Family Physicians Research Articles

“Tell me I’m okay”: A cross-sectional quality-of-life assessment of patients in a breast cancer survivorship program.

213 Background: The number of breast cancer survivors is increasing due to improvements in care and an aging population, leading to an increased need for care that addresses the physical and psychological needs of patients after completion of active treatment. The Sunnybrook Breast Cancer Survivorship Program was established to provide comprehensive evidence-based survivorship care and facilitate the transition to family doctors. Despite rising interest in dedicated survivorship care, there is little consensus regarding which individuals are likely to suffer the most long-term impacts of breast cancer treatment. Factors as varied as age, ethnicity, socioeconomic status, and treatment type can influence Quality-of-Life (QoL) outcomes. This cross-sectional assessment uses mixed methods to evaluate QoL trends in the patient cohort. Methods: Current patients of the Sunnybrook Breast Cancer Survivorship Program were asked to complete a baseline information form, as well as the EORTC QLQ-30 and BR-45, two validated measures of QoL for breast cancer patients and survivors. QoL, functional, and symptom domains were calculated from these responses accordingly and analyzed statistically. Patients reported their most bothersome QoL concerns through an open-ended questionnaire, which was analyzed and organized thematically. 99 patients have been recruited to date, of a planned 200. Results: We find that sexual health is of importance for this population, with 50 (50.5%) participants reporting sexual activity. Patients under 50 have poorer sexual functioning scores (p<0.01) as well as more issues with body image (p<0.05) than older survivors. Both married and under-50 patients are significantly more likely to have poorer outlooks on the future (p<0.05; p<0.01). Younger patients also tended to have worse role functioning, cognitive functioning, emotional functioning, and social functioning scores, though these differences were not statistically significant. Thematic analysis of qualitative data showed that patients’ chief concerns were the impact that ongoing side effects had on their daily functioning, impact of treatment on body image, disruptions to work and personal relationships, and strong anxiety about potential recurrence. Conclusions: While it is understood that younger BC survivors face unique challenges, our findings indicate that these obstacles persist into older age groups. In addition to physical side effects, such concerns as body image issues, social strain, and emotional functioning can drive QoL scores for these patients. Notably, many patients endorsed strong anxiety regarding potential recurrence that affected QoL, and identified dedicated survivorship follow-up as an ameliorating factor. Further research should be conducted into the unique needs of under-50 survivors, as well as the role of recurrence anxiety in impacting QoL.

Distribution of vectors and arboviruses, and healthcare workers' knowledge of vector-borne diseases in Armenia.

Armenia's favorable geographical and climatic conditions support mosquitoes, sandflies, and ticks that can transmit various diseases. This study aimed to determine the prevalence of these vectors and circulating arboviruses in Armenia and assess healthcare workers` knowledge of arboviral diseases. In 2021, we conducted fieldwork, combining morphological identification of vectors with polymerase chain reaction (PCR) analysis of pathogens to map the distribution of potential arbovirus vectors across Armenia. Our entomological surveys identified four mosquito genera-Anopheles, Aedes, Culex, and Culiseta-comprising 20 species; and 11 species of Ixodidae ticks. Culex pipiens was found in all 11 regions, while Culiseta spp. was absent in Ararat Province. PCR testing of mosquito and tick samples revealed Crimean-Congo hemorrhagic fever virus (CCHFV) in 13 tick samples, but West Nile virus (WNV) was not detected in mosquitoes. Specifically, 13 out of 525 Ixodes tick pools tested positive for CCHFV; the positive samples originated from Hyalomma marginatum ticks in Syunik's Sisian region. None of the 11 pools that contained 473 Cx. pipiens mosquitoes tested positive for WNV. Analysis of questionnaires from 499 healthcare workers showed that epidemiologists, infectious disease specialists, and family doctors had greater awareness of arboviral diseases than other specialists. However, there was a low rate of sample submission for laboratory diagnosis and confirmation. The extensive presence of vectors combined with limited knowledge of arboviral diseases complicates disease understanding in Armenia. Strengthening the surveillance system through training and improved sample collection is essential for disease monitoring and public health interventions.

