Browsing by Author "Family Medicine, School of Medicine"

Now showing 1 - 10 of 41
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    Are low-carbohydrate or low-fat diets effective in reducing adult acne?
    (Wolters Kluwer, 2020-01) Dams, Travis; Norkus, Bryan; Williams, Ashley; Williams, Jeff; Family Medicine, School of Medicine
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    Assessing a Rural Academic-Community Partnership Using Ripple Effect Mapping
    (Taylor & Francis, 2020) Taylor, Jennifer; Goletz, Sarah; Ballard, Jim; Family Medicine, School of Medicine
    As Area Health Education Centers (AHECs) expand their efforts to improve the distribution and diversity of the healthcare workforce, one common question is how these activities impact their local communities. Ripple Effect Mapping (REM) is an evaluation method designed to assess a program’s intended and unintended impacts, social capital, and partner reciprocity. This study used REM to uncover and explore the intended and unintended impact of a rural AHEC in a 14-county region. The findings of this study provide direction to the AHEC in relation to strengthening their partnerships, social capital, and improving the health workforce in their region.
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    Becoming an Agile Change Conductor
    (Frontiers, 2022) Mehta, Jade; Aalsma, Matthew C.; O'Brien, Andrew; Boyer, Tanna J.; Ahmed, Rami A.; Summanwar, Diana; Boustani, Malaz; Family Medicine, School of Medicine
    Background: It takes decades and millions of dollars for a new scientific discovery to become part of clinical practice. In 2015, the Center for Health Innovation & Implementation Science (CHIIS) launched a Professional Certificate Program in Innovation and Implementation Sciences aimed at transforming healthcare professionals into Agile Change Conductors capable of designing, implementing, and diffusing evidence-based healthcare solutions. Method: In 2022, the authors surveyed alumni from the 2016–2021 cohorts of the Certificate Program as part of an educational quality improvement inquiry and to evaluate the effectiveness of the program. Results: Of the 60 alumni contacted, 52 completed the survey (87% response rate) with 60% of graduates being female while 30% were an under-represented minority. On a scale from 1 to 5, the graduates agreed that the certificate benefited their careers (4.308 with a standard deviation (SD) of 0.612); expanded their professional network (4.615, SD of 0.530); and had a large impact on the effectiveness of their leadership (4.288, SD of 0.667), their change management (4.365, SD of 0.742), and their communication (4.392, SD of 0.666). Graduates claimed to use Agile Processes (Innovation, Implementation, or Diffusion), storytelling, and nudging weekly. On a scale from 0 to 10 where 10 indicates reaching a mastery, the average score for different Agile competencies ranged from 5.37 (SD of 2.80) for drafting business proposals to 7.77 (SD of 1.96) for self-awareness. For the 2020 and 2021 cohorts with existing pre and post training competency data, 22 of the 26 competencies saw a statistically significant increase. Conclusion: The Graduate Certificate has been able to create a network of Agile Change Conductors competent to design, implement, and diffuse evidence-based care within the healthcare delivery system. Further improvements in building dissemination mastery and program expansion initiatives are advised.
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    Beyond the Lines: Exploring the Impact of Adverse Childhood Experiences on NCAA Student-Athlete Health
    (CSRI, 2020) Brown, Braden J.; Jensen, Jakob F.; Hodgson, Jennifer L.; Schoemann, Alexander M.; Rappleyea, Damon L.; Family Medicine, School of Medicine
    Emerging research has highlighted a link between adverse childhood experiences (ACEs) and various health concerns experienced by NCAA student-athletes. Building on prior work (Kaier, Cromer, Davis, & Strunk, 2015), we hypothesized that ACEs would significantly predict student-athletes’ biopsychosocial (BPS) health and that spirituality would serve as a protective factor against the effect of ACEs on BPS health outcomes. Division I, II, and III NCAA student-athletes (N = 477) representing 20 sports across 53 universities completed an online quantitative survey (k = 133) that assessed for ACEs, injury/physical health concerns, anxiety, depression, stress, social support, substance use, and spirituality. Nearly two-thirds (64.5%) of student-athletes endorsed at least one ACE. Structural Equation Models (SEMs) yielded significant positive relationships between ACEs and anxiety, depression, perceived stress, injury/health problems, and substance use, and a negative relationship with social support while controlling for sex, race, school, and division. Additionally, spirituality had a significant negative effect on anxiety, depression, perceived stress, injury/health problems, and substance use, and a positive effect on social support. SEM moderation analyses indicated that spirituality only moderated the relationship between ACEs and substance use. Specifically, at average and high levels of spirituality, the relationship between ACEs and substance use was stronger. Clinical implications, study limitations, and future research directions are discussed.
