1
|
Practice change intentions after academic detailing align with subsequent opioid prescribing. J Am Pharm Assoc (2003) 2020; 60:1001-1008. [DOI: 10.1016/j.japh.2020.08.011] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 07/21/2020] [Accepted: 08/06/2020] [Indexed: 11/30/2022]
|
2
|
Sasser CW, Miller ML, Schellhase E, Dascanio SA, Steeb DR. Creating global health leaders in pharmacy by evolving postgraduate training. Res Social Adm Pharm 2020; 16:1622-1625. [PMID: 32591327 DOI: 10.1016/j.sapharm.2020.06.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Revised: 05/19/2020] [Accepted: 06/01/2020] [Indexed: 11/25/2022]
Abstract
There has been a push for increasing global health education and training opportunities within the pharmacy profession. Global health postgraduate learning opportunities are necessary to define pharmacy career paths in global health and develop global health leaders. There are many challenges to starting a global health postgraduate training program including economic burden, logistics of extramural rotations, local and international resources, and program sustainability. In the face of barriers inhibiting formal program establishment, different strategies can be used to incorporate global health topics into existing postgraduate training opportunities. Possible solutions include relating local health to global health to develop a global mindset, expanding upon existing partnerships to provide international global health experiences, use of technology and simulation for virtual global health interaction, and emphasis of implementation science principles to connect and translate local health interventions to a global scale.
Collapse
Affiliation(s)
- Caroline W Sasser
- The University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - Monica L Miller
- Purdue University College of Pharmacy, Indianapolis, IN, USA
| | | | - Sarah A Dascanio
- The University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA
| | - David R Steeb
- The University of North Carolina at Chapel Hill Eshelman School of Pharmacy, Chapel Hill, NC, USA.
| |
Collapse
|
3
|
Gathirua-Mwangi W, Cohee A, Tarver WL, Marley A, Biederman E, Stump T, Monahan P, Rawl S, Skinner CS, Champion VL. Factors Associated with Adherence to Mammography Screening Among Insured Women Differ by Income Levels. Womens Health Issues 2018; 28:462-469. [DOI: 10.1016/j.whi.2018.06.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/31/2018] [Accepted: 06/06/2018] [Indexed: 12/11/2022]
|
4
|
Abstract
Most diabetes care is provided in primary care settings, but typical primary care clinicians struggle to keep up with the latest evidence on diabetes screening, pharmacotherapy, and monitoring. Accordingly, many patients with diabetes are not receiving optimal guideline-based therapy. Relying on front-line clinicians on their own to assess the huge volume of new literature and incorporate it into their practice is unrealistic, and conventional continuing medical education has not proven adequate to address gaps in care. Academic detailing, direct educational outreach to clinicians that uses social marketing techniques to provide specific evidence-based recommendations, has been proven in clinical trials to improve the quality of care for a range of conditions. By directly engaging with clinicians to assess their needs, identify areas for change in practice, and provide them with specific tools to implement these changes, academic detailing can serve as a tool to improve care processes and outcomes for patients with diabetes.
Collapse
Affiliation(s)
- Michael A Fischer
- National Resource Center for Academic Detailing, Division of Pharmacoepidemiology and Pharmacoeconomics, Brigham and Women's Hospital, 1620 Tremont St, suite 3030, Boston, MA, 02120, USA.
| |
Collapse
|
5
|
The Role of Health Literacy in Reducing Negative Perceptions of Breast Health and Treatment Among Uninsured Primary Care Patients. J Community Health 2016; 41:858-63. [PMID: 26856733 DOI: 10.1007/s10900-016-0164-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Breast cancer is the second leading cause of cancer death among women in the United States. There are disparities in breast cancer mortality by race/ethnicity and socio-economic factors. Health literacy may have an impact on breast health disparities. In addition, learning about people's perceptions of breast health and treatment is important to understand why some do not seek a mammogram or treatment for breast cancer. The purpose of this study is to examine the association between health literacy and negative perceptions of breast health and treatment among female uninsured primary care patients utilizing a free clinic for underserved populations. Women utilizing a free clinic who were aged 40 years or older (N = 276) participated in a self-administered survey from September to December in 2015. Higher levels of health literacy were associated with lower levels of negative perceptions of breast cancer and treatment. Non-US born English speakers reported higher levels of negative perceptions of breast cancer and treatment than US born English speakers and Spanish speakers. While there were no significant differences in health literacy among the groups, US born English speakers were less likely to have had a mammogram in the past 3 years compared with non-US born English speakers and Spanish speakers. Future research should consider where women are obtaining information and how the method of exposure shapes their attitudes towards breast health and in turn, their rates of examinations for breast cancer. Cultural factors may be also important determinants of the perceptions and need to be further examined.