Vaginal microbiome: modern approaches for correction and/or restoration

Today, women’s health is a separate issue for doctors of many specialties, including obstetricians and gynecologists, family doctors, etc. There is a wide range of treatment options for managing diseases of the reproductive system in women. But despite this, many of these strategies do not work for our patients. Therefore, we need the latest personalized approaches to therapy. One of the newest trends in women’s health is the correction or restoration of the vaginal microbiome. In our previous publications, we have covered the issue of the normal composition of the vaginal microbiome and its changes in various pathological conditions. Modification of the vaginal microbiome can be a useful strategy in the treatment of sexually transmitted infections, bacterial vaginosis, candidiasis, benign, precancerous and even malignant diseases of the female reproductive system, miscarriage, preterm birth and other pregnancy complications.The concept of using exogenous microorganisms as a treatment has been known for centuries. Possible mechanisms by which exogenous strains of lactobacilli can affect vaginal microbiome include vaginal recolonization, increased production or release of lactic acid and other antimicrobial compounds, and modulation of the local mucosal immune response. From a microbiome perspective, “prebiotics” are nutraceutical compounds that induce bacterial growth or the activity of probiotics or beneficial endogenous microorganisms. One of the limitations of prebiotics is their dependence on the presence of lactobacilli, which are absent or almost absent in dysbiosis. Symbiotics are combinations of prebiotics and probiotics based on the concept that the first nutraceutical can improve the bacterial growth and function of the other. This review highlights the latest views on correction and/or restoration of the vaginal microbiome using not only probiotics, prebiotics, and symbiotic, but also phage-altering agents, phage therapy, vaginal microbiome transplantation, etc. Such methods of correction and/or restoration are currently relevant in the reproductive medicine, gynecology and obstetrics all over the world. Despite the fact that these are the newest methods of correction and/or restoration, they are developing every day and require more detailed coverage of this issue.

Early Childhood Development Awareness and Practices of Family Physicians According to Healthcare Service Affiliation: Primary versus Secondary and Tertiary

Early Childhood Development Awareness and Practices of Family Physicians According to Healthcare Service Affiliation: Primary versus Secondary and Tertiary

Assessment of knowledge regarding prediabetes among a sample of family physicians in (Baghdad city).

To assess the level of knowledge among family physicians regarding prediabetes. The cross-sectional study was conducted from March 1 to June 30, 2020, at primary healthcare centers in Al-Karkh and Al-Rusafa health directorates of Baghdad, Iraq, after approval from the ethics review committee of the College of Medicine, Mustansiriyah University, Baghdad. The sample comprised family physicians of either gender. Data was collected using an pre-designed, structured questionnaire that was disseminated online. Data was collected using SPSS 25. Of the 145 questionnaires distributed, 113(78%) were returned duly filled; 99(87.6%) females and 14(12.4%) males. The overall mean age was 34.21±5.8 years (range: 26-49 years), The knowledge level was good in 60(53.1%) cases, and 59(52.2%) suggested screening programmes as a preventive measure. Good level of knowledge was significantly associated with having diabetes or family member with diabetes 44(51.7%), attending training courses 37(44.1%) and professional experience >10 years 15(25%). More than half the respondents had a good level of knowledge about prediabetes. There is a need to improve the knowledge of physicians further about prediabetes.

The role of family doctors in developing primary care systems in Asia: a systematic review of qualitative research conducted in middle-income countries 2010-2020.

