Category Archives: Family Medicine

In our study, we found that FM residents associate family physicians with leadership, desire more personal and system-level leadership training, and think that leadership training may be increased in the current curriculum and established in new areas.

The significant difference (p<0.001) between the Likert scale scores for the highest-ranked leadership ideal ('Family physicians should take on leadership roles in their clinical settings') and the lowest-ranked ('I am a leader') implies that there is room for growth regarding residents' development as leaders. The results are generally higher than those of other studies that used the same scale [5, 7].

In resident education, current leadership curriculum guidelines emphasize the development of lower-level leadership skills and knowledge [3]. The current curriculum has undoubtedly been significantly developed from the previous curriculum, but according to the study results, trainees still desire to learn more comprehensive leadership skills [4]. These results show that trainees' need to improve their leadership skills was greater than in the previous study in Canada [5] and similar previous studies conducted in many countries. This confirms trainees' need for more training in several leadership skills, giving the impression that a curriculum focusing more on leadership skills must be developed [7,8,9].

Conflict resolution (69%), teaching (67%), feedback, and system transformation (67%) are among the more advanced concepts that residents want to learn more about, which was higher than the need for training in Canada [5]. To account for statistical differences across domains, there was no curriculum focused specifically on leadership available at the time of this study.

There was a preference for both experiential and didactic learning opportunities. Curriculum components requiring some deliverable documents, such as leadership portfolios, were considered less desirable. This may be due to the nature and complexity of the current portfolio, which caused the trainees not to prefer it as a means of developing their leadership skills. This calls for studies to evaluate its effectiveness and ways to develop it, considering trainees' experience, opinion of development, and satisfaction.

Residents' level of agreement with several leadership ideals was unaffected by age, gender, or year of training. The desire for more training among third- and fourth-year residents is comparable to that of first- and second-year residents, which could be explained by a lack of substantial exposure to leadership domain training throughout their residency. Regarding leadership ideals, little variation existed between first- and fourth-year residents. A need may exist to provide residents with proper leadership training and competency, as there was no formal leadership training available when this poll was conducted.

Most residents (76%) indicated that leadership electives could be incorporated into the curriculum to foster leadership skills, which was higher than the percentage in Canada [5]. This may also be an opportunity to conduct studies to determine the importance of adding some new electives or rotations to the curriculum, the extent of the feasibility of some of the existing rotations and evaluate the possibility of modifying the rotations to be less lengthy and more numerous, especially after reducing the years of training in the new curriculum to three years.

Also, most residents (65%) indicated that WADAs are a part of developing their leadership skills and a good indicator for confirming the trainees' belief in the importance of this day in developing their academic skills, allowing them to evaluate the possibility of developing this day to include other skills, including leadership skills. Teaching junior learners (with training) has been suggested by most of the trainees (59%) to develop their skills, which may be a chance to consider adopting it as part of the curriculum. Overall, the percentage of residents desiring more leadership training in Saudi Arabia is higher than in Canada in all leadership domains [5].

A quantitative cross-sectional survey is the best way to get a wide range of views. In addition, only a modest number of people answered the survey. Only 30% of Riyadh's 900 residents responded to the questionnaire, which was sent to all the training centers in the city. Furthermore, due to the quantitative nature of this study, we were only able to collect a limited amount of information. One of the most pressing needs is to learn how residents view leadership and whether or not they believe family physicians should adopt a particular leadership style. Finally, there are no other local or regional studies to compare our findings to.

Reducing the Appeal of Smoking: Study Confirms Tobacco … – UNC Health and UNC School of Medicine

March 31, 2023 medical

Leah Ranney, PhD, MA, associate professor in the Department of Family Medicine at the UNC School of Medicine, and Adam Goldstein, MD, MPH, professor and director of Departmental Advancement at the UNC Department of Family Medicine, led a first-in-kind study showing how tobacco warnings can improve considerably to follow proposed WHO FCTC guidelines.

CHAPEL HILL, NC Smoking has been glamorized to consumers for decades, but the packaging of combustible tobacco products have been the central target in a global effort to get more people to not smoke. From colorful pictures to specific wording, what is seen on the surface packaging of these products has long served as the main component in advertising for tobacco companies. In an effort to implement warning labels to help communicate health risks to both current and potential consumers, one study confirms that effective warnings can increase knowledge of the grim realities of tobacco use and awareness of its risks.

