Understanding primary care provider's knowledge and perceptions of diabetes self-management education and support.

Objective: The American Diabetes Association Standards of Care recommends that individuals with diabetes receive self-management education, but the utilization of these services remains low. This study explores primary care providers' knowledge and perceptions of diabetes self-management education and support (DSMES).

Study Design: A convergent mixed methods study design grounded in the Theoretical Domains Framework was conducted with an initial provider survey, followed by semi-structured interview of a purposeful sub-sample of providers.

EHR Smart Phrases Used as Enrollment Mechanism in Diabetes Self-Management Support Programs: Preliminary Outcomes.

Diabetes in the United States is increasing rapidly. Innovative strategies are needed for diabetes prevention and self-management. This study assessed the usability, acceptability, and awareness of an electronic health record (EHR) tool for referring patients to a community-based diabetes self-management support program.

"It's a proactive intervention instead of a reactive one": measuring facilitators and barriers regarding readiness to implement a treatment program for infants with neonatal opioid withdrawal syndrome.

Background: Managing Abstinence in Newborns (MAiN) is an evidence-based, cost-saving approach to caring for infants at risk of developing neonatal opioid withdrawal syndrome (NOWS). MAiN provides medication management in combination with education and is being implemented in hospitals across South Carolina (SC). This expansion of MAiN throughout the state includes educational training for providers on managing NOWS symptomology and evaluation support for data collection and analysis.

Health Extension for Diabetes: Impact of a Community-Based Diabetes Self-Management Support Program on Older Adults' Activation.

Objective: The goals of this study were to determine whether completion of a community-based diabetes self-management support (DSMS) program delivered through a university Cooperative Extension network increased Patient Activation Measure (PAM) scores and to examine predictors of improvement in PAM score in individuals participating in the DSMS.

Methods: The Health Extension for Diabetes (HED) is a 4-month program delivered via a paraprofessional extension agent in partnership with an established diabetes self-management education and support program. The study population included 148 adults (median age 69 years; interquartile range 60-74 years) with diabetes recruited from local community organizations.

SARS-CoV-2 Viral Incidence, Antibody Point Prevalence, Associated Population Characteristics, and Vaccine Attitudes, South Carolina, February 2021.

The SARS-CoV-2 outbreak from October 2020 through February 2021 was the largest outbreak as of February 2021, and timely information on current representative prevalence, vaccination, and loss of prior antibody protection was unknown. In February 2021, the South Carolina Department of Health and Environmental Control conducted a random sampling point prevalence investigation consisting of viral and antibody testing and an associated health survey, after selecting participants aged ≥5 years using a population proportionate to size of South Carolina residents. A total of 1917 residents completed a viral test, 1803 completed an antibody test, and 1463 completed ≥1 test and a matched health survey.

Enhancing the practice of medicine with embedded multi-disciplinary researchers in a model of change.

Successfully embedding researchers in a health care setting brings unique challenges and opportunities. Through a joint clinical and academic partnership, we have developed a novel approach to problem-solving in the health care context, by employing a model for leading through change to embed researchers in transformative initiatives. Using the model, we have been able to leverage our local environment and resources to engage multi-disciplinary researchers in solving complex issues.

The Act of Listening Well: Improving Communication Skills through Bibliotherapy.

Health professions education programs have the ability to educate future healthcare professionals on the technical aspects of medicine and physical function, yet it is difficult to provide students with the skills to effectively communicate with patients. Communication is a critical competency for all healthcare professionals, and it is well-documented that patient-provider communication is an important factor in affecting patient views and care outcomes. In this essay, a program of bibliotherapy, or reading therapy, is explored as a means to teach health professions students to effectively and compassionately communicate with patients.

Factors associated with longer endocrine therapy use by South Carolina Medicaid-insured breast cancer survivors.

Purpose: The objective of this study is to determine demographic, clinical, and pharmaceutical factors that are associated with longer endocrine therapy usage duration.

Methods: South Carolina Central Cancer Registry incidence data linked with South Carolina Medicaid prescription claims and administrative data were used. The study included a sample ( = 1399) of female South Carolina Medicaid recipients with hormone receptor-positive breast cancer diagnosed between 2000 and 2012 who filled at least one ET prescription.

Endocrine therapy use in the twenty-first century: usage rates and temporal trends illustrate opportunities for improvement for South Carolina Medicaid women.

Purpose: This study examines endocrine therapy (ET) non-initiation, non-adherence, and duration by age, race, temporal trend for South Carolina Medicaid-enrolled women diagnosed with estrogen receptor-positive breast cancer between 2000 and 2014 (N = 3830).

Methods: Age, race, relative risk, and median duration of ET use were compared. Temporal trends in ET non-initiation, non-adherence, and duration were observed using linear and logistic regression models, controlling for age and race.

Early Treatment Innovation for Opioid-Dependent Newborns: A Retrospective Comparison of Outcomes, Utilization, Quality, and Safety, 2006-2014.

Background: Few coordinated treatment programs address the needs of infants and families struggling with the effects of substance use. In 2003 a large Southeastern regional hospital launched the Managing Abstinence in Newborns (MAiN) program, providing multidisciplinary, coordinated, community-based care for neonatal abstinence syndrome (NAS). A hypothesis-generating study was conducted to compare the outcomes of MAiN infants to comparable NAS infants receiving traditional care from 2006 through 2014 in South Carolina.