The Asia Pacific Region's middle-income countries (MICs) face unique challenges in the ongoing development of primary care (PC) systems. This development is complicated by systemic factors, including rapid policy changes and the introduction of private healthcare services, as well as the mounting challenges associated with ageing populations and increasing rates of chronic diseases. Despite the widespread acknowledgement of the importance of family doctors in the development of PC services, relatively little is known about how these roles have developed in Asian MICs. To address this gap, this systematic review presents a synthesis of recent research focused on the role of family doctors within the PC systems of MICs in the Asia Pacific Region. We searched six electronic databases (CINAHL Complete, Embase, PsycINFO, PubMed, Web of Science, and Index Medicus for the South-East Asia Region and Western Pacific) for peer-reviewed qualitative literature published between January 2010 and December 2020. The quality of the studies was evaluated using the Critical Appraisal Skills Programme tool. Eighteen articles were included in the analysis. Findings from these articles were extracted and synthesised using qualitative thematic synthesis. We used the Rainbow Framework to analyse the interconnections within health systems at the macro, meso and micro levels. Our analysis of the included articles showed that family doctors play a crucial role in bridging the gap between hospitals and communities. They are essential in adopting holistic approaches to health and wellbeing and are in a unique position to try and address social, psychological, and biological aspects of health. Our findings also highlight the influence of policy changes at the macro level on the role and responsibilities of family doctors at the meso (organisational) and micro (interpersonal) levels. Limited research has explored the role of family doctors in the ongoing development of primary care systems in MICs in the Asia Pacific Region. The findings of this review have significant implications for policymakers and healthcare administrators involved in ongoing improvements to and strengthening of PC systems. Areas of particular concern relate to policy linked with training and workforce development, insurance systems and public awareness of what primary care services are.

Sources and processes of social influence on health-related choices: A systematic review based on a social-interdependent choice paradigm

BackgroundMost choices in healthcare are not made in social isolation. However, current econometric models treat patients' preferences as the sole determinants of their choices.Through the lens of sociology and medical sociology theories, this paper presents a systematic literature review of identifiable social influences on patients’ choices, serving as a first step in developing a social-interdependent choice paradigm. MethodsFollowing the PRISMA guideline and using nine databases, we identified the individual agents or groups involved in health-related choices, the functional content through which social relationships influence patients, and the choice constructs affected by these processes. From 9036 screened articles, we selected 208 to develop an analytical framework connecting social relationships with choice constructs. ResultsSocial influences predominantly come from family, friends, specialized physicians, and general practitioners. We decomposed the functional content of social relationships into functions and contents. Dyadic interactions and expert knowledge were prominent functions, followed by social control. Prescriptive and informational contents were prevalent, followed by instrumental and emotional ones. Expert knowledge and social norms aligned with prescriptive and informational signals, while dyadic interactions provide emotional and instrumental signals. Reference points for social norms included friends, coworkers, and patients. Social relationships primarily impact which alternatives are evaluated, followed by alternative evaluation strategies and goal selection. Distinctions between medical domains and dimensions emerged, highlighting how the medical area conditions the social influence process. ConclusionThis systematic review presents a comprehensive framework that elucidates the social influence process in healthcare patient decision-making. By detailing the functional content of social relationships into functions and contents and linking these components to the elements of the choice process, we created a structured approach to understanding how social relationships impact patient choices. This will facilitate the systematic integration of social relationships into econometric models of patient choice.

2023 guidelines on the management of psoriasis by the Dermatological Society of Singapore.

Psoriasis is a multisystem, chronic, inflammatory dermatological disease. In routine clinical practice, the management of psoriasis varies significantly. The current study aimed to develop a set of practice guidelines relevant to dermatology practice in Singapore. The Psoriasis Therapeutic Guidelines Workgroup, comprising members of the Dermato-logical Society of Singapore with a subspecialisation in psoriasis, was convened to develop the guidelines. Clinical questions on selected topics were generated and refined by the workgroup. A literature search using PubMed was performed on their assigned topics from June 2013 to December 2023. The articles were included and graded based on the level of evidence. The guidelines address topics ranging from clinical assessment to practical considerations in the management of mild, moderate and severe psoriasis, including delivery of care, referrals to specialists and adherence to treatment. The recommended therapies include phototherapy, methotrexate, acitretin, cyclosporine; apremilast; topical corticoste-roids, calcipotriol, topical calcineurin inhibitors; and biologics (i.e. adalimumab, infliximab, secukinumab, ixekizumab, ustekinumab, etanercept) either in combina-tion or as monotherapy. Common therapeutic concerns relating to biologic use were addressed. Recommendations on generalised pustular psoriasis, palmoplantar pustular psoriasis and psoriatic arthritis were also made. Patients on systemic therapy would receive appropriate vaccine counselling. Therapeutic implica-tions in special populations, such as pregnant/ lactating women, children, the elderly, those undergo-ing surgery and those suffering from specific infections and cancer were addressed. These guidelines were developed for dermatologists, family physicians, rheumatologists and other specialists to support their selection of appropriate management options.

