Brian Jack - Profile on Academia.edu (original) (raw)

Papers by Brian Jack

Journal of General Internal Medicine, Oct 4, 2013

BACKGROUND: Patient activation is linked to better health outcomes and lower rates of health serv... more BACKGROUND: Patient activation is linked to better health outcomes and lower rates of health service utilization. The role of patient activation in the rate of hospital readmission within 30 days of hospital discharge has not been examined. METHODS: A secondary analysis using data from the Project RED-LIT randomized controlled trial conducted at an urban safety net hospital. Data from 695 Englishspeaking general medical inpatient subjects were analyzed. We used an adapted, eight-item version of the validated Patient Activation Measure (PAM). Total scores were categorized, according to standardized methods, as one of four PAM levels of activation: Level 1 (lowest activation) through Level 4 (highest activation). The primary outcome measure was total 30-day post-discharge hospital utilization, defined as total emergency department (ED) visits plus hospital readmissions including observation stays. Poisson regression was used to control for confounding.

Competency-based continuing education for nurses in lesotho

Annals of global health, Mar 12, 2015

Development and calibration data for the Illness Burden item bank: a new computer adaptive test for persons with type 2 diabetes mellitus

Quality of Life Research, Oct 25, 2022

Frontiers in Endocrinology, Aug 4, 2022

Editorial on the Research Topic Using technology for healthy lifestyle and weight management Tech... more Editorial on the Research Topic Using technology for healthy lifestyle and weight management Technology is a double-edged sword when it comes to lifestyle and healthcare. Whilst technology can lead to sedentary behaviors and weight gain, it also has benefits such as greater accessibility and equity for lifestyle modification and health promotion. Traditional lifestyle and weight management interventions are often intense and time consuming hence proving difficult to integrate into routine clinical care. The recent Covid-19 pandemic has further revealed the advantage of technology in delivering health interventions especially when face to face interactions had to be limited. This collection of articles presents a variety of strategies and implications of technology use for healthy lifestyle and weight management including adaptations to target specific populations. It also informs future research by identifying the gaps in the current literature. A meta-review of 72 systematic reviews of Randomised Clinical Trials (RCTs) by Castro et al. demonstrated that smartphone apps and websites were the most frequently used methods of digital health interventions for improving lifestyle. Among the 6 domains of lifestyle, digital health interventions most commonly addressed diet and physical activity. Their review highlights that very few studies to date have investigated the role of digital interventions in other lifestyle aspects including substance use, stress management, sleep, and social relationships. Digital health is a rapidly developing field with over 350,000 applications available globally (1). This vast number of options can leave clinicians and patients feeling inundated and overwhelmed. The review by Ghelani et al. serves to update and notify clinicians about the position of technology in the field of lifestyle and weight Frontiers in Endocrinology frontiersin.org 01

Public Health Research & Practice, Oct 1, 2022

• There is increasing recognition in policy, research and healthcare that a focus on health and w... more • There is increasing recognition in policy, research and healthcare that a focus on health and wellbeing prior to pregnancy is needed to improve health across the population-including for women, men, their future pregnancies and children

BMC Complementary and Alternative Medicine, Jun 1, 2012

Little is known about the use of herbs in low income underserved mothers and patterns of communic... more Little is known about the use of herbs in low income underserved mothers and patterns of communication about herb use to prenatal providers. We sought to examine these issues among women delivering at Boston Medical Center (BMC), an urban medical center serving many of the low income and underserved populations of Boston, Massachusetts.