Research has been underway to assess adoption of warning labels for combustible tobacco products worldwide. Led by Leah Ranney, PhD, MA, associate professor in the UNC Department of Family Medicine and Adam Goldstein, MD, MPH, professor and director of Departmental Advancement at the UNC Department of Family Medicine, UNC School of Medicine researchers conducted a study published in the BMJ Open titled, How do current tobacco warnings compare to the World Health Organization (WHO) Framework Convention for Tobacco Control (FCTC) guidelines: a content analysis of combustible tobacco warnings worldwide. After identifying a total of 316 warnings from 26 English-speaking countries or jurisdictions results showed only 53 warnings or just 17% included three key characteristics recommended by the WHO FCTC on a single warning: a marker word such as WARNING prior to the warning statement, cessation resources (i.e., quitline phone number or website) and a pictorial that was not a smoking cue (like a burning cigarette.)

Our systematic evaluation of combustible tobacco warnings was important to understand the current landscape of warnings worldwide and to assess at what level evidence-based research was being implemented into these warnings, said Ranney, first author of the study and director of UNCs Tobacco Prevention and Evaluation Program. Our research is the first to compile existing English language combustible tobacco warnings, and our findings confirm that tobacco warnings can improve considerably to follow proposed WHO FCTC guidelines.

These guidelines from the WHO explicitly recommend removing advertising and promotion on tobacco product packaging, including all design features that make tobacco products attractive. Research supporting this recommendation concludes that plain packaging with health warning pictures increases visual attention to warnings, increases harm perceptions,and reduces pack appeal, but may not increase the effectiveness of the health warning labels.As of October 2020, 17 countries have adopted plain packaging.

According to the study, 182 Parties/countries and jurisdictions, which is 90% of the world population, have signed the WHO FCTC treaty in agreement that they will strive to support and ratify these measures. Warnings included in this study were from countries that have signed and ratified the treaty with the exception of the USA, which signed the FCTC on May 10, 2004 but has yet to ratified the treaty (formally entered into the force of the FCTC).

Unfortunately, the US is the only country we reviewed with text only tobacco warnings and recent tobacco industry litigation in US courts for incorporating images to strengthen US tobacco warnings has been delayed for over a decade, said Goldstein, a co-author on the study and director of the Tobacco Intervention Programs at the UNC School of Medicine.

Current research suggests that larger warnings with pictures/images are more likely to be noticed and more effective in communicating the health risks of smoking. Warnings with pictures identified in the study were primarily from the UK, Canada and Jamaica.Compared with text-only warnings, warnings with images are rated as more personally relevant,more likely to draw attention and be remembered, promote cessation attempts and decrease consumption. Key recommendations from the FCTC include having a variety of warning labels that clearly communicate health risks as well as different issues related to tobacco use; such as, advice on quitting, the addictive nature of tobacco and adverse economic outcomes. The WHO guidelines also recommend several design elements for tobacco warnings, including: location, size, use of pictures, color, rotation, message content, language and source attribution.

These recommendations are a key component for implementing a comprehensive integrative approach to tobacco control, said Ranney.An abundance of research shows that well-designed warnings on tobacco products can increase public awareness of the health effects of tobacco use and be effective in reducing tobacco product use.

Goldstein said, A person who smokes a pack a day will see a tobacco warning on their pack over 7,000 times a year, proving an incredibly potent stimulus to help them quit smoking.

Of these warnings, the study shows, 94% included warning text and an image. Warning text statements most often described health effects to the respiratory (26%), circulatory (19%) and reproductive systems (19%). Cancer was the most frequently mentioned health topic (28%). Fewer than half of warnings included a Quitline resource (41%). Few warnings included messages about secondhand smoke (11%), addiction (6%) or cost (1%). Of warnings with images, most were in color and showed people (88%), mostly adults (40%). More than 1 in 5 warnings with images included a smoking cue.

Ranney said its important for readers to understand that this study, while it includes a great deal of combustible (i.e., cigarette, cigars, hookah, pipes, bidis) tobacco warnings from many countries, is not inclusive of all tobacco warnings globally. Also, there were some limitations: researchers collected only English-language warnings, all the warnings were identified through electronic database searches, and some of the warning images were poor making it difficult to identify and code all warning characteristics.