Collapse
|
6
|
Blitz DA, Mallen JR, Kwiatkowski TG, Rabin JM, Dlugacz YD, Silverman RA. Not for industry only: medical students and office-based academic detailing the PIVOT (Pregnant women Influenza Vaccine Optimization Team) initiative. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2015; 6:323-327. [PMID: 25926764 PMCID: PMC4403885 DOI: 10.2147/amep.s72384] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Academic detailing is a method of educational outreach that utilizes individualized encounters with physicians to broach specific medical issues in an evidence-based and quality-driven manner. Medical students utilized the matter of influenza vaccination during pregnancy as a lens through which to explore the methods of academic detailing in a community setting. Structured and customized dialogues between North Shore-LIJ affiliated obstetricians and Hofstra North Shore-LIJ medical students were conducted regarding the disparity between the proportion of providers that recommend the vaccine and the percentage of pregnant women being vaccinated annually. Ultimately the project aimed to increase vaccine-carrying rates throughout office based practices in the community, while establishing a viable method for up-to-date information exchange between practicing physicians and academic medicine. While the extent of affected change is currently being quantified, the project proved successful insofar as academic detailing allowed the students to gain access to physicians, and engage in compelling and educational conversations. Both the physicians and students felt these interactions were valuable and well worth continuing. The goal for the future is to expand these practices to other pressing public health issues while continuing to refine the technique.
Collapse
Affiliation(s)
- Daina A Blitz
- Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
| | | | - Thomas G Kwiatkowski
- Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
- Department of Emergency Medicine, North Shore-LIJ Health System, New Hyde Park, NY, USA
| | - Jill M Rabin
- Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
- Department of Obstetrics and Gynecology, North Shore-LIJ Health System, New Hyde Park, NY, USA
| | - Yosef D Dlugacz
- Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
- Krasnoff Quality Management Institute, North Shore-LIJ Health System, New Hyde Park, NY, USA
| | - Robert A Silverman
- Hofstra North Shore-LIJ School of Medicine, Hempstead, NY, USA
- Krasnoff Quality Management Institute, North Shore-LIJ Health System, New Hyde Park, NY, USA
- Department of Emergency Medicine, North Shore-LIJ Health System, New Hyde Park, NY, USA
| |
Collapse
|
7
|
Siegl EJ, Miller JW, Khan K, Harris SE. Quality assurance through quality improvement and professional development in the National Breast and Cervical Cancer Early Detection Program. Cancer 2014; 120 Suppl 16:2584-90. [PMID: 25099901 DOI: 10.1002/cncr.28822] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2014] [Accepted: 03/04/2014] [Indexed: 11/09/2022]
Abstract
Quality assurance (QA) is the process of providing evidence that the outcome meets the established standards. Quality improvement (QI), by contrast, is the act of methodically developing ways to meet acceptable quality standards and evaluating current processes to improve overall performance. In the case of the National Breast and Cervical Cancer Early Detection Program (NBCCEDP), the desired outcome is the delivery of quality health care services to program clients. The NBCCEDP provides professional development to ensure that participating providers have current knowledge of evidence-based clinical standards regarding breast and cervical cancer screening and diagnosis and are monitoring women with abnormal screening results for timely follow-up. To assess the quality of clinical care provided to NBCCEDP clients, performance data are collected by NBCCEDP grantees and compared against predetermined Centers for Disease Control and Prevention (CDC) benchmarks known as Data Quality Indicator Guides. In this article, the authors describe 1) the development and use of indicators for QI in the NBCCEDP and 2) the professional development activities implemented to improve clinical outcomes. QA identifies problems, whereas QI systematically corrects them. The quality of service delivery and improved patient outcomes among NBCCEDP grantees has enhanced significantly because of continuous monitoring of performance and professional development. By using QA, NBCCEDP grantees can maximize the quality of patient screening, diagnostic services, and follow-up. Examples of grantee activities to maintain quality of care are also described in this report.
