Addressing food insecurity in rural primary care: a mixed-methods evaluation of barriers and facilitators.

Background: Food insecurity (FI) is associated with negative health outcomes and increased healthcare utilization. Rural populations face increased rates of FI and encounter additional barriers to achieving food security. We sought to identify barriers and facilitators to screening and interventions for FI in rural primary care practices.

"Everyone's struggling right now": Impact of COVID-19 on addressing food insecurity in rural primary care.

Background: Primary care practices can address food insecurity (FI) through routine screening, practice-based food programmes, and referrals to community resources. The COVID-19 pandemic had disproportionate impacts on health outcomes for food-insecure households.

Objective: To describe the impact of the COVID-19 pandemic on FI screening and interventions in rural primary care practices in northern New England.

Assessing and Identifying Improvements for Lung Cancer Screening in a Rural Population: A Human-Centered Design and Systems Approach.

Although lung cancer claims more lives than any other cancer in the United States, screening is severely underutilized, with <6% of eligible patients screened nationally in 2021 versus 76% for breast cancer and 67% for colorectal cancer. This article describes an effort to identify key reasons for the underutilization of lung cancer screening in a rural population and to develop interventions to address these barriers suitable for both a large health system and local community clinics. Data were generated from 26 stakeholder interviews (clinicians, clinical staff, and eligible patients), a review of key systems (Electronic Health Record and billing records), and feedback on the feasibility of several potential interventions by health care system staff.

The Impact of the COVID-19 Pandemic on Food Insecurity in Northern New England Primary and Prenatal Care Settings.

Introduction And Objective: Food insecurity (FI) is associated with adverse health outcomes across the lifespan. Primary care and prenatal practices can identify and address FI among patients through screening and interventions. It is unclear how practices and communities responded to FI during the COVID-19 pandemic, and how the pandemic may have impacted practices' FI strategies.

Sexual and Reproductive Health Content in the 3 Ps in Nurse Practitioner Education.

Background: Nurse practitioners (NPs) in primary care provide sexual and reproductive health care, an integral component of health and well-being. This study explored the degree of inclusion of sexual and reproductive health content in the foundational courses in NP preparation including advanced health assessment, advanced physiology and pathophysiology, and advanced pharmacology, known as the 3 Ps.

Method: Qualitative interviews were conducted with 30 NPs in their first 2 years of practice.

Missed opportunities to improve food security for pregnant people: a qualitative study of prenatal care settings in Northern New England during the COVID-19 pandemic.

Background: Food insecurity during pregnancy has important implications for maternal and newborn health. There is increasing commitment to screening for social needs within health care settings. However, little is known about current screening processes or the capacity for prenatal care clinics to address food insecurity among their patients.

The key to successful NP transition to practice.

This article explores the experiences of the new NP's onboarding process based on data from two qualitative studies. Interviews with 27 new graduates were used to inform the design, implementation, and experience of an onboarding program in a small healthcare setting without robust internal resources or a human resource department.

Did I learn enough to practice? Reflections of new nurse practitioner graduates in providing sexual and reproductive health care.

Background: The Centers for Disease Control and Prevention and the US Office of Population Health have published guidelines for providing family planning services.

Purpose: The study explores how nurse practitioners (NPs) perceived their preparation and competency in providing a range of sexual and reproductive health care in their first two years of community-based practice.

Methodological Orientation: Qualitative.

A Peer-Based Strategy to Overcome HPV Vaccination Inequities in Rural Communities: A Physical Distancing-Compliant Approach.

The human papilloma virus (HPV) vaccine is the world's first proven and effective vaccine to prevent cancers in males and females when administered pre-exposure. Like most of the US, barely half of Vermont teens are up-to-date with the vaccination, with comparable deficits in New Hampshire and Maine. The rates for HPV vaccine initiation and completion are as low as 33% in rural New England.

Impact of Knowledge and Risk Perceptions on Older Adults' Intention for Surveillance Colonoscopy.

Goals: The authors aimed to characterize older adults' intentions for future surveillance colonoscopy, knowledge of polyps, and predictors of colonoscopy plans.

Background: Guidelines recommend that the decision to continue or stop surveillance colonoscopy in older adults with colon polyps be "individualized." Although older adults want to be included in decision making, how knowledge regarding polyps influences decisions is unknown.

Investigation of factors influencing the implementation of two shared decision-making interventions in contraceptive care: a qualitative interview study among clinical and administrative staff.

Background: There is limited evidence on how to implement shared decision-making (SDM) interventions in routine practice. We conducted a qualitative study, embedded within a 2 × 2 factorial cluster randomized controlled trial, to assess the acceptability and feasibility of two interventions for facilitating SDM about contraceptive methods in primary care and family planning clinics. The two SDM interventions comprised a patient-targeted intervention (video and prompt card) and a provider-targeted intervention (encounter decision aids and training).

Smoke-Free Moms: Financial Rewards for Smoking Cessation by Low-Income Rural Pregnant Women.

Introduction: Maternal smoking places the child at risk during pregnancy and postpartum. Most women who quit smoking do so early when they first learn of pregnancy. Few low-income women quit once they enter prenatal care.

Longitudinal study of advanced practice nurses' implementation of screening intervals for cervical cancer screening.

Background And Purpose: The past two decades brought changes in cervical cancer screening guidelines. Frequent modifications and earlier lack of agreement about recommendations created confusion. The purpose of this study was to explore to what extent advanced practice nurses (APNs) adopted cervical cancer screening guidelines.

Right For Me: protocol for a cluster randomised trial of two interventions for facilitating shared decision-making about contraceptive methods.

Introduction: Despite the observed and theoretical advantages of shared decision-making in a range of clinical contexts, including contraceptive care, there remains a paucity of evidence on how to facilitate its adoption. This paper describes the protocol for a study to assess the comparative effectiveness of patient-targeted and provider-targeted interventions for facilitating shared decision-making about contraceptive methods.

Methods And Analysis: We will conduct a 2×2 factorial cluster randomised controlled trial with four arms: (1) video+prompt card, (2) decision aids+training, (3) video+prompt card decision aids+training and (4) usual care.