Intake Form Research Articles

The Use, Profile, Uptake, Characteristics and Attributes of Users of Homeopathy: Initial Findings from a Student Teaching Tele-Healthcare Clinic Based in North America

Research into the uptake profile and usage of Homeopathy has hitherto tended to be buried amongst complementary medicine research. Despite high levels of uptake of homeopathy, and robust numbers of over-the-counter sales of homeopathic products the current evidence evaluating the uptake of homeopathy remains limited on several fronts. The aim of this study is to explore the basic demographic features and characteristics of users of homeopathy services. The setting is a student teaching tele-health facility based in NA. Concurrent intake forms from 303 participants were analyzed. Intake forms were entered into a coding frame instrument designed and developed to explore health care information. A majority of participants (70%) who attend this clinic are female. The average age is 31 years old. Almost half of the participants in this clinic were using other additional complementary therapies in the management of their conditions. Almost the same number of participants (134) were only using homeopathy. The majority had some prior use of homeopathic products (91.6%), but 52.8% of participants had never worked with a professional homeopath. Twenty-four conditions are listed by participants as chief health complaints. Findings are in alignment with what is already known about the uptake in complementary medicine. Findings also reveal that the users of Homeopathy are seeking an ‘alternative’ to conventional medicine rather than only using Homeopathy as ‘complementary’ medicine. A proportion of participants in this clinical setting find homeopathy through over-the-counter sales and are, for a period, self-prescribing in chronic conditions. Further comparative research is needed to compare this to other complementary medicine avenues as well as conventional medicine settings. Conclusion: This in-depth empirical study of the users of homeopathy at one clinical facility represents initial, novel measured preliminary insights into the participants features and characteristics.

Incidence and predictors of opportunistic infections among HIV-infected children on antiretroviral therapy at public health facilities of Southwest Ethiopia People Regional State, 2023: a multicenter retrospective follow-up study

BackgroundOpportunistic infections (OIs) pose a significant threat to children infected with HIV. Despite advancements in antiretroviral therapy (ART), these infections continue to be a public health concern. However, there is limited evidence regarding the incidence and predictors of OIs among HIV-infected children in Ethiopia, particularly in the study area. Therefore, the objective of this study was to assess the incidence and predictors of OIs among HIV-infected children on ART at public health facilities of Southwest Ethiopia People Regional State.MethodsThe study employed an institution-based retrospective cohort design, conducted from July 1, 2018 to July 31, 2023, among HIV-infected children aged less than 15 years. Data were extracted using the national ART intake and follow-up forms. KoboCollect version 2023.2.4 and STATA version 14.0 were used for data collection and analysis, respectively. The Kaplan-Meier survival curve was used to estimate the probability of OI-free survival time. Variables with P-value < 0.25 in the bivariable Cox proportional hazard model were selected as candidates. In multivariable analysis, P-value < 0.05 and adjusted hazard ratio (AHR) with 95% confidence interval (CI) were used to declare statistically significant predictors.ResultsOf the total 409 HIV infected children, 122(29.8%) developed at least one OI, contributing to 954.95 person-years of risk. The overall incidence rate was 12.8 (95% CI: 10.7, 15.2) per 100 person-years. The OI-free survival probability at the end of the follow-up period was 0.277(95% CI: 0.139, 0.434). The commonest OI was pulmonary tuberculosis, 30.33% (95% CI: 22.7, 39.2). Non-disclosing HIV status (AHR: 2.56, 95% CI: 1.42, 4.63), children aged 10–14 years (AHR: 2.34, 95% CI: 1.10, 4.95), no history of prevention of mother-to-child transmission of HIV (AHR: 2.33, 95% CI: 1.48, 3.66), hemoglobin level < 10 mg/dL (AHR: 2.26, 95% CI: 1.37, 3.75), fair or poor adherence to ART (AHR: 1.74, 95% CI: 1.09, 2.79), and having past history of OIs (AHR: 1.61, 95% CI: 1.03, 2.55) were statistically significant predictors of OIs.Conclusion and recommendationsThe incidence of OIs was high in the study area. Hence, health facilities need to regularly monitor hemoglobin, enhance ART adherence, provide OI prophylaxis for at-risk children, reinforce PMTCT programs for early OI detection and management, and encourage timely and age-appropriate HIV status disclosure. Caregivers of HIV-infected children are also required to oversee and assist their children in adhering to the ART.

