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Sharpe E, Butler MP, Clark-Stone J, Soltanzadeh R, Jindal R, Hanes D, Bradley R. A closer look at yoga nidra- early randomized sleep lab investigations. J Psychosom Res 2023; 166:111169. [PMID: 36731199 PMCID: PMC9973252 DOI: 10.1016/j.jpsychores.2023.111169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 01/21/2023] [Accepted: 01/22/2023] [Indexed: 01/30/2023]
Abstract
OBJECTIVES We aimed to examine trial feasibility plus physiological and psychological effects of a guided meditation practice, Yoga Nidra, in adults with self-reported insomnia. METHODS Twenty-two adults with self-reported insomnia were recruited to attend two visits at our research center. At Visit 1 (V1), participants were asked to lie quietly for ninety minutes. The primary outcome was change in electroencephalography (EEG). Heart rate variability (HRV), respiratory rate and self-reported mood and anxiety were also measured. At Visit 2 (V2), the same protocol was followed, except half of participants were randomized to practice Yoga Nidra for the first 30-min. RESULTS There were no between-group changes (V1-V2) in alpha EEG power at O1 (Intervention: 13 ± 70%; Control: -20 ± 40%), HRV or sleep onset latency in response to Yoga Nidra. Respiratory rate, however, showed statistically significant difference between groups (Yoga Nidra -1.4 breaths per minute (bpm) change during and - 2.1 bpm afterwards vs. Control +0.2 bpm during and + 0.4 bpm after; p = .03 for both during and after). The intervention displayed good acceptability (well-tolerated) and credibility (perceived benefit ratings) with implementation success (target sample size reached; 5% dropout rate). CONCLUSIONS This preliminary clinical trial provides early evidence that Yoga Nidra is a well-tolerated, feasible intervention for adults reporting insomnia. Decreased respiratory rate in response to Yoga Nidra needs to be confirmed in more definitive studies. TRIAL REGISTRATION INFORMATION This trial was registered on ClinicalTrials.gov as "A Closer Look at Yoga Nidra: Sleep Lab Analyses" (NCT#03685227).
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Affiliation(s)
- Erica Sharpe
- National University of Natural Medicine, Portland, OR, USA; State University of New York at Canton, Canton, NY, USA.
| | | | | | | | - Ripu Jindal
- Birmingham VA Medical Center, Birmingham, AL, USA.
| | - Douglas Hanes
- National University of Natural Medicine, Portland, OR, USA.
| | - Ryan Bradley
- National University of Natural Medicine, Portland, OR, USA; University of California, San Diego, La Jolla, CA, USA.
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2
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Cychosz M, Cristia A. Using big data from long-form recordings to study development and optimize societal impact. Adv Child Dev Behav 2022; 62:1-36. [PMID: 35249679 DOI: 10.1016/bs.acdb.2021.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Big data are everywhere. In this chapter, we focus on one source: long-form, child-centered recordings collected using wearable technologies. Because these recordings are simultaneously unobtrusive and encompassing, they may be a breakthrough technology for clinicians and researchers from several diverse fields. We demonstrate this possibility by outlining three applications for the recordings-clinical treatment, large-scale interventions, and language documentation-where we see the greatest potential. We argue that incorporating these recordings into basic and applied research will result in more equitable treatment of patients, more reliable measurements of the effects of interventions on real-world behavior, and deeper scientific insights with less observational bias. We conclude by outlining a proposal for a semistructured online platform where vast numbers of long-form recordings could be hosted and more representative, less biased algorithms could be trained.
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Affiliation(s)
- Margaret Cychosz
- Department of Hearing and Speech Sciences, University of Maryland, College Park, MD, United States; Center for Comparative and Evolutionary Biology of Hearing, University of Maryland, College Park, MD, United States
| | - Alejandrina Cristia
- Laboratoire de Sciences Cognitives et de Psycholinguistique, Département d'études cognitives, ENS, EHESS, CNRS, PSL University, Paris, France.
