BACKGROUND Incorporating shared medical appointments (SMAs) or group visits into clinical practice to improve care and increase efficiency has become a popular intervention, but the processes to implement and sustain them have not been well described. The purpose of this study was to describe the process of implementation of SMAs in the local context of a primary care clinic over time. METHOD...

BACKGROUND Antenatal care (ANC) clinics serve as key gateways to screening and treatment interventions that improve pregnancy outcomes, and are especially important for HIV-infected women. By disaggregating data on access to ANC, we aimed to identify variation in ANC attendance by level of care and across vulnerable groups in inner-city Johannesburg, and document the impact of non-attendance on...

BACKGROUND The elderly population consumes a large share of medical resources in the western world. A significant portion of the expense is related to hospitalizations. OBJECTIVES To evaluate an intervention program designed to reduce the number of hospitalization of elderly patients by a more optimal allocation of resources in primary care. METHODS A multidimensional intervention program w...

Witnessing violence can have an adverse effect on children and adults. To determine the prevalence and selected correlates of witnessing violence among young children and their mothers, we consecutively recruited 143 parents (88% of those eligible) with children 1 to 5 years of age from the pediatric primary care clinic at Boston City Hospital. The final sample of 115 mothers were English-speak...

OBJECTIVE To measure exposure to different types of violence among school-aged children in a primary care setting. DESIGN Child interviews using an instrument measuring 4 types of exposure (direct victimization, witnessing, hearing reports, media). Violent acts measured include being beaten up, chased/threatened, robbed/mugged, stabbed/shot, killed. SETTING Pediatric primary care clinic of ...

Simple questions are the most commonly used measures of antiretroviral treatment (ART) adherence in sub-Saharan Africa (SSA), but rarely validated. We administered five adherence questions in a public-sector primary care clinic in rural South Africa: 7-day recall of missed doses, 7-day recall of late doses, a six-level Likert item, a 30-day visual analogue scale of the proportion of doses misse...

1Howard University, Washington, DC; 2University of Michigan, Ann Arbor; 3Pulmonary and Vascular Medicine Branch, National Heart, Lung and Blood Institute, and Critical Care Medicine Department, Clinical Center, National Institutes of Health, Bethesda, MD; 4Children’s National Medical Center, Washington, DC; and 5Division of Pulmonary, Allergy and Critical Care Medicine, University of Pittsburgh...

1 Stanford Prevention Research Center, Department of Medicine and Department of Health Research and Policy, Stanford University School of Medicine, Stanford, California, United States of America, 2 Center for Health Policy and Center for Primary Care and Outcomes Research, Stanford University School of Medicine, Stanford, California, United States of America, 3 Veterans Affairs Palo Alto Health...

BACKGROUND Psychosocial constructs are widely used to predict colorectal cancer screening and are targeted as intermediate outcomes in behavioral intervention studies. Reliable and valid instruments for measuring general colorectal cancer screening psychosocial constructs are needed; yet, few studies have conducted psychometric analyses. This study replicated a five-factor structure for 16 theo...

A subsidized primary care clinic in Singapore wanted to evaluate the impact of different patient appointment apportionment and patient-doctor allocation strategies on the cycle time that their patients need to spend during their clinic visits. To the best of the authors’ knowledge, there is limited literature on such studies. This paper aims to fill this research gap via scientific evaluation o...