Preventive Care: Controversies, Challenges and Upcoming Changes in Guidelines

Objectives Organizations who make guidelines Current guidelines for average-risk adults, with a focus on guidelines with differing recommendations and challenges to implementation/operational issues Preview of upcoming changes in guidelines Cases to illustrate some of the common questions that come up in delivering office-based preventive care Some disclaimer

Accelerating Primary Care Transformation at Jefferson (JeffAPCT): Reflections from a Five- Year HRSA Grant

JeffAPCT Overview Five year HRSA-funded grant (7/1/15-6/30/20) Leadership team from Family Medicine, Internal Medicine, Physician Assistant Program Objective 1: To improve/ expand primary care and population health curriculum across the continuum of primary care providers and trainees (students, residents, and practitioners) Objective 2: To create an enhanced, sustainable model of primary care physician faculty development for PCMH Transformation Objective 3: To create a new, sustainable model of faculty development for community-based primary care preceptors (MD/DO, PA, NP, others

“Taking the Pulse of Jefferson Primary Care: Provider and Team Wellness Survey Results and Next Steps”

Agenda Context (Randa Sifri) Results (Amy Cunningham) Action Steps (Keith Sweigard) Q&

Increasing Colorectal Cancer Screening Among Hispanic Primary Care Patients: RE-AIM Analysis.

Context: Hispanic adults experience disparities in rates of colorectal cancer (CRC) screening. This RE-AIM analysis encompassed a multilevel decision support and navigation intervention (DSNI) for CRC screening. Interim findings were previously presented; we now aim to share the final analysis, particularly for effectiveness and implementation. Objective: Apply RE-AIM framework to a completed randomized controlled trial of a CRC screening intervention for Hispanic adults Setting: Five primary care practices Patients or Other Participants: Potential participants included a sampling frame of 2,720 screening-eligible patients, ages 50-75, Hispanic ethnicity, without history of CRC and polyps. 400 participants were enrolled. Intervention/Instrument: Decision support and navigation by a bilingual Patient Assistant (PA) as compared to a standard mailed intervention (SI) Main and Secondary Outcome Measures: 1) Reach- Study participants as compared to sampling frame 2) Effectiveness- Screening adherence 3) Adoption- Number of practice participants to complete intervention, engagement of patient and stakeholder advisory committee (PASAC) 4) Implementation- Quantitative data pertaining to patient contacts and communication of screening plan to primary care practices, Qualitative data on PA and Telephone Interviewer (TI) experiences 5) Maintenance- Health system dissemination (Pending). Results: 1) Reach- Study participants differed from the sampling frame in that ages 50-59 were overrepresented. There were no differences in race, gender, or language. 2) Effectiveness- Screening adherence was significantly increased in the DSNI group (73%) as compared to the SI group (44%) (OR=3.48, CI: 2.29-4.29,

Performance of Colorectal Cancer Screening Steps in Primary Care

Discussion: This analysis revealed the differences in which physicians in primary care complete CRC screening steps. The approach and completion of screening steps varied greatly among practices. There was a correlation between the quantitative data and the qualitative data. The analysis from both methodologies produced similar results and supports each other\u27s assessment. All of the practices analyzed possessed one of the essential elements (a physician recommendation) which is the foundation for increased screening. All of the practices have the potential to expand upon this foundation in order to ensure that all eligible patients are approached and screened for CRC. The correlation between the essential elements and completion of screening will be further explored in future research