Tecovirimat Use under Expanded Access to Treat Mpox in the United States, 2022–2023

BackgroundDuring the ongoing outbreak of clade II monkeypox virus (MPXV), many U.S. patients were prescribed tecovirimat, an antiviral drug that was made available under an expanded access Investigational New Drug (EA-IND) program. We evaluated EA-IND data to summarize characteristics of treated patients, outcomes, and serious adverse events (SAEs).MethodsWe evaluated data from patients prescribed tecovirimat from May 29, 2022, through July 10, 2023. Baseline patient characteristics, clinical courses, and outcomes were evaluated via intake forms, outcome forms, and patient diaries. Data were summarized in aggregate by human immunodeficiency virus (HIV) status and by comorbidities of special interest. Reported SAEs were also compiled.ResultsTecovirimat was prescribed for over 7100 patients in the United States, most often for lesions in sensitive anatomical areas, such as certain anogenital lesions (83.5%; 5135 out of 6148 patients), and pain (52.5%; 3227 out of 6148 patients). The demographic and clinical characteristics mirrored those of patients worldwide. Among the 7181 patients with returned intake forms, 1626 also had returned outcome forms (22.6%). Many patients with severe immunocompromise (e.g., HIV with CD4 counts <200 cells/μl) received multiple courses of tecovirimat (43.1%; 22 out of 51 patients), including intravenously, and often experienced poor outcomes (35.3%; 18 out of 51 patients). Overall, 223 SAEs and 40 deaths were reported. Most SAEs were among patients who were severely immunocompromised, one of whom experienced hallucinations after tecovirimat was administered at twice the standard dose.ConclusionsTecovirimat was used extensively. The returned EA-IND data suggest that life-threatening or protracted infections occurred in persons who were severely immunocompromised. SAEs were not commonly reported. The EA-IND data are not definitive; controlled clinical trial data are essential to elucidating if and how tecovirimat should be used.

B - 80 The Long-Term Memory Sign in Adults Referred for Neuropsychological Evaluation

Abstract Objective We investigated the clinical utility of the newly described long-term memory (LTM) sign in adults referred for neuropsychological evaluation. Individuals with dementia often report short-term episodic memory decline or no memory decline, but rarely report long-term episodic memory decline. The LTM sign refers to patient self-report of long-term episodic memory decline, that is equivalent to/or greater than, subjective short-term episodic memory decline. Method The LTM sign was endorsed on a pre-visit intake form and established during clinical interview in 568 patients (M age = 63, SD = 14.3) referred for neuropsychological evaluation at a large medical center in the Northwest United States. Results In our sample of 568 patients, 79 (14%) reported the LTM sign. In 79 patients with the LTM sign, 45 were diagnosed with a primary psychiatric disorder (57%), 23 were diagnosed with mild neurocognitive disorder (29%), seven had no cognitive or psychiatric diagnosis (9%), and four had dementia (5%). The LTM sign was most common in those with a history of trauma in childhood or adolescence (52/79, 66%) and substance use disorders (50/79, 63%). Conclusions The LTM sign was rare in dementia, but common in those with a current psychiatric diagnosis. These findings support the literature on episodic memory decline in dementia populations and suggests that encoding of early memories and/or retrieval of old memories is negatively impacted by a current psychiatric disorder, traumatic events in childhood and adolescence, and lifetime history of substance use disorder. The LTM sign is a valuable addition to the clinical interview of neuropsychological patients.

Predictors for the incidence of pneumonia among HIV-infected children on antiretroviral therapy in Amhara Regional State Comprehensive Specialized Hospitals, Ethiopia: a multicenter retrospective follow-up study

