Role Of Care Providers Research Articles

Experiences and challenges of nurses in initiating antiretroviral drugs among adolescents living with HIV and AIDS in Thaba-Tseka, Lesotho

Background: Lesotho has the second-highest HIV and AIDS prevalence globally and is the country’s second leading cause of death. Despite increasing ART coverage, adolescents remain left behind and face high mortality because of delayed ART initiation. This study aimed to explore the experiences and challenges of nurses when initiating adolescents living with HIV on ART in Thaba-Tseka, Lesotho. Methods: A qualitative descriptive research design and twelve in-depth interviews were conducted among nurses from a hospital in the Thaba-Tseka district. Participants were selected purposively until data saturation was reached. Data were transcribed verbatim and analysed manually using the thematic analysis approach. The findings were presented in themes and sub-themes. Individual face-to-face interviews were conducted in English and Sesotho from May to August 2021. Results: The key findings in this study involved adolescents’ attendance at the health care facility, ART initiation process, HIV stigma influencing the uptake of ART, poor ART follow-up and socio-economic factors affecting adherence to ART. Conclusion: The themes uncovered in this study provide valuable insights into the gaps in ART initiation, and highlight the challenges encountered by nurses during this process among adolescents in Lesotho. The experiences and obstacles shared by nurses during ART initiation cover a range of issues, collectively demonstrating their engagement in HIV and ART care. These findings emphasise the critical role of policymakers and health care providers in devising customised ART initiation interventions for adolescents. Addressing these challenges will be crucial for enhancing ART uptake and adherence among adolescents living with HIV in Lesotho.

The Role of Primary Care Providers in Lung Cancer Screening: A Cross-Sectional Survey

BackgroundMultidisciplinary lung cancer screening (LCS) programs that perform shared decision-making visits (SDMV) and follow up annual low dose computed tomography (LDCT) have been emerging. We hypothesize that primary care providers (PCPs) prefer to refer patients to LCS programs instead of facilitating the screening process themselves. MethodsThis is a mixed-methods, cross-sectional study in which an online survey was administered to PCPs between April 2023 and June 2023. Results58 PCPs in the same hospital network participated in the study with a median age of 43 (34-51), predominance of women (77.6%), and clinicians of white and Asian race (44.8% and 48.3%). Respondents estimated that 26.1% (SD 32.4%) of their eligible patients participate in LCS screening. PCPs thought that an LCS program was equally convenient to performing screening themselves for identifying eligible patients and ordering LDCT. However, 63.8% of participants preferred an LCS program for performing SDMVs, 62.1% for ensuring annual follow-up on negative LDCTs, 70.7% for deciding next steps on positive LDCTs, and 60.4% for performing smoking cessation counseling. PCPs agreed that an LCS program saves time (69%), allows patients to receive specialty care (65.6%), addresses patient concerns (70.7%), ensures annual follow-up (77.6%), and manages abnormal findings (79.3%). However, they also expressed concerns about an additional visit for the patient (48.2%) and patient cost (46.5%). ConclusionMost PCPs believe that formal LCS programs have many benefits including providing specialized care and follow up, although there were concerns about patient time and cost.

School refusal: Considerations for the primary care NP.

School refusal refers to child- or adolescent-motivated refusal to attend school or remain in school for the duration of the school day. Importantly, the child or adolescent does not conceal their absence from school from their caregivers. Root causes for school refusal include anxiety, mood disorders, untreated learning disorders, and social difficulties. Long-term outcomes of school refusal include further social withdrawal, ongoing mental health issues, and unemployment. This article reviews the differences between school refusal and other types of chronic absenteeism, and it describes behaviors that may manifest in a child or adolescent who avoids attending school. The primary care provider's role in evaluation and treatment of this population is discussed.

Diagnostic and therapeutic challenges for PCPs regarding heart failure with preserved ejection fraction and obesity: results of an online internet-based survey