830-P: The Development of a New Computer Adaptive Test of Illness Burden for Use in People with Type 2 Diabetes Mellitus (T2DM)

Diabetes, Jun 1, 2021

In recent years, a growing body of research has established that social determinants of health in... more In recent years, a growing body of research has established that social determinants of health influence the health outcomes of patients, especially those with T2DM. We developed a new patient-reported outcome (PRO) measure of an important social determinant of behavior that is specific to persons with T2DM: illness burden. Qualitative and quantitative methods informed the development of this new PRO. A literature review and semi-structured key informant interviews guided the establishment of an initial item pool. Expert and patient review, reading level assessment (to ensure no item had >5th grade reading-level language), and a translatability review were all used to refine the original item pool to 47 items. The refined item pool was then tested in 225 patients with T2DM. No items had sparse response option cells or problems with monotonicity; two items were deleted due to low item-rest correlations. Factor analyses (exploratory and confirmatory) supported the retention of 29 items. With those 29 remaining items, a constrained (common slope) graded response model (GRM) fit assessment indicated that two items had misfit and were excluded. No items displayed differential item functioning by age, sex, education, or socio-economic status. Thus, the final item bank is comprised of 27 items. Psychometric considerations (based on item information values) were used, in conjunction with expert content review, to select a 6-item static short form. IRT-based item parameters were employed to make this new measure available as a computer adaptive test. Internal consistency of the new PRO was excellent (α ≥ .90 for all administration formats). The new Illness Burden item bank captures patients’ perceptions of the impact that having T2DM has on their daily lives. It can be used in conjunction with the broader measurement system, the Re-Engineered Discharge for Diabetes Computer Adaptive Test, to evaluate important social determinants of behavior in persons with T2DM. Disclosure S. Mitchell: Other Relationship; Self; See Yourself Health LLC, Speaker’s Bureau; Self; Merck Sharp & Dohme Corp. M. A. Kallen: None. A. Bragg: None. I. Moldovan: None. J. M. Howard: None. B. W. Jack: None. J. A. Miner: None. C. M. Graves: None. N. Carlozzi: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (1R21DK121092)

831-P: The Development of a New Computer Adaptive Test of Medication Adherence for People with Type 2 Diabetes Mellitus: Medication Adherence Item Bank

Diabetes, Jun 1, 2021

Over 27 million Americans have type 2 diabetes mellitus (T2DM), accounting for >7.... more Over 27 million Americans have type 2 diabetes mellitus (T2DM), accounting for >7.7 million hospital admissions. Social determinants of behavior, including medication adherence, play a critical role in their health outcomes. We developed a new patient-reported outcome (PRO) measure to evaluate medication adherence in people with T2DM, using established measurement development standards. An item pool was created that reflected important content related to medication adherence for people with T2DM. The item pool was then refined, using feedback from experts, a reading-level assessment (ensuring no >5th grade reading-level content was included), a translatability review (e.g., to allow future measure translation into Spanish), and feedback from T2DM patients. Next, 225 people with T2DM completed 58 self-report medication adherence items. Exploratory factor analysis supported the item pool’s essential unidimensionality. Five items were excluded due to low item-rest correlations. Confirmatory factor analysis supported retaining 27 items. All items fit the graded response model, and no items had meaningful differential item functioning for the factors age, sex, education, or socioeconomic status. The final item bank is comprised of 27 items and can be administered as a computer adaptive test or 6- item short form. Internal consistency reliability was excellent for all administration formats (α’s all ≥ .90). The new Medication Adherence item bank provides a reliable, content-relevant assessment of medication adherence for people with T2DM. It is part of the comprehensive Re-Engineered Discharge for Diabetes Computer Adaptive Test (REDD-CAT) measurement system, which is designed to capture important social determinants of behavior for people with T2DM. Work is underway to establish additional psychometric properties (e.g., test-retest reliability, validity) of this new measure. Disclosure S. Mitchell: Other Relationship; Self; See Yourself Health LLC, Speaker’s Bureau; Self; Merck Sharp & Dohme Corp. M. A. Kallen: None. A. Bragg: None. I. Moldovan: None. J. M. Howard: None. B. W. Jack: None. J. A. Miner: None. C. M. Graves: None. N. Carlozzi: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R21DK121092)