Content that Promotes Intent to Change: Asynchronous and Synchronous Professional Development for Family Doctors in Continuing Medical Education

Background In 2020, a medical school in northern Ontario launched “Overcoming Barriers to Safe Opioid Prescribing,” a continuing professional development program consisting of an asynchronous online module followed by a series of optional synchronous videoconferences, which together formed a virtual community of practice (VCoP). The videoconferences followed a structured format, where a case study was introduced by one of the participants from their practice, followed by group reflections on the case and the development of strategies for implementing the learnings in their practices. Methods Mixed methods data was collected from participants utilizing a variety of tools and at different times before, during and after their engagement in the program. Qualitative data analysis produced a list of key themes that were cross-validated by anonymized, aggregated program evaluation data to identify further, module-specific themes. Results This paper examines the learning experiences and outcomes of primary care providers that participated in the online modules and synchronous videoconferences and proposes content design strategies that led to these educational experiences. The online module created a baseline of knowledge, increased participants’ familiarity with practice guidelines, comfort and confidence in prescribing and deprescribing behaviours, and increased participants’ familiarity with tools, resources, and strategies for safe opioid prescribing in their practices. The synchronous videoconferences developed a community of learning through modeling, experiential learning and the sharing of experiences and best practices. Conclusions The combination of the online module and synchronous videoconferences led to an increase in the intent to change practice, particularly with enhanced the principles of patient-centred care through their focus on practical, real-world strategies and physician-patient communication techniques. Participants noted that the foundational knowledge and resources provided in the online course was supported and contextualized through the synchronous discussions.

A Phenomenological Qualitative Study: Family Physicians Experiences of Consulting Older Adults

Objective: Due to the aging population, older adult health became important. Family physicians play an important role in the health of older adults. This study aims to identify the challenges family physicians experience in counselling older adults. Method: A qualitative, phenomenological methodology was used. Authors conducted three semi-structured focus group interviews with 22 family physicians. The recorded interviews were transcribed, and thematic analysis was applied. Results: The mean age of the participants was 33.68 ± 8.37. The mean professional years of the participating physicians were 8.77±8.26 years. Seven of the participants were women and fifteen were men. Three themes emerged: (1) patient-related factors, (2) physician-related factors, and (3) physician remedies. Conclusion: There are positive and negative aspects to consulting older adults. Understanding the difficulties experienced can facilitate the solution. Physicians stated that there was no geriatrics training both in their medical school undergraduate and postgraduate curriculum. They also stated that they found themselves inadequate in this regard and that creates anxiety. Effective communication is important both physically and emotionally during the interview. In fact, communication and active listening skills can be taught and postgraduate training in geriatrics can be organized.

EXPERIENCES IN THE AMAZON

The text explores the formation of family and community doctors with a specific focus on acting in rural areas and the health of the indigenous population, a frequently neglected aspect in residency programs in large urban centers. The narrative details an internship at the Macapá Indigenous Health Support House (Casai) and at the base hub of the Manga village, located in Oiapoque, Amapá. During this internship, the resident doctor of the municipality of Rio de Janeiro-RJ had the opportunity to provide medical attention directly to indigenous communities of the villages of Amapá and northern Pará. A central aspect of the text is the importance of exchange between scientific knowledge and traditional indigenous practices. The respect demonstrated by the indigenous population and the credibility attributed to their beliefs were essential to the effectiveness of the care performed. This experience offered the resident significant learning about person -centered medicine, allowing enriching contact with different cultures and traditions. These cultures have unique visions and understandings about the process of getting sick and healing, which contributed to a broader and more integrated understanding of health care. The internship stressed the importance of recognizing and respecting cultural practices in medical practice.

