Lifestyle Medicine Implementation in Family Medicine Clinic.

Lifestyle medicine, a patient-centered approach promoting healthy lifestyle behaviors, is an evidence-based tool for preventing and treating chronic diseases. It has been shown to reduce the burden of physical and psychological diseases. Despite this, clinical implementation is lagging, with physicians facing barriers effectively encouraging lifestyle change.

Exploring Correlates of Resource Insecurity Among Older Black or African Americans with HIV in Ohio.

Objectives: Resource insecurity is a social determinant of health that can impact people with HIV (PWH), in particular older African Americans (AA) or blacks with HIV. The purpose of this study was to identify resource insecurities among older Blacks or AA PWH specifically related to food and housing. Secondary focus was to find associations between resource insecurity and substance use history, stigma, and various forms of discrimination.

Internalized HIV stigma and viral suppression: examining the mediating and moderating roles of substance use and social support.

Objective: The aim of this study was to examine the effects of internalized HIV stigma on viral nonsuppression via depressive symptoms, alcohol use, illicit drug use, and medication adherence and investigate whether social support moderates these effects.

Design: Longitudinal observational clinical cohort of patients in HIV care in the US.Methods: Data from the CFAR Network for Integrated Clinical Systems (2016-2019) were used to conduct structural equation models (SEM) to test the indirect effects of internalized HIV stigma on viral nonsuppression through depressive symptoms, illicit drug use, alcohol use, and medication adherence.

Compassionate Curiosity: Mitigating the Effects of Bias Through Motivational Interviewing.

There is strong evidence that the implicit biases of health care professionals affect the treatment of patients, and that minority and other marginalized patients are disproportionately harmed. Assumptions made about patient knowledge or lack thereof function as judgments that are prone to bias, which then affect the education and advice imposed upon patients. We review how the motivational interviewing (MI) approach to patient engagement includes components of evidence-based bias-mitigating strategies, such as understanding circumstances from the patient's point of view, and therefore we propose that the MI approach can reduce the impact of bias in patient care.

Interface Between Motivational Interviewing and Burnout.

Background: The contemporary challenges of improving patient engagement in chronic disease management and addressing the growing problem of physician burnout are commonly viewed as separate issues. However, there is extensive evidence that person-centered approaches to patient engagement, such as motivational interviewing (MI), are associated both with better outcomes for patients and improved well-being for clinicians.

Methods: We conducted an exploratory survey study to ascertain whether resident physicians who perceive that they embrace and utilize the MI approach also report less burnout.

Motivational interviewing skills practice enhanced with artificial intelligence: ReadMI.

Background: Finding time in the medical curriculum to focus on motivational interviewing (MI) training is a challenge in many medical schools. We developed a software-based training tool, "Real-time Assessment of Dialogue in Motivational Interviewing" (ReadMI), that aims to advance the skill acquisition of medical students as they learn the MI approach. This human-artificial intelligence teaming may help reduce the cognitive load on a training facilitator.

A Refined Teach-back Observation Tool: Validity Evidence in a Pediatric Setting.

Background: Teach Back (TB) is recommended to assess and ensure patient understanding, thereby promoting safety, quality, and equity. There are many TB trainings, typically lacking assessment tools with validity evidence. We used a pediatric resident competency-based communication curriculum to develop initial validity evidence and refinement recommendations for a Teach-back Observation Tool (T-BOT).

Implantable arterial doppler efficacy in free flap reconstruction: A systematic review and meta-analysis.

The implantable arterial doppler (IAD) is frequently used to postoperatively monitor free flaps with high accuracy, but there are no guidelines for its use. Bedside exam is used adjunctively to determine necessary intervention. This systematic review seeks to discover why the doppler is used adjunctively despite its established record of accuracy.

The Psychometric Properties of the World Health Organization Quality of Life-BREF Questionnaire in College Students.

Because there are conflicting perspectives on the factor structure of the World Health Organization Quality of Life-BREF (WHOQOL-BREF) Questionnaire among college students, we evaluated the psychometric properties of the instrument in a sample of U.S. college students.

PRESTO: Promoting Engagement for the Safe Tapering of Opioids.

Twenty-four percent of all U.S. opioid overdose deaths involve a prescription opioid.

Perception versus Reality: A Review of Narcotic Prescribing Habits After Common Laparoscopic Surgeries.

Introduction: Data on how surgeons perceive their habits of prescribing narcotics compared to their actual practice are scarce. This study examines the perception and actual narcotic prescribing habits of surgeons and advanced practitioners.

Methods: Surgical residents, attendings, and advanced practice providers (APPs) were surveyed to assess their perceived prescribing habits at discharge for laparoscopic appendectomy and laparoscopic cholecystectomy.

Exploring the Impact of Experiences with Everyday and Major Discrimination and HIV-Related Stigma on Engagement in HIV Care Among Older African Americans Living with HIV.

Objectives: The purpose of this pilot study was to explore the effect of HIV-related stigma and everyday major experiences of discrimination on medication and clinic visit adherence among older African Americans living with HIV in Ohio.