BackgroundObesity (body mass index ≥ 30 kg/m2) is a major risk factor for heart failure with preserved ejection fraction (HFpEF) and affects most patients with HFpEF. Patients living with obesity may experience delays in HFpEF diagnosis and management. We aimed to understand the clinical journey of patients with obesity and HFpEF and the role of primary care providers (PCPs) in diagnosing and managing patients with both conditions.MethodsAn anonymous, US population-based online survey was conducted in September 2020 among 114 patients with self-reported HFpEF and obesity and 200 healthcare providers, 61 of whom were PCPs who treat patients with HFpEF and obesity.ResultsHalf of patients (51%) with HFpEF reported waiting an average of 11 months to discuss their symptoms with a PCP; 11% then received their diagnosis from a PCP. PCPs initiated treatment and oversaw the management of HFpEF only 35% of the time, and 44% of PCPs discussed obesity treatment medication options with their patients. Only 20% of PCPs indicated they had received formal obesity management training, and 79% of PCPs indicated they would be interested in obesity management training and support.ConclusionPCPs could play a valuable role in addressing obesity and referring patients with obesity and signs and symptoms of HFpEF to cardiologists. Increased awareness of HFpEF and its link to obesity may help PCPs more quickly identify and diagnose their patients with these conditions.Graphical

Oral Health Care Among Women in Perimenopause or Menopause: An Integrative Review.

Women in menopause are at a higher risk of developing oral health problems, affecting their overall quality of life. Several studies have identified the role of health care providers in addressing women's oral health needs across various phases of their lives, yet a review in the area of perimenopause and menopause has not been undertaken. Therefore, the aim of this review was to explore current evidence regarding the oral health knowledge, attitudes, and practices of women in perimenopause or menopause and their health care providers. Additionally, guidelines and recommendations to inform strategies for oral health promotion are included. A systematic search was carried out across 5 databases. Inclusion criteria included articles published in English that examined at least one study outcome: oral health knowledge, attitudes, and practices of either women in perimenopause or menopause or of health care providers or guidelines around oral health care. Qualitative, quantitative, mixed-methods, and experimental studies with survey components were included with no restrictions on publication period, quality, or setting. A total of 12 articles met the inclusion criteria, with a majority being of poor quality and mostly from low-income and middle-income countries. Overall findings indicated that there was a lack of knowledge and limited practices in maintaining oral hygiene and visiting the dentist among women in perimenopause or menopause. Health care providers exhibited poor attitudes in advising the importance of periodic dental check-ups and informing oral health changes during this period. There were also insufficient guidelines to adopt care for women and guide health care providers in their practice. Women in perimenopause or menopause have limited oral health knowledge and unmet oral health needs. Appropriate guidelines and supportive strategies are required to assist health care providers in providing comprehensive care and encouragement to women in perimenopause or menopause to improve their oral health.

Disparities in Telehealth Offer and Use among U.S. Adults: 2022 Health Information National Trends Survey.

Objective: Understanding the sources of telehealth disparities can inform efforts to ensure equity. This study examines disparities in telehealth offer and use to understand the role of health care providers in increasing telehealth access. Methods: This cross-sectional analysis of the 2022 Health Information National Trends Survey (n = 5,295) used survey-weighted proportions to characterize telehealth use and multivariable logistic regressions to test associations of sociodemographic and social determinants with (1) telehealth offer and (2) use among those offered the option. Results: Among U.S. adults, 57% were offered telehealth, 80% of whom used it. Technology difficulties and privacy concerns were barriers for 15%-20% of U.S. adults. Compared to telehealth users, most nonusers preferred in-person care (25% versus 84%). Age, education, geographic location, and broadband internet access were related to telehealth offer, whereas no significant disparities emerged in telehealth use. Conclusions: Telehealth use is widespread, but structural and provider-level engagement are needed to achieve equity.

A Narrative Review of Alzheimer Dementia in African American and Hispanic Populations: The Health Care Provider's Role

African Americans and Hispanics, especially those of advanced age living with chronic diseases, have a higher risk of developing Alzheimer dementia (AD). Poor control of chronic diseases, such as diabetes, lack of awareness of increased risk factors by health care providers, or fragmented provider care can lead to missed opportunities to adopt early assessment strategies that can mitigate the effects or onset of AD. Nurse practitioners and other health care providers can play a crucial role in implementing chronic disease management strategies and educating patients who are at risk for AD among African Americans and Hispanics.

Physical Activity in Older Adults: What Every Internist Needs to Know

The Physical Activity Guidelines for Americans (Guidelines) advises older adults to be as active as possible. Yet, despite the many benefits of physical activity, less than 15% of people ages 65 years and older meet the Guidelines. To address this, the U.S. Department of Health and Human Services developed a Midcourse Report focused on the strategies and settings that can help increase physical activity levels among older adults. Internists are well positioned to encourage older adults to be more physically active. Health care providers can leverage this position to talk about the importance of regular physical activity; assess physical activity levels; share information and resources about how to safely get started; and provide counseling, guidance, and/or referrals to additional providers or programs for further support. This article provides an overview of the recently released Physical Activity Guidelines for Americans Midcourse Report: Implementation Strategies for Older Adult and highlights the role of internists and other health care providers to encourage and support their patients to be more physically active.