Collapse
Affiliation(s)
- Elvira J Siegl
- Michigan Breast and Cervical Cancer Control Program, Lansing, Michigan
| | | | | | | |
Collapse
|
8
|
Jeudin P, Liveright E, Del Carmen MG, Perkins RB. Race, ethnicity, and income factors impacting human papillomavirus vaccination rates. Clin Ther 2014; 36:24-37. [PMID: 24417783 DOI: 10.1016/j.clinthera.2013.11.001] [Citation(s) in RCA: 118] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2013] [Revised: 11/05/2013] [Accepted: 11/06/2013] [Indexed: 12/18/2022]
Abstract
BACKGROUND Human papillomavirus (HPV) infection and cervical cancer disproportionately affect low-income and minority women. HPV vaccines have the potential to either reduce or exacerbate racial disparities in HPV-related diseases and cervical cancers, depending on the equitability of vaccine uptake. OBJECTIVES This review aims to identify barriers and facilitators of equitable uptake of HPV vaccination among low-income and minority girls. This review discusses factors related to race, ethnicity, and income that are associated with initiation and completion rates of the 3-dose HPV vaccine series and presents targets for intervention. METHODS We reviewed relevant English-language literature to identify current vaccination rates and factors associated with vaccine uptake. Study findings related to race (black, Latino, Asian), and incomes were summarized. RESULTS Current trends in the United States indicate low uptake among all adolescents, and that rates stagnated between 2011 and 2012. Low-income and minority adolescents are equally or more likely to start the HPV vaccination series than are white and higher-income adolescents, but are less likely to complete all 3 shots. Provider recommendation is a key factor in HPV vaccination, and minorities are less likely to report receiving recommendations for HPV vaccination. CONCLUSIONS As black, Hispanic, and Asian populations continue to grow in the United States over the next several decades, it is imperative that we not only improve HPV vaccination rates overall, but also focus on high-risk populations to prevent an increase in cervical cancer disparities.
Collapse
Affiliation(s)
- Patricia Jeudin
- Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts
| | - Elizabeth Liveright
- Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts
| | - Marcela G Del Carmen
- Division of Gynecologic Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Rebecca B Perkins
- Boston University School of Medicine/Boston Medical Center, Boston, Massachusetts.
| |
Collapse
|
9
|
Jeudin P, Liveright E, del Carmen MG, Perkins RB. Race, ethnicity and income as factors for HPV vaccine acceptance and use. Hum Vaccin Immunother 2013; 9:1413-20. [PMID: 23571170 DOI: 10.4161/hv.24422] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
If distributed equitably, Human Papillomavirus (HPV) vaccines have the potential to reduce racial disparities in HPV-related diseases and cervical cancers. However, current trends in the US indicate low uptake among all adolescents, with persistent disparities among minority and low-income adolescents despite largely positive views of vaccination among their parents. As Black, Hispanic, and Asian populations continue to grow in the US over the next 40 y, it is imperative that we not only improve HPV vaccination rates overall, but focus on high-risk populations to prevent an increase in cervical cancer disparities. This review discusses initiation and completion rates of the three-dose HPV vaccine series among adolescents in high-risk groups and describes cultural similarities and differences in motivation and barriers to vaccination. The goal of this review is to highlight factors leading to vaccination in different adolescent racial groups and to help guide the development of strategies to increase rates of vaccine initiation and completion among groups at the highest risk for developing cervical cancer.