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van de Graaf FW, Eryigit Ö, Lange JF. Current perspectives on video and audio recording inside the surgical operating room: results of a cross-disciplinary survey. Updates Surg 2020; 73:2001-2007. [PMID: 33105017 PMCID: PMC8500875 DOI: 10.1007/s13304-020-00902-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2020] [Accepted: 10/13/2020] [Indexed: 12/03/2022]
Abstract
The availability of intraoperative multimedia recording is increasing. Considering the growing call for physicians’ accountability, it is inevitable that multimedia will play an important role in aiding quality control by improving the adequacy of operative reporting. However, the perspectives of medical professionals on this matter are poorly known. In this cross-disciplinary survey, we aimed to investigate the current viewpoints concerning the use of multimedia recording in the operating room. We conducted an electronic survey among all affiliated members of the Association of Surgeons of the Netherlands, the Dutch Urological Association and the Dutch Society of Obstetrics and Gynecology containing questions regarding current use of intraoperative recording and the level of likelihood or objection for certain scenarios. The response rate was 27.8%. The survey encompasses 370 (54.5%) surgeons, 71 (10.5%) urologists, 80 (11.8%) gynecologists, and 158 (23.3%) residents in training. 52.4% of respondents feel that the currently used operative report is insufficient for future quality requirements. 58.5% think it is unlikely they would behave differently during surgery when intra-operative video recording is applied. 82.8% think it is unlikely that their surgical methods would be altered. 63.8% of respondents preferred only video registration when intraoperative recording is implemented. The majority of respondents agree that the current method of operative reporting is insufficient for future quality requirements. There is support for intraoperative video recording, however, legal transparency is needed before either intraoperative video or audio recording could be implemented to protect not only the patients, but also the healthcare providers.
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Affiliation(s)
- Floyd W van de Graaf
- Department of Surgery, Erasmus University Medical Center (Erasmus MC), University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands.
| | - Özgür Eryigit
- Department of Surgery, Erasmus University Medical Center (Erasmus MC), University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Johan F Lange
- Department of Surgery, Erasmus University Medical Center (Erasmus MC), University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands
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Wolderslund M, Kofoed PE, Holst R, Waidtløw K, Ammentorp J. Outpatients' recall of information when provided with an audio recording: A mixed-methods study. Patient Educ Couns 2020; 103:63-70. [PMID: 31473043 DOI: 10.1016/j.pec.2019.08.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/02/2018] [Revised: 08/18/2019] [Accepted: 08/19/2019] [Indexed: 06/10/2023]
Abstract
OBJECTIVE While the ability to recall medical information is crucial, it is known to be a considerable challenge for many patients. Consequently, we aimed to investigate whether replay could enhance information recall and to explore the extent of information recall in a group of Danish outpatients. METHODS This study utilized a mixed-methods approach and evaluated patients' recall by comparing seven key themes between the interviews and the recordings. A total of 33 patients were included from three outpatient clinics. RESULTS Overall, 61% of the information was recalled. However, the study could not confirm an effect of replay on patients' information recall. Information recall was associated with age and information load. Accordingly, patients younger than 70 years had a 2.46 higher probability of recall (95%CI: 1.1-5.5, p = 0.027), whereas an increase in information load negatively influenced recall. CONCLUSION The study power is insufficient to provide a definite answer to the hypothesis regarding a positive association between replay and recall. Patients' information recall depended on the information theme, their age, and amount of information provided in the consultation. PRACTICE IMPLICATIONS The critical consequences of information overload necessitate an increased awareness of how to prioritise information, particularly when communicating with older patients.