A Phenomenological Approach to Medication Adherence in Elderly Patients: A Qualitative Study.

Background: Patient adherence to drug treatment is crucial to the success of any prescribed therapy, especially in chronic conditions. The present phenomenological qualitative study aims to explore the elderly experience in managing their medication therapy and their perception of medication adherence. Methods: Based on Husserl's perspective, a qualitative descriptive study was conducted utilizing the phenomenological approach, specifically Interpretative Phenomenological Analysis (IPA). The data analysis followed Giorgi's phenomenological approach and the inductive content analysis method. Approval for the study was obtained from the relevant Ethics Committee. Results: Themes emerged when participants described experiences about their own adherence to therapy. The following general theme emerged from the interviews and the phenomenological analysis: Generating awareness: taking therapy saves your life. It was followed by three other themes: (1) Drug therapy awareness; (2) Drug therapy in daily life; and (3) Drug therapy as a life partner. Conclusions: Elderly patients undergoing polypharmacological treatment emphasize the key factors for improving medication adherence, highlighting the influence of individual, motivational, and relational aspects. They express a strong desire for information and value the support of family doctors and nurses in managing therapy. Patient interviews indicate general support among elderly patients for using mobile health in pharmacological treatment, recognizing its potential and limitations.

Family Physician Education and Barriers to Promoting Smoking Cessation: A Multiservice Investigation.

Cigarette smoking remains the leading cause of preventable disease and death in the United States. Brief discussions with doctors increase cessation rates by two-thirds, and physicians trained in smoking cessation are more likely to perform counseling. Multiple organizations also recommend connecting counseling with lung cancer screening (LCS), yet physicians and patients report a lack of such integration. We sought to characterize the education received and the barriers to providing smoking cessation counseling, and to determine its integration with LCS among military Family Medicine physicians. This is a cross-sectional study of registered attendees of 2022 Uniformed Services Academy of Family Physicians Annual Conference. Our study aimed to: (1) Assess the amount of formal smoking cessation education during and after residency; (2) assess barriers to providing smoking cessation within the military health care system; and (3) assess if physicians connect smoking cessation counseling and LCS. Descriptive statistics with chi-squared analysis were used to analyze the survey results. With a response rate of 61% (n = 323/487), most participants reported receiving <3 sessions of formal education during residency (72.9%) and <3 h after residency (76.2%). Forty-eight percent cited their health care system never or rarely provided resources on smoking cessation. Time was the largest barrier to promoting smoking cessation (62.6%) and to integrating it with LCS (56.7%), although a considerable percentage also cited lack of supporting staff (34.3%). Furthermore, only 50.6% of respondents always reported counseling on smoking cessation with LCS. Smoking cessation education is provided in family medicine residencies but rarely offered afterwards. Time and lack of support staff and resources are recognized as notable barriers within the military health care system. A large proportion of uniformed Family Medicine physicians also do not link LCS guidelines with patient education on tobacco cessation and resources. Further research is needed to guide interventions to overcome these challenges within the military health care system.

Quality Indicators for Pain in Adults: A Review of Performance Measures by the American College of Physicians.

Pain is a debilitating symptom generally caused by injuries or various conditions. It can be acute, subacute, or chronic and can have a significant impact on a patient's quality of life. The goal of managing pain is to relieve or reduce suffering and improve patient functioning. Several performance measures that address the treatment of pain are used in payment, public reporting, or accountability programs. The American College of Physicians (ACP) embraces performance measurement as a means to improve quality of care. ACP believes that a performance measure must be methodologically sound and evidence-based to be considered for inclusion in payment, accountability, or reporting programs. However, a plethora of performance measures that provide minimal or no value to patient care have inundated physicians, practices, and systems with the burden of collecting and reporting data. ACP's Performance Measurement Committee (PMC) reviews performance measures using a validated process to recognize high-quality performance measures, address gaps and areas for improvement in performance measures, and help reduce reporting burden. There is a need for a higher standard for a performance measure when reputation and reimbursement are on the line. This paper aims to present a review of current performance measures for pain to inform physicians, payers, and policymakers in their selection and use of performance measures. The PMC reviewed 6 performance measures for pain relevant to internal medicine physicians, of which 3 were considered valid at their intended levels of attribution ("Use of Imaging for Low Back Pain," "Use of Opioids at High Dosage in Persons Without Cancer," and "Use of Opioids From Multiple Providers in Persons Without Cancer"). This paper also proposes a performance measure concept to address a quality-of-care gap based on the current clinical guideline from ACP and the American Academy of Family Physicians, "Nonpharmacologic and Pharmacologic Management of Acute Pain From Non-low Back, Musculoskeletal Injuries in Adults."

