern and southeastern United States, stratified by rural/non-rural and Appalachian/non-Appalachian practice location (n = 176).

Cardiovascular risk education and social support (CaRESS): report of a randomized controlled trial from the Kentucky Ambulatory Network (KAN).

Purpose: Test a practice-based intervention to foster involvement of a relative or friend for the reduction of cardiovascular risk in patients with type 2 diabetes.

Methods: We enrolled in a randomized controlled trial 199 patients and 108 support persons (SPs) from 18 practices within a practice-based research network. All patient participants had type 2 diabetes with suboptimal blood pressure control and were prepared to designate a SP.

Six-year update on the financial status of US Family Medicine Departments.

Background: The financial climate for academic family medicine departments is increasingly threatened by reductions in federal funding and ever more competitive health care markets.

Objectives: Our objective was to evaluate the financial status of US Departments of Family Medicine, comparing 1998 and 2004 data.

Methods: In 1999 and 2005, family medicine department chairs were surveyed for the Association of Departments of Family Medicine.

Patient safety in after-hours telephone medicine.

Objectives: This study analyzed our family medicine department's after-hours telephone medicine systems at an academic health center from a patient safety perspective. The research questions were (1) What are the threats to patient safety associated with after-hours telephone medicine and (2) What kinds of errors are made during after-hours telephone medicine?

Methods: Subjects were patients at the University of Kentucky family medicine practice who called in to the after-hours answering service. Telephone interviews were conducted with 64 patients over 10 weeks.

Patients, practices, and relationships: challenges and lessons learned from the Kentucky Ambulatory Network (KAN) CaRESS clinical trial.

The Cardiovascular Risk Education and Social Support (CaRESS) study is a randomized controlled trial that evaluates a social support intervention toward reducing cardiovascular risk in type 2 diabetic patients. It involves multiple community-based practice sites from the Kentucky Ambulatory Network (KAN), which is a regional primary care practice-based research network (PBRN). CaRESS also implements multiple modes of data collection.

Communication about complementary and alternative medicine: perspectives of primary care clinicians.

Background: People in the United States are using complementary and alternative medicine (CAM) increasingly while they are also receiving conventional care. National population-based surveys and studies in primary care settings have documented inadequate communication about CAM between patients and their conventional healthcare providers. Most studies about CAM communication have surveyed urban practices and focused on physicians.

Practices and Perceptions of Family Practice Residency Directors toward International Medical Graduate Applicants: A National Survey.

Purpose - International Medical Graduates (IMGs) are increasingly filling Family Medicine residency positions. (1) To what extent are residency programs recruiting and accepting IMG applicants? (2) What are program directors' perceptions of IMG applicants? (3) What program characteristics are associated with their practices and perceptions? Methods - A 2002 national survey of Family Medicine program directors assessed program demographics and directors' recruiting practices and perceptions regarding IMG applicants. Results - Although 88% of respondents would rank IMG applicants, only 40% agreed that they would perform as well as U.

Information-seeking behaviors of practitioners in a primary care practice-based research network (PBRN).

Objective: The aim of this study was to examine the information-seeking behaviors (e.g., information resource usage patterns, access to types of sources and to medical libraries, and use of particular information technologies) of members in a primary care practice-based research network (PBRN) to inform future efforts supporting primary care practitioners in their daily care of patients.

How and why to study the practice content of a practice-based research network.

Background: We describe the rationale, methods, and important lessons learned from doing a practice content study in a new practice-based research network (PBRN).

Methods: We performed a modified replication of the National Ambulatory Medical Care Survey (NAMCS) in the Kentucky Ambulatory Network (KAN). Network clinicians had input into focused modifications of the NAMCS protocol, including addition of data fields of special interest to them.

Current state of information technology use in a US primary care practice-based research network.

Objectives: To examine the current levels of information technology (IT) use in a primary care practice-based research network (PBRN) in order to inform future development of its infrastructure.

Participants: Every primary care practitioner who is a member of the Kentucky Ambulatory Network (KAN),as well as the office managers of each practice. Practitioners included family practitioners, general practitioners, nurse practitioners and physician assistants.

Exploration of the relationship between continuity, trust in regular doctors and patient satisfaction with consultations with family doctors.

Objective: To determine the influence of longitudinal continuity and trust in patients' regular family doctors on patient satisfaction with consultations.

Design: Observational questionnaire study.

Setting: Three family practice centres in the USA and four general practices in the UK.