Measuring a Critical Component of Contraceptive Decision Making: The Contraceptive Concerns and Beliefs Scale.

Introduction: Concerns about safety and side effects from contraceptives are widespread and related to reluctance to use them. Measuring these concerns is an essential component of understanding contraceptive decision-making and guiding contraceptive and interpregnancy clinical care.

Methods: We used qualitative research and item response theory to develop and test a psychometric instrument to measure contraceptive concerns and beliefs.

Effect of Social Needs Case Management on Hospital Use Among Adult Medicaid Beneficiaries : A Randomized Study.

Background: Case management programs assisting patients with social needs may improve health and avoid unnecessary health care use, but little is known about their effectiveness.

Objective: This large-scale study assessed the population-level impact of a case management program designed to address patients' social needs.

Design: Single-site randomized encouragement design with administrative enrollment from an eligible population and intention-to-treat analysis.

Intersecting systemic and personal barriers to accessing social services: qualitative interviews in northern California.

Background: Addressing social risks in the clinical setting can increase patient confidence in the availability of community resources and may contribute to the development of a therapeutic alliance which has been correlated with treatment adherence and improved quality of life in mental health contexts. It is not well understood what barriers patients face when trying to connect to community resources that help address social risks. This paper aims to describe patient-reported barriers to accessing and using social needs-related resources to which they are referred by a program embedded in a safety net primary care clinic.

Patient Perspectives on Addressing Social Needs in Primary Care Using a Screening and Resource Referral Intervention.

Background: Interest is growing in interventions to address social needs in clinical settings. However, little is known about patients' perceptions and experiences with these interventions.

Objective: To evaluate patients' experiences and patient-reported outcomes of a primary care-based intervention to help patients connect with community resources using trained volunteer advocates.

Adherence to planned risk management interventions in Swedish forensic care: What is said and done according to patient records.

Both structured and unstructured clinical risk assessments within forensic care aim to prevent violence by informing risk management, but research about their preventive role is inconclusive. The aim of this study was to investigate risk management interventions that were planned and realized during forensic care by analysing patient records. Records from a forensic clinic in Sweden, covering 14 patients and 526 months, were reviewed.

Physician champions are key to improving antibiotic prescribing quality.

Background: The previously reported IMPAACT study was a cluster randomized controlled trial of a patient and physician educational intervention designed to reduce antibiotic prescribing for acute respiratory tract infections (ARIs) in emergency departments (EDs) in the United States. On average, the intervention resulted in a modest improvement in antibiotic prescribing behavior at the end of Year 1 and further improvement after Year 2. Yet the intervention's impact was large at some sites but minimal or even negative at others.

Perceived social support among adults seeking care for acute respiratory tract infections in US EDs.

Emergency departments (EDs) provide a disproportionate amount of care to disenfranchised and vulnerable populations. We examined social support levels among a diverse population of adults seeking ED care for acute respiratory tract infections. A convenience sample of adults seeking care in 1 of 15 US EDs was telephone interviewed 1 to 6 weeks postvisit.

C-reactive protein testing does not decrease antibiotic use for acute cough illness when compared to a clinical algorithm.

Background: Antibiotics are commonly overused in adults seeking emergency department (ED) care for acute cough illness.

Objective: To evaluate the effect of a point-of-care C-reactive protein (CRP) blood test on antibiotic treatment of acute cough illness in adults.

Methods: A randomized controlled trial was conducted in a single urban ED in the United States.

Cluster-randomized trial to improve antibiotic use for adults with acute respiratory infections treated in emergency departments.

Study Objective: We evaluate the effectiveness of an educational program in hospital emergency departments (EDs) targeting reduction in antibiotic overuse for acute respiratory tract infections.

Methods: Sixteen hospitals participated in the cluster randomized trial, selecting a Veterans Administration (VA) and non-VA hospital within each of 8 metropolitan regions. Intervention sites received performance feedback, clinician education, and patient educational materials, including an interactive computer kiosk located in the waiting room.

Antibiotic treatment of acute respiratory infections in acute care settings.

Objectives: To examine the patterns of antibiotic use for acute respiratory tract infections (ARIs) in acute care settings.

Methods: Chart reviews were performed retrospectively on a random sample of adult ARI visits to seven Veterans Affairs (VA) and seven non-VA emergency departments (EDs) for the period of November 2003 to February 2004. Visits were limited to those discharged to home and those with primary diagnoses of antibiotic-responsive (pneumonia, acute exacerbation of chronic bronchitis, pharyngitis, sinusitis) and antibiotic-nonresponsive conditions (acute bronchitis, nonspecific upper respiratory tract infection [URI]).

Randomized clinical trial of the efficacy of bupropion combined with nicotine patch in the treatment of adolescent smokers.

Adolescent smokers (N = 211) were randomized to 1 of 2 groups: (a) nicotine patch plus bupropion SR (sustained release; 150 mg per day) or (b) nicotine patch plus placebo. Group skills training sessions were conducted each week by research staff. Abstinence rates at Weeks 10 and 26 were as follows: (a) patch plus bupropion, 23% and 8%, (b) patch plus placebo, 28% and 7%.