A Compelling Health Promoting Primary Care Clinic Using a Settings-Based Approach: A Demonstration Project.

The Ottawa Charter for Health Promotion, issued by the World Health Organization in 1986, called for several strategies to promote the public's health. One of the strategies was to create health-promoting health services. Over 35 years have passed since the Ottawa Charter was released, since then, efforts to improve health care have been implemented such as the Patient-Centered Medical Home, the Triple Aim, and the Affordable Care Act, yet little has been done to reorient the cultural and physical environment of health care services to one focused on health promotion.

Profiles of Nonpharmacologic Treatment Receipt in the First 10 Weeks Following a New Back Pain Diagnosis Among Active Duty Soldiers: A Latent Class Analysis.

Introduction: US service members experience high rates of back pain. Guidelines prioritize nonpharmacologic treatment (NPT) as first-line pain treatments; however, NPT utilization patterns research is limited. This study examined NPT patterns of care within the first 10 weeks following an index back pain diagnosis.

Changes in Mental Health Services Use Under the ACA in One State: Role of Mental Health Provider Shortages.

Objective: This study aimed to examine whether changes in mental health services use under the Patient Protection and Affordable Care Act (ACA) differed in Mental Health Professional Shortage Areas (MHPSAs) versus non-MHPSAs.

Methods: Multiple waves of data from the California Health Interview Survey (2011-2018) were analyzed. The sample (N=10,497) was restricted to adults (ages 18-64) who reported experiencing serious psychological distress (SPD) during the past 12 months.

Xylazine's Impacts on the Community in Philadelphia: Perspectives of People Who Use Opioids and Harm Reduction Workers.

Background: Xylazine is in 99% of the fentanyl supply in Philadelphia, PA and is on the rise throughout the United States. Perspectives about this emerging crisis among people who use opioids (PWUO) and harm reduction workers are lacking.

Methods: We conducted focus groups with PWUO and harm reduction workers in Philadelphia, PA.

Correction: Late date of human arrival to North America: Continental scale differences in stratigraphic integrity of pre-13,000 BP archaeological sites.

[This corrects the article DOI: 10.1371/journal.pone.

Divergent trends in accidental deaths since return from an Afghanistan/Iraq deployment among army soldiers.

Purpose: Accidental death is a leading cause of mortality among military members and Veterans; however, knowledge is limited regarding time-dependent risk following deployment and if there are differences by type of accidental death.

Methods: Longitudinal cohort study (N = 860,930) of soldiers returning from Afghanistan/Iraq deployments in fiscal years 2008-2014. Accidental deaths (i.

Clinician approaches to new spine pain cases in primary care: Balance of opioid prescribing and early linkage to exercise therapy and spinal manipulation.

Rationale, Aims And Objectives: Spine pain (SP) is common and often disabling. Clinical practice guidelines discourage opioid treatment and outline the value of varied nonpharmacologic therapies (NPTs). This study elucidates the amount of variability in primary-care clinicians' (PCPs') prescribing of opioids and in their cases' receipt of the two most common NPTs (exercise therapy and spinal manipulation).

Opioid Prescription Clusters Associated With Early or Unplanned Military Separation.

Introduction: Early/unplanned military separation in Active Component U.S. service members can result in reduced readiness during periods of high-tempo combat and increased demand for health care services within the Military Health System and Veterans Administration.

Healthcare utilization and readiness outcomes among soldiers with post-deployment at-risk drinking, by multimorbidity class.

Although alcohol use disorder (AUD) regularly co-occurs with other conditions, there has not been investigation of specific multimorbidity classes among military members with at-risk alcohol use. We used latent class analysis (LCA) to cluster 138,929 soldiers with post-deployment at-risk drinking based on their co-occurring psychological and physical health conditions and indicators of alcohol severity. We examined the association of these multimorbidity classes with healthcare utilization and military readiness outcomes.

Using a rapid ethnographic assessment to explore vaccine hesitancy on a public university campus in the Upper Midwest.

This exploratory study examined campus attitudes toward vaccines to guide subsequent development of context-relevant interventions for increasing vaccine acceptance and uptake. We gathered ethnographic data on a convenience sample of campus community members (students, faculty, staff) at a public university over six weeks in spring 2022. Student researchers conducted a rapid ethnographic assessment across campus locations.