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Affiliation(s)
- Maiken Wolderslund
- Health Services Research Unit, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
| | - Poul-Erik Kofoed
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Department of Paediatrics, Lillebaelt Hospital - University Hospital of Southern Denmark, Kolding, Denmark.
| | - René Holst
- Department of Regional Health Research, University of Southern Denmark, Odense, Denmark; Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway.
| | - Karin Waidtløw
- Health Services Research Unit, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark.
| | - Jette Ammentorp
- Health Services Research Unit, Lillebaelt Hospital - University Hospital of Southern Denmark, Vejle, Denmark; Department of Regional Health Research, University of Southern Denmark, Odense, Denmark.
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Hall J, Rus-Calafell M, Omari-Asor L, Ward T, Emsley R, Garety P, Craig TKJ. Assessing the subjective experience of participating in a clinical trial (AVATAR). Psychiatry Res 2018; 263:82-87. [PMID: 29502043 DOI: 10.1016/j.psychres.2018.02.026] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Revised: 02/12/2018] [Accepted: 02/12/2018] [Indexed: 11/25/2022]
Abstract
This study assessed the subjective experience of participating in a clinical trial, specifically positive and negative experiences and the experience of audio recording assessment sessions. The study was cross-sectional from a single blinded randomised controlled trial. Forty participants with a primary diagnosis of non-organic psychosis completed baseline and 12-week follow-up questionnaires assessing their experiences. Participants rated research interviews as moderately helpful in facilitating their therapy and talking to the interviewer as moderately helpful at baseline and 12-week follow-up. Self-report ratings of the degree of self-realisation promoted by the research questionnaires were significantly higher at 12-week follow-up compared to baseline. Participants adjusted quickly to being audio recorded and rated interviews as not at all disruptive and not at all to slightly intrusive. On average there were neutral emotional reactions, positive gains and minimal inconveniences as a result of participation. The main reasons for taking part were: 'To help myself', 'I was curious' and 'To help others'. The findings offer support to previous research reporting that individuals with mental health problems find participating in clinical trials a beneficial experience. This may alleviate concerns that participation in similar studies may be personally intrusive or harmful.
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Affiliation(s)
- Jheanell Hall
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Mar Rus-Calafell
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Lorraine Omari-Asor
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Thomas Ward
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Richard Emsley
- Centre for Biostatistics, Institute of Population Health, The University of Manchester, Manchester Academic Health Science Centre, Manchester, UK
| | - Philippa Garety
- Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Tom K J Craig
- Department of Health Services and Population Research, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Henry SG, Penner LA, Eggly S. Associations between thin slice ratings of affect and rapport and perceived patient-centeredness in primary care: Comparison of audio and video recordings. Patient Educ Couns 2017; 100:1128-1135. [PMID: 28087212 PMCID: PMC5410186 DOI: 10.1016/j.pec.2016.12.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 12/02/2016] [Accepted: 12/17/2016] [Indexed: 05/16/2023]
Abstract
OBJECTIVE To investigate associations between ratings of "thin slices" from recorded clinic visits and perceived patient-centeredness; to compare ratings from video recordings (sound and images) versus audio recordings (sound only). METHODS We analyzed 133 video-recorded primary care visits and patient perceptions of patient-centeredness. Observers rated thirty-second thin slices on variables assessing patient affect, physician affect, and patient-physician rapport. Video and audio ratings were collected independently. RESULTS In multivariable analyses, ratings of physician positive affect (but not patient positive affect) were significantly positively associated with perceived patient-centeredness using both video and audio thin slices. Patient-physician rapport was significantly positively associated with perceived patient-centeredness using audio, but not video thin slices. Ratings from video and audio thin slices were highly correlated and had similar underlying factor structures. CONCLUSION Physician (but not patient) positive affect is significantly associated with perceptions of patient-centeredness and can be measured reliably using either video or audio thin slices. Additional studies are needed to determine whether ratings of patient-physician rapport are associated with perceived patient-centeredness. PRACTICE IMPLICATIONS Observer ratings of physician positive affect have a meaningful positive association with patients' perceptions of patient-centeredness. Patients appear to be highly attuned to physician positive affect during patient-physician interactions.
