The COVID-19 pandemic shed light on the burden of behavioral health conditions prevalent in the United States (U.S.). Consequently, there is a behavioral healthcare provider shortage, particularly in rural areas, to support this need. Recently, primary care providers (PCPs) have shifted to incorporate behavioral health to their practice. However, many PCPs lack knowledge and skills to successfully manage their patients' behavioral health conditions. In response to the need for effective behavioral healthcare across the U.S. Weitzman ECHO launched the Advanced Primary Care (APC ECHO) Adult Psychiatry Module to provide continuing education (CE) for rural PCPs. This study presents the results from the APC ECHO pilot to demonstrate how CE can support PCPs in addressing their patients' mental health needs. Evaluators used a one-group repeated measures study design to assess the APC ECHO Module and understand learner outcomes and individual practice changes. Participant characteristics and individual practice changes were summarized using descriptive statistics, with support from open-ended responses to illustrate findings. Repeated measures analyses of covariance were applied to compare the differences in pre- and post-module learner outcomes. A total of 18 providers participated in the study, with the majority encompassing medical providers (72.2%). There was a significant increase in knowledge (pre-module: 21.11 + 6.99; post-module: 25.08 + 5.66; < .01), self-efficacy (pre-module: 6.89 + 3.05; post-module: 9.78 + 3.25; < .01), and skills (pre-module: 7.67 + 4.03; post-module: 10.06 + 3.23; < .05) gained over the duration of the ECHO module. Additionally, participants indicated they are applying best practices learned through the module to their patients experiencing psychiatric conditions (3.96 + 0.09). This study suggests that tailored CE for PCPs can promote an increase in knowledge, self-efficacy, and skills to apply best practices when treating patients with behavioral health conditions. This, in turn, allows patients to receive more comprehensive care and mitigates access barriers, especially for rural populations.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9817131 | PMC |
http://dx.doi.org/10.1080/10872981.2022.2164470 | DOI Listing |
JAMA Cardiol
January 2025
Center for Health Incentives and Behavioral Economics, University of Pennsylvania, Philadelphia.
Importance: A comprehensive lipid panel is recommended by guidelines to evaluate atherosclerotic cardiovascular disease risk, but uptake is low.
Objective: To evaluate whether direct outreach including bulk orders with and without text messaging increases lipid screening rates.
Design, Setting, And Participants: Pragmatic randomized clinical trial conducted from June 6, 2023, to September 6, 2023, at 2 primary care practices at an academic health system among patients aged 20 to 75 years with at least 1 primary care visit in the past 3 years who were overdue for lipid screening.
JAMA
January 2025
Division of General Internal Medicine and Geriatrics, Indiana University School of Medicine, Indianapolis.
Importance: Care management benefits community-dwelling patients with dementia, but studies include few patients with moderate to severe dementia or from racial and ethnic minority populations, lack palliative care, and seldom reduce health care utilization.
Objective: To determine whether integrated dementia palliative care reduces dementia symptoms, caregiver depression and distress, and emergency department (ED) visits and hospitalizations compared with usual care in moderate to severe dementia.
Design, Setting, And Participants: A randomized clinical trial of community-dwelling patients with moderate to severe dementia and their caregivers enrolled from March 2019 to December 2020 from 2 sites in central Indiana (2-year follow-up completed on January 7, 2023).
JAMA Netw Open
January 2025
Department of Medicine, University of Chicago, Chicago, Illinois.
JAMA Netw Open
January 2025
Department of Pediatrics, The Children's Hospital at Montefiore, Albert Einstein College of Medicine, Bronx, New York.
Importance: Pediatric obesity and hypertension are highly correlated. To mitigate both conditions, provision of counseling on nutrition, lifestyle, and weight to children with high blood pressure (BP) measurements is recommended.
Objective: To examine racial and ethnic disparities in receipt of nutrition, lifestyle, and weight counseling among patients with high BP at pediatric primary care visits stratified by patients' weight status.
JAMA Netw Open
January 2025
Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California.
Importance: Limited research explores mental health disparities between individuals in sexual and gender minority (SGM) populations and cisgender heterosexual (non-SGM) populations using national-level data.
Objective: To explore mental health disparities between SGM and non-SGM populations across sexual orientation, sex assigned at birth, and gender identity within the All of Us Research Program.
Design, Setting, And Participants: This cross-sectional study used survey data and linked electronic health records of eligible All of Us Research Program participants from May 31, 2017, to June 30, 2022.
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