Patient reactions to proactive tobacco cessation counseling using a decision aid in primary care: A qualitative study.

Medications for smoking cessation can double quit rates but are underused in primary care. This qualitative study aimed to explore: (1) patients' perspectives regarding having their general practitioner (GP) use a proactive approach to smoking cessation treatment using an encounter decision aid (DA), and (2) their expectations regarding their GP's role. We conducted qualitative semi-structured interviews with participants of the FIRST randomized trial (adults who smoke daily with any level of motivation for tobacco quitting).

Bayesian hierarchical network autocorrelation models for estimating direct and indirect effects of peer hospitals on outcomes of hospitalized patients.

Unlabelled: When an hypothesized peer effect (also termed social influence or contagion) is believed to act between units (e.g., hospitals) above the level at which data is observed (e.

Healthcare providers' experiences of maternity care service delivery during the COVID-19 pandemic in the United Kingdom: a follow-up systematic review and qualitative evidence synthesis.

Problem And Background: During the COVID-19 pandemic, there was substantial reconfiguration of maternity care services, affecting both users and healthcare providers (HCPs), in the United Kingdom (UK) and globally.

Aim: To further our understanding of the impact of maternity service reconfigurations in the UK, from the perspective of maternity HCPs.

Methods: Scopus, MEDLINE, EMBASE, CINAHL, PsycINFO and the Cochrane COVID Study Register were searched for relevant studies reporting qualitative data from the UK, published in English between 01 June 2021 and 30 September 2023.

Traumatic Brain Injury and Risk of Incident Comorbidities.

Importance: Traumatic brain injury (TBI) is associated with chronic medical conditions. Evidence from diverse clinical administrative datasets may improve care delivery.

Objective: To characterize post-TBI risk of incident neuropsychiatric and medical conditions in a California health care system administrative database and validate findings from a Massachusetts dataset.

Nurse practitioner race and ethnicity and interest in independent primary care practice and serving Medicaid enrollees.

Nurse practitioners (NPs) are important providers of primary care to underserved populations, particularly in areas with lower physician supply. In 2023, California implemented new regulations aimed at improving access to care, especially primary care services, by providing a pathway for NPs to practice without formal supervision after 3 years of practice and without any physician relationship after 5 years of practice. This study used data from a representative survey of California-licensed NPs fielded in late 2022 to examine NPs' current practice and intentions following implementation of the new regulations.

"I didn't go into medicine just to be on the phone": Emotional Expression as Sacrosanct During Derious Illness Patient-Physician Advanced Cancer Care Communication During the COVID-19 Pandemic.

Guided by communication accommodation theory, we studied 27 physician reports of patient-physician advanced cancer communication during the COVID-19 pandemic. Advanced cancer communication requires recognizing patients' psychosocial states and collaboratively engaging patients empathetically to develop the shared understanding necessary to guide decision-making. However, physicians found their communication underaccommodated, stemming from personal protection equipment, social distancing, and telemedicine.

Effect of Rurality on Type of Clinicians Delivering Psychotherapy and Prescribing Antidepressants to Veterans.

Objective: Mental health care is delivered by teams that include social workers, psychologists, nonphysician prescribing clinicians (NPPCs), and physicians. The objective of this study was to determine whether patient rurality has an effect on the types of U.S.

Associations Between Oncology Outreach and Patient-Sharing Measures of Care Coordination.

Background: Oncology outreach is a common strategy for addressing cancer workforce shortages, where traveling oncologists commute across clinical settings to extend their services. Despite its known benefits specifically for rural patients, oncology outreach reallocates physician resources to satellite clinics and may negatively impact the coordination of cancer care.

Methods: In this retrospective study, we identified patients with incident breast, colorectal, and lung cancers from 2016-2019 nationwide Medicare claims and linked them to oncologists using Part B.

Does machine learning improve prediction accuracy of the Endoscopic Third Ventriculostomy Success Score? A contemporary Hydrocephalus Clinical Research Network cohort study.

Purpose: This Hydrocephalus Clinical Research Network (HCRN) study had two aims: (1) to compare the predictive performance of the original ETV Success Score (ETVSS) using logistic regression modeling with other newer machine learning models and (2) to assess whether inclusion of imaging variables improves prediction performance using machine learning models.

Methods: We identified children undergoing first-time ETV for hydrocephalus that were enrolled prospectively at HCRN sites between 200 and 2020. The primary outcome was ETV success 6 months after index surgery.

Accelerating evidence generation: Addressing critical challenges and charting a path forward.

Efficient evidence generation to assess the clinical and economic impact of medical therapies is critical amid rising healthcare costs and aging populations. However, drug development and clinical trials remain far too expensive and inefficient for all stakeholders. On October 25-26, 2023, the Duke Clinical Research Institute brought together leaders from academia, industry, government agencies, patient advocacy, and nonprofit organizations to explore how different entities and influencers in drug development and healthcare can realign incentive structures to efficiently accelerate evidence generation that addresses the highest public health needs.