While theres still more research that needs to be done, this systematic study identified the key characteristics of existing combustible tobacco warnings to better understand how these warnings compare to current warning guidelines based on research.

Population-based tobacco control interventions like effective tobacco product warnings working synergistically with other tobacco control interventions (media campaigns, cessation programs, anti-tobacco policies, etc.) is the strategy for moving towards tobacco free environments and reduce tobacco product consumption, said Ranney.

Media Contact: Brittany Phillips, Communications Specialist, UNC Health, UNC School of Medicine

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Reducing the Appeal of Smoking: Study Confirms Tobacco ... - UNC Health and UNC School of Medicine

Family Medicine

6 recognized in Bedford County Hall of Excellence – WTAJ – www.wtaj.com

March 31, 2023 medical

BEDFORD COUNTY, Pa. (WTAJ) The Bedford Area School District is giving back to six people who have had a positive impact on the community.

Six people were inducted into the Hall of excellence in Bedford County on Thursday. They traveled from all over the country to be recognized for their contributions to the community. From family doctors to athletic coaches to cancer researchers, they each have positively impacted those around them.

According to the events organizers, The Hall of Excellence honors individuals who have made significant life-long contributions as either graduates of the Bedford Area School District, former educators who served with distinction, or those who have made significant contributions of time and effort to the District.

Here are this years inductees for the Hall of Excellence:

Dr. David Baer (Class of 1971): David graduated from Juniata College in 1975 and then attended Thomas Jefferson Medical School in the Physician Shortage Area Program (PSAP) with early admission. This program encouraged and trained rural students to return to underserved areas.Dr. Baer graduated from PSAP in 1979. He then trained in residency and fellowship in family medicine at St. Margaret Memorial Hospital in Pittsburgh. After graduating, he served as an ER Physician in Indiana, PA for two years from 1983 to 1985, before returning to Bedford to start a private practice as a family doctor.

William Bill Creps (Class of 1956): Bill attended Frostburg University and received a degree in education. He then taught at Everett for half a year before he began teaching and coaching at Bedford High School in 1966. He taught math for 33 years. During that time he coached track, wrestling, and football during and after teaching at Bedford High School. He was the first Jr. High Wrestling Coach. He then coached varsity wrestling for 25 years.

Douglas Kuhns Ph.D. (Class of 1972): Doug graduated from the University of Pittsburgh in 1985. He has over 100 published works in cancer research. He currently works at Frederick National Laboratory for Cancer Research and has been in his current position for 35 years. Doug has discovered and developed new tools to help diagnose and understand Chronic Granulomatous Disease better.

William Bill Masterson: Bill Masterson was born in New York City on November 25, 1914. His parents were actors in New York City, he was raised in Lock Haven by his grandparents, Mr. and Mrs. Harvey Gahagan. Bill was the first male teacher ever at the Bedford Elementary School. He was a sixth-grade teacher for 30 years from 1946-1976. He started the Parks and Recreation Program in 1949. He officiated basketball and football for 25 years.

Norma L. (Gloor) Pyle (Class of 1953): After graduating high school, Norma attended Penn State University to major in music education. She was hired by the Everett School District as the elementary school music teacher. She then furthered her education at PSU Altoona and obtained her Early Childhood Education Degree. Norma then became employed by the Bedford Area School District as a third grade teacher and introduced the Gifted Education Program.

Mark Tennant (Class of 1979): He went on to attend Oral Roberts University, graduating in 1983. In 1992 he founded The Arrow Child & Family Ministries, which is a Christian-based foster care and adoption organization. After founding and serving Arrow Child and Family Ministries, Mark became the vice president of ministry advancement for East-West Ministries International.

This is a great event, Eric Zembower, President of the Bedford Area School District said. To hear these stories of these folks who have given to the community is truly unbelievable.

Organizers also say theyre glad to be back on track since they had to double up on inductees last year because of the covid-19 pandemic.

The event took place on Thursday, March 30 at 6:30 p.m. in the Bedford High School auditorium.

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6 recognized in Bedford County Hall of Excellence - WTAJ - http://www.wtaj.com

Family Medicine

Community Health Centers in Riverton and Lander are thankful for … – County 10 News

March 31, 2023 medical

March 30 is National Doctors Day, and we appreciate all the work they do for our patients and community.

