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Health Trends Across Communities: Engaging Healthcare Systems, Public Health and Community in a Statewide Public Health Tool [Social determinants and vulnerable populations]

Annals of Family Medicine

Context: Building patients’ and health professionals’ trust in health research includes responsibly sharing health information. Objective: To use an iterative, community-engaged process to inform the development of the publicly-available HTAC dashboard. Study Design and Analysis: Qualitative descriptive.

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Implementation of Combined PCBH and CCBHC Models: Key Considerations

Integrated Care News by CFHA

On January 7, 2025, SAMHSA announced the award of one-year Certified Community Behavioral Health Clinics (CCBHCs) Demonstration planning grants to 14 states and Washington, D.C., Leverage Technology and Data Implement measurement-based care tools that work across both systems to track patient outcomes and demonstrate effectiveness.

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Churning out of insurance among patients with diabetes served in US Community Health Centers [Economic or policy analysis]

Annals of Family Medicine

Health insurance instability may be particularly challenging for patients with diabetes who need regular chronic care management to reduce the risk of diabetes complications. 46,844 patients were diagnosed with diabetes during study period. Study Design: Retrospective observational cohort study.

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SGLT-2 inhibitor, cardiovascular risk and outcome in patients with comorbidity of hypertension and diabetes [Cardiovascular disease]

Annals of Family Medicine

Context Two thirds of diabetes patients complicated with hypertension, and comorbidity increase 4-fold risk of atherosclerotic cardiovascular disease (ASCVD). Study design and analysis This is a multiple-center retrospective real-world cohort study. Setting or Dataset Five electronic systems of community clinic.

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Pap-HPV co-testing adoption trends for cervical cancer screening in a multi-state Practice Research Network (PBRN) 2012-2017 [Health care disparities]

Annals of Family Medicine

Little is known about variation in adoption of CCS modalities in federally qualified health centers (FQHCs) in communities where cervical cancer disparities persist. Setting or dataset: Electronic health record data from 25 primary care clinics in 3 FQHCs in Washington and Idaho PBRN from 2012-2017.

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Personalized medicine in a community health system: the Endeavor Health experience [Dissemination and implementation research]

Annals of Family Medicine

Context: Genomic and personalized medicine implementation efforts have largely centered on specialty care in tertiary health systems. In 2014, Endeavor Health (formerly NorthShore University HealthSystem) launched the Center for Personalized Medicine to catalyze the delivery of personalized medicine.

Community 130
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Factors Associated with Documenting Social Determinants of Health in Electronic Health Records by Family Physicians [Social determinants and vulnerable populations]

Annals of Family Medicine

Understanding SDOH documentation in electronic health records (EHRs) is crucial for care management to improve patient outcomes and mitigate health inequities. Conclusions: Socioeconomic aspects of the communities and a practice-level capacity to address SDOH were the biggest predictors of documenting SDOH.