(191) Contraception: How Ecology and Gender Equality are the New Deal

Abstract Introduction Since more than 10 years health care providers often hear from their patients that they want a natural contraception without hormones because of their potentials side-effects on bodies and environment by water contamination. In fact numerous scientific articles available on the web etablish that steroid hormones in wastewater are micropollutants and endocrine disruptors, especially wastewater treatment plants can not eradicate synthetic progestins after excretion. Nevertheless the situation remains paradoxical since the morning-after pill contains up to 50 times more hormones than the daily pill and is widely used, in France 2,2 millions of morning-after pills are sold each year. Looking for "green solutions", users are turning to menstruations apps, but are they aware of the pollution generated by materials and operations of digital industries? This is another paradox in the new contraceptive behaviours. Objective know different possible causes of contraceptive refusal take into account potential environmental effects when prescribing contraceptives and opt for the least polluting solutions. be aware of the environmental impact of digital health techniques take account of claims for gender-equal contraception Methods Literature review on PubMed for the 12 last months, Google Scholar since 2 years and mainstream media with the keywords: hormonal contraception and water pollution contraception and ecology Contraceptives residues and health Data Centers pollution contraception and gender equality Male contraception Results On Google Scholar numerous articles deal with the pollution of waste water and drinking water by steroid hormones at concentrations ranging from ng/L to g/L. Synthetic hormone compounds toxicity is widely recognized and can affect cell metabolism, causing various diseases such as obesity, infertility, endocrine disorders, even neoplasia or neuro-degenerative disease, although the effect of environmental synthetic hormones on the nervous system is still poorly documented. These data are public and can influence contraceptive behaviours On PubMed the focus is on endocrine-disrupting chemicals such as phtalates, dioxins, polychlorinated-biphenyl, biphenol A and analogs, I found only 2 surveys about residues of synthetic human hormones. 21 relevant surveys are found on PubMed about gender equality in contraception: these studies show an emerging interesr among men in controlling their fertilizing power, but a low support of pharmaceutical industries, leading them to use restrictive methods such as thermal contraception. Conclusions This work aims to highlight the contraceptive shift in progress. Consumers claim an ecological position, but use methods that contradict their stated convictions, such as morning-after pill or menstruations app causing digital pollution. Men want to involve themself in their reproductive health but are they heard enough? A low-risk, inexpensive and non-pollutante method such as vasectomy is still subject to false beliefs due to a lack of information and education, male hormonal contraception remains anecdotal (only in France). These observations highlight the role of the health care providers in sexual and reproductive health education and counselling, and of the industry's support, listening to people. Disclosure No.

The impact of leukemia on quality of life and mental health: Insights from a case study examining physical, social, and cultural implications

Introduction: Leukemia presents a significant health challenge globally, affecting patients physically and mentally. The symptoms and adverse effects of treatments impact the health-related quality of life (QOL) of leukemia patients. Family caregivers, often family members, play a crucial role in care provision, especially in regions with limited professional nursing. Aim: This research aimed to explore the QOL of a leukemia patient, the effects on the individual and family, factors contributing to well-being, social support networks, and healthcare resources. Insights gained could enhance the QOL for patients and families confronting this challenging disease. Method: A qualitative case study approach was employed. The researchers focused on a single instance, utilizing semi-structured interviews. This technique allowed for an in-depth exploration of the experiences from anthropological perspectives. Data collection involved non-structured interviews with a 42-year-old woman diagnosed with acute leukemia, who had previously recovered from breast cancer. Results: Leukemia patients and family caregivers face substantial psychological distress due to caregiving roles. Anxiety, stress, and depression in caregivers can be mitigated through tailored programs addressing their psychological needs. Such interventions are likely to positively impact the overall quality of life for families. Future research should explore specific factors contributing to psychological distress and evaluate the effectiveness of needs-based programs. Conclusions: To enhance the well-being of both adult leukemia patients and their family caregivers, healthcare professionals should consider family-level intervention programs. The resilience demonstrated by individuals like Ms. Maria, who navigate challenges with determination, serves as inspiration for others facing acute leukemia. Further studies should delve into patient and caregiver factors affecting psychological distress, offering a comprehensive understanding of the holistic care needed for leukemia patients and their families.