The priority of organizational improvement of preventive vector in the system of intersectoral interaction for the preservation of children’s eye health

Background. The relevance of the study is due to a need to apply a comprehensive differentiated approach to the organization of preventive diagnostic examinations and monitoring the formation of visual functions in children of various ages in the difficult conditions of hostilities on the territory of our country. Children’s health remains a strategic task for the formation of Ukraine’s defense capabilities in the future. Full vision is necessary for the formation of a physically healthy and socially adapted personality, good quality of life, learning, working capacity, both in childhood and in working age. In difficult domestic conditions and taking into account the forecast calculations of international experts, which testify to the formed trends towards the growth of ophthalmic pathology, the research on the implementation of modern organizational approaches to the formation of healthy visual functions from childhood is gaining relevance. The purpose of the study was to justify the use of systemic measures of intersectoral interaction to preserve the eye health of children. Materials and methods. The materials for the study were the results of a sociological survey of doctors who provide medical and preventive care to children at outpatient and polyclinic basis (a total of 504 questionnaires were analyzed). The procedure of filling out the questionnaires required anonymity and the prior voluntary verbal consent of the doctors to participate in the study. The research methods were sociological survey, analytical synthetic, content analysis, systemic approach and systemic analysis, medical statistical (calculation of representativeness and reliability of sociological research results). Results. The need for justified organizational improvement in the preventive approach to preserving visual functions in children has been pro­ven. The algorithm of preventive intervention, based on organizational, diagnostic, treatment and preventive measures, is primarily focused on the cooperation of family doctors, family pediatricians, pediatric ophthalmologists and secondary medical staff of medical and educational institutions when introducing modern regular medical and preventive technologies, identifying risk factors and conducting effective supervision of the formation of visual functions in children of various ages, will contribute to the early detection of possible vision disorders for the timely implementation of the necessary treatment and preventive measures. Most interviewed doctors of the outpatient polyclinic level expressed the feasibility of introducing regular systemic supervision of visual functions in preschool and school-age children in the context of implementing state preventive programs to preserve vision from childhood in Ukraine. Conclusions. The medical and social importance of preserving eye health from childhood requires organizational improvement of a preventive approach whose introduction will contribute to the early detection of risk factors, early signs and manifestations, the implementation of the necessary medical and preventive measures, timely diagnosis, correction and treatment of diseases of the eye and its accessory parts in children. The obtained results open the prospect of establishing systemic intersectoral interaction in the planning and implementation of measures of comprehensive programs to prevent the development of ophthalmic pathology among children of various ages.

The peculiarities of labor legal relations with a family doctor in the context of healthcare reform in Ukraine