BackgroundHuman Immune deficiency Virus (HIV) infected children are at higher risk of developing pneumonia. Particularly, in the early phase of HIV infection, the risk of acquiring pneumonia is high, and it remains a major public health problem even after the test and treatment strategy. There is no clear evidence of the overall incidence of pneumonia among HIV-infected children in Amhara region. Aimed to assess the incidence of pneumonia and its predictors among HIV-infected children receiving Antiretroviral therapy in Amhara Region Comprehensive Specialized Hospitals, 2022.MethodsA multicenter retrospective follow-up study was conducted from June 10, 2014, to February 28, 2022, among 430 HIV-positive children receiving antiretroviral therapy. A simple random sampling technique was used. The data was taken from the national antiretroviral intake and follow-up forms. The data were collected via the KoBo toolbox and analyzed using Stata version 17. The Kaplan–Meier curve and log-rank test were employed. Bivariable and multivariable Cox regression was carried out to identify predictors of pneumonia and a P-value < 0.05 was considered significant in to multivariable analysis.ResultsA total of 407 children with a record completeness rate of 94.7% were analyzed in the study. The incidence rate of pneumonia was 4.55 (95% CI; 3.5, 5.92) per 100 person-years observation. The mean survival time was 77.67 months and the total times at risk during follow-up period were yielding 1229.33 person-year observations. Having CD4 cell count below threshold [AHR; 2.71 (95% CI: 1.37, 5.35)], WHO stage III and IV [AHR: 2.17 (95% CI: 1.15, 4.08)], ever had fair and poor treatment adherence [AHR: 2.66 (95% CI: 1.45, 4.89)], and not initiated antiretroviral therapy within seven days [AHR: 2.35 (95% CI: 1.15, 4.78)] were the positive predictors for incidence of Pneumonia.ConclusionsIn this study, the incidence of pneumonia was lower than the previous studies. CD4 cells below the threshold, ever had fair and poor adherence to antiretroviral therapy, WHO stage III and IV, and not initiated antiretroviral therapy within seven days were significant predictors. Therefore,, it is crucial to detect baseline assessment and give attention to those identified predictors promptly, and timely initiation of antiretroviral therapy need special attention.

Perspectives and Attitudes Toward Healthcare and Access Among Transgender and Nonbinary Patients in Ventura County, CA

Transgender and nonbinary (TNB) patients require clinically and culturally appropriate and responsive care in affirming spaces, but barriers exist that prevent TNB patients from accessing or dissuade them from pursuing such care. In this research brief, we summarize findings from a virtual focus group (N= 6) designed to assess perspectives and attitudes toward accessing and receiving care among TNB patients in Ventura County, CA. Qualitative analysis revealed themes related to (1) the importance of enhanced TNB knowledge and sensitivity among medical personnel (particularly among nonprovider staff in healthcare settings), (2) the importance of updating data collection and data management systems with TNB-appropriate terms and diagnoses (e.g., on intake forms), and (3) the importance of self-advocacy and self-education among TNB patients in navigating the healthcare system. Findings indicate that those looking to increase healthcare access and quality among TNB patients in the area should focus their efforts on increasing TNB knowledge and sensitivity among all healthcare employees (i.e., not just providers), enhancing TNB data collection, and making institutional changes such that TNB patients do not have to rely as heavily on themselves when navigating the healthcare system.

Standardized clinical data capture to describe cerebral palsy.

To describe a standardized methodology for capturing clinically valuable information on young people with cerebral palsy (CP) from caregivers and clinicians during routine clinical care. We developed a caregiver-facing intake form and clinician-facing standardized note template and integrated both into routine clinical care at a tertiary care CP center ( https://bit.ly/CP-Intake-Methodology ). We extracted this caregiver and clinician-entered data on people with an ICD10 diagnosis of CP seen between 3/22/23 and 12/28/23. We used this data to describe how CP manifests in this group and which medical features affected the odds of walking, oral feeding, and speech by age 5. Of 686 visits, 663 (97%) had caregiver- and clinician-entered data and 633 had a clinician-confirmed CP diagnosis (mean age 9.1, 53.4% Male, 78.5% White). It was common to have quadriplegia (288/613, 47.0%), both spasticity and dystonia (257/632, 40.7%), walk independently (368/633, 58.1%), eat all food and drink safely by mouth (288/578, 55.9%), and produce understandable speech (249/584, 42.6%). Cortical grey matter injury and duration of initial critical care unit stay affected the odds of walking, oral feeding, and speech (binary logistic regression, p<0.001). We comprehensively captured caregiver and clinician-entered data on 97% of people seen in a tertiary care CP Center and used this data to determine medical features affecting the odds of three functional outcomes. By sharing our methodology, we aim to facilitate replication of this dataset at other sites and grow our understanding of how CP manifests in the US. Using caregiver and clinician-entered data on people seen in a tertiary-care CP center, we determined medical features affecting the odds of three functional outcomes. Detailed CP characterization can be limited if using population-based registries and retrospective chart review alone, including limited data on recently validated functional classification systems for CP. We comprehensively captured caregiver and clinician-entered data on 97% of people seen in our CP Center to describe how CP manifests and show that cortical injury and initial ICU stay duration affect the odds of walking, oral feeding, and speech. Susie Kim helped design the study, aggregated data, carried out data analyses, and critically reviewed and revised the manuscript.Kelsey Steffen helped conceptualize and design the study and critically reviewed and revised the manuscript.Lauren Gottschalk, Jennifer Miros, Katie Leger, Amy Viehoever, and Karen Taca helped design the study and critically reviewed and revised the manuscript.Bhooma Aravamuthan conceptualized and designed the study, supervised data collection and analysis, drafted the initial manuscript, and critically reviewed and revised the manuscript.