BMC Health Services Research, 2017

Background: Project Re-Engineered Discharge (RED) is an evidence-based strategy to reduce readmis... more Background: Project Re-Engineered Discharge (RED) is an evidence-based strategy to reduce readmissions disseminated and adapted by various health systems across the country. To date, little is known about how adapting Project RED from its original protocol impacts RED implementation and/or sustainability. The goal of this study was to identify and characterize contextual factors influencing how five California hospitals adapted and implemented RED and the subsequent impact on RED program sustainability. Methods: Participant observation and key informant and focus group interviews with 64 individuals at five California hospitals implementing RED in 2012 and 2013 were conducted. These involved hospital leadership, personnel responsible for Project RED implementation, hospital staff, and clinicians. Interview transcripts were coded and analyzed using a modified grounded theory approach and constant comparative analysis. Results: Both internal and external contextual factors were identified that influenced hospitals' decisions on RED adaptation and implementation. These also impacted RED sustainability. External factors included: impending federal penalties for hospitals with high readmission rates targeting specific diagnoses, and access to external funding and technical support to help hospitals implement RED. Internal or organizational level contextual factors included: committed leadership prioritizing Project RED; RED adaptations; depth, accountability and influence of the implementation team; sustainability planning; and hospital culture. Only three of the five hospitals continued Project RED beyond the implementation period. Conclusions: The sustainability of RED in participating hospitals was only possible when hospitals approached RED implementation as a transformational process rather than a patient safety project, maintained a high level of fidelity to the RED protocol, and had leadership and an implementation team who embraced change and failure in the pursuit of better patient care and outcomes. Hospitals who were unsuccessful in implementing a sustainable RED process lacked all or most of these components in their approach.

Cervical Cancer (Nursing)

Journal of Human Growth and Development, Oct 15, 2020

Introduction: During the past few decades, health workers have come to agree that there is a very... more Introduction: During the past few decades, health workers have come to agree that there is a very important place for preconception care (PCC) in improving maternal and infant pregnancy outcomes. The United States Centers for Disease Control and Prevention (CDC) and the World Health Organization issued recommendations encouraging countries to develop and implement preconception care programs. The reports include an in-depth discussion of the rationale and scientific evidence behind PCC as well as definitions, goals, components and recommended interventions to be included in PCC. These reports also offer very broad guidelines but do not offer details on how to develop and implement preconception care programs. Objective: The CDC and WHO reports identify the need for multisectoral engagement in developing and implementing preconception care programs and propose some activities and strategies to be considered in developing PCC programs. However, the recommendations fall short of specifying real steps that countries and regions should take in implementing PCC programs. In this publication we propose action steps for developing and implementing regional or national preconception care programs. Methods: We reviewed the published and unpublished literature (using PubMed and the Internet) to identify reports that describe processes for developing and implementing PCC programs. We used information from the literature along with experiences we gained through our work and interaction with States and developing countries to prepare a detailed description of the steps involved in developing and implementing a PCC program. Results: We found very little in terms of "tools" for program managers and providers to use when developing and implementing PCC programs. We prepared a guide, including a summary of steps and a proposed timeline, for program directors to use for developing and implementing PCC programs. Conclusion: Developing and implementing a sustainable PCC program should address issues related to educating the public, providers and policy makers about the benefits of PCC. It also includes establishing an infrastructure within the departments of health and ensuring resources to build, guide, monitor and evaluate the PCC program. Finally, implementation of a successful program depends heavily on the proper training of public health and clinical care providers in the delivery of the services included in the program.

Family physicians are an important source of newborn care: the case of the state of Maine

PubMed, Aug 15, 2003

Family physicians (FPs) provided 30 percent of inpatient newborn care in Maine in the year 2000. ... more Family physicians (FPs) provided 30 percent of inpatient newborn care in Maine in the year 2000. FPs cared for a large proportion of newborns, especially those insured by Medicaid and in smaller, rural hospitals where FPs also delivered babies. Family medicine's commitment to serve vulnerable populations of newborns requires continued federal, state, and institutional support for training and development of future FPs.

