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Pilot Testing of the Treatment Burden Screening in Diabetes Tool in Primary Care [Multimorbidity]

Annals of Family Medicine

Context: Nearly all patients with type 2 diabetes have comorbid chronic conditions, adding complexity to self-management. A tool to more efficiently relay points of patient-perceived treatment burden during a primary care visit may lead to more patient-centered care plans and improved outcomes.

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An Open Letter to Robert F. Kennedy, Jr. On Why Integrated Care Should Be a Cornerstone of the HHS Agenda

Integrated Care News by CFHA

CFHA represents thousands of professionals across the country who are implementing integrated care —the coordination of medical and behavioral health care in primary care and specialty settings. Also encourage state Medicaid offices to renew efforts to limit regulation related to integrated care practices.

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Adoption, implementation, and impact of a Diabetes Navigator program based in primary care [Diabetes and endocrine disease]

Annals of Family Medicine

Context: Patients with diabetes who receive structured and integrated care have better control and outcomes; however, care may shift between multiple settings making coordination challenging. Early indications suggest potential A1c improvement with the Diabetes Navigator program.

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Clinician perception of the relationship between mental health, health-related social needs, and diabetes outcomes [Diabetes and endocrine disease]

Annals of Family Medicine

Context: Health-promoting behaviors are crucial for good outcomes in diabetes. Addressing mental health and HRSNs can improve diabetes outcomes, but stigma surrounding these issues can make both patients and providers uncomfortable during clinical discussions. Intervention/Instrument: Semi-structured interview guide.

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Reliability and Validity of a Comprehensiveness of Care Measure in Primary Care, A Case Study of the PRIME Registry [Research methodology and instrument development]

Annals of Family Medicine

Context: Comprehensiveness of care represents an important process measure within the contexts of primary care for core services. These services represent the provision of integrated, accessible health care services by clinicians who are accountable for addressing a large majority of personal health care needs.

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Implementation Evaluation of a Community Health Worker Program for Patients with Type 2 Diabetes or Hypertension [Dissemination and implementation research]

Annals of Family Medicine

Context Disparities in type 2 diabetes mellitus (T2D) and hypertension (HTN) control are well-described. Setting 3 primary care clinics in SW Virginia. Intervention Exposure to a CHW vs. usual care. Results 10,509 unique patients with T2D and/or HTN visited the primary care clinics. I) There was a mean of 2.8

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Development and Testing of an Interoperable e-care Plan for Person-Centered Care Planning for Multiple Chronic Conditions [Multimorbidity]

Annals of Family Medicine

Central tenets of primary care are essential to the delivery of effective MCC care: person & family-centered, comprehensive, equitable, team-based, collaborative, coordinated and integrated. The emergence of FIHR enables the development of interoperable apps to facilitate comprehensive, shared care planning.