Potential for Medicaid Savings: A State and National Comparison of an Innovative Neonatal Abstinence Syndrome Treatment Model.

In recent years, neonatal abstinence syndrome (NAS) rates have increased rapidly across the United States, rising from 1.2 (2000) to 5.8 (2012) per 1000 hospital births annually.

Enhancing mHealth Technology in the Patient-Centered Medical Home Environment to Activate Patients With Type 2 Diabetes: A Multisite Feasibility Study Protocol.

Background: The potential of mHealth technologies in the care of patients with diabetes and other chronic conditions has captured the attention of clinicians and researchers. Efforts to date have incorporated a variety of tools and techniques, including Web-based portals, short message service (SMS) text messaging, remote collection of biometric data, electronic coaching, electronic-based health education, secure email communication between visits, and electronic collection of lifestyle and quality-of-life surveys. Each of these tools, used alone or in combination, have demonstrated varying degrees of effectiveness.

Early Treatment for Neonatal Abstinence Syndrome: A Palliative Approach.

 To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal.  This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth.  For this cohort, mean length of stay was 8.

Assessing medical student cultural competence: what really matters.

Objectives: The study aimed to explore medical students' attitudes and beliefs toward Latino patients, specifically: to assess students' levels of knowledge, cultural competence, and comfort with Latinos; to determine students' exposure to and previous experience with Latinos; and to evaluate whether factors such as study abroad, living abroad, previous clinical experience with Latinos, and language proficiency predict Latino knowledge, cultural competence, and comfort with Latinos.

Methods: This study utilized a cross-sectional survey design. Participants were third and fourth year medical students at three medical schools in the Southeastern United States.

Cutting Corners: Provider Perceptions of Interpretation Services and Factors Related to Use of an Ad Hoc Interpreter.

Introduction: This study assessed health providers' perceptions of factors related to professional interpretation services and the association between these factors and the potential use of ad hoc interpreters.

Method: Data were collected from a convenience sample of 150 health services providers at a large, regional health system in South Carolina.

Results: Providers rated "ability to communicate effectively during a clinical encounter" as paramount regarding the use of interpretation services.

Preparing for patient-centered care: assessing nursing student knowledge, comfort, and cultural competence toward the Latino population.

As the Latino population continues to grow throughout the United States, cultural competence training of nursing students at the baccalaureate level has become a priority. This study aimed to explore undergraduate nursing students' attitudes and beliefs toward Latino patients and their perceived readiness to provide care to Latino patients. A cross-sectional survey was conducted at four major nursing schools in the southeastern United States, which is the region that has seen the highest percentage of growth in the Latino population.

Content, placement, and acquisition of cancer education for Latino patient care: a qualitative study of medical and nursing students.

A focus group study was conducted with five medical and nursing education programs in Southeastern USA. Twenty-five third and fourth year students were queried about their experiences, beliefs, and attitudes regarding Latino patients and cancer care. A general inductive process using open coding and content comparison to identify emerging themes was used to analyze the qualitative data.

Mentoring in health services management: reflections on an evolving training ground.

Since the University of Chicago Health Management program was first initiated in 1932, programs and health delivery organizations have dealt with the issue of how to best provide a meaningful transition from academia to entry-level management. Today, new challenges face the same old questions: New federal legislation and increased demand for a finite supply of services cause increased revenue and expense pressures and result in the need for a higher performance level by a well-coordinated management team. In addressing these challenges, mentoring is an essential requirement for survival and success in health services.

Targeting cardiovascular risk: early identification of insulin resistance.

Purposes: To review current data regarding the known pathophysiology of insulin resistance and its associated sequelae related to cardiovascular risk, to discuss the current measures for insulin sensitivity and studies associated with measures of insulin resistance, and to summarize the impact of insulin resistance.

Data Sources: CINAHL, Health and Wellness Resource Center, and Medline.

Findings: Insulin resistance yields a diminished sensitivity of key target cells to the actions of insulin and is present early in the course of insulin resistance syndrome, also known as metabolic syndrome, leading to prediabetes and cardiovascular disease approximately 10 years before the diagnosis of type 2 diabetes.

Mapping competencies for the multiskilled health care professional: an allied health curriculum reform project.

Health care organizations increasingly face the pressures of meeting the needs of patients while responding to the financial pressures of cost containment and quality optimization. One strategy that health care providers use to adapt to the changing environment is multiskilling. Multi-skilled health care technicians are trained to perform multiple tasks so that they can be deployed more efficiently within health care organizations.

Educational and health services innovation to improve care for rural Hispanic communities in the US.

Background: Access to comprehensive and quality health care services is difficult for socioeconomically disadvantaged groups in rural regions. Barriers to health care for rural Latinos include lack of insurance, language barriers and cultural differences. For the Latino immigrant population in rural areas, barriers to access are compounded.

MD/MBA Students: An Analysis of Medical Student Career Choice.

Background: An increasing number of medical schools are offering dual degree MD/MBA programs. Career choices and factors influencing students to enter these programs provide an indicator of the roles in which dual degree students will serve in health care as well as the future of dual degree programs.

Purpose: Using career choice theory as a conceptual framework, career goals and factors influencing decisions to enter dual degree programs were assessed among dual degree medical students.