Collapse
Affiliation(s)
- Patricia Jeudin
- Boston University School of Medicine; Boston Medical Center; Boston, MA USA
| | | | | | | |
Collapse
|
10
|
Temel JS, Greer JA, Gallagher ER, Jackson VA, Lennes IT, Muzikansky A, Park ER, Pirl WF. Electronic Prompt to Improve Outpatient Code Status Documentation for Patients With Advanced Lung Cancer. J Clin Oncol 2013; 31:710-5. [DOI: 10.1200/jco.2012.43.2203] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose Rates of documentation of end-of-life care preferences in the medical record remain low, even among patients with incurable malignancies. We therefore conducted a two-phase study to develop and assess the effect of electronic prompts to encourage oncology clinicians to document code status in the outpatient electronic health record (EHR) of patients with advanced lung cancers. Patients and Methods To determine the optimal delivery, content, and timing of the electronic prompt, we first facilitated focus groups with oncology clinicians at an affiliated medical center. Given this feedback, we developed e-mail reminders timed to the start of each new chemotherapy regimen. Between July 2009 and January 2011, 102 eligible patients with incurable lung cancer were approached, and 100 agreed to participate. We compared e-mail prompt participants (EPPs) with a cohort of 100 consecutive historical controls who began therapy for incurable lung cancer at least 1 year before the start of this study. The primary outcome measure was clinician documentation of code status in the EHR. Results EPPs were similar to historical controls, with no significant differences in demographic or clinical characteristics. At 1-year follow-up, 33.7% (n = 33/98) of EPPs had a code status documented in the outpatient EHR compared with 14.5% (n = 12/83) of historical controls (P = .003). Mean time to code status documentation was significantly shorter in EPPs (8.6 months [95% CI, 7.6 to 9.5]) compared with controls (10.5 months [95% CI, 9.8 to 11.3]; P = .004). Conclusion e-mail prompts may improve the rate and timing of code status documentation in the EHR and warrant further investigation.
Collapse
Affiliation(s)
| | | | | | | | - Inga T. Lennes
- All authors: the Massachusetts General Hospital, Boston, MA
| | | | - Elyse R. Park
- All authors: the Massachusetts General Hospital, Boston, MA
| | | |
Collapse
|
11
|
Perkins RB, Apte G, Marquez C, Porter C, Belizaire M, Clark JA, Pierre-Joseph N. Factors affecting human papillomavirus vaccine use among White, Black and Latino parents of sons. Pediatr Infect Dis J 2013; 32:e38-44. [PMID: 22914585 DOI: 10.1097/inf.0b013e31826f53e3] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Although human papillomavirus (HPV) vaccination has been available for males since 2009, its uptake remains low. In light of new recommendations for universal vaccination of males, understanding parental attitudes toward this vaccine is important. This study aimed to describe HPV-related knowledge and intention to accept HPV vaccination among White, Black and Latino parents of sons and to assess vaccination rates among their sons. METHODS We interviewed parents (68 Black, 28 Latino and 24 White; mean age, 43.5) of sons (mean age, 14) attending an urban academic medical center and a community health center. Eligible parents self-identified as White, Black or Latino and spoke English, Spanish or Haitian-Creole. We collected demographic information, knowledge related to HPV vaccination, parents' intent to vaccinate sons and HPV vaccination rates. Descriptive statistics and multivariable logistic regression were used to describe data. RESULTS Most parents were mothers, married, expressed a religious affiliation and had completed high school or college. Parents had limited knowledge about HPV; White parents were more knowledgeable than Black parents. Most parents (75%) intended to accept HPV vaccination if recommended by physicians; no racial differences were noted. However, only 30% of sons were vaccinated. Logistic regression indicated that internet use was negatively associated with intention to vaccinate. Intention to vaccinate, clinical site of care and having an older son were associated with vaccine receipt. CONCLUSIONS Although parents in our study had limited understanding of HPV disease in males, most would vaccinate their sons if recommended by their physicians.
Collapse
Affiliation(s)
- Rebecca B Perkins
- Department of Obstetrics and Gynecology and Pediatrics, Boston University School of Medicine, Boston, MA 02118, USA.