Dr. Daniel Bender, DO provides care in Riverton with our Family Medicine team.

My patients are given the opportunity to express their values and preferences and to strongly participate in decisions about their care.

Dr. Benders goal in his practice is to design an individual treatment plan to help each one of his patients achieve the best outcome possible.

Dr. Maggie Bonilla, DO provides care in Lander Pediatrics.

I am passionate about evidence-based medicine and shared decision-making.

Dr. Bonilla offers support in breastfeeding and lactation, nutrition medicine, BMI/lifestyle counseling and advocates for pediatric mental health.

Dr. Cheryl Fallin, MD provides care in Lander Pediatrics.

Kids never cease to amaze me with their insights and resilience.

Her greatest joy in practice is watching the children she cares for become amazing adults. She has been in Lander for over 18 years and is invested in the care our youth and their families receive.

Dr. Ken Holt, DO provides care in Riverton for Womens Health.

Dr. Holt is an OB/GYN and has alsoreceived extensive training in both minimally invasive surgery and the treatment of urologic disorders in women.

Community Health Centers in Riverton, Lander and Dubois are accepting new patients. Financial services include Wyoming Medicaid/Medicare, most insurances, and a sliding fee scale to help qualifying patients. Visitchccw.orgto request an appointment and learn more about our caring providers!

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UND medical students celebrate Match Day 2023 – UND Today – University of North Dakota

March 31, 2023 medical

More than half of the M.D. Class of 2023 graduates matched into primary care specialties

Editors note: This story originally appeared in the UND School of Medicine & Health Sciences For Your Healthblog. Its beingreprinted here with permission.

Im overwhelmed and excited, smiled Grand Forks native Annabel Jiran from a classroom on the second floor of the main UND School of Medicine & Health Sciences (SMHS) building in Grand Forks. UND has prepared me well for the next phase of training through fostering my ability to question, think critically, integrate knowledge, communicate clearly, and empathize some of the most important skills for continuing life-long learning and practicing medicine.

Shes headed to Klamath Falls, Ore., in June, said Jiran, to begin a family medicine residency at Oregon Health & Science University.And she couldnt be happier.

I chose family medicine so I can work with patients in all walks of life and build lasting relationships with them, their families, and their community, Jiran said. I also want to reach those for whom healthcare is the least accessible, and family medicine will equip me well to serve a rural, underserved area where I can pursue a variety of passions within medicine.

Jiran is among the 72 fourth-year medical students at the SMHS who on Friday, March 17, 2023, matched via the nationwide medical student Match Day. Every year on Match Day, graduating students learn where they will complete their residency, a period of advanced intensive training in their chosen specialty, before embarking on independent practice as a physician.

At noon (EST) last Friday, such residency matches were given out to a total of 40,375 medical students in the United States the largest Match Day on record by theNational Resident Matching Program(NRMP), which is celebrating its 70thyear of matching graduating medical students to residency programs. Depending on the medical specialty, medical school graduates complete anywhere from three to seven years of residency training after medical school.

UND students are no exception.

UND prepared me well for this transition to residency by exposing me to many medical situations and encouraging independence in patient encounters, added Velva, N.D., native Sarah Wherley, who is soon starting a family medicine residency in Bismarck, N.D. I am so relieved to be staying close to home for the rest of my training. I feel lucky that we have opportunities to learn from talented physicians here in North Dakota.I also enjoy teaching, so primary care puts me in a position to educate patients and increase healthcare literacy.

Wherley is among the 52 percent of the M.D. Class of 2023 graduates (38/72) who matched into primary care specialties of family medicine, internal medicine, obstetrics & gynecology, and pediatrics. More than 13 percent (10 of 72) of the cohort are set to enter family medicine above the national average of students matching into family medicine while 14 students (nearly 20 percent) are entering internal medicine residencies.

This is a strong class whose dedication to primary care is obvious, added Dr. Joshua Wynne, dean of the SMHS. And were very happy to see that more than one out of every five of this years graduates [22 percent] will be completing a residency in North Dakota.

Retaining such graduates for North Dakota residencies matters, said Wynne, because many residents end up practicing at or close to hospitals and clinics where they complete their residencies. As such, more North Dakota residency matches likely means more physicians staying in North Dakota, helping ameliorate the states provider shortage across specialties.