Community Engagement Studios to advance multi-site research with older adults.

Introduction: Operationalizing multi-site Community Engagement (CE) Studios to inform a research program is valuable for researchers. We describe the process and outcomes of hosting three CE Studios with Community Experts aged 65 years or older with chronic conditions and care partners of older adults. Experts gave feedback about processes for testing the feasibility, efficacy, effectiveness, and implementation of audio recording clinic visits and sharing recordings with patients who have multimorbidity and their care partners.

The Implementation of Integrated Youth Services in Canada: Planning and Costing of a Pan-Canadian Model: La mise en œuvre des services intégrés pour les jeunes au Canada : planification et établissement des coûts d'un modèle pancanadien.

Objective: The implementation of Integrated Youth Services (IYS) can help ensure that youth are adequately supported. The objective of this analysis was to provide a model for the planning and costing of IYS throughout Canada over a 15-year period.

Methods: To estimate resource allocation for IYS, we determined the number of hubs and hub staffing requirements by service level and jurisdiction, backbone support and infrastructure requirements by jurisdiction.

Decision-Making Interventions for Pelvic Organ Prolapse: A Systematic Review, Meta-Analysis, and Environmental Scan.

People diagnosed with pelvic organ prolapse (POP) face preference-sensitive treatment decisions. We conducted a systematic review, meta-analysis, and narrative synthesis to determine the effect of decision-making interventions for prolapse on patient-reported outcomes. To gain a more complete understanding of all potentially accessed resources, we also conducted an environmental scan to determine the quantity and quality of online interventions for prolapse decision-making.

The feasibility of sharing digital audio-recordings of clinic visits online with older adults in primary care settings: A multisite trial.

Objective: The objective of this trial was to determine the feasibility, acceptability, and preliminary effectiveness of sharing audio recordings of primary care visits with older adults with multimorbidity.

Methods: We used a two-arm, randomized, controlled, feasibility trial with 3-month follow-up. Patients aged ≥ 65 years-with diabetes and hypertension-were recruited from academic primary care settings in New Hampshire, Tennessee, and Texas.

Towards a Multi-Stakeholder process for developing responsible AI governance in consumer health.

Introduction: AI is big and moving fast into healthcare, creating opportunities and risks. However, current approaches to governance focus on high-level principles rather than tailored recommendations for specific domains like consumer health. This gap risks unintended consequences from generic guidelines misapplied across contexts and from providing answers before agreeing on the questions.

Oncology Physician Turnover in the United States Based on Medicare Claims Data.

Objective: Physician turnover rates are rising in the United States. The cancer workforce, which relies heavily on clinical teamwork and care coordination, may be more greatly impacted by turnover. In this study, we aimed to characterize oncologists who move to identify targets for recruitment and retention efforts.

Health System Expansion and Changes in Medicare Beneficiary Utilization of Safety Net Providers.

Background: Evidence is limited on insured patients' use of safety net providers as vertically integrated health systems spread throughout the United States.

Objectives: To examine whether market-level health system penetration is associated with: (1) switches in Medicare beneficiaries' usual source of primary care from federally qualified health centers (FQHCs) to health systems; and (2) FQHCs' overall Medicare patient and visit volume.

Research Design: Beneficiary-level discrete-time survival analysis and market-level linear regression analysis using Medicare fee-for-service claims data from 2013 to 2018.

Medicare Enrollment and Spending Among Patients Initiating Dialysis After the Affordable Care Act.

Importance: Medicare finances health care for most US patients with end-stage kidney disease (ESKD), regardless of age. Medicare enrollment may have slowed for patients with incident ESKD who gained access to new private insurance options with the 2014 passage of the Affordable Care Act (ACA) and introduction of the ACA Marketplace.

Objective: To describe trends in public and private insurance coverage and dialysis spending among patients with incident ESKD from 2012 to 2017.

How often are patients recording their healthcare consultations in Australia and why? An online survey.

Purpose: Recording important healthcare consultations can benefit patients. Technological developments enable recordings by patients and health professionals, as well as real-time 'listening' by AI scribes. Not enough is known about whether and why patients record their consultations.

Technology-Based Interventions for Substance Use Treatment Among People Who Identify as African American or Black, Hispanic or Latino, and American Indian or Alaska Native: Scoping Review.

Background: In the United States, racial and ethnic disparities in substance use treatment outcomes are persistent, especially among underrepresented minority (URM) populations. Technology-based interventions (TBIs) for substance use treatment show promise in reducing barriers to evidence-based treatment, yet no studies have described how TBIs may impact racial or ethnic health equity.

Objective: This study explored whether TBIs in substance use treatment research promote health equity among people who identify as African American or Black, Hispanic or Latino, and American Indian or Alaska Native through their inclusion in research.