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Affiliation(s)
- Stephen G Henry
- Department of Internal Medicine, University of California Davis, Sacramento, USA.
| | - Louis A Penner
- Department of Oncology, Wayne State University, Karmanos Cancer Institute, Detroit, USA
| | - Susan Eggly
- Department of Oncology, Wayne State University, Karmanos Cancer Institute, Detroit, USA
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Jerant A, Hanson B, Kravitz RL, Tancredi DJ, Hanes E, Grewal S, Cabrera R, Franks P. Detecting the effects of physician training in self-care interviewing skills: Coding of standardized patient (SP) visit recordings versus SP post-visit ratings. Patient Educ Couns 2017; 100:367-371. [PMID: 27578271 PMCID: PMC5318274 DOI: 10.1016/j.pec.2016.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 08/05/2016] [Accepted: 08/21/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE To compare how coder ratings of standardized patient (SP) visit recordings and SP ratings of the visits detect primary care physician (PCP) training in self-efficacy enhancing interviewing techniques (SEE IT). METHODS Analyses of data from 50 PCPs who participated in a randomized controlled trial of SEE IT training, which led to increased SEE IT use during three SP visits 1-3 months post-intervention. Untrained SPs rated SEE IT use post-visit. Subsequently, three trained coders generated a consensus SEE IT rating from visit audio recordings. SPs and coders were blinded to provider study arm, and coders to SP ratings. RESULTS SP and coder ratings were correlated (r=0.62). In detecting the intervention effect, the areas under the receiver operating characteristic curve were 0.80 (95% CI 0.74-0.87) and 0.76 (95% CI 0.69-0.84) for consensus coder and SP ratings, respectively (difference 0.04, 95% CI -0.04-0.11; z=1.04, p=0.30). CONCLUSION SP ratings were not significantly different from coder ratings of SP visit recordings in detecting PCP SEE IT training. PRACTICE IMPLICATIONS If similar findings are observed in larger studies, it would suggest a greater role for SP ratings in detecting provider interviewing skills training, given the relative simplicity, low cost, and non-intrusiveness of the approach.
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Affiliation(s)
- Anthony Jerant
- Department of Family and Community Medicine, University of California Davis, Sacramento, USA.
| | - Brent Hanson
- Department of Family and Community Medicine, University of California Davis, Sacramento, USA.
| | - Richard L Kravitz
- Department of Internal Medicine, University of California Davis, Sacramento, USA.
| | - Daniel J Tancredi
- Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA.
| | - Emily Hanes
- Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA.
| | - Sanjeet Grewal
- Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA
| | - Rimaben Cabrera
- Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA.
| | - Peter Franks
- Department of Family and Community Medicine, University of California Davis, Sacramento, USA.
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8
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Murad MS, Spiers JA, Guirguis LM. Expressing and negotiating face in community pharmacist-patient interactions. Res Social Adm Pharm 2016; 13:1110-1126. [PMID: 27816565 DOI: 10.1016/j.sapharm.2016.10.003] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2016] [Revised: 09/07/2016] [Accepted: 10/10/2016] [Indexed: 11/28/2022]
Abstract
BACKGROUND A collaborative patient-pharmacist interaction is fundamental to greater patient satisfaction with pharmacy care and improved medication adherence. Effective pharmacist-patient communication occurs when both pharmacist and patient are able to successfully attend to not only the typical tasks and goals of the interaction but also basic face needs that underlie all social interaction; autonomy, competence or esteem, and fellowship. Addressing face needs occurs through conventional and strategic communication strategies that respond to the emerging needs throughout an interaction. Pharmacist-patient interactions are not just about transfer of information and medications. Both parties assess the situation, the others' intentions within the context of their own goals and this influences how they choose to act throughout the interaction. Face-work Theory provides a framework to understand these interaction processes in pharmacist-patient communication. OBJECTIVES The aim of this study was to determine face needs, threats and the strategic communication strategies used to address these within community pharmacist-patient interactions. METHODS This exploratory descriptive study drew upon principles of ethology to first describe naturally occurring behaviour and then to interpret this behaviour within the context of Face-work theory. Twenty-five audio-recorded community pharmacist-patient interactions were collected and analyzed. The average length of these interactions was 3:67 min with a range of 0.39 s-9:35 min. RESULTS Multiple face needs for both pharmacist and patient were evident in most interactions. Autonomy, competence and fellowship face needs were negotiated in the following contexts: participative relationships, concordant role expectations, sensitive topics, and negotiating expertise and knowledge. Competence face needs for both parties were the most dominant need found in negotiating role expectations. The most common communication strategies used to support face were solidarity based strategies while indirect and depersonalized questions were commonly employed to mitigate face threat. IMPLICATIONS AND SIGNIFICANCE Face-work Theory is a novel approach to understand processes and outcomes of patient-pharmacist interactions in community pharmacies. Linking speech acts with face needs and threats may help to elucidate how pharmacist-patient interactions achieve both task oriented and interpersonal goals.