Primary care notwithstanding, other specialties chosen by this years class include anesthesiology, diagnostic radiology, emergency medicine, neurology (including child neurology), psychiatry, and both general and orthopedic surgery.

I was ecstatic to find out where I matched! beamed Mandan, N.D., native Justin Schafer, who is headed to Regions Hospital/Hennepin Healthcare in Minneapolis/St. Paul for a psychiatry residency. Ive loved my training experience in North Dakota, and I am excited to experience a different patient population that Minneapolis has to offer. Minneapolis is also close to family so I know Ill always be a quick drive home if needed.

Schafer said he fell in love with acute psychiatric care during a rotation at the State Hospital in Jamestown, N.D.

The complex social situations, the rapid improvements seen with patients, the constant innovations, and the high mental health need I witnessed in my local communities were the reasons I felt a calling for psychiatry, he continued. UND provided me with a diverse range of training opportunities which included a longitudinal multidisciplinary rotation in Dickinson, a rural-focused experience in Hettinger, and time with semi-urban populations in Fargo and Bismarck. Ive been able to grow my confidence, independence, and adaptability by being in these vastly different locations.

This years UND cohort will see UND SMHS graduates entering not only the several residency programs in North Dakota but those in half of the other American states around the country, including at the Mayo Clinic in Rochester, Minn., and programs in Alaska, Arizona, California, Colorado, Delaware, Florida, Illinois, Iowa, Kansas, Nebraska, New Hampshire, New York, North Carolina, Ohio, Oregon, Pennsylvania, Michigan, Missouri, Tennessee, Texas, Utah, Washington, and Wisconsin.

Match Day is the culmination of work conducted by the NRMP, a private, not-for-profit corporation founded in 1952 at the request of medical students to standardize the residency selection process and establish a uniform date of appointment to positions in graduate medical education (GME) training programs. The NRMP is governed by a board of directors that includes representatives from national medical and medical education organizations as well as medical students, resident physicians and GME program directors.

Results of the Match are closely watched because they can predict future changes in the physician workforce. Of the more than 40,000 slots filled this year, said the NRMP, 34,822 were first-year (PGY-1), an increase of 1.0 percentage point over last year.

I am very excited for our graduating students, said Jim Porter, Ph.D., associate dean for Student Affairs & Admissions at the SMHS. This class, perhaps more than any other, was impacted by the onset of COVID in the spring of their first year. They were thrown for a major loop, but have shown real resilience and grit in getting through their studies and matching into some very competitive programs. Friday was a good day.

The full Match Day 2023 list is available courtesy of the SMHS.

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UND medical students celebrate Match Day 2023 - UND Today - University of North Dakota

Family Medicine

Columbia Establishes the Center for the Transition to Parenthood with Funding from the Bezos Family Foundation – Newswise

March 31, 2023 medical

Newswise NEW YORK, NY (March 30, 2023)--With a transformational gift from the Bezos Family Foundation, Columbia will launch the Center for the Transition to Parenthood (TtP) in the Department of Obstetrics and Gynecology (Ob/Gyn). Supported by the most advanced scientific knowledge in the field, the TtP Center seeks to reinvent prenatal care, address the mental health of parents, improve the overall health of their infants, and promote family well-being.

The Center, established with a gift of $21 million from the Bezos Family Foundation, will develop, test, and put into practice a range of accessible educational tools for new parents to help reduce stress, improve social support, protect sleep, set intentions for parenting that take into account ones own upbringing, prepare for postpartum isolation, manage couple conflict, and foster an understanding of fetal exposures that increase the risk of neurobehavioral disorders later in life. The TtP Center will be a pioneer in assembling these services and augmenting and accelerating applicable research to support interventions promoting optimal outcomes for parents-to-be and their developing children.

The Center will be led by Dr. Catherine Monk, the inaugural Diana Vagelos Professor of Womens Mental Health in the Department of Obstetrics & Gynecology, Professor of Medical Psychology in the Department of Psychiatry at Columbia University Vagelos College of Physicians and Surgeons, and Research Scientist at New York State Psychiatric Institute. Dr. Monk leads the Perinatal Pathways Lab at CUIMC.

