Implementing and monitoring high-quality community health worker care in adult primary care at New York City Health + Hospitals.

Background: This study describes how New York City (NYC) Health + Hospitals implemented a large-scale Community Health Worker (CHW) program in adult primary care clinics between January 2022 and December 2023 and established metrics to monitor program implementation. This study is timely as healthcare systems consider how to scale high-quality CHW programs.

Methods: We collected metrics in the following areas: (1) Workforce demographics, team structure, and training; (2) Enrolled patient demographics; (3) Patient-centered metrics, such as patient counts (e.

An Unconditional Cash Transfer Program for Low-Income New Yorkers Affected by COVID-19.

Early in the pandemic, New York City's public hospital system partnered with multiple philanthropic foundations to offer an unconditional cash transfer program for low-income New Yorkers affected by COVID-19. The $1000 cash transfers were designed to help people meet their most immediate health and social needs and were incorporated into healthcare delivery and contact tracing workflows as a response to the public health emergency. To better understand program recipients' experiences, researchers conducted 150 telephone surveys with randomly sampled cash transfer recipients and 20 in-depth qualitative interviews with purposefully sampled survey participants.

Factors associated with COVID-19 vaccine receipt at two integrated healthcare systems in New York City: a cross-sectional study of healthcare workers.

Objectives: To examine the factors associated with COVID-19 vaccine receipt among healthcare workers and the role of vaccine confidence in decisions to vaccinate, and to better understand concerns related to COVID-19 vaccination.

Design: Cross-sectional anonymous survey among front-line, support service and administrative healthcare workers.

Setting: Two large integrated healthcare systems (one private and one public) in New York City during the initial roll-out of the COVID-19 vaccine.

Cross-sectional study evaluating the seroprevalence of SARS-CoV-2 antibodies among healthcare workers and factors associated with exposure during the first wave of the COVID-19 pandemic in New York.

Objective: Estimate the seroprevalence of SARS-CoV-2 antibodies among New York City Health and Hospitals (NYC H+H) healthcare workers during the first wave of the COVID-19 pandemic, and describe demographic and occupational factors associated with SARS-CoV-2 antibodies among healthcare workers.

Design: Descriptive, observational, cross-sectional study using a convenience sample of data from SARS-CoV-2 serological tests accompanied by a demographic and occupational survey administered to healthcare workers.

Setting: A large, urban public healthcare system in NYC.

Surge and Mortality in ICUs in New York City's Public Healthcare System.

Objectives: To evaluate the impact of ICU surge on mortality and to explore clinical and sociodemographic predictors of mortality.

Design: Retrospective cohort analysis.

Setting: NYC Health + Hospitals ICUs.

IMPACT OF MULTIDISCIPLINARY PROCESS IMPROVEMENT INTERVENTIONS ON GLUCOMETRICS IN A NONCRITICALLY ILL SETTING.

This study aimed to assess the impact of multidisciplinary process improvement interventions on glycemic control in the inpatient setting of an urban community hospital, utilizing the daily simple average as the primary glucometric measure. From 2010-2014, five process of care interventions were implemented in the noncritical care inpatient units of the study hospital. Interventions included education of medical staff, implementation of hyperglycemia and hypoglycemia protocols, computerized insulin order entry, and coordination of meal tray delivery with finger stick and insulin administration.

Study protocol for a pragmatic trial of the Consult for Addiction Treatment and Care in Hospitals (CATCH) model for engaging patients in opioid use disorder treatment.

Background: Treatment for opioid use disorder (OUD) is highly effective, yet it remains dramatically underutilized. Individuals with OUD have disproportionately high rates of hospitalization and low rates of addiction treatment. Hospital-based addiction consult services offer a potential solution by using multidisciplinary teams to evaluate patients, initiate medication for addiction treatment (MAT) in the hospital, and connect patients to post-discharge care.

Insulin non-persistence among people with type 2 diabetes: how to get your patients to stay on insulin therapy.

Continuing use of medication is key to effective treatment and positive health outcomes, particularly in chronic conditions such as diabetes. However, in primary care, non-persistence (i.e.

Telephone Intervention to Improve Diabetes Control: A Randomized Trial in the New York City A1c Registry.

Introduction: Scalable self-management interventions are necessary to address suboptimal diabetes control, especially among minority populations. The study tested the effectiveness of a telephone behavioral intervention in improving glycemic control among adults with diabetes in the New York City A1c Registry.

Design: RCT comparing a telephone intervention to print-only intervention in the context of the A1c Registry program.

Impact of a focused nutrition educational intervention coupled with improved access to fresh produce on purchasing behavior and consumption of fruits and vegetables in overweight patients with diabetes mellitus.

Purpose: The purpose of this study was to test the impact of distributing coupons redeemable at farmers markets plus an educational intervention on fruit and vegetable (F&V) purchase and consumption in overweight patients with type 2 diabetes (T2DM).

Methods: Seventy-eight participants with T2DM being followed at Jacobi Medical Center, a large public hospital in the Bronx, New York, were randomized to receive the standard of care or a 1-hour session focused on benefits of F&V consumption and $6 in coupons. Questionnaires assessed demographics, F&V intake, and farmers market purchasing at baseline and 12 weeks.

Predictors of sustained reduction in energy and fat intake in the Diabetes Prevention Program Outcomes Study intensive lifestyle intervention.

