The Colorado Immersion Training in Community Engagement (CIT) program supports a change in the research trajectory of junior faculty, early career researchers, and doctoral students toward Community-Based Participatory Research (CBPR). CIT is within the Community Engagement and Health Equity Core (CEHE) at the Colorado Clinical and Translational Sciences Institute (CCTSI), an NIH-funded Clinical and Translational Science award. This Translational Science Case Study reports on CIT's impacts from 2010 to 2019.
View Article and Find Full Text PDFBackground: The difference in survival between sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) remains controversial.
Objective: To investigate the comparative survival difference between SG and RYGB in adults with morbid obesity.
Setting: A meta-analysis.
Background: Continuous glucose monitoring (CGM) for patients with type 1 and type 2 diabetes is associated with improved clinical, behavioral, and psychosocial patient health outcomes and is part of the American Diabetes Association's Standards of Medical Care. CGM prescription often takes place in endocrinology practices, yet 50% of adults with type 1 diabetes and 90% of all people with type 2 diabetes receive their diabetes care in primary care settings. This study examined primary care clinicians' perceptions of barriers and resources needed to support CGM use in primary care.
View Article and Find Full Text PDFPurpose: Opioid dependence and use disorders (OUDs) are serious public health crises resulting in a rising number of opioid-related deaths. Medication assisted treatment (MAT), in this case treatment with buprenorphine, is an evidence-based solution to combatting OUD; however, MAT has been largely unavailable in rural areas. This study investigated what it took to increase MAT in rural Colorado primary care practices.
View Article and Find Full Text PDFWe present here the case of a woman in her 40s with a history of an adjustable gastric band placed a decade ago. After the initial procedure, she had issues with a port-site hernia, mesh placement, and explantation secondary to mesh infection. Her port was removed at the time, with the tubing left in situ with hopes of future salvage.
View Article and Find Full Text PDFThe usual challenges of conducting primary care research, including randomized trials, have been exacerbated, and new ones identified, during the COVID-19 pandemic. HOMER (Home versus Office for Medication Enhanced Recovery; subsequently, Comparing Home, Office, and Telehealth Induction for Medication Enhanced Recovery) is a pragmatic, comparative-effectiveness research trial that aims to answer a key question from patients and clinicians: What is the best setting in which to start treatment with buprenorphine for opioid use disorder for this patient at this time? In this article, we describe the difficult journey to find the answer. The HOMER study began as a randomized trial comparing treatment outcomes in patients starting treatment with buprenorphine via induction at home (unobserved) vs in the office (observed, synchronous).
View Article and Find Full Text PDFBackground: Diabetes self-management education and support can be effectively and efficiently delivered in primary care in the form of shared medical appointments (SMAs). Comparative effectiveness of SMA delivery features such as topic choice, multi-disciplinary care teams, and peer mentor involvement is not known.
Objective: To compare effects of standardized and patient-driven models of diabetes SMAs on patient-level diabetes outcomes.
Purpose: To understand motivators, concerns, and factors associated with COVID-19 vaccine initiation for adults in five racial/ethnic communities across Colorado.
Methods: Community-based data collectors surveyed participants from five Colorado communities (urban and rural Latina/o/x, urban Black, rural African American immigrant, and urban American Indian) about vaccine attitudes, intentions, and uptake from September to December 2021. Bivariate and multivariable logistic regression models were used to examine factors associated with the primary outcome of COVID-19 vaccine "initiation.
We present a case of a woman in her 60s, with a history of a gastric sleeve resection, over 50% excess body weight loss, and subsequent severe gastroesophageal reflux disease refractory to maximal medical therapy, who underwent a conversion of a sleeve gastrectomy to a Roux-en-Y gastric bypass with hiatal hernia repair. On postoperative day five, she was evaluated at our emergency department for vomiting and inability to tolerate oral intake. Imaging revealed a large retrocardiac hiatal hernia and extraluminal contrast extravasation.
View Article and Find Full Text PDFBackground: Engaging patients and community members in healthcare implementation, research and evaluation has become more popular over the past two decades. Despite the growing interest in patient engagement, there is scant evidence of its impact and importance. Boot Camp Translation (BCT) is one evidence-based method of engaging communities in research.
View Article and Find Full Text PDFFam Med Community Health
April 2024
is a 12-part series of thematically linked essays with accompanying illustrations that explore the many dimensions of family medicine, as interpreted by individual family physicians and medical educators in the USA and elsewhere around the world. In 'V: ways of thinking-honing the therapeutic self', authors present the following sections: 'Reflective practice in action', 'The doctor as drug-Balint groups', 'Cultivating compassion', 'Towards a humanistic approach to doctoring', 'Intimacy in family medicine', 'The many faces of suffering', 'Transcending suffering' and 'The power of listening to stories.' May readers feel a deeper sense of their own therapeutic agency by reflecting on these essays.
View Article and Find Full Text PDFProviding communities with COVID-19 vaccination information is essential for optimizing equitable vaccine uptake. Using rapid community translation, adapted from Boot Camp Translation, five community teams transcreated COVID-19 vaccination campaigns. Transcreated messaging incorporated community attitudes, culture, and experiences.
View Article and Find Full Text PDFOpioid use disorder (OUD) represents a public health crisis in the United States. Medication for opioid use disorder (MOUD) with buprenorphine in primary care is a proven OUD treatment strategy. MOUD induction is when patients begin withdrawal and receive the first doses of buprenorphine.
View Article and Find Full Text PDFContext: Continuous glucose monitoring (CGM) for patients with type 1 and type 2 diabetes is associated with improved patient health outcomes including reduced glycated hemoglobin (A1c) and hypoglycemia and is part of ADA Standards of Medical Care. CGM prescription often takes place in endocrinology practices. With limited access to endocrinologists, many patients could benefit from receiving CGM through primary care.
View Article and Find Full Text PDFPurpose: Diabetes affects approximately 34 million Americans and many do not achieve glycemic targets. Continuous glucose monitoring (CGM) is associated with improved health outcomes for patients with diabetes. Most adults with diabetes receive care for their diabetes in primary care practices, where uptake of CGM is unclear.
View Article and Find Full Text PDFThe Balint Method has been used worldwide since Michael and Enid Balint developed it in the 1950s. Even with the proliferation of Balint groups there were still doctors and other clinicians who did not have local access. The online format was developed to provide Balint groups to those individuals.
View Article and Find Full Text PDFIntroduction: Obesity is one of the leading public health concerns with over half a million Americans being classified as obese and almost two billion classified as overweight. This has an impact on overall health of the individual, with increased comorbidities and premature death, as well as increased economic cost. This study evaluates the weight loss of patients with limited societal support and resources cared for at a single bariatric center of excellence, The Center for Surgical Weight Control, in Cabell County, West Virginia.
View Article and Find Full Text PDFPurpose: Evidence supports treatment for opioid use disorder (OUD) with buprenorphine in primary care practices (PCPs). Barriers that slow implementation of this treatment include inadequately trained staff. This study aimed to increase the number of rural PCPs providing OUD treatment with buprenorphine.
View Article and Find Full Text PDFIn 2018, general surgery topped the number of robotic cases. Over 90% of residents participate, but only 65% of programs have a formal curriculum, and less than half track progress. Many are insufficient at training due to an observational role.
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