We can improve outcomes for new parents and infants by applying our knowledge of how parents well-being affects their offspring before birth and our understanding of what happens to the parental brain during and after pregnancy. Its time we put this science into practice and change the standard of care, said Dr. Monk. The Bezos Family Foundations support enables us to develop successful models to enhance prenatal care and help build healthy families at their origins, in the prenatal period.

The TtP Center will bring together what is known from the fields of perinatal psychiatry, obstetrics, developmental psychobiology, and neuroscience to focus on the earliest influences on childrens developmental trajectoriesthose that happen in uteroto prevent risk for mental health disorders in children.The work will involve an interdisciplinary team of psychologists, neuroscientists, and mental health clinicians, as well as community experts such as doulas, midwives and family medicine doctors, partnering with their Ob/Gyn colleagues. The Center will engage community-based organizations, community health workers, and patients with lived experiences from diverse backgrounds to ensure equity in creating new perinatal care practices and to effectively develop materials that reflect the latest science. Routine focus groups will provide insight into patient and provider experiences from the community that will be instrumental in developing materials made by and for the people who will use them.

We are thrilled to be able to build upon the support we offer to pregnant and postpartum patients as they transition to parenthood and grateful that the Bezos Family Foundation is making this expansion possible, said Mary DAlton, the Willard C. Rappleye Professor of Obstetrics & Gynecology, Chair of the Columbia University Department of Obstetrics & Gynecology. Their commitment to fostering research on the earliest connections between parents and their infants is critical to further developing innovative programs that will have an impact well beyond Columbia.

Starting in 2019 with support from the Bezos Family Foundation, Columbia launched an initiative to embed mental health professionals in its Department of Ob/Gyn to increase access to insurance-based mental health care, particularly during pregnancy, and enhance multidisciplinary collaboration.

We are proud to support Columbia in launching the Transition to Parenthood Center to focus on this important period of development for infants and their families, said Jackie Bezos, President of the Bezos Family Foundation. Science is clear that the prenatal period is critical to the future well-being of families. With its strong team, deep roots in research, and commitment to collaborating with patients and community partners, Columbia is well-positioned to advance scientific discoveries and create research-based programs and models of care to improve the health and well-being of children and their parents."

I am looking forward to seeing this first-of-its-kind Center make meaningful improvements in the psycho-social health of new parents and their children, said Katrina Armstrong, MD, Dean of the Vagelos College of Physicians and Surgeons and Executive Vice President for Health and Biomedical Sciences for Columbia University. The Bezos Family Foundation is a superb partner, and we especially appreciate their determination to help reduce disparities in the care received by pregnant women.

Addressing a Public Health Need

Even before the birth of a child, emerging parenthood is marked by changes in the brain comparable to that of adolescence. Meanwhile, in utero, the future childs brain is shaped by biological cues related to a pregnant persons well-being, nutritional status, stress, and mental health. While substantial research documents this two-generation brain plasticity, prenatal clinical services have not yet incorporated these findings into the standard of care.

An estimated 30% of pregnant women report psychosocial stress, including job strain and depression or anxiety symptoms, and nearly 12% of pregnant individuals meet criteria for a perinatal mental health condition; sadly, less than 50% of women in need of care receive it, and the rate is even lower among women of color.

In the U.S., the prevalence of child neurobehavioral problems is significant: 6.1 million children have been diagnosed with ADHD, 4.4 million with anxiety, and 7 million are classified as disabled based on learning difficulties. Some of these problems have roots in the prenatal period, potentially related to high levels of maternal stress, anxiety, and depression.

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Columbia University Vagelos College of Physicians and Surgeons

Columbia University Vagelos College of Physicians and Surgeons (VP&S) is the medical school of Columbia University, and located at Columbia University Irving Medical Center, a clinical, research, and educational campus located in New York City. Founded in 1767, VP&S was the first medical school in the United States to award the Doctor of Medicine (MD) degree. VP&S iscommitted to providing inclusive and equitable health and medical education, scientific research, and patient care, and working together with our local upper Manhattan communityone of New York City's most diverse neighborhoods. For more information, please visitvagelos.columbia.edu.

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Columbia Establishes the Center for the Transition to Parenthood with Funding from the Bezos Family Foundation - Newswise

Family Medicine

Doctor calls for increase in family planning education | Loop Jamaica – Loop News Jamaica

March 31, 2023 medical

Family Medicine Physician at the Westmoreland Health Services, Dr Henrika Gayle, is calling for an increase in family planning education, particularly for women who have never been pregnant.

