A theoretical explanation of naloxone provision among primary care physicians and community pharmacists in Tennessee.

Background: Increasing access to naloxone reduces opioid-related morbidity and mortality. Primary care and community pharmacy settings are critical access points, yet limited theoretical research has examined naloxone prescribing and dispensing behaviors.

Objectives: To determine if the theory of planned behavior (TPB) combined with theoretical constructs from communication science explains intentions to co-prescribe and discuss co-dispensing naloxone among primary care physicians and community pharmacists, respectively.

Primary care physicians' opioid-related prevention behaviors and intentions: A descriptive analysis.

Objective: Primary care physicians (PCPs) are positioned to mitigate opioid morbidity and mortality, but their engagement in primary, secondary, and tertiary opioid-related prevention behaviors is unclear. The objective of this study was to evaluate Tennessee PCPs' engagement in and intention to engage in multiple opioid-related prevention behaviors.

Methods: A survey instrument was developed, pretested, and pilot tested with practicing PCPs.

Community pharmacist engagement in opioid use disorder prevention and treatment behaviors: A descriptive analysis.

Objectives: This study describes community pharmacists' opioid analgesic and medication for opioid use disorder (MOUD) practice behaviors and behavioral intentions in the context of primary, secondary, and tertiary prevention of opioid use disorder (OUD).

Methods: The study sampling frame consisted of 2302 Tennessee community-practice pharmacists who were asked to complete a mailed, paper questionnaire. Behavioral intentions were elicited by asking pharmacists to indicate the number of times (0 to 10) they engage in a behavior, given 10 patients in 3 distinct vignettes.

Communication Experiences of DATA-Waivered Physicians with Community Pharmacists: A Qualitative Study.

Patients engaged in evidence-based opioid use disorder (OUD) treatment can obtain prescriptions for buprenorphine containing products from specially trained physicians that are subsequently dispensed by community pharmacists. Despite the involvement of physicians and community pharmacists in buprenorphine prescribing and dispensing, respectively, our understanding of their interactions in this context is limited. To qualitatively describe the communication and collaborative experiences between Drug Addiction Treatment Act 2000 (DATA)-waivered physicians and community pharmacists from the perspective of the physician.

Opioid Prescribing in Rural Family Practices: A Qualitative Study.

Background: Rural Tennessee, especially rural East Tennessee has seen a dramatic increase in rates of controlled drug prescriptions and controlled drug overdose deaths in recent years. However, little is known about the individual decisions to prescribe or continue prescriptions with relation to addiction concerns.

Objectives: The purpose of this study was to learn more about what factors lead to physicians' prescribing control drugs for non-cancer pain through the use of focus groups.

Interprofessional prescription opioid abuse communication among prescribers and pharmacists: A qualitative analysis.

Background: Prescribers and community pharmacists commonly perceive prescription opioid abuse to be a problem in their practice settings and communities. Both cohorts have expressed support for interventions that improve interprofessional communication and reduce prescription opioid abuse. The objective of this study was to describe prescription opioid abuse-related communication among and between prescribers and community pharmacists in South Central Appalachia.

Breaking bad news to patients with cancer: A randomized control trial of a brief communication skills training module incorporating the stories and preferences of actual patients.

Objective: This study tested the effectiveness of a brief, learner-centered, breaking bad news (BBN) communication skills training module using objective evaluation measures.

Methods: This randomized control study (N=66) compared intervention and control groups of students (n=28) and residents' (n=38) objective structured clinical examination (OSCE) performance of communication skills using Common Ground Assessment and Breaking Bad News measures.

Results: Follow-up performance scores of intervention group students improved significantly regarding BBN (colon cancer (CC), p=0.

Prescription drug abuse communication: A qualitative analysis of prescriber and pharmacist perceptions and behaviors.

Background: Interpersonal communication is inherent in a majority of strategies seeking to engage prescriber and pharmacist health care professionals (HCPs) in the reduction and prevention of prescription drug abuse (PDA). However, research on HCP PDA communication behavioral engagement and factors that influence it is limited.

Objectives: This study quantitatively examined communication behaviors and trait-level communication metrics, and qualitatively described prescription drug abuse-related communication perceptions and behaviors among primary care prescribers and community pharmacists.

Innovative patient-centered skills training addressing challenging issues in cancer communications: Using patient's stories that teach.

This workshop demonstrated the utility of a patient-centered web-based/digital Breaking Bad News communication training module designed to educate learners of various levels and disciplines. This training module is designed for independent, self-directed learning as well as group instruction. These interactive educational interventions are based upon video-recorded patient stories.

Parent report of child's health-related quality of life after a primary-care-based weight management program.

Background: Health-related quality of life (HRQoL) has been recognized as an important target and health outcome in obesity research. The current study aimed to examine HRQoL in overweight or obese children after a 10-week primary-care-based weight management program, Parent-Led Activity and Nutrition for Healthy Living, in southern Appalachia.

Methods: Sixty-seven children (ages 5-12 years) and their caregivers were recruited from four primary care clinics, two of which were randomized to receive the intervention.

Home food environment, dietary intake, and weight among overweight and obese children in Southern Appalachia.

Objectives: This study examined the relation of multiple aspects of the home food environment to dietary intake and body weight among overweight and obese children in southern Appalachia.

Methods: The study used baseline data from a cluster-randomized controlled trial, Parent-Led Activity and Nutrition for Healthy Living, evaluating a parent-mediated approach to treating child overweight and obesity in the primary care setting in southern Appalachia. Sixty-seven children ages 5 to 11 years were recruited from four primary care clinics.