The Use of Acoustic Mapping to Improve Surveillance of Pediatric Patient with Residual COVID-19 Symptomology

Objective: This study was designed to assess the severity of lung tissue changes due to COVID-19 in a pediatric cohort that still complained of post-COVID-19 symptoms. Materials and Methods: Parents and adolescents, 13 to 22 years old and have had a confirmatory positive polymerase chain reaction (+PCR) and/or rapid antigen test for COVID-19, consented to have a series of diagnostic tests to determine the level of lung tissue changes due to COVID-19. Sixteen adolescents completed the intake form and lung sonography. The lung sonogram was completed using the bedside lung ultrasound in emergency (BLUE) point method and a GE Logiq I laptop ultrasound system, as well as a linear 7.5-MHz or 3.0-MHz convex-array transducers. Thirteen adolescents completed a chest magnetic resonance imaging (MRI) examination on a 0.55T Siemens MAGNETOM Free.Max scanner. The examination included the heart and lungs of each participant and took about 90 minutes. A radiologist, sonographer, and computed tomography (CT) technologist reviewed and scored the images. Those positive lung sonogram scores were matched anatomically to the same slice within the chest MRI examination. Results: Based on the 13 participants, the acoustic mapping process demonstrated no diagnostic matches for positively scored sonograms at the pleural line or pulmonary parenchyma with the corresponding MRI image slices. There were diagnostic matches for negatively scored sonograms at the pleural line or pulmonary parenchyma with the corresponding MRI image slices. Conclusion: With lingering post-COVID-19 symptomology, this adolescent cohort demonstrated that acoustic mapping of their lung sonograms and chest MRI images had important combined diagnostic value. Lung sonography demonstrated diagnostic effectiveness for evaluating the periphery of the lung tissue, in this cohort but limited in viewing deeper structures. Conversely, MRI provided definitive views of the entire chest cavity and lung tissue, which is important for properly evaluating deeper pulmonary parenchyma.

Cyberbullying and Bullying Reports Among Youth in a Behavioral Health Inpatient Unit: Insights From Youth and Parent Intake Surveys.

BACKGROUND: Limited studies have examined the extent to which cyberbullying and offline bullying are factors related to youth admissions to behavioral health inpatient units. However, considering the rising use of technology and prevalence of youth bullying, intake procedures require adaptation to account for modern-day psychological pressures facing youth. AIMS: Our aims were to pilot and analyze results from a novel intake form, assessing offline bullying and cyberbullying, in a youth inpatient behavioral health facility. METHODS: Upon admission at an inpatient behavioral health facility in the Midwestern United States, 622 youth (ages 10 and older) and their parent/guardian completed intake forms including questions about their experience of bullying, cyberbullying, and feelings of safety in different environments, and feelings about whether bullying contributed to their inpatient admission. RESULTS: Overall, 21.50% (134/622) of youth self-reported being a cybervictim, 6.10% (38/622) reported being an offline bully victim, and 8.04% (50/622) reported mixed bullying. Bullied youth felt significantly less safe in all environments than non-bullied youth, and bullied youth who felt unsafe were more likely to attribute their hospitalization to bullying. Troublingly, only about one-third of parents were aware of cyberbullying. CONCLUSION: Using traditional standards of care that do not address offline bullying/cyberbullying, mental health care workers may be missing critical factors that contribute to youth inpatient hospitalization for mental health issues. Behavioral health units should consider adapting intake forms to include offline bullying/cyberbullying questions and developing programming for parents and adults to address issues of online and offline safety.