Preconception care (or how all family physicians can 'do' OB)

PubMed, Jun 1, 1995

A Systematic Review of Clinical Guidelines for Preconception Care

Seminars in Reproductive Medicine, May 16, 2022

Preconception care (PCC) involves a wide-ranging set of interventions to optimize health prior to... more Preconception care (PCC) involves a wide-ranging set of interventions to optimize health prior to pregnancy. These interventions seek to enhance conception rates, pregnancy outcomes, childhood health, and the health of future generations. To assist health care providers to exercise high-quality clinical care in this domain, clinical practice guidelines from a range of settings have been published. This systematic review sought to identify existing freely accessible international guidelines, assess these in terms of their quality using the AGREE II tool, and assess the summary recommendations and the evidence level on which they are based. We identified 11 guidelines that focused on PCC. Ten of these were classified as moderate quality (scores ranging from 3.5 to 4.5 out of 7) and only one was classified as very high quality, scoring 6.5. The levels of evidence for recommendations ranged from the lowest possible level of evidence (III) to the highest (I-a): the highest quality evidence available is for folic acid supplementation to reduce risk of neural tube defects and the role of antiviral medication to prevent HIV transmission. This systematic review identified that high-quality guidelines on PCC are lacking and that few domains of PCC recommendations are supported by high-quality evidence.

American Journal of Obstetrics and Gynecology, Dec 1, 2008

have no conflict of interest including grants, honoraria, advisory board membership, or share hol... more have no conflict of interest including grants, honoraria, advisory board membership, or share holdings. Dean V. Coonrod, MD, MPH is a Grant Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic and has funding from CMS (#1HOCMS030207 101) working on compliance with the 6 week postpartum visit as a strategy to improve preconception care.

American Journal of Obstetrics and Gynecology, Dec 1, 2008

have no conflict of interest including grants, honoraria, advisory board membership, or share hol... more have no conflict of interest including grants, honoraria, advisory board membership, or share holdings. Dean V. Coonrod, MD, MPH, is a Grant Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic and from the State of Arizona for a hospital-based domestic violence program. He has funding from CMS (#1HOCMS030207 101) working on compliance with the 6 week postpartum visit as a strategy to improve preconception care.

The Association Between Adequacy of Prenatal Care Utilization and Subsequent Pediatric Care Utilization in the United States

Pediatrics, Jul 1, 1998

Objective. To explore the association between adequacy of prenatal care utilization and subsequen... more Objective. To explore the association between adequacy of prenatal care utilization and subsequent pediatric care utilization. Design. A longitudinal follow-up of a nationally representative sample of infants born in 1988. Participants. Nine thousand four hundred forty women who had a live birth in 1988, and whose child was alive at the time of interview, and 8285 women from the original sample who were reinterviewed in 1991. Main Outcome Measure. There were four outcome measures: number of well-child visits; adequate immunization for diphtheria, tetanus, and pertussis; adequate immunization for polio; and continuity of a regular source of care, as measured by the number of sites for pediatric care. Results. Children whose mothers had less than adequate prenatal care utilization had significantly fewer well-child visits, and were significantly less likely to have adequate immunizations, even after income, health insurance coverage, content of prenatal care, wantedness of child, sites of prenatal and pediatric care, and maternal and pregnancy risk characteristics were taken into account. Less than adequate prenatal care utilization was not associated with having more than one pediatric care site. Conclusions. Prenatal care utilization can be used to identify and target interventions to women who are at risk for not obtaining well-child care or complete immunizations for their children.

American Journal of Obstetrics and Gynecology, Dec 1, 2008

Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic and has fu... more Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic and has funding from CMS (#1HOCMS030207 101) working on compliance with the 6 week postpartum visit as a strategy to improve preconception care.

Main text 3859 excluding references. Abbreviations: CCI = Consumer and community involvement; HiP... more Main text 3859 excluding references. Abbreviations: CCI = Consumer and community involvement; HiPPP = Health in preconception, pregnancy and postpartum. Declarations Ethical approval and consent to participate: Not applicable Consent for publication: Not applicable. Availability of data and material: Documentation and materials relating to phases 1-3 are summarised within the manuscript.