Building climate resilience: awareness of climate change adaptation in German outpatient medical practices

BackgroundClimate change is seen as the biggest health threat of the twenty-first century. Making outpatient medical practices resilient is therefore crucial to protect vulnerable groups and maintain quality of care. Awareness is a precondition for action. This study aims to explore awareness (knowledge, experience and attention) of climate change adaptation among stakeholders of outpatient medical practices.MethodsSemi-structured interviews and focus groups with stakeholders of outpatient medical practices were conducted. The qualitative data were analysed in a two-step Thematic Analysis process.ResultsIn total, n = 40 stakeholders participated in two focus groups and 26 interviews. The findings show a mixed degree of awareness in outpatient medical practices. The spectrum ranged from a passive role with curative acting only, handing over responsibility to others and a low perceived self-efficacy to a proactive and responsible implementation of adaptation strategies. Participants who saw the need and responsibility of climate change adaptation in medical practices perceived low additional workload. In general, implementation of climate change adaptation measures and general awareness of climate change adaptation appeared to be depending on a certain tension for change and a higher self-efficacy.ConclusionMedical practices, and specifically primary care, plays a crucial role in climate change adaptation, and awareness needs to be increased further in order to cope with consequences of climate change. To facilitate this, there should be a strong emphasis on climate change adaptation strategies being part of outpatient care provider roles rather than being perceived as an “add-on” to already high workloads.

A qualitative study of physical activity drivers in autistic individuals using COM-B. Autistic and non-autistic perspectives

BackgroundDespite evidence of the health benefits of physical activity in non-autistic populations and the additional benefits for autistic populations, physical activity levels remain stubbornly low in autistic individuals. Understanding the determinants of physical activity is essential in order to support intervention development. MethodsThe current research applied the Theoretical Domains Framework (TDF) and Capability Opportunity Motivation, Behaviour (COM-B) model of behaviour to identify determinants of physical activity behaviour, mechanisms of action, and potentially efficacious behaviour change techniques. Fifteen semi-structured interviews were conducted with autistic adults (N = 4) and children (N = 2), parents of autistic children (N = 4), and stakeholders in autism care and support (N = 5). A deductive approach was taken to map themes onto TDF and COM-B. ResultsParticipants identified three overarching themes: Discordance between autistic and non-autistic perspectives; physically active environments; and autonomy and choice. Eight subthemes were identified and mapped onto COM-B and TDF. Recommendations for intervention development are made and potential behaviour change techniques are identified. ConclusionsGiven the important role of care providers, future research should focus on the attitudes and behaviours of individuals who care for and support autistic individuals to identify barriers and drivers of physical activity promotion, particularly for individuals with high support needs. An argument is made for co-design in future intervention development.

COVID-19 Vaccine Acceptance Among Parents of Children With Multisystem Inflammatory Syndrome in Children.

Data on COVID-19 vaccine acceptability among parents of children with multisystem inflammatory syndrome (MIS-C) are limited. In this cohort of children with MIS-C, enrolled in the Swissped RECOVERY trial (NCT04826588), comparing intravenous immunoglobulins or methylprednisolone, who, in accordance with Swiss guidelines, were recommended for SARS-CoV-2 vaccination, 65% (73/112) of parents reported being vaccinated against SARS-CoV-2 before the MIS-C, while 70% were vaccinated after the MIS-C episode of their child. None of the children were vaccinated before the occurrence of the MIS-C, and only 9% (5/56) received the COVID-19 vaccine after the MIS-C. The predominant barriers to COVID-19 vaccination were concerns over potential side effects and insufficient support from their doctors. This emphasizes the crucial role of health care providers in promoting COVID-19 vaccination among children.

Continuity of care in suicide prevention: current status and future directions.

Continuity of Care (CoC) is central to suicide prevention. The present study aims to review contemporary definitions, operationalization in research, and key components of CoC in the prevention of suicide. The present study is a narrative review. A thorough search of available literature on CoC and suicidality was conducted. Studies published between 1995 and 2021 were reviewed and selected based on relevance to CoC and suicidality. Selected research was subsequently summarized to outline definitions of CoC, its operationalization in research, and key components for suicide prevention. The definition, measurement, and operationalization of CoC in suicide prevention varies tremendously, derailing clinical practice. Key elements of CoC identified across the literature include (1) CoC across multiple levels of care, (2) the role of primary care providers and case managers in CoC of suicidal patients, (3) the importance of follow up contact with suicidal patients post-treatment, and (4) the role of national and institutional guidelines for CoC of suicidal patients. Limitations: There is a dearth of randomized controlled trials and insufficient evidence on specific populations. CoC refers to a wide, complex concept that must be broken down into specific categories that can provide more nuanced guidance of research and clinical implications.

