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Compass Rose for Generating Community-based Referrals via Epic: Best Practices and Lessons Learned [Social determinants and vulnerable populations]

Annals of Family Medicine

We also assessed patterns of social risks and need for assistance among our patient populations. A Compass Rose episode was automatically generated in the patient’s medical record in Epic if patients indicated that they had at least one of the four social risk factors on the screening tool.

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Risks and Needs: Lessons Learned from Assessing Patients Willingness to Receive Help for Social Risks in Primary Care [Social determinants and vulnerable populations]

Annals of Family Medicine

Context: In May 2023, Mayo Clinic implemented a revised screening tool to assess social determinants of health (SDOH) for its patients. The final question asked patients, who have at least one risk factor, if they would like assistance with their need(s). Study Design and Analysis: Descriptive analysis of secondary data.

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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). Setting or Dataset Five electronic systems of community clinic. Study design and analysis This is a multiple-center retrospective real-world cohort study.

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Breaking Barriers: Perspectives on Clinical Trial Participation Among Older Hispanic/Latino Adults of Mexican Origin [Clinical trial]

Annals of Family Medicine

Participants emphasized the role of family support and their reliance on adult children for decision-making and assistance with transportation and interpretation.

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Strategies to Improve Diversity in Lymphoma Trials

Physician's Weekly

Strategies to improve minority enrollment include multidisciplinary tumor boards to identify eligible patients, patient navigators to guide participants, community engagement, modernized eligibility criteria, culturally relevant education, and reduced participation burdens.

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Addressing diabetes management in the context of social needs: a qualitative study of primary care providers [Diabetes and endocrine disease]

Annals of Family Medicine

Context: Diabetes management (DM) for patients with Type 2 Diabetes (T2D) can be hindered by non-medical, health-related social needs. Population Studied: Purposive sample of care team members (eg, physicians, social workers, diabetes educators, dietitians, community health workers).

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Integrated care for adults with complex needs: opportunities of case management in primary care to improve equity [Health care disparities]

Annals of Family Medicine

Social workers who collaborated in dyad with nurse case managers helped in identifying patients’ mental health issues as well as unmet social needs, e.g. poor-quality housing, social isolation, and difficulty affording transportation, or food.