Browsing by Subject "Integrated care"

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    Addressing Food Insecurity: Lessons Learned from Co-Locating a Food Pantry with a Federally Qualified Health Center
    (Ubiquity Press, 2022-09-30) Reinoso, Deanna; Haut, Dawn; Claffey, Stephen; Hahn Keiner, Kathy; Chavez, Alejandra; Nace, Nicole; Carter, Amy; Pediatrics, School of Medicine
    Introduction: Social determinants of health, such as food insecurity, contribute to chronic health conditions, decreased quality of life, and health disparities. Increasingly, healthcare systems seek to address social determinants of health by integrating medical and social care. Description: Eskenazi Health Center Pecar is a Federally Qualified Health Center providing comprehensive primary care to vulnerable patients in Indianapolis, IN, USA. This health center, in coalition with community partners, established and continually developed an integrated food pantry model to address food insecurity, improve nutrition education, and support patient access to healthy food. Discussion: Food insecurity and poor nutrition are common in primary care and contribute to the incidence and outcomes of chronic conditions such as obesity, hypertension, and diabetes. Long-term management of food assistance and nutrition programs requires substantial resources, partnerships, and leadership. We describe lessons learned in food pantry partnership, funding, logistics, and sustainability in a collaborative food access model integrated into healthcare. These lessons learned can be utilized by other health systems to scale up and accelerate strategies to better address food security and nutrition education. This paper articulates best practices for integrating a food pantry model within primary care with the goal of long-term sustainability and direct impact on patient health outcomes.
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    The influence of decision-making preferences on medication adherence for persons with severe mental illness in primary health care
    (2014-10) Wright-Berryman, Jennifer; Kim, Hea-Won
    People with severe mental illness (SMI) often suffer from comorbid physical conditions that result in chronic morbidity and early mortality. Physical health decision-making is one area that has been largely unexplored with the SMI population. This study aimed to identify what factors contribute to the physical healthcare decision-making autonomy preferences of persons with SMI, and to identify the impact of these autonomy preferences on medication adherence. Ninety-five adults with SMI were recruited from an integrated care clinic located in a community mental health center. Fifty-six completed a three-month follow-up. Multiple linear regression for hypothesis 1 (n=95) and hierarchical regression for hypothesis 2 (n=56) were used to analyze data on personal characteristics, physical health decision-making autonomy preferences and medication adherence. For the open-ended questions, thematic analysis was used to uncover facilitators and barriers to medication adherence. With this sample, being male predicted greater desired autonomy, and having less social support predicted less desired autonomy. When background characteristics were held constant, autonomy preferences and perceived autonomy support from the physician only contributed an additional 1% of the variance in medication adherence. Lastly, participants reported behavioral factors and having family/personal support to take medications as facilitators to medication adherence for physical health care, while citing financial and other resource limitations as barriers.