| | | | | | | | | | | | | |
Collapse
|
12
|
Perkins RB, Clark JA. What affects human papillomavirus vaccination rates? A qualitative analysis of providers' perceptions. Womens Health Issues 2012; 22:e379-86. [PMID: 22609253 DOI: 10.1016/j.whi.2012.04.001] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2011] [Revised: 04/03/2012] [Accepted: 04/03/2012] [Indexed: 11/26/2022]
Abstract
PURPOSE To define factors that providers perceive as affecting their administration of human papillomavirus (HPV) vaccination in their clinical practices. METHODS We conducted in-depth, qualitative interviews with 34 pediatric and family medicine providers in four community health centers to explore providers' perceptions of factors that either enabled or impeded their ability to vaccinate their patients against HPV. RESULTS Providers' self-reported vaccination rates ranged from 25 to 95% (median, 75%) of the 11- to 26-year-old females in their practices. Factors that enabled vaccination included providers' beliefs that HPV vaccines were safe and would provide important health benefits, structured visits that promoted vaccination, and coadministration of HPV with other recommended vaccines. Factors that impeded vaccination included safety concerns, a low perceived severity of HPV disease, lack of school mandates, and policies against coadministration of HPV and meningococcal vaccines. Providers who described more enabling factors than impeding factors reported vaccinating more of their patients. CONCLUSIONS Provider perceptions around the ease or difficulty of providing HPV vaccination may influence their behavior when offering HPV vaccines to their patients.
Collapse
Affiliation(s)
- Rebecca B Perkins
- Boston University School of Medicine, Department of Obstetrics and Gynecology, Boston, MA 02118, USA.
| | | |
Collapse
|
13
|
Patel B. Back to School: Quality Improvement through Academic Detailing. AMERICAN HEALTH & DRUG BENEFITS 2011; 4:455-459. [PMID: 25126369 PMCID: PMC4106497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Affiliation(s)
- Barry Patel
- President, Total Therapeutic Management, Kennesaw, GA, and Adjunct Clinical Associate Professor, Department of Pharmacy Practice, Mercer University, Atlanta, GA
| |
Collapse
|
14
|
Approaches to improving breast screening uptake: evidence and experience from Tower Hamlets. Br J Cancer 2010; 101 Suppl 2:S64-7. [PMID: 19956166 PMCID: PMC2790710 DOI: 10.1038/sj.bjc.6605393] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
This paper reports on an innovative whole-systems approach to improving uptake of breast screening in Tower Hamlets, a deprived borough in the East End of London with a large minority ethnic population. The approach, developed by the public health team at NHS Tower Hamlets, draws on analysis of needs and existing literature about effective interventions to promote breast screening. Social marketing research led to a campaign targeted at Bangladeshi women, together with a range of initiatives to promote breast screening through primary care services and community outreach through local well-known organisations. The breast screening service itself was upgraded and a new service specification is being introduced from April 2009.
Collapse
|
15
|
Are health-care relationships important for mammography adherence in Latinas? J Gen Intern Med 2008; 23:2024-30. [PMID: 18839258 PMCID: PMC2596511 DOI: 10.1007/s11606-008-0815-6] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2007] [Revised: 04/18/2008] [Accepted: 09/12/2008] [Indexed: 01/15/2023]
Abstract
BACKGROUND Latinas are the fastest growing racial ethnic group in the United States and have an incidence of breast cancer that is rising three times faster than that of non-Latino white women, yet their mammography use is lower than that of non-Latino women. OBJECTIVES We explored factors that predict satisfaction with health-care relationships and examined the effect of satisfaction with health-care relationships on mammography adherence in Latinas. DESIGN AND SETTING We conducted a cross-sectional survey of 166 Latinas who were >or=40 years old. Women were recruited from Latino-serving clinics and a Latino health radio program. MEASUREMENTS Mammography adherence was based on self-reported receipt of a mammogram within the past 2 years. The main independent variable was overall satisfaction with one's health-care relationship. Other variables included: self report of patient-provider communication, level of trust in providers, primary language, country of origin, discrimination experiences, and perceptions of racism. RESULTS Forty-three percent of women reported very high satisfaction in their health-care relationships. Women with high trust in providers and those who did not experience discrimination were more satisfied with their health-care relationships compared to women with lower trust and who experienced discrimination (p < .01). Satisfaction with the health-care relationship was, in turn, significantly associated with mammography adherence (OR: 3.34, 95% CI: 1.47-7.58), controlling for other factors. CONCLUSIONS Understanding the factors that impact Latinas' mammography adherence may inform intervention strategies. Efforts to improve Latina's satisfaction with physicians by building trust may lead to increased use of necessary mammography.
Collapse
|