The use of technology to address loneliness and social isolation among older adults: the role of social care providers

BackgroundAddressing loneliness and social isolation among older adults remains a public health priority. The restrictions enforced during the COVID-19 pandemic simultaneously heightened the need for services to overcome social isolation and reduce loneliness among older adults, while also limiting social care providers’ ability to deliver these. The aim of this study was to explore the experiences of social care providers in using technology to address loneliness and social isolation among older adults during the pandemic.MethodsThis was a mixed methods study involving an online survey and interviews with providers of older adult social care in Wales, UK. Invitations to participate were sent to commissioners and providers of adult social care services, including those working in the voluntary and community sectors, across all local authorities in Wales. Data was collected between September 2021 and January 2022.ResultsSixty-one service providers completed the survey, 19 of whom also took part in an interview. Addressing loneliness and isolation among older adults was reported as a key concern by nearly all survey respondents. While telephone calls were the most common means of facilitating social interaction, many service providers also tried to support older adults to make more use of devices that they already had (e.g., smartphones to hold video calls). Where funding was available, organisations purchased devices, such as tablets and smart speakers, for older adults. Analysis of interviews resulted in three themes: (1) The potential and limitations of technology; (2) Individuals’ capabilities, confidence, motivations and values; and (3) The wider system.ConclusionsTechnology was employed in a variety of ways during the pandemic to address loneliness and social isolation among older adults; many service providers continue to use technology in a hybrid system of care now that pandemic-related social restrictions have been lifted. Our findings emphasise a need for technology-assisted interventions to be designed and deployed in alignment with service users’ values, motivations and capabilities. Further, there is a need to better support service providers to assess loneliness and social isolation among older adults, and to acknowledge the important role providers play in helping older adults to adopt technology-assisted interventions.

How Physicians Should Respond to Climate Change.

Urgent warnings about the existential threat of climate change are coming from leaders in nearly every sector of society, including virtually all climate scientists, notable heads of civil governments around the globe, the world's top religious leaders, prestigious medical journals, as well as principals of the largest financial firms. Surveys show that the majority of U.S. physicians in several specialties are caring for patients who are experiencing direct health harms due to climate change. In public platforms, physicians are expressing their awareness that this public health crisis places everyone at risk, but many people are at greater risk, including children, pregnant women, people with chronic health conditions, elders, and those who experience environmental injustice or live in harm's way. Physicians should respond to this crisis with meaningful activities performed within the context of their current roles. The role of medical care provider is the best known role. But, throughout their careers, physicians have ongoing responsibilities as educators of colleagues, trainees, and patients. They are influential employees of medical institutions, trusted experts who exercise civic responsibility, and sources of guidance for public policymakers. Physicians and other health professionals, individually and through their organizations, also work to influence our societal response to the challenge of climate change. The first annual Lancet Journal Countdown Report in 2016 tracking health indicators of climate change stated that climate change had the potential to wipe out all public health gains of the last half century, but it also presents a tremendous opportunity to save lives and improve health. All physicians should work toward the latter outcome.

Knowledge, Attitude, and Practice of Antibiotic Resistance Among General Population in Saudi Arabia: A Cross-Sectional Study.

Antibiotic resistance is a global public health concern, and understanding the knowledge, attitudes, and practices (KAP) of the general population is essential for effective prevention and management. This cross-sectional study aimed to assess the KAP of antibiotic resistance among adults in Saudi Arabia. Between August 2023 and October 2023, 1000 participants aged 16-65 years from various regions in Saudi Arabia were surveyed using an online questionnaire. Data were analyzed using Excel and IBM SPSS Statistics version 27.0.0 (Armonk, NY: IBM Corp.). The sociodemographic characteristics of the participants were examined, and KAP variables towards antibiotic resistance were explored through a range of statistical methods, including frequencies, percentages, means, and standard deviations. Significance was defined as a p-value of ≤0.05. The majority of participants were Saudi natives (98.1%) with ages between 16 and 25 years (38%), and over half were female (55.7%). More than half held a university degree (54.7%), mainly in non-medical fields (73.3%), and a significant portion reported a monthly income above 10,000 Saudi Riyals (49.7%). Regarding knowledge, 76.5% were aware of antibiotic resistance, but only 24.2% correctly identified its causes. Attitude assessments showed that 50.8% never used antibiotics as a preventive measure, and 47.3% always followed medical prescriptions. Practices revealed that 50.5% rarely used antibiotics, and 68.8% obtained antibiotic prescriptions from doctors. Additionally, 68.9% stopped taking antibiotics only after completing the course. It is important to implement health education campaigns aimed at the public, emphasize the role of health care providers in health education for the general public, and enforce stringent regulations to control the non-prescription dispensing of antibiotics. However, further studies are needed on this subject in the future.