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    Billing by residents and attending physicians in family medicine: the effects of the provider, patient, and visit factors
    (BMC, 2018-06-13) Al Achkar, Morhaf; Kengeri-Srikantiah, Seema; Yamane, Biniyam M.; Villasmil, Jomil; Busha, Michael E.; Gebke, Kevin B.; Family Medicine, School of Medicine
    BACKGROUND: Medical billing and coding are critical components of residency programs since they determine the revenues and vitality of residencies. It has been suggested that residents are less likely to bill higher evaluation and management (E/M) codes compared with attending physicians. The purpose of this study is to assess the variation in billing patterns between residents and attending physicians, considering provider, patient, and visit characteristics. METHOD: A retrospective cohort study of all established outpatient visits at a family medicine residency clinic over a 5-year period was performed. We employed the logistic regression methodology to identify residents' and attending physicians' variations in coding E/M service levels. We also employed Poisson regression to test the sensitivity of our result. RESULTS: Between January 5, 2009 and September 25, 2015, 98,601 visits to 116 residents and 18 attending physicians were reviewed. After adjusting for provider, patient, and visit characteristics, residents billed higher E/M codes less often compared with attending physicians for comparable visits. In comparison with attending physicians, the odds ratios for billing higher E/M codes were 0.58 (p = 0.01), 0.56 (p = 0.01), and 0.63 (p = 0.01) for the third, second, and first years of postgraduate training, respectively. In addition to the main factors of patient age, medical conditions, and number of addressed problems, the gender of the provider was also implicated in the billing variations. CONCLUSION: Residents are less likely to bill higher E/M codes than attending physicians are for similar visits. While these variations are known to contribute to lost revenues, further studies are required to explore their effect on patient care in relation to attendings' direct involvement in higher E/M-coded versus their indirect involvement in lower E/M-coded visits.
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    Can behavioral therapies assist with cannabis use disorder?
    (Wolters Kluwer, 2023-04) Adame, John D.; Jhon, Nogales-Pimienta; Poonia, Jasmin; Family Medicine, School of Medicine
    Psychosocial/behavioral interventions (primarily cognitive behavioral therapy and motivational enhancement therapy) decrease cannabis use frequency (SOR: A, systematic reviews with meta-analyses of randomized controlled trials [RCTs]). Digital treatment interventions are also effective in reducing cannabis use, albeit with a small overall effect size (SOR: A, systematic review and meta-analysis of RCTs).
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    Conducting Effective Faculty Annual Reviews: A Workshop for Academic Leaders
    (AAMC, 2015-11) Lees, N. Douglas; Palmer, Megan; Dankoski, Mary; Family Medicine, School of Medicine
    Most if not all medical schools require annual performance reviews to be conducted on all or a subset of the faculty. Despite this being a common and recurring job expectation for academic leaders such as department chairs and division directors, such leaders are often poorly prepared to conduct effective reviews. Some of the difficulties stem from lack of training, avoidance of confrontation, lack of role modeling, and the time-consuming and high-stakes nature of the process itself. In addition, administrators report challenges related to insufficient methods for assessing teaching and research, variability in evaluation processes and criteria, and a disconnect between evaluation and salary. Thus, for some academic administrators, the faculty annual review can be perceived as a burden. This 2.5-hour workshop provides academic leaders an opportunity to engage with others about faculty annual reviews so they can have more confidence and resources when engaging in the evaluation process. This resource includes materials related to a leadership development workshop on this topic. The workshop is designed for academic leaders with responsibility for monitoring and assessing the performance of faculty, such as department chairs and division directors. The overall goals of the workshop are to improve the preparation of academic leaders in conducting reviews that provide constructive feedback to faculty members regarding their overall performance and to increase academic leaders’ awareness of and capacity in the use of annual reviews as a means toward increased faculty vitality. Although few attendees submitted formal program evaluations, the workshop was well received when offered at our institution. Six evaluations were submitted from the 18 institutional leaders who attended the workshop. Though few in number, the comments received on the program evaluation indicate a positive response and that our objectives were met. All attendees noted that they were able to identify something they planned to act upon.