Dr Gayle, who undertook a study entitled, Prevalence and Determinants of Non-barrier Contraceptive Use Among Women in Westmoreland, was a winner in two categories at the 2022 National Health Research Conference.

These were Best Overall Poster Presentation and Most Impactful Poster Presentation.

The study revealed a high prevalence of non-barrier contraception among parous women (women who have children) and low rates among nulligravid women (women who have never been pregnant).

Dr. Gayle explained that this demonstrated high rates of unplanned pregnancies and that many women used contraception for the first time after being pregnant at least once.

A cross-sectional study design was used across five randomly selected health centres in Westmoreland. A total of 243 non-pregnant women aged 16 to 49 years were sampled using a questionnaire divided into three parts demographics, reproductive history and access to contraception.

The study found that while the prevalence of non-barrier contraception use was 53 per cent, it was just 21 per cent in nulligravid women. It was also determined that parous women were 8.5 times more likely to use non-barrier contraception than nulligravid women.

Daily I see young women who are sexually active come into the office and decisively tell me that they do not want to get pregnant, yet still they are not using contraception and when you delve a little bit deeper and you ask why is it that they are not using contraception, they are hardly ever able to give a real answer, Dr. Gayle said.

She lamented the fact that although there are contraceptive options available to women, they are having unwanted or unplanned pregnancies, and these are associated with an increased risk of poverty, reduced educational attainment, reduced personal attainment and a reduced quality of life for both mother and child.

Dr. Gayle referenced previous studies done in Jamaica, which showed that up to 40 per cent of women in the country get pregnant before 20 years old and that up to 80 per cent of those pregnancies are unwanted.

This, she added, represents a high pregnancy rate, especially among teenage mothers.

The family medicine physician noted that similar to what has been found in these national studies, the parish of Westmoreland has a high rate of pregnancy.

Westmoreland was ranked the parish with the fifth highest pregnancy rate in the age groups 15 to nine years old, so it highlights the need for appropriate family planning methods, Dr. Gayle emphasised.

The objectives of the study were to determine the prevalence of non-barrier contraceptive usage in women in Westmoreland; and to examine determinants that influence its usage.

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Doctor calls for increase in family planning education | Loop Jamaica - Loop News Jamaica

Family Medicine

Growing Readers program expanding – The Republic

March 31, 2023 medical

In partnership with local pediatric care providers, the Bartholomew County Public Library and Viewpoint Books are expanding the Growing Readers program to increase access to early literacy resources throughout the community.

The Growing Readers program began last year with the aim of encouraging children to read 1,000 books before kindergarten, but it is growing to meet evolving needs within the community, according to organizers. Thanks to grants from both the Heritage Fund the Community Foundation of Bartholomew County, and the Mildred A. Reeves Early Education Fund, the program will now extend beyond the initial scope and increase impact by:

Research has shown that when it comes to early literacy development, it is not the just quantity of words a child hears from their caregivers or the number of books they read together, but the quality of the interactions between them that matters most.

Organizers said the expanded program, with its emphasis on providing both reading materials and caregiver education, seeks to empower families to be involved in their childrens early literacy development in ways that are both meaningful and effective.

After extensive research and discussions with local pediatric care providers, it became clear that the most effective means of reaching children and their caregivers would be at scheduled well-medical visits. With roughly 95 percent of children living in Bartholomew County attending their scheduled well visits, this partnership program will provide the tools and information families need by reaching them in a place they are already visiting regularly.

During the initial pilot period, families with children between 6 months and 5 years old at Northside Pediatrics and Sandcrest Family Medicine will receive quality books, early literacy tips, and support information suited to their childs age and development.

Organizers said that eventually, the program hopes to work with all of the pediatric care providers in the county and in doing so to reach all children in the community.

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Growing Readers program expanding - The Republic

Family Medicine

AAFP President: We Need to Go Forward, Not Backward, on Racial … – Patient Care Online

March 31, 2023 medical

"As a family physician one finding that particularly stood out to me is that adults of color were more likely than white adults to report not having a usual doctor or provider and to have to go without care because of the cost."