Journal of General Internal Medicine, Oct 4, 2013

BACKGROUND: Patient activation is linked to better health outcomes and lower rates of health serv... more BACKGROUND: Patient activation is linked to better health outcomes and lower rates of health service utilization. The role of patient activation in the rate of hospital readmission within 30 days of hospital discharge has not been examined. METHODS: A secondary analysis using data from the Project RED-LIT randomized controlled trial conducted at an urban safety net hospital. Data from 695 Englishspeaking general medical inpatient subjects were analyzed. We used an adapted, eight-item version of the validated Patient Activation Measure (PAM). Total scores were categorized, according to standardized methods, as one of four PAM levels of activation: Level 1 (lowest activation) through Level 4 (highest activation). The primary outcome measure was total 30-day post-discharge hospital utilization, defined as total emergency department (ED) visits plus hospital readmissions including observation stays. Poisson regression was used to control for confounding.

Competency-based continuing education for nurses in lesotho

Annals of global health, Mar 12, 2015

Development and calibration data for the Illness Burden item bank: a new computer adaptive test for persons with type 2 diabetes mellitus

Quality of Life Research, Oct 25, 2022

Frontiers in Endocrinology, Aug 4, 2022

Editorial on the Research Topic Using technology for healthy lifestyle and weight management Tech... more Editorial on the Research Topic Using technology for healthy lifestyle and weight management Technology is a double-edged sword when it comes to lifestyle and healthcare. Whilst technology can lead to sedentary behaviors and weight gain, it also has benefits such as greater accessibility and equity for lifestyle modification and health promotion. Traditional lifestyle and weight management interventions are often intense and time consuming hence proving difficult to integrate into routine clinical care. The recent Covid-19 pandemic has further revealed the advantage of technology in delivering health interventions especially when face to face interactions had to be limited. This collection of articles presents a variety of strategies and implications of technology use for healthy lifestyle and weight management including adaptations to target specific populations. It also informs future research by identifying the gaps in the current literature. A meta-review of 72 systematic reviews of Randomised Clinical Trials (RCTs) by Castro et al. demonstrated that smartphone apps and websites were the most frequently used methods of digital health interventions for improving lifestyle. Among the 6 domains of lifestyle, digital health interventions most commonly addressed diet and physical activity. Their review highlights that very few studies to date have investigated the role of digital interventions in other lifestyle aspects including substance use, stress management, sleep, and social relationships. Digital health is a rapidly developing field with over 350,000 applications available globally (1). This vast number of options can leave clinicians and patients feeling inundated and overwhelmed. The review by Ghelani et al. serves to update and notify clinicians about the position of technology in the field of lifestyle and weight Frontiers in Endocrinology frontiersin.org 01

Public Health Research & Practice, Oct 1, 2022

• There is increasing recognition in policy, research and healthcare that a focus on health and w... more • There is increasing recognition in policy, research and healthcare that a focus on health and wellbeing prior to pregnancy is needed to improve health across the population-including for women, men, their future pregnancies and children

BMC Complementary and Alternative Medicine, Jun 1, 2012

Little is known about the use of herbs in low income underserved mothers and patterns of communic... more Little is known about the use of herbs in low income underserved mothers and patterns of communication about herb use to prenatal providers. We sought to examine these issues among women delivering at Boston Medical Center (BMC), an urban medical center serving many of the low income and underserved populations of Boston, Massachusetts.

830-P: The Development of a New Computer Adaptive Test of Illness Burden for Use in People with Type 2 Diabetes Mellitus (T2DM)