According to national and international legislation, every person on the territory of Ukraine has the right to qualified medical assistance. As a result of healthcare reform in Ukraine, family doctors have started working, with whom patients conclude declarations in accordance with Ukrainian legislation. Consideration of labor legal relations with a family doctor is extremely important and relevant, as there are many problems and gaps in practice and legislative activities that require research and resolution. The full-scale invasion of Russia on the territory of our state had a negative impact on labor legal relations with family doctors. Due to hostilities, many patients have left for safer places in Ukraine or abroad. Many family doctors, who left their home and place of residence, are generally forced to seek for another place of work. These are significant drawbacks of labor law in the field of medicine, which we are currently facing in Ukraine and which require regulation and finding ways to resolve them. Therefore, consideration of theoretical and legislative material is relevant and extremely important. The purpose is to study the peculiarities of labor legal relations with a family doctor in the context of healthcare reform in Ukraine. The object is the legal basis and legislative framework, which regulate labor legal relations with a family doctor. Conducting research and summarizing qualifications, it can be said that general scientific methods, general methods, interdisciplinary methods, and specialized methods are applied. The analysis of the theoretical and legal source base, from the labor legislation, reveals ways to solve the problematic issues that family doctors face today. Incorporating positive international experience and making proposals for its further consideration and implementation in practice will make it possible to solve the current problems, taking into account all the risks. It is proposed to increase the salary of family doctors, regardless of the number of patients who have signed declarations with them. It is proposed to highlight the fundamental principles of labor activity with family doctors, which are based on the principles of legality, openness, voluntariness, normativity, transparency, control, and informativeness. The proposal is to enhance public awareness of the services of family doctors and the conclusion of declarations without being tied to the location.

Advancing Indigenous primary health care research and education capacity: a qualitative study in Alberta, Canada

Background/Purpose The study explores the perspectives of family physicians in Alberta regarding Indigenous health research education within the framework of primary health care (PHC). Recognizing the key role of PHC in healthcare system, the research identified the preferences and needs of family physicians for relevant and accessible research skills education. To design effective research education, it is critical to understand the skills, content, and delivery methods desired by family physicians engaged in Indigenous health research. The Indigenous Primary Health Care and Policy Research (IPHCPR) Network is examined as a potential transformative platform aligned with Truth and Reconciliation Commission principles and Calls to Action. Methods Through purposive sampling, 12 family physicians practicing in Alberta were recruited to participate in semi-structured qualitative interviews . The study utilized a thematic content approach for data analysis. Results Four key themes emerged from the analysis: 1) Indigenous role modeling; 2) cohort-based learning; 3) relational learning; and 4) the epistemic importance of Indigenous perspectives on learning. Participants emphasized the need for mentorship, collaborative learning settings, and meaningful connections within a research network. Discussion The IPHCPR Network stands out as a pivotal platform for transformative change in healthcare research education, offering opportunities for family physicians, researchers, trainees, and communities to collaboratively improve Indigenous health outcomes. Through its inclusive practices, the network aligns with TRC principles to advance Indigenous health equity and addressing critical gaps in Indigenous primary health research and practice.

Abstract A144: Insight into cervical cancer screening and HPV self-sampling among Vietnamese immigrants in Southern California

Abstract Background: Screening can effectively identify precancerous lesions for early treatment to prevent cervical cancer. However, only 69% of Vietnamese immigrants in the U.S. reported screening in the past 3 years compared to 84% of non-Hispanic White women. Human papillomavirus (HPV) self-sampling is a novel cervical cancer screening approach that does not require women to visit healthcare providers and has been shown to increase screening uptake in several minority populations. Understanding the attitudes towards cervical cancer screening, including HPV self-sampling, among Vietnamese immigrants could inform strategies to improve their screening rates. Methods: We conducted two online semi-structured focus groups with a total of nine Vietnam-born women aged 50-65 living in Southern California, which has the largest Vietnamese community outside of Vietnam, to understand their awareness of, attitudes towards, and experiences with cervical cancer screening. Participants also watched two short videos on two cervical cancer screening methods (Papanicolaou "Pap" test and HPV self-sampling) and shared their thoughts on each method. Each focus group was recorded, transcribed, translated into English, and coded and analyzed using NVivo 14. Results: Three main themes emerged from the focus groups. First, participants showed a strong acceptance of cervical cancer screening despite poor knowledge of the disease and its prevention as well as logistic and psychosocial barriers associated with visiting healthcare providers for screening. Second, participants found HPV self-sampling to be highly acceptable, mentioning advantages like its convenience and the lack of embarrassment compared to visiting healthcare providers. However, there were some concerns regarding the mailing of the self-collected samples and the cost of the test. Third, participants described circumstances that may be immigrant-specific, such as a shift from making gynecologic appointments themselves in Vietnam to relying on family doctors as gatekeepers for such appointments in the U.S., a strong preference for Vietnamese- speaking providers, and the use of English as a Second Language (ESL) centers, community organizations, radio stations, and newspapers targeting Vietnamese communities to obtain healthcare information. Conclusions: HPV self-sampling has the potential to improve cervical cancer screening uptake in Vietnamese immigrants since it can overcome barriers associated with visiting healthcare providers for a Pap test. Education campaigns are needed to increase awareness of cervical cancer screening and address concerns related to HPV self-sampling. Engagement with healthcare providers, organizations, and media channels that serve Vietnamese communities may be effective since Vietnamese immigrants often receive health-related information from these sources. It is necessary to explore the perceptions of younger immigrants and U.S.-born Vietnamese women to inform efforts that can improve screening uptake in all Vietnamese women; focus groups and interviews of these women are underway. Citation Format: Minh T. Phung, Ivy Nguyen, Bethany Nguyen, Hailey Nguyen, Becky Nguyen, Dung Hua, Celeste L. Pearce, Alice W. Lee. Insight into cervical cancer screening and HPV self-sampling among Vietnamese immigrants in Southern California [abstract]. In: Proceedings of the 17th AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2024 Sep 21-24; Los Angeles, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2024;33(9 Suppl):Abstract nr A144.