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Affiliation(s)
- Muna S Murad
- Faculty of Pharmacy and Pharmaceutical Sciences, 3-171, Edmonton Clinic Health Academy, 11405 87 Avenue, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada
| | - Judith A Spiers
- Faculty of Nursing, Level 3, Edmonton Clinic Health Academy, 11405 87 Avenue, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada
| | - Lisa M Guirguis
- Faculty of Pharmacy and Pharmaceutical Sciences, 3-171, Edmonton Clinic Health Academy, 11405 87 Avenue, University of Alberta, Edmonton, Alberta, T6G 1C9, Canada.
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Henry SG, Jerant A, Iosif AM, Feldman MD, Cipri C, Kravitz RL. Analysis of threats to research validity introduced by audio recording clinic visits: Selection bias, Hawthorne effect, both, or neither? Patient Educ Couns 2015; 98:849-856. [PMID: 25837372 PMCID: PMC4430356 DOI: 10.1016/j.pec.2015.03.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/01/2014] [Revised: 02/05/2015] [Accepted: 03/07/2015] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To identify factors associated with participant consent to record visits; to estimate effects of recording on patient-clinician interactions. METHODS Secondary analysis of data from a randomized trial studying communication about depression; participants were asked for optional consent to audio record study visits. Multiple logistic regression was used to model likelihood of patient and clinician consent. Multivariable regression and propensity score analyses were used to estimate effects of audio recording on 6 dependent variables: discussion of depressive symptoms, preventive health, and depression diagnosis; depression treatment recommendations; visit length; visit difficulty. RESULTS Of 867 visits involving 135 primary care clinicians, 39% were recorded. For clinicians, only working in academic settings (P=0.003) and having worked longer at their current practice (P=0.02) were associated with increased likelihood of consent. For patients, white race (P=0.002) and diabetes (P=0.03) were associated with increased likelihood of consent. Neither multivariable regression nor propensity score analyses revealed any significant effects of recording on the variables examined. CONCLUSION Few clinician or patient characteristics were significantly associated with consent. Audio recording had no significant effect on any of the 6 dependent variables examined. PRACTICE IMPLICATIONS Benefits of recording clinic visits likely outweigh the risks of bias in this setting.
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Affiliation(s)
- Stephen G Henry
- Department of Internal Medicine, University of California Davis, Sacramento, USA; Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA.
| | - Anthony Jerant
- Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA; Department of Family and Community Medicine, University of California Davis, Sacramento, USA
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California Davis, Davis, USA
| | - Mitchell D Feldman
- Department of Medicine, University of California San Francisco, San Francisco, USA
| | - Camille Cipri
- Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA
| | - Richard L Kravitz
- Department of Internal Medicine, University of California Davis, Sacramento, USA; Center for Healthcare Policy and Research, University of California Davis, Sacramento, USA
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