Evaluation of a quality improvement curriculum for family medicine residents.

Background And Objectives: East Tennessee State University's (ETSU) Department of Family Medicine initiated Quality Improvement (QI) training in its three residency programs in 2008. The purpose of the project was to develop, implement, and assess a formal curriculum and experiential learning process to train family medicine residents in QI knowledge and skills.

Methods: Family medicine faculty members received training in QI theory and design.

Enhancing partner support to improve smoking cessation.

Background: While many cessation programmes are available to assist smokers in quitting, research suggests that partner involvement may encourage long-term abstinence.

Objectives: The purpose of this review was to determine if an intervention to enhance partner support helps smoking cessation when added as an adjunct to a smoking cessation programme, and to estimate the size of any effect.

Search Methods: For the most recent update, the search was limited to the Cochrane Tobacco Addiction Group Specialized Register.

Predictors of fetal demise after trauma in pregnant Saudi Arabian women.

In Saudi Arabia, road traffic crashes are becoming a serious public health problem and there are no recent, large-scale, published reports discussing maternal and fetal injuries. We aimed to explore the predictors of fetal death/abortion after maternal trauma. A retrospective case-control study was performed exploring cases of maternal trauma.

Parent-Led Activity and Nutrition (PLAN) for healthy living: design and methods.

Child obesity has become an important public health concern, especially in rural areas. Primary care providers are well positioned to intervene with children and their parents, but encounter many barriers to addressing child overweight and obesity. This paper describes the design and methods of a cluster-randomized controlled trial to evaluate a parent-mediated approach utilizing physician's brief motivational interviewing and parent group sessions to treat child (ages 5-11 years) overweight and obesity in the primary care setting in Southern Appalachia.

Bupropion and restless legs syndrome: a randomized controlled trial.

Introduction: Restless legs syndrome (RLS) is a common neurological disorder affecting 10% of the population. Most antidepressants exacerbate symptoms; however, correlational studies have noted symptom improvement with bupropion. The purpose of the current study was to examine whether, in a controlled study, bupropion would improve the symptoms of RLS, or at least not exacerbate them.

Primary care practice addressing child overweight and obesity: a survey of primary care physicians at four clinics in southern Appalachia.

Objective: The prevalence of childhood overweight and obesity in southern Appalachia is among the highest in the United States (US). Primary care providers are in a unique position to address the problem; however, little is known about attitudes and practices in these settings.

Methods: A 61-item healthcare provider questionnaire assessing current practices, attitudes, perceived barriers, and skill levels in managing childhood overweight and obesity was distributed to physicians in four primary care clinics.

Joint effects of child temperament and maternal sensitivity on the development of childhood obesity.

The interplay between child characteristics and parenting is increasingly implicated as crucial to child health outcomes. This study assessed the joint effects of children's temperamental characteristics and maternal sensitivity on children's weight status. Data from the National Institute of Child Health and Human Development's Study of Early Child Care and Youth Development were utilized.

Depression screening patterns for women in rural health clinics.

Context: Rates and types of screening for depression in rural primary care practices are unknown.

Purpose: To identify rates of depression screening among rural women in a sample of rural health clinics (RHCs).

Methods: A chart review of 759 women's charts in 19 randomly selected RHCs across the nation.

Reliability and validity testing of an evidence-based medicine OSCE station.

The six competencies of the Accreditation Council for Graduate Medical Education include the lifelong learning skills of evidence-based medicine (EBM)/information mastery. We developed and tested an Objective Structured Clinical Examination (OSCE) station that would measure these skills in family medicine residents. This EBM OSCE station is a 30-minute station within a regular OSCE exam.

Enhancing research in a family medicine program: one institution's story.

Background And Objectives: To enhance research productivity among East Tennessee State University's faculty, the Department of Family Medicine developed and implemented a multi-component initiative to expand multidisciplinary primary care research.

Methods: The research support infrastructure expanded to include a family physician research director, three PhD faculty researchers, two research assistants, a statistician, and a grant/science writer. A monthly seminar series, quarterly workshops, and a formal mentoring program paired more-experienced with less-experienced faculty researchers.

Women's preventive screening in rural health clinics.

Context: Despite the strong interest in health care quality, little is known about the quality of preventive care among women in rural primary care settings.

Purpose: We sought to assess the quality of screening practices in Rural Health Clinics (RHCs) as measured by the rates at which female patients received screening within national guidelines.

Methods: A cross-sectional, retrospective chart review of 480 charts of female patients in 12 randomly selected RHCs was conducted.

Child overweight interventions in rural primary care practice: a survey of primary care providers in southern Appalachia.

Child overweight has reached an epidemic level throughout the United States. A total of 65 primary care providers in southern Appalachia were surveyed to understand current issues in addressing child overweight in rural primary care practice. The study shows that while providers realized the importance of child overweight intervention, many were not ready and did little to address child overweight in their practices.

Primary care providers' perceptions of home diabetes telemedicine care in the IDEATel project.

Context: Few telemedicine projects have systematically examined provider satisfaction and attitudes.

Purpose: To determine the acceptability and perceived impact on primary care providers' (PCP) practices of a randomized clinical trial of the use of telemedicine to electronically deliver health care services to Medicare patients with diabetes in federally designated medically underserved areas of upstate New York, primarily those in rural areas and small towns with limited access to primary care.

Methods: A longitudinal phone survey was completed by 116 PCPs with patients with diabetes in the treatment arm of the trial, and conducted 12 and 24 months after a PCP's first patient was randomized to the home telemedicine arm of the trial.