Changes in Racial and Ethnic Disparities in Use of Mental Health Services under the Affordable Care Act: Evidence from California.

Background: The Affordable Care Act (ACA) aimed to expand mental health service use in the US, by expanding access to health insurance. However, the gap in mental health utilization by race and ethnicity is pronounced: members of racial and ethnic minoritized groups remain less likely to use mental health services than non-Hispanic White individuals even after the ACA.

Aims Of The Study: This study assessed the effect of the Affordable Care Act (ACA) on mental health services use in one large state (California), and whether that effect differed among racial and ethnic groups.

Preparedness for a pandemic: Independent community pharmacists' experiences delivering COVID-19 vaccines.

Objective: To identify the experiences and preparedness for independent community pharmacies to deliver COVID-19 vaccines.

Design: A mixed-methods study collected quantitative and qualitative data.

Setting And Participants: Every independent community pharmacy providing COVID-19 vaccines in North Dakota.

Adverse childhood experiences are associated with increased overdose risk in predominately Latinx adults seeking treatment for substance use disorders.

Introduction: Almost no previous studies explored the relationship between adverse childhood experiences (ACEs) and overdose risk for individuals with substance use disorders (SUDs), and these did not focus on a Latinx population. This study examined the relationship between ACEs, reporting PTSD symptoms, and lifetime experience of overdose in a sample ( = 149) of primarily Latinx adults seeking treatment for substance use disorder (SUD).

Materials And Methods: Administrative data from an integrated behavioral health and primary care treatment system in Massachusetts were analyzed through bivariate analyses and multiple logistic regression.

Variation in prescribing of opioids for emergency department encounters: A cohort study in the Military Health System.

Unlabelled: RATIONALE, AIMS AND OBJECTIVES: Emergency department (ED) clinicians account for approximately 13% of all opioid prescriptions to opioid-naïve patients and variability in the rates of prescribing have been noted among individual clinicians and different EDs. This study elucidates the amount of variability within a unified health system (the U.S.

An Innovative Approach to Remote Electronic Health Onboarding Record Education Amid a Global Pandemic.

The COVID-19 pandemic required social and physical distancing to reduce the spread of disease. The reduction in meeting sizes made it difficult to offer traditional in-person EHR training to new and transferring employees. This paper aims to share how one nurse educator team used an innovative approach to transition traditional EHR onboarding education to synchronous remote learning during the global pandemic.

Late date of human arrival to North America: Continental scale differences in stratigraphic integrity of pre-13,000 BP archaeological sites.

By 13,000 BP human populations were present across North America, but the exact date of arrival to the continent, especially areas south of the continental ice sheets, remains unclear. Here we examine patterns in the stratigraphic integrity of early North American sites to gain insight into the timing of first colonization. We begin by modeling stratigraphic mixing of multicomponent archaeological sites to identify signatures of stratigraphic integrity in vertical artifact distributions.

Dose of Exercise Therapy Among Active Duty Soldiers With Chronic Pain Is Associated With Lower Risk of Long-Term Adverse Outcomes After Linking to the Veterans Health Administration.

Introduction: Research in soldiers who had been deployed to Iraq or Afghanistan suggests that nonpharmacological treatments may be protective against adverse outcomes. However, the degree to which exercise therapy received in the U.S.

The relationship between capacity and utilization of nonpharmacologic therapies in the US Military Health System.

Background: Nonpharmacologic therapies (NPTs) are recommended as first-line treatments for pain, however the impact of expanding professional capacity to deliver these therapies on use has not been extensively studied. We sought to examine whether an effort by the US Military Health System (MHS) to improve access to NPTs by expanding professional capacity increased NPT utilization in a cohort at higher risk for pain - Army soldiers returning from deployment.

Methods: Our study involved secondary analysis of MHS workforce data derived from the Defense Medical Human Resources System Internet (DMHRSi), and healthcare utilization data obtained from two ambulatory record systems of the Military Health System (MHS) for a sample of 863,855 Army soldiers previously deployed to Iraq or Afghanistan over a 10-year period (2008-2017).

Association between 1-year patient outcomes and opioid-prescribing group of emergency department clinicians: A cohort study with Army active-duty soldiers.

Objective: The objective was to examine the association between clinicians' opioid prescribing group and patients' outcomes among patients treated in the emergency department (ED).

Methods: This was a retrospective cohort study. The setting was the EDs of the U.