Intake Characteristics as Predictors of Psychotherapy Outcome in a Practice Research Network in Argentina

There are few studies exploring intake diagnostic characteristics as predictors of change in integrative naturalistic settings. The aim of this study is to explore baseline variables at the intake process and establish the predictive value of the individual trajectories of the patients. We recruited 259 patients undergoing an integrative psychotherapy network of psychotherapists from Buenos Aires, Argentina. Every therapist completed the intake form of each patient involved in the routine outcome monitoring. Thereafter step-wise regressions based on forward selection strategies were used, in order to identify meaningful baseline predictors of patients’ clinical evolution, derived from the intake process. The selected predictors were social support network, subjective distress, the initial measure of clinical distress, unemployment, sociocultural status and reactance. When including those six variables in a multilevel model, the results indicate that social support network, subjective distress, and the initial measure of clinical distress were significant predictors of the trajectories of OQ-30, whereas unemployment, sociocultural status and reactance were not significant. The results regarding social support network are in line with the literature, while results of socioeconomic status (unemployment and sociocultural level) move in an opposite direction in comparison to the available evidence. Moreover, the mental health findings (initial OQ-30 and subjective distress) confirm the contradictory body of literature produced in this domain. Finally, reactance seems to be a significant predictor in previous study in contradiction of our results. Overall, this endeavor constitutes important but preliminary evidence to enhance the production of bottom-up science within practice research networks in the global south.

Successful Distribution of Tecovirimat During the Peak of the Mpox Outbreak - Los Angeles County, June 2022-January 2023.

Tecovirimat is the first-line antiviral treatment recommended for severe mpox or for persons with mpox who are at risk for severe disease; tecovirimat is available in the United States under an expanded access investigational new drug (IND) protocol. During the 2022-2023 mpox outbreak, local U.S. health jurisdictions facilitated access to tecovirimat. In June 2022, Los Angeles County (LAC) rapidly developed strategies for tecovirimat distribution using existing medical countermeasure distribution networks established by the Public Health Emergency Preparedness Program and the Hospital Preparedness Program, creating a hub and spoke distribution network consisting of 44 hub facilities serving 456 satellite sites across LAC. IND patient intake forms were analyzed to describe mpox patients treated with tecovirimat. Tecovirimat treatment data were matched with case surveillance data to calculate time from specimen collection to patients receiving tecovirimat. Among 2,281 patients with mpox in LAC, 735 (32%) received tecovirimat during June 2022-January 2023. Among treated patients, approximately two thirds (508; 69%) received treatment through community clinics and pharmacies. The median interval from specimen collection to treatment was 2 days (IQR=0-5 days). Local data collection and analysis helped to minimize gaps in treatment access and facilitated network performance monitoring. During public health emergencies, medical countermeasures can be rapidly deployed across a large jurisdiction using existing distribution networks, including clinics and pharmacies.

(087) SMALL FIBER NEUROPATHY AND FEMALE SEXUAL FUNCTION

Abstract Introduction Small fiber neuropathy (SFN) can result in a variety of pain and autonomic symptoms due to its impact on small-diameter somatic and autonomic unmyelinated C-fibers and/or thinly myelinated A-delta (Aδ) fibers. It has been identified in 66% of patients with complex (refractory or multisystem) pelvic pain. Objective The objective of this study was to characterize the differences between sexual symptoms in patients with and without SFN. Methods This was a retrospective case control study involving patients seen at a subspecialty Urogynecology and Reconstructive Surgery clinic between January 2023 and October 2023. All patients presenting for evaluation were offered an electronic pre-visit intake form inclusive of the PISQ-IR (evaluation tool validated by the IUGA for sexual dysfunction symptoms). The primary outcome measured was self-reported quality of sexual function, represented by PISQ-IR score. Secondary outcomes included comparisons of survey scores for arousal, orgasm, and dyspareunia between SFN and non-SFN patients. Results A total of 89 patients were analyzed, 11 with definitive SFN and 78 without SFN. Results were compared between these two groups using chi-square tests and Mann-Whitney U tests. PISQ-IR scores were significantly different between SFN and non-SFN patients. Mean scores of 2.9 (SD 0.6) and 3.5 (SD 0.6) were calculated, respectively, indicating worse overall sexual function in SFN patients (p = 0.01). Secondary outcomes analyzed were significant for lower orgasm intensity scores in SFN patients (median of 2 vs 3 in non-SFN patients, p = 0.02 Mann-Whitney test). Arousal scores and pain scores were not significantly different between the two patient populations. Conclusions SFN is associated with worse sexual function and decreased orgasm intensity in the subspecialty Urogynecology and Reconstructive Surgery population. Disclosure No.