Women, Infants, and Children (WIC) Enrollment: Learning From Key Informants to Enhance Utilization.

Enrollment in the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) is suboptimal, particularly for eligible children aged 1 to 4 years. We used converged data from key informants from October 2021 to January 2023 to understand the barriers to and opportunities for WIC utilization and the role of the health care provider in links to WIC. Families and WIC staff identified gaps in provider knowledge and an expressed need for improved collaboration between health providers and WIC. (Am J Public Health. 2023;113(S3):S220-S223. https://doi.org/10.2105/AJPH.2023.307443).

Electronic Health Record Tools to Facilitate Diagnosis of Cognitive Impairment in Primary Care

AbstractWith novel biomarkers and treatments for dementia on the horizon, the need to detect cognitive impairment at early stages is urgent. The role of primary care providers (PCPs) in the diagnosis of mild cognitive impairment and dementia is essential in meeting this need. Cognition in Primary Care (CPC) is a quality improvement program developed at the University of Washington (UW), Seattle, which includes a three‐part Continuing Medical Education (CME), clinical workflow, and electronic health record toolset to support PCPs in early diagnosis of mild cognitive impairment and dementia. This program was developed using input from UW providers in primary care practice and elements from the KAER (Kickstart, Assess, Evaluate, Refer) Toolkit developed by the Gerontological Society of America (GSA). Our pragmatic approach involved the development of tools integrated into Epic, the electronic health record system in place at UW, that can be used during a patient visit to guide PCPs through the process of evaluating cognitive function. The toolset includes 1) a list of signs that may trigger the need for a dedicated follow‐up visit to evaluate cognition; 2) a cognitive checklist for related conditions affecting cognition (e.g., potentially harmful medications, depressive symptoms, alcohol use, and obstructive sleep apnea); 3) a structured framework for cognitive evaluation including validated instruments (e.g., MoCA and AD8); 4) referrals to specialty care; 5) billing guidelines; and 6) community resources and materials that patients and care partners can use both pre‐ and post‐diagnosis. We have pilot‐tested these tools in UW primary care clinics and found high utilization both within and outside of targeted clinics indicating a halo effect of usage beyond those who attended the CME training. In this presentation, we will provide detailed descriptions of these Epic tools focusing on clinical application to total patient care. We plan to publish these workflow tools onto the Epic Digital Library to be downloaded and used by other health systems. Future plans include producing on‐demand CME training modules, a post‐diagnosis checklist, and applications for use of these tools in systems outside of Epic.

The role of primary care providers in testing for sexually transmitted infections in the MassHealth Medicaid program.

The objective of this study was to determine the prevalence and predictors of testing for sexually transmitted infections (STIs) under an accountable care model of health care delivery. Data sources were claims and encounter records from the Massachusetts Medicaid and Children's Health Insurance Program (MassHealth) for enrollees aged 13 to 64 years in 2019. This cross-sectional study examines the one-year prevalence of STI testing and evaluates social determinants of health and other patient characteristics as predictors of such testing in both primary care and other settings. We identified visits with STI testing using procedure codes and primary care settings from provider code types. Among 740,417 members, 55% were female, 11% were homeless or unstably housed, and 15% had some level of disability. While the prevalence of testing in any setting was 20% (N = 151,428), only 57,215 members had testing performed in a primary care setting, resulting in an 8% prevalence of testing by primary care clinicians (PCCs). Members enrolled in a managed care organization (MCO) were significantly less likely to be tested by a primary care provider than those enrolled in accountable care organization (ACO) plans that have specific incentives for primary care practices to coordinate care. Enrollees in a Primary Care ACO had the highest rates of STI testing, both overall and by primary care providers. Massachusetts' ACO delivery systems may be able to help practices increase STI screening with explicit incentives for STI testing in primary care settings.