Evaluating the Reach of a Patient Navigation Program for Follow-up Colonoscopy in a Large Federally Qualified Health Center.

Patient navigation (PN) has been shown to improve participation in cancer screening, including colorectal cancer screening, and is now a recommended practice by the Community Preventive Services Task Force. Despite the effectiveness of PN programs, little is known about the number of contacts needed to successfully reach patients or about the demographic and healthcare utilization factors associated with reach. PRECISE was an individual randomized study of PN versus usual care conducted as a partnership between two large health systems in the Pacific Northwest.

Effectiveness of a culturally tailored diabetes education curriculum with real-time continuous glucose monitoring in a Latinx population with type 2 diabetes: the CUT-DM with CGM for Latinx randomised controlled trial study protocol.

Introduction: The prevalence of type 2 diabetes (T2D) is increasing in the Latinx community. Despite telehealth and technology becoming more available, these resources are not reaching the Latinx population. Diabetes education is a cornerstone of treatment; however, access to culturally tailored content is a barrier to the Latinx population.

Expanding a photographic grading system for trachomatous scarring.

Background: The purpose was to assess an expansion of a previously published photographic four-step severity grading scale for trachomatous scarring (TS).

Methods: Images of everted eyelids of adult women in Tanzania were graded for the presence and severity of TS. The previous S3 grade was subdivided into two categories: S3A, one-third to <50% of the upper eyelid conjunctiva scarred; and S3B, 50% to <90%.

"Sorry for laughing, but it's scary": humor and silence in discussions of Colorectal Cancer with Urban American Indians.

Background: Given high rates of cancer mortality in Native communities, we examined how urban American Indian and Alaska Native elders talk about colorectal cancer (CRC) and CRC screening.

Methods: We conducted seven focus groups with a total of 46 participants in two urban clinics in the Pacific Northwest to assess participant awareness, perceptions, and concerns about CRC and CRC screening. Using speech codes theory, we identified norms that govern when and how to talk about CRC in this population.

Integrating MOUD and Primary Care: Outcomes of a Multicenter Learning Collaborative.

Background And Objectives: Opioid use and overdose remain a central and worsening public health emergency in the United States and abroad. Efforts to expand treatment have struggled to match the rising incidence of opioid use disorder (OUD), and treating patients in primary care settings represents one of the most promising opportunities to meet this need. Learning collaboratives (LCs) are one evidence-based strategy to improve implementation of medication treatment for opioid use disorder (MOUD) in primary care.

Validation of the PEG Scale in Spanish (PEG-S) Among Adults Receiving Care for Pain in US Primary Care.

This study sought to evaluate the psychometric properties of a Spanish version of the PEG scale (PEG-S, whose items assess Pain intensity and pain interference with Enjoyment of life and General activity) in a sample of Spanish-speaking adults receiving care for pain at primary care clinics in the Northwestern United States. We evaluated the PEG-S's 1) internal consistency, 2) convergent validity, and 3) discriminant validity. All participants (n = 200, mean age = 52 years [SD = 15], 76% women, mean PEG-S score = 5.

Exploring Barriers to Access Prenatal Care Among Indigenous Mexican and Guatemalan Women in Washington State.

Migrant and Seasonal Agricultural Workers including indigenous women that are not of Hispanic descent face many barriers to access prenatal care. We conducted a survey in Spanish and three indigenous languages to explore knowledge, attitudes and behaviors regarding prenatal care among 82 female agricultural workers, Mixteco, Triqui and Awakateko, residing in the State of Washington. Our findings highlight the importance of collecting disaggregated data from different indigenous communities and of providing indigenous language support.

Integrated Case Presentation Seminar: Bridging Parallel Fields to Improve Psychiatry and Psychology Learner Experience.

Daily clinical practice of mental health professionals often requires interaction between providers from diverse training and professional backgrounds. Efforts to engage mental health trainees across disciplines are necessary and have had varied outcomes. The current study reviews the development and implementation of a monthly one-hour integrated case presentation seminar (ICPS) as part of independent psychology and psychiatry two-year fellowships at a Midwestern teaching hospital.

Cultural Considerations in Working with Arab American Youth.

There is limited literature on Arab American mental health, particularly among youth. This chapter will provide an overview of the Arab American/MENA population, their migration to the United States, traditional Arab culture and values, Arab American youth identity, acculturation and acculturation stress, the impact of discrimination on Arab American youth, mental illness in Arab American youth, and cultural variables to consider in seeking help. This chapter will provide recommendations and cultural considerations when working with Arab American youth.