Rapid Development of a Registry to Accelerate COVID-19 Vaccine Clinical Trials.

The unprecedented scientific response to the SARS-Cov-2 pandemic in 2020 required the rapid development and activation of extensive clinical trial networks to study vaccines and therapeutics. The COVID-19 Prevention Network (CoVPN) coordinated hundreds of sites conducting phase 2 and 3 clinical trials of vaccines and antibody therapeutics. To facilitate these clinical trials, the CoVPN Volunteer Screening Registry (VSR) was created to collect volunteer information at scale, identify volunteers at risk of COVID-19 who met enrollment criteria, distribute candidates across clinical trial sites, and enable monitoring of volunteering and enrollment progress. We developed a secure database to support three primary web-based interfaces: a national volunteer questionnaire intake form, a clinical trial site portal, and an Administrative Portal. The Site Portal supported filters based on volunteer attributes, visual analytics, enrollment status tracking, geographic search, and clinical risk prediction. The Administrative Portal supported oversight and development with pre-specified reports aggregated by geography, trial, and trial site; charts of volunteer rates over time; volunteer risk score calculation; and dynamic, user-defined reports. Over 650,000 volunteers joined the VSR, and 1094 users were trained to utilize the system. The VSR played a key role in recruitment for the Moderna, Oxford-AstraZeneca, Janssen, and Novavax vaccine clinical trials, provided support to the Pfizer and Sanofi vaccine and prophylactic antibody clinical trials, and enhanced the diversity of trial participants. Clinical trial sites selected 166,729 volunteer records for follow-up screening, and of these 47·7% represented groups prioritized for increased enrollment. Despite the unprecedented urgency of its development, the system maintained 99·99% uptime. The success of the VSR demonstrates that information tools can be rapidly yet safely developed through a public-private partnership and integrated into a distributed and accelerated clinical trial setting. We further summarize the requirements, design, and development of the system, and discuss lessons learned for future pandemic preparedness.

The Impact of a Digital Contraceptive Decision Aid on User Outcomes: Results of an Experimental, Clinical Trial.

Nearly 40% of unplanned pregnancies in the USA are the result of inconsistent or incorrect contraceptive use. Finding ways to increase women's comfort and satisfaction with contraceptive use is therefore critical to public health. One promising pathway for improving patient outcomes is through the use of digital decision aids that assist women and their physicians in choosing a contraceptive option that women are comfortable with. Testing the ability of these aids to improve patient outcomes is therefore a necessary first step toward incorporating this technology into traditional physician appointments. To evaluate the effectiveness of a novel contraceptive decision aid at minimizing decisional conflict and increasing comfort with contraception among adult women. In total, 310 adult women were assigned to use either the Tuune contraceptive decision aid or a control aid modeled after a leading online contraceptive prescriber's patient intake form. Participants then completed self-report measures of decisional conflict, contraceptive expectations, satisfaction, and contraceptive use intentions. Individual between-subjects analysis of variance (ANOVA) models were used to examine these outcomes. Women using the Tuune decision aid (vs. those using the control aid) reported lower decisional conflict, more positive contraceptive expectations, greater satisfaction with the decision aid and recommendation, and more positive contraceptive use intentions. Use of Tuune improved each of the predicted patient outcomes relative to a control decision aid. Online decision aids, particularly when used alongside physician consultations, may be an effective tool for increasing comfort with contraceptive use. NCT05177783, ClinicalTrials.gov, https://clinicaltrials.gov/ct2/show/NCT05177783.

Assessing the Feasibility and Effectiveness of Screening for Indoor Tanning in the Primary Care Setting: A Report of Preliminary Findings

Introduction: Indoor tanning is a major modifiable risk factor in the development of both melanontic and non-melanotic skin cancers. Investigation of behavior-altering interventions is an area of active research. As with other preventative measures, screening of high-risk populations can be an important aspect of a multimodality public health intervention. We sought to further the limited understanding of indoor tanning screening practices in the primary care setting.Methods: Physicians practicing within the scope of primary care in the northeast were surveyed in 2022 on practice patterns around frequency of indoor tanning screening, barriers encountered with implementing screening, and actions taken with a positive screen. Research methodology adhered to the Joanna Briggs Institute research study critical appraisal checklist.Results: Of 26 primary care physicians (PCPs), only 7.7% routinely screened for indoor tanning. Barriers identified included time limitations (76.9%) and prioritization of other health concerns (96.2%). All PCPs (100%) reacted to reports of indoor tanning with an intervention, most commonly counseling on the risks of indoor tanning (92.6%).Conclusions: Our data suggests that screening for indoor tanning use could be improved. We recommend the incorporation of a standardized screening question regarding indoor tanning in intake forms.