Methods: We collected data from 53 individuals who were living with HIV in Ohio, ≥ 50 years of age, and who identified as Black or African American. We conducted logistic regression models to examine the impact of HIV-related stigma and experiences of discrimination on medication and visit adherence.

Perceptions of the SARS-CoV2 pandemic: a small comparative survey analysis between language preference populations in a United States community health center.

In 2019, a new variant of coronavirus, SARS-CoV-2 (COVID-19) created a global pandemic that has highlighted and exacerbated health disparities. Educating the general public about COVID-19 is one of the primary mitigation strategies amongst health professionals. English is not the preferred language for an estimated 22% of the United States population making effective mass communication efforts difficult to achieve.

An Interactive Game with Virtual Reality Immersion to Improve Cultural Sensitivity in Health Care.

Purpose: Biased perceptions of individuals who are not part of one's in-groups tend to be negative and habitual. Because health care professionals are no less susceptible to biases than are others, the adverse impact of biases on marginalized populations in health care warrants continued attention and amelioration.

Method: Two characters, a Syrian refugee with limited English proficiency and a black pregnant woman with a history of opioid use disorder, were developed for an online training simulation that includes an interactive life course experience focused on social determinants of health, and a clinical encounter in a community health center utilizing virtual reality immersion.

Patient-Identified Markers of Quality Care: Improving HIV Service Delivery for Older African Americans.

Background: Over 50% of new AIDS/HIV diagnoses are older adults and disproportionately African American people. Longstanding health inequities, driven by the enduring nature of systemic racism, pose challenges to obtaining optimal HIV services. Patient experiences and identities shape the health care experience, yet patient voices are often minimized, including their assessment of quality HIV care.

Exploring the Impacts of Alcohol and Other Drug Use on HIV Care Among Older African American Adults in Kentucky: A Constructivist Grounded Theory Study.

This grounded theory study examined the use of alcohol and other drugs (AOD) on the management of HIV disease among 27 older African Americans (≥50 years). Interview transcripts were analyzed using constructivist grounded theory analytic techniques. Participants reported facing (a) environmental impacts of AOD use and (b) discrimination from the health care system.

"The Heart is a House": A Heuristic for Generating Cardiac Differential Diagnoses.

Background: Differential diagnosis (DDx) is a core clinical reasoning skill that all medical students and physicians must acquire and develop. Metamemory techniques (MMTs), including mnemonic devices and other heuristics, are frequently taught to students as a means of enhancing DDx generation. (HIAH) an MMT that works by prompting students to think about cardiac disease in terms of four structural subsystems, can be used to facilitate the generation of cardiac differentials, but its efficacy has not been studied.

Cigarette smoking cessation and mental health treatment receipt in a U.S national sample of pregnant women with mental illness.

Objectives: To (1) compare the probability of cigarette smoking cessation for pregnant women with and without past-year mental illness by the trimester of pregnancy; and (2) examine the association between the receipt of past-year mental health treatment and prenatal cigarette smoking cessation among pregnant lifetime-smokers with mental illness.

Methods: We conducted secondary analysis of data from the National Survey on Drug Use and Health (NSDUH) 2008-2014. The NSDUH included 2019 pregnant lifetime smokers aged 18-44 years, 528 of whom had a mental illness.

Unmasking bias and perception of lead surgeons in the operating room: A simulation based study.

Background: Perception of a surgeon based on physical attributes in the operating room (OR) environment has not been assessed, which was our primary goal.

Methods: A common OR scenario was simulated using 8 different actors as a lead surgeon with combinations of age (<40 vs. >55), race (white vs.

Laboratory markers predictive of fulminant infection refractory to fluid resuscitation.

Background: Old age, leucocytosis, hypoalbuminemia, and elevated creatinine have been identified as risk factors for fulminant infection (CDI). High ATLAS scores have also been linked to fatal disease. The affiliated studies, however, involved patients prescribed metronidazole - a regimen no longer standard of care.

Advancing Motivational Interviewing Training with Artificial Intelligence: ReadMI.

Background: Motivational interviewing (MI) is an evidence-based, brief interventional approach that has been demonstrated to be highly effective in triggering change in high-risk lifestyle behaviors. MI tends to be underutilized in clinical settings, in part because of limited and ineffective training. To implement MI more widely, there is a critical need to improve the MI training process in a manner that can provide prompt and efficient feedback.

Promoting Motivational Interviewing in Primary Care: More Than Intention.

Introduction: Interacting with patients in a manner that furthers self-responsibility for health is an important skill for primary care clinicians. Motivational interviewing (MI) is such an approach to patient engagement, but it remains to be more widely implemented. In a program training health professionals and health professions students in MI, we examined posttraining attitudes and intentions regarding the utilization of MI.

The distribution of Ohio's Certificates to Recommend: who will "prescribe" medical marijuana?

Background: Under Ohio Medical Marijuana Control Program rules, Ohio physicians that recommend medical marijuana (MMJ) to patients must possess a Certificate to Recommend (CTR) from the State Medical Board. Although a pre-program state survey indicated that more than a quarter of Ohio physicians were likely to recommend MMJ, only 473 physicians obtained CTRs in the first year of the program, amounting to just 1.39% of the physician workforce.