Reducing missed psychotherapy appointments: An advanced practice nurse-initiated telephone orientation protocol.

Purpose: Missed appointments pose significant challenges to the health care system as they contribute to the inefficient use of resources, increase costs, and result in poor outcomes. The aim of this project was to reduce the rate of missed adult psychotherapy appointments by implementing a Psychiatric-Mental Health Nurse Practitioner-initiated telephone orientation protocol (TOP).

Design: Quasi-experimental.

Follow-up colonoscopy after an abnormal stool-based colorectal cancer screening result: analysis of steps in the colonoscopy completion process.

Background: Delays in receiving follow-up colonoscopy after an abnormal fecal immunochemical test (FIT) result are associated with increased colorectal cancer incidence and mortality. Little is known about patterns of follow-up colonoscopy completion in federally qualified health centers.

Methods: We abstracted the medical records of health center patients, aged 50-75 years, who had an abnormal FIT result between August 5, 2017 and August 4, 2018 (N = 711).

Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.

To evaluate the diagnostic impact of point-of-care breast ultrasound by trained primary care physicians (PCPs) as part of a breast cancer detection program using clinical breast exam in an underserved region of Peru. Medical records and breast ultrasound images of symptomatic women presenting to the Breast Cancer Detection Model (BCDM) in Trujillo, Peru were collected from 2017-2018. Performance was measured against final outcomes derived from regional cancer center medical records, fine needle aspiration results, patient follow-up (sensitivity, specificity, positive, and negative predictive values), and by percent agreement with the retrospective, blinded interpretation of images by a fellowship-trained breast radiologist, and a Peruvian breast surgeon.

The Epidemiology, Risk Factors, and Nonsurgical Treatment of Injuries Related to Endurance Running.

Running is a popular form of exercise that is easily accessible to various populations; endurance running, defined as distances beyond 5 km, continues to grow within the sport. Endurance running-related injuries are common in the lower extremities and are primarily overuse related. A multitude of risk factors for injury exist, including extrinsic factors, such as running distance and frequency, and intrinsic factors, such as biomechanics and nutrition status.

Physician and behavioral health provider diagnostic agreement in a general hospital setting.

Objective: Behavioral health providers are often employed in inpatient settings. However, it is unclear if there is mental health diagnosis agreement between referring physicians and behavioral health providers. The purpose of this study is to assess for referring physician and behavioral health provider mental health diagnostic agreement in a general hospital setting.

The association between mental health diagnoses and influenza vaccine receipt among older primary care patients.

Evidence suggests mental health diagnoses are associated with an increased likelihood of not having an influenza vaccine. However, little is known about this association in older adult primary care patients. The purpose of this study was to determine the association between flu vaccine receipt in patients 65 to 80 years old and any mental health diagnoses, defined as depression and/or anxiety in a primary care setting.

Guidance for Genuine Collaboration: Insights from Academic, Tribal, and Community Partner Interviews on a New Research Partnership.

As community engaged research (CEnR) increases in popularity and recognition, specific guidance on partnership approaches that are more likely to lead to community benefits is needed. Here, we describe a qualitative interview study aimed at better understanding community and academic perspectives on elements of genuine collaboration within a project's new community-academic partnership. This partnership involved a large, public, urban university, a tribal nation government program, a small, rural, community-based university, and a local high school working together to develop CEnR on air quality.

Patient randomized trial of a targeted navigation program to improve rates of follow-up colonoscopy in community health centers.

Background: Colorectal cancer (CRC) screening by annual fecal immunochemical test (FIT) is an accessible and cost-effective strategy to lower CRC incidence and mortality. However, this mode of screening depends on follow-up colonoscopy after a positive FIT result. Unfortunately, nearly one-half of FIT-positive patients fail to complete this essential screening component.

Understanding Complex Roles of Family for Latina Health: Evaluating Family Obligation Stress.

We developed a measure of family obligation stress and compared its relationship to health and unmet health care needs relative to social support among a sample of US-based Latinas. Data come from a randomized controlled trial within 4 clinics to increase mammography among Latinas (n = 539). The 1-factor measure had acceptable reliability and construct validity.

Effect of Reminding Patients to Complete Fecal Immunochemical Testing: A Comparative Effectiveness Study of Automated and Live Approaches.

Background: The Community Preventive Services Task Force recommends multi-component interventions, including patient reminders, to improve uptake of colorectal cancer screening.

Objective: We sought to compare the effectiveness of different forms of reminders for a direct-mail fecal immunochemical test (FIT) program.

Design: Patient-randomized controlled trial.