Analysis of reconstructed oropharynx shape after total glossolaryngectomy reconstruction using a free rectus abdominis musculocutaneous flap

IntroductionRestoring oral intake through oropharyngeal reconstruction is vital for patients undergoing total glossolaryngectomy. Despite its importance, research in this area is limited, leaving clinicians with few guidelines. The debate regarding the optimal shape of the reconstructed oropharynx highlights the need for further research. MethodsThis retrospective study analysed data from 16 consecutive patients who underwent primary reconstruction with a free rectus abdominis musculocutaneous flap after total glossolaryngectomy at the University of the Ryukyus Hospital between April 2015 and March 2022. Parameters assessed included reconstructed oropharynx shape (flat or funnel-shaped), demographics, flap characteristics, post-operative course and oral intake outcomes. ResultsAmong the 16 patients, 10 had flat oropharynx, whereas 6 had a funnel-shaped oropharynx. At 6 months post-surgery, 13 patients resumed oral feeding, whereas 3 did not. Significant differences were observed between the groups in preoperative body mass index (21.1 kg/m² vs 17.8 kg/m², Welch's t-test, p=0.035) and days until the first oral intake (34.2 days vs 19.2 days, Welch's t-test, p=0.01). However, no significant differences were found in the form of oral intake at 6 months after surgery (Fisher's exact test, p=0.518). ConclusionThis study suggests that the shape of the reconstructed oropharynx (flat or funnel-shaped) does not significantly impact long-term post-operative oral intake. These findings provide valuable insights into oropharyngeal reconstruction outcomes after total glossolaryngectomy and offer guidance for future research in this area. Nevertheless, further studies are warranted to elucidate the clinical implications of these findings and address any limitations of this study, particularly those regarding sample size constraints.

Abstract PO3-28-03: Mitigating Financial Toxicity Through Individualized Education

Abstract Background Triage Cancer® offers a free Legal &amp; Financial Navigation Program (LFN) that supports individuals coping with cancer, their caregivers, and health care providers as they navigate the legal and practical matters that arise after a diagnosis. Without access to the proper resources, individuals impacted by cancer may suffer the financial burden of a diagnosis – or financial toxicity, as coined by researchers at Duke. Financial toxicity has proven to have a negative impact on quality of life and mental and physical health of individuals coping with cancer. The LFN provides individuals impacted by a diagnosis with the accurate information and resources needed to help mitigate financial toxicity. The LFN addresses the gap in education around cancer-related legal issues to improve the overall health of individuals coping with cancer. This tailored education is particularly important for providers, as there is a significant lack of training around cancer-related legal issues. Consequently, health care providers are often not equipped to answer their patient’s complex questions about cancer-related legal issues, including health insurance, disability insurance, and employment. The LFN provides personalized education on relevant laws and actionable steps to navigate the situation, which improves the provider’s ability to support their patients and the patients’ ability to self-advocate. Methods To start the process, individuals complete a brief intake form online and schedule a call with the staff. During the call, the staff provides education around relevant laws and practical options to manage the situation. The efficacy of the program is measured through voluntary survey response. Callers receive a follow-up email with a one question survey within a day of the initial call. After three weeks, the caller also receives a detailed survey. Results In 2022, Triage Cancer® provided direct consultation to 1,289 callers; 384 with breast cancer. For those callers, the most common topics included: employment, disability insurance, and health insurance. Survey data indicates that after speaking with staff, 93% felt better prepared with regard to their options and 94% agreed that they had actionable next steps. Conclusion The LFN provides tailored education around cancer-related legal issues in order to improve the quality of life of individuals coping with cancer. The LFN provides accurate information on relevant laws and actionable steps to help individuals make informed decisions to mitigate financial toxicity. Citation Format: Joanna Doran, Monica Bryant. Mitigating Financial Toxicity Through Individualized Education [abstract]. In: Proceedings of the 2023 San Antonio Breast Cancer Symposium; 2023 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2024;84(9 Suppl):Abstract nr PO3-28-03.