Diabetes, Jun 1, 2021

In recent years, a growing body of research has established that social determinants of health in... more In recent years, a growing body of research has established that social determinants of health influence the health outcomes of patients, especially those with T2DM. We developed a new patient-reported outcome (PRO) measure of an important social determinant of behavior that is specific to persons with T2DM: illness burden. Qualitative and quantitative methods informed the development of this new PRO. A literature review and semi-structured key informant interviews guided the establishment of an initial item pool. Expert and patient review, reading level assessment (to ensure no item had >5th grade reading-level language), and a translatability review were all used to refine the original item pool to 47 items. The refined item pool was then tested in 225 patients with T2DM. No items had sparse response option cells or problems with monotonicity; two items were deleted due to low item-rest correlations. Factor analyses (exploratory and confirmatory) supported the retention of 29 items. With those 29 remaining items, a constrained (common slope) graded response model (GRM) fit assessment indicated that two items had misfit and were excluded. No items displayed differential item functioning by age, sex, education, or socio-economic status. Thus, the final item bank is comprised of 27 items. Psychometric considerations (based on item information values) were used, in conjunction with expert content review, to select a 6-item static short form. IRT-based item parameters were employed to make this new measure available as a computer adaptive test. Internal consistency of the new PRO was excellent (α ≥ .90 for all administration formats). The new Illness Burden item bank captures patients’ perceptions of the impact that having T2DM has on their daily lives. It can be used in conjunction with the broader measurement system, the Re-Engineered Discharge for Diabetes Computer Adaptive Test, to evaluate important social determinants of behavior in persons with T2DM. Disclosure S. Mitchell: Other Relationship; Self; See Yourself Health LLC, Speaker’s Bureau; Self; Merck Sharp & Dohme Corp. M. A. Kallen: None. A. Bragg: None. I. Moldovan: None. J. M. Howard: None. B. W. Jack: None. J. A. Miner: None. C. M. Graves: None. N. Carlozzi: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (1R21DK121092)

831-P: The Development of a New Computer Adaptive Test of Medication Adherence for People with Type 2 Diabetes Mellitus: Medication Adherence Item Bank

Diabetes, Jun 1, 2021

Over 27 million Americans have type 2 diabetes mellitus (T2DM), accounting for >7.... more Over 27 million Americans have type 2 diabetes mellitus (T2DM), accounting for >7.7 million hospital admissions. Social determinants of behavior, including medication adherence, play a critical role in their health outcomes. We developed a new patient-reported outcome (PRO) measure to evaluate medication adherence in people with T2DM, using established measurement development standards. An item pool was created that reflected important content related to medication adherence for people with T2DM. The item pool was then refined, using feedback from experts, a reading-level assessment (ensuring no >5th grade reading-level content was included), a translatability review (e.g., to allow future measure translation into Spanish), and feedback from T2DM patients. Next, 225 people with T2DM completed 58 self-report medication adherence items. Exploratory factor analysis supported the item pool’s essential unidimensionality. Five items were excluded due to low item-rest correlations. Confirmatory factor analysis supported retaining 27 items. All items fit the graded response model, and no items had meaningful differential item functioning for the factors age, sex, education, or socioeconomic status. The final item bank is comprised of 27 items and can be administered as a computer adaptive test or 6- item short form. Internal consistency reliability was excellent for all administration formats (α’s all ≥ .90). The new Medication Adherence item bank provides a reliable, content-relevant assessment of medication adherence for people with T2DM. It is part of the comprehensive Re-Engineered Discharge for Diabetes Computer Adaptive Test (REDD-CAT) measurement system, which is designed to capture important social determinants of behavior for people with T2DM. Work is underway to establish additional psychometric properties (e.g., test-retest reliability, validity) of this new measure. Disclosure S. Mitchell: Other Relationship; Self; See Yourself Health LLC, Speaker’s Bureau; Self; Merck Sharp & Dohme Corp. M. A. Kallen: None. A. Bragg: None. I. Moldovan: None. J. M. Howard: None. B. W. Jack: None. J. A. Miner: None. C. M. Graves: None. N. Carlozzi: None. Funding National Institute of Diabetes and Digestive and Kidney Diseases (R21DK121092)