American Academy of Family Physicians president Tochi Iroku-Malize, MD, MPH, MBA, referred to findings from the recent Kaiser Family Foundation update to its data on health and health care in the US by race and ethnicity. The update revealed that approximately one-third of Hispanic adults, one-quarter of American Indian Alaskan Native adults, and 1 in 5 Black and Asian adults do not have a personal health care provider vs 16% of White adults.

Among other grave concerns about the findings, Iroku-Malize framed data on US maternal and infant mortality among racial and ethnic minorities as moving backward in the 21st century, not forward. More of her conversation with Patient Care follows.

Tochi Iroku-Malize, MD, MPH, a family physician in Long Island, New York, is current president of the American Academy of Family Physicians. Iroku-Malize serves as founding chair and professor of family medicine for the Donald and Barbara Zucker School of Medicine at Hofstra/Northwell in Hempstead, New York, and is senior vice president and chair of the family medicine service line for Northwell Health. She oversees 4 family medicine residency programs and 3 fellowships spread across 23 hospitals. She was previously the director of the family medicine residency program at Southside Hospital in Bay Shore, New York. She is currently a member of the Society of Teachers of Family Medicine and is active in the Association of Departments of Family Medicine.

Tobacco assessments decline in primary care – Healio

March 31, 2023 medical

March 30, 2023

2 min read

Disclosures: Flocke and colleagues report no relevant financial disclosures.

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The monthly rates of tobacco assessments in primary care decreased by half during the early months of the COVID-19 pandemic and remained low despite transitions back to in-person care, according to a recent study.

Since the start of the pandemic, several studies have shown a decline in receipt of preventive care and chronic disease management, Susan A. Flocke, PhD, a professor in the department of family medicine at Oregon Health & Science University, and colleagues wrote in Annals of Family Medicine. Little is known about the impact of the pandemic on addressing tobacco use. Given the relevance of tobacco use for severe symptoms of COVID-19, it is important to understand the pandemics impact on tobacco assessment and cessation assistance.

Furthermore, diminishing the harms of smoking is particularly important in the context of community health centers (CHCs) which provide primary care services for a large proportion of socioeconomically disadvantaged patients, the researchers wrote.

To evaluate changes in tobacco assessments and cessation assistance, Flocke and colleagues analyzed electronic health record data from 217 CHCs across 13 states. The analysis included 759,138 in-person and telehealth visits that occurred from Jan. 1, 2019, to July 31, 2021.

Tobacco assessment rates declined from 155.7 per 1,000 patients in January 2019 to February 2020 to 77.7 per 1,000 patients in March 2020 to May 2020, equaling a 50% decrease. Although rates rose from June 2020 to May 2021, they remained 33.5% below pre-pandemic levels, according to Flocke and colleagues.

Provisions of tobacco cessation counseling also decreased, although to a lesser extent, from 109.5 per 1,000 tobacco users in January 2019 to February 2020 to 87.1 per 1,000 tobacco users in March 2020 to May 2020. Like tobacco assessments, provisions increased to 107.9 per 1,000 tobacco users from June 2020 to May 2021, though were still 2.5% lower than pre-pandemic levels.

Provision of tobacco cessation medications was low, 43.9 per 1,000 tobacco users from January 2019 to February 2020, and declined slightly across the time periods, the researchers wrote.

Flocke and colleagues noted it is possible that tobacco assessments were interrupted during the transition to telehealth and never reestablished when care returned to the physical clinical setting.

Tobacco assessment before the pandemic was likely conducted by medical assistants during the rooming process involving vital signs and tobacco use history, they wrote. It is likely that telehealth visits changed this workflow such that gathering vital signs typically done by the person who roomed the patient was omitted as a step before initiating the interaction between the patient and clinician.

Additionally, though telehealth services could be effective in assessing patients tobacco history and potential treatments, lack of standard workflow on when and who should assess tobacco history during telehealth visits in CHCs could have impeded tobacco assessment performance, the researchers wrote.

They concluded that due to the health consequence of tobacco use, all primary care settings should have a process in place to routinely assess tobacco status and to provide assistance for quitting.

Careful examination of procedural changes that promote or impede assessment of tobacco, including adaptation to support tobacco assessment via telehealth, is needed to guide resilient procedures that can weather operational changes, they wrote.

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