Level of Implementation of Drug Rehabilitation Program, Treatment and Intervention for Persons Who Use Drugs (PWUD) in Basud, Camarines Norte, Philippines

The study specifically assessed the level of implementation of the Drug Rehabilitation Program, treatment and intervention for Persons Who Use Drugs (PWUD) in Basud, Camarines Norte. It employed descriptive research where 300 respondents participated as respondents. As to the findings, in terms of community preparation PNP Basud initiates advocacy programs on drug education in the community. The least implemented practice was initiating activities in organizing screening for person who use drugs. Meanwhile, in terms of screening, it was found that MHO Basud initiates accomplishing intake form during the screening process. The least practice was initiating schedule check-up by MHO Basud. In terms of assessment, the results showed that MHO Basud ensures other assessment of other mental health conditions using mhGAP IG. The least practice, however, was ensuring request for laboratory/diagnostic test by the MHO Basud. In terms of implementation of intervention, it was revealed that MHO Basud implements community-based treatment for person who uses drugs. The least practice was implements inpatient treatment for person who uses drugs by MHO Basud. Finally, in terms of aftercare program, it was revealed that DILG Basud undertakes community reintegration for person who formerly uses drugs. The least practice, however, was ensuring follow-up for person who formerly uses drugs by the DILG Basud. Comprehensive community-based training programs and educational orientation on drug-related treatment, rehabilitation and interventions may be continuously provided to the implementers of interventions to raise public awareness on the essence, objectives and processes involved in community-based drug rehabilitation.

Improvement in quality of trauma care at non-tertiary hospitals in Ghana during on-hours and off-hours with a trauma intake form: A stepped-wedge cluster randomized trial

BackgroundWe sought to determine the achievement of key performance indicators (KPIs) of initial trauma care at non-tertiary hospitals in Ghana during on-hours (8AM-5PM weekdays) compared to off-hours (nights, weekends, and holidays). We also sought to assess the effectiveness of a standardized trauma intake form (TIF) with built-in decision support prompts to improve care and to assess whether this effectiveness varied between on-hours and off-hours. MethodsA stepped-wedge cluster randomized trial was performed with research assistants directly observing trauma care before and after introducing the TIF at emergency units of eight hospitals for 17.5 months. Differences in KPIs and mortality were assessed using multivariable logistic regression and generalized linear mixed regression. ResultsManagement of 4,077 patients was observed; 1,126 (28 %) during on-hours and 2,951(72 %) during off-hours. At baseline, four of 20 KPIs were performed significantly more often during off-hours. TIF improved care during both on- and off-hours. Seventeen KPIs improved during on-hours and 18 KPIs improved during off-hours. After TIF, six KPIs were performed more often during on-hours, but differences, though significant, were small (1–5 %). Examples of KPIs which were performed more often during on-hours after TIF included: airway assessment (99 % for on-hours vs. 98 % for off-hours), evaluation for intra-abdominal bleeding (91 % vs. 87 %), and spine immobilization for blunt trauma (90 % vs. 85 %) (all p < 0.05). At baseline, mortality among seriously injured patients (Injury Severity Score >9) was higher during on-hours (27 %) compared to off-hours (17 %, p = 0.047). TIF lowered mortality for seriously injured patients during both on-hours (27 % before TIF, 8 % after, p = 0.027) and during off-hours (17 % before, 7 % after, p = 0.004). After TIF, mortality among seriously injured patients was equal between on- and off-hours (8 % vs. 7 %, NS). ConclusionsAt baseline, KPIs of trauma care were slightly better during off-hours compared with on-hours, and mortality was lower among seriously injured patient during off-hours. A quality improvement initiative (the TIF) using built-in decision support prompts improved care strongly in both on- and off-hours and eliminated the mortality difference between on- and off-hours. Use of similar decision support prompts during initial trauma care should be promoted widely in other low- and middle-income countries.

Pilot Test of A Gender-conscious Sexual Health Intake Questionnaire: Increasing Inclusivity and Mitigating Bias in Sexual History Taking

Background: Sexual health is critical to overall health, yet sexual history taking is challenging. LGBTQ+ patients face additional barriers due to cis/heteronormativity from the medical system. We aimed to develop and pilot test a novel sexual history questionnaire called the Sexual Health Intake (SHI) form for patients of diverse genders and sexualities. Methods: The SHI comprises four pictogram-based questions about sexual contact at the mouth, anus, vaginal canal, and penis. We enrolled 100 sexually active, English