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    Dental safety net capacity: An innovative use of existing data to measure dentists’ clinical engagement in state Medicaid programs
    (Wiley, 2018) Maxey, Hannah L.; Norwood, Connor W.; Vaughn, Sierra X.; Wang, Yumin; Marsh, Stacie; Williams, John; Family Medicine, School of Medicine
    Background The demand for dentists available for state Medicaid populations has long outpaced the supply of such providers. To help understand the workforce dynamics, this study sought to develop a novel approach to measuring dentists’ relative contribution to the dental safety net and, using this new measurement, identify demographic and practice characteristics predictive of dentists’ willingness to participate in Indiana's Medicaid program. Methods We examined Medicaid claims data for 1,023 Indiana dentists. We fit generalized ordered logistic regression models to measure dentists’ level of clinical engagement with Medicaid. Using a partial proportional odds specification model, we estimated proportional adjusted odds ratios for covariates and separate estimates for each contrast of nonproportional covariates. Results Though 75% of Medicaid‐enrolled dentists were active providers, only 27% of them had 800 or more claims during fiscal year 2015. As has been shown in previous studies, our findings from the proportional odds model reinforced certain demographic and practice characteristics to be predictive of dentists’ participation in state Medicaid programs. Conclusions In addition to confirming predictive factors for Medicaid enrollment, this study validated the clinical engagement measure as a reliable method to assess the level of Medicaid participation. Prior studies have been limited by self‐reported data and variations in Medicaid claims reporting.
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    Does Attending a Regional Medical Campus Influence the Training Outcomes of Family Medicine Residents?
    (University of Minnesota Libraries, 2019-07) Kochhar, Komal; Fancher, Laurie M.; Brokaw, James J.; Nalin, Peter M.; Family Medicine, School of Medicine
    Introduction: Indiana University School of Medicine (IUSM) is the largest medical school in the nation, with its main campus located in Indianapolis and eight regional medical campuses (RMC) distributed across the state. In this study, we compared the survey responses of family medicine residents who had attended medical school at the main campus in Indianapolis versus an RMC to see if there were any noticeable differences in their residency training outcomes. Methods: From 2012 to 2017, in the spring of each year, a cross-sectional survey was administered to all final-year family medicine residents graduating from the eleven family medicine residency programs in Indiana. A total of 519 out of 520 residents completed the survey. Of whom, 132 respondents indicated they had graduated from IUSM; 45 reported they had attended the Indianapolis campus and 87 had attended one of the RMCs in the state. Our dataset for this study was comprised of these 132 respondents. Chi-square test or Fisher’s exact test were used to compare responses between groups. P-values ≤ 0.05 were considered statistically significant. Results: In the ACGME competency areas, the residents who attended an RMC versus the Indianapolis campus were significantly more likely to report being fully competent in Medical Knowledge (90% vs. 76%, p = 0.032) and Systems-Based Practice (83% vs. 64%, p = 0.019). Additionally, the residents who attended an RMC compared to their Indianapolis counterparts reported significantly higher rates of being trained to serve rural populations (73% vs. 52%, p = 0.017) as well as being fully competent to serve rural populations (69% vs. 42%, p = 0.003). However, the residents who attended an RMC were no more likely to establish a practice in a rural area than were the residents who attended Indianapolis (18% vs. 17%, p = 0.845). Conclusions: Based on these self-reported data, the family medicine residents who attended an RMC may perceive themselves to be better-prepared in a few core competency areas, as well as in serving rural populations, compared to those who attended the Indianapolis campus. These findings suggest that IUSM’s complex statewide system of medical education may offer some unique advantages in preparing students for residency, especially in family medicine.
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    Effectiveness of a Third Dose of mRNA Vaccines Against COVID-19–Associated Emergency Department and Urgent Care Encounters and Hospitalizations Among Adults During Periods of Delta and Omicron Variant Predominance — VISION Network, 10 States, August 2021–January 2022
    (U.S. Department of Health & Human Services, 2022-01-28) Thompson, Mark G.; Natarajan, Karthik; Irving, Stephanie A.; Rowley, Elizabeth A.; Griggs, Eric P.; Gaglani, Manjusha; Klein, Nicola P.; Grannis, Shaun J.; DeSilva, Malini B.; Stenehjem, Edward; Reese, Sarah E.; Dickerson, Monica; Naleway, Allison L.; Han, Jungmi; Konatham, Deepika; McEvoy, Charlene; Rao, Suchitra; Dixon, Brian E.; Dascomb, Kristin; Lewis, Ned; Levy, Matthew E.; Patel, Palak; Liao, I-Chia; Kharbanda, Anupam B.; Barron, Michelle A.; Fadel, William F.; Grisel, Nancy; Goddard, Kristin; Yang, Duck-Hye; Wondimu, Mehiret H.; Murthy, Kempapura; Valvi, Nimish R.; Arndorfer, Julie; Fireman, Bruce; Dunne, Margaret M.; Embi, Peter; Azziz-Baumgartner, Eduardo; Zerbo, Ousseny; Bozio, Catherine H.; Reynolds, Sue; Ferdinands, Jill; Williams, Jeremiah; Link-Gelles, Ruth; Schrag, Stephanie J.; Verani, Jennifer R.; Ball, Sarah; Ong, Toan C.; Family Medicine, School of Medicine