BMC Health Services Research, 2017

Background: Project Re-Engineered Discharge (RED) is an evidence-based strategy to reduce readmis... more Background: Project Re-Engineered Discharge (RED) is an evidence-based strategy to reduce readmissions disseminated and adapted by various health systems across the country. To date, little is known about how adapting Project RED from its original protocol impacts RED implementation and/or sustainability. The goal of this study was to identify and characterize contextual factors influencing how five California hospitals adapted and implemented RED and the subsequent impact on RED program sustainability. Methods: Participant observation and key informant and focus group interviews with 64 individuals at five California hospitals implementing RED in 2012 and 2013 were conducted. These involved hospital leadership, personnel responsible for Project RED implementation, hospital staff, and clinicians. Interview transcripts were coded and analyzed using a modified grounded theory approach and constant comparative analysis. Results: Both internal and external contextual factors were identified that influenced hospitals' decisions on RED adaptation and implementation. These also impacted RED sustainability. External factors included: impending federal penalties for hospitals with high readmission rates targeting specific diagnoses, and access to external funding and technical support to help hospitals implement RED. Internal or organizational level contextual factors included: committed leadership prioritizing Project RED; RED adaptations; depth, accountability and influence of the implementation team; sustainability planning; and hospital culture. Only three of the five hospitals continued Project RED beyond the implementation period. Conclusions: The sustainability of RED in participating hospitals was only possible when hospitals approached RED implementation as a transformational process rather than a patient safety project, maintained a high level of fidelity to the RED protocol, and had leadership and an implementation team who embraced change and failure in the pursuit of better patient care and outcomes. Hospitals who were unsuccessful in implementing a sustainable RED process lacked all or most of these components in their approach.

Cervical Cancer (Nursing)

Journal of Human Growth and Development, Oct 15, 2020

Introduction: During the past few decades, health workers have come to agree that there is a very... more Introduction: During the past few decades, health workers have come to agree that there is a very important place for preconception care (PCC) in improving maternal and infant pregnancy outcomes. The United States Centers for Disease Control and Prevention (CDC) and the World Health Organization issued recommendations encouraging countries to develop and implement preconception care programs. The reports include an in-depth discussion of the rationale and scientific evidence behind PCC as well as definitions, goals, components and recommended interventions to be included in PCC. These reports also offer very broad guidelines but do not offer details on how to develop and implement preconception care programs. Objective: The CDC and WHO reports identify the need for multisectoral engagement in developing and implementing preconception care programs and propose some activities and strategies to be considered in developing PCC programs. However, the recommendations fall short of specifying real steps that countries and regions should take in implementing PCC programs. In this publication we propose action steps for developing and implementing regional or national preconception care programs. Methods: We reviewed the published and unpublished literature (using PubMed and the Internet) to identify reports that describe processes for developing and implementing PCC programs. We used information from the literature along with experiences we gained through our work and interaction with States and developing countries to prepare a detailed description of the steps involved in developing and implementing a PCC program. Results: We found very little in terms of "tools" for program managers and providers to use when developing and implementing PCC programs. We prepared a guide, including a summary of steps and a proposed timeline, for program directors to use for developing and implementing PCC programs. Conclusion: Developing and implementing a sustainable PCC program should address issues related to educating the public, providers and policy makers about the benefits of PCC. It also includes establishing an infrastructure within the departments of health and ensuring resources to build, guide, monitor and evaluate the PCC program. Finally, implementation of a successful program depends heavily on the proper training of public health and clinical care providers in the delivery of the services included in the program.

Family physicians are an important source of newborn care: the case of the state of Maine

PubMed, Aug 15, 2003

Family physicians (FPs) provided 30 percent of inpatient newborn care in Maine in the year 2000. ... more Family physicians (FPs) provided 30 percent of inpatient newborn care in Maine in the year 2000. FPs cared for a large proportion of newborns, especially those insured by Medicaid and in smaller, rural hospitals where FPs also delivered babies. Family medicine's commitment to serve vulnerable populations of newborns requires continued federal, state, and institutional support for training and development of future FPs.