Background: Few lifestyle intervention studies examine long-term sustainability of dietary changes.

Objective: To describe sustainability of dietary changes over 9 years in the Diabetes Prevention Program and its outcomes study, the Diabetes Prevention Program Outcomes Study, among participants receiving the intensive lifestyle intervention.

Design: One thousand seventy-nine participants were enrolled in the intensive lifestyle intervention arm of the Diabetes Prevention Program; 910 continued participation in the Diabetes Prevention Program Outcomes Study.

Dietary patterns in Blacks and Hispanics with diagnosed diabetes in New York City's South Bronx.

Background: An understanding of dietary patterns in diverse populations may guide the development of food-based, rather than nutrient-based, recommendations.

Objective: We identified and determined predictors of dietary patterns in low-income black and Hispanic adults with diagnosed diabetes.

Design: A food-frequency questionnaire was used to assess dietary intake in 235 adults living in the South Bronx, New York City, NY.

Training residents in obesity counseling: incorporating principles of motivational interviewing to enhance patient centeredness.

Background: The US Preventive Services Task Force and the American Academy of Pediatrics recommend that physicians screen patients for obesity and practice counseling interventions to achieve modest (4%-8%) weight loss. Despite this, physicians frequently do not document obesity and/or counsel on weight loss. Our goal was to develop an innovative, easily disseminated workshop to improve resident physicians' skills and confidence in weight-loss counseling.

Diabetes-specific quality of life after a low-carbohydrate and low-fat dietary intervention.

Purpose: The purpose of the study was to examine the impact of a 12-month weight loss intervention with either a low-carbohydrate or a low-fat diet on quality of life (QOL) among obese patients with type 2 diabetes.

Methods: Participants were enrolled in a randomized trial comparing a low-carbohydrate to a low-fat diet in type 2 diabetes. QOL was assessed with the Diabetes-39 questionnaire, which measures QOL within 5 distinct scales: anxiety and worry, diabetes control, energy and mobility, social burden, and sexual functioning.

Differential effects of low-carbohydrate and low-fat diets on inflammation and endothelial function in diabetes.

Objective: To characterize acute (postprandial) and chronic (after a 6-month period of weight loss) effects of a low-carbohydrate vs. a low-fat diet on subclinical markers of cardiovascular disease (CVD) in adults with type 2 diabetes.

Design: At baseline and 6 months, measures of C-reactive protein (CRP), interleukin-6 (IL-6), soluble intercellular adhesion molecule (sICAM) and soluble E-selectin were obtained from archived samples (n = 51) of participants randomized in a clinical trial comparing a low-carbohydrate and a low-fat diet.

Low-carbohydrate diets: an update on current research.

The diabetes and obesity epidemics have stimulated research to assess the benefits and potential risks of low-carbohydrate diets. Carbohydrate comprises less than 45% of calories in carbohydrate-restricted diets, but very low carbohydrate ketogenic diets may restrict carbohydrate to 20 g initially with variability in the carbohydrate level subsequently. Some research suggests that low-carbohydrate diets may achieve better early weight loss than comparison diets higher in carbohydrate.

Trends and disparities in provider diagnosis of overweight analysis of NHANES 1999-2004.

Rates of overweight and obesity are disproportionately high within minority populations. This study examined the trends in provider diagnosis of overweight from 1999 to 2004 and examined whether there were differences in provider diagnosis based on race/ethnicity. We examined data from 4,071 adults with BMI >or=30 who participated in the National Health and Nutrition Examination Surveys (NHANES) (1999-2004).

Comparative study of the effects of a 1-year dietary intervention of a low-carbohydrate diet versus a low-fat diet on weight and glycemic control in type 2 diabetes.

Objective: To compare the effects of a 1-year intervention with a low-carbohydrate and a low-fat diet on weight loss and glycemic control in patients with type 2 diabetes.

Research Design And Methods: This study is a randomized clinical trial of 105 overweight adults with type 2 diabetes. Primary outcomes were weight and A1C.

Serum potassium changes with initiating low-carbohydrate compared to a low-fat weight loss diet in type 2 diabetes.

Objective: To evaluate the change in potassium after initiating a low-carbohydrate or low-fat weight loss diet.

Methods: Participants randomized to a low-carbohydrate (low-CHO) or a low-fat diet had serum potassium measured at baseline, 3 days, 1 week, 2 weeks, and 1 month after dietary initiation. Paired t tests and repeated measure analysis of variance (ANOVA) compared changes within each subject and between groups.

Resident physician attitudes and competence about obesity treatment: need for improved education.

Background: Obesity is a common problem in primary care, but little is known about Internal Medicine residents' attitudes towards obesity treatment.

Objective: To describe resident attitudes about obesity treatment.

Methods: Cross-sectional survey of 101 Internal Medicine residents in Philadelphia, PA, and Bronx, NY.

Obesity management: physician practice patterns and patient preference.

Purpose: The purpose of this study was to assess inner-city clinic patient attitudes about weight loss counseling and to assess practice behaviors of primary care physicians in residency training.

Methods: This is a cross-sectional survey of consecutive patients attending an outpatient internal medicine resident continuity clinic in the Bronx, New York. Participants completed a 30-item questionnaire; a 17-item Quick Weight, Activity & Excess Screener (WAVE); and 13 items to assess patients' attitudes about the physician's role in weight management.