Priority of competencies in the professional activities of general practitioners (family doctors)

The functional responsibilities of general practitioners (family doctors) (GPs) have changed significantly over the past decade. The number of GP functions has expanded. Despite the increasingly complex professional activities of GPs, there is no scientific evidence for the qualification characteristics of GPs expressed in knowledge, skills, abilities, and competencies in the theory and practice in training. In this regard, a study was conducted to determine the priority of GP competencies that make up the qualification characteristics of a specialist. Aim. To analyze, generalize and rationale the research results, as well as to develop preliminary guidelines for GP training. Material and methods. The information base for the study was the results of ranking competencies according to their importance in the professional activities of GPs in Russia. It was obtained during the ascertaining experiment, implemented using the Delphi method as a method of expert assessment and strategic planning of training specialists. Conclusion. The analysis of competencies developed and agreed upon by experts showed its compliance with the job functions of GPs, the requirements of the Federal State Educational Standard for the General Medical Practice (Family Medicine) and the WONCA guidelines. A summary of the study results to determine the priority of competence in GP activities showed the following: — all competencies (25) were defined as necessary and constitutive of GP qualification; — 21 competencies were considered significant and highly significant for GPs; — 4 competencies were considered as of moderate significance and below moderate significance. The analysis of the priority of competences revealed insufficient methodological support for GP training in accordance with the social order. The results obtained showed the need to continue the study within the project "Quality Management of Training of General Practitioners (Family Doctors)".

Methodological characteristics of the academic competition for general practitioners, family doctors and internists as a type of informal education

The article analyzes the results of the All-Russian competition for general practitioners, family doctors and internists held over five years by the National Medical Research Center for Therapy and Preventive Medicine with the support of the Russian Society for the Prevention of Non communicable Diseases.Aim. To determine the methodological characteristics of managing the academic competition as a type of informal education.Material and methods. To conduct the competition, practice-oriented tasks corresponding to professional tasks of a general practitioner were developed. In addition, we developed an original questionnaire to assess the impact of participation in the academic competition on the professional development. Family doctors and general practitioners with 1-10 years of experience, as well as internists, were included.Results. The methodological characteristics of the academic competition management as a type of informal education were determined: practice-oriented goals aimed at improving the knowledge, skills and abilities, competencies of the participants; the content of tasks based on the theory-practice relationship; compliance of tasks and real situations in the practice of a general practitioner; a systematic approach to competition management. Conclusion. The effectiveness of the academic competition as a type of informal education contributes to the professional development of participants, promotes the development of long-term attitudes towards improving professional knowledge, skills, abilities and competencies necessary for solving professional problems.