Preconception care (or how all family physicians can 'do' OB)

PubMed, Jun 1, 1995

A Systematic Review of Clinical Guidelines for Preconception Care

Seminars in Reproductive Medicine, May 16, 2022

Preconception care (PCC) involves a wide-ranging set of interventions to optimize health prior to... more Preconception care (PCC) involves a wide-ranging set of interventions to optimize health prior to pregnancy. These interventions seek to enhance conception rates, pregnancy outcomes, childhood health, and the health of future generations. To assist health care providers to exercise high-quality clinical care in this domain, clinical practice guidelines from a range of settings have been published. This systematic review sought to identify existing freely accessible international guidelines, assess these in terms of their quality using the AGREE II tool, and assess the summary recommendations and the evidence level on which they are based. We identified 11 guidelines that focused on PCC. Ten of these were classified as moderate quality (scores ranging from 3.5 to 4.5 out of 7) and only one was classified as very high quality, scoring 6.5. The levels of evidence for recommendations ranged from the lowest possible level of evidence (III) to the highest (I-a): the highest quality evidence available is for folic acid supplementation to reduce risk of neural tube defects and the role of antiviral medication to prevent HIV transmission. This systematic review identified that high-quality guidelines on PCC are lacking and that few domains of PCC recommendations are supported by high-quality evidence.

American Journal of Obstetrics and Gynecology, Dec 1, 2008

have no conflict of interest including grants, honoraria, advisory board membership, or share hol... more have no conflict of interest including grants, honoraria, advisory board membership, or share holdings. Dean V. Coonrod, MD, MPH is a Grant Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic and has funding from CMS (#1HOCMS030207 101) working on compliance with the 6 week postpartum visit as a strategy to improve preconception care.

American Journal of Obstetrics and Gynecology, Dec 1, 2008

have no conflict of interest including grants, honoraria, advisory board membership, or share hol... more have no conflict of interest including grants, honoraria, advisory board membership, or share holdings. Dean V. Coonrod, MD, MPH, is a Grant Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic and from the State of Arizona for a hospital-based domestic violence program. He has funding from CMS (#1HOCMS030207 101) working on compliance with the 6 week postpartum visit as a strategy to improve preconception care.

The Association Between Adequacy of Prenatal Care Utilization and Subsequent Pediatric Care Utilization in the United States

Pediatrics, Jul 1, 1998

Objective. To explore the association between adequacy of prenatal care utilization and subsequen... more Objective. To explore the association between adequacy of prenatal care utilization and subsequent pediatric care utilization. Design. A longitudinal follow-up of a nationally representative sample of infants born in 1988. Participants. Nine thousand four hundred forty women who had a live birth in 1988, and whose child was alive at the time of interview, and 8285 women from the original sample who were reinterviewed in 1991. Main Outcome Measure. There were four outcome measures: number of well-child visits; adequate immunization for diphtheria, tetanus, and pertussis; adequate immunization for polio; and continuity of a regular source of care, as measured by the number of sites for pediatric care. Results. Children whose mothers had less than adequate prenatal care utilization had significantly fewer well-child visits, and were significantly less likely to have adequate immunizations, even after income, health insurance coverage, content of prenatal care, wantedness of child, sites of prenatal and pediatric care, and maternal and pregnancy risk characteristics were taken into account. Less than adequate prenatal care utilization was not associated with having more than one pediatric care site. Conclusions. Prenatal care utilization can be used to identify and target interventions to women who are at risk for not obtaining well-child care or complete immunizations for their children.

American Journal of Obstetrics and Gynecology, Dec 1, 2008

Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic and has fu... more Recipient from the March of Dimes Arizona Chapter to develop an internatal Care Clinic and has funding from CMS (#1HOCMS030207 101) working on compliance with the 6 week postpartum visit as a strategy to improve preconception care.

Main text 3859 excluding references. Abbreviations: CCI = Consumer and community involvement; HiP... more Main text 3859 excluding references. Abbreviations: CCI = Consumer and community involvement; HiPPP = Health in preconception, pregnancy and postpartum. Declarations Ethical approval and consent to participate: Not applicable Consent for publication: Not applicable. Availability of data and material: Documentation and materials relating to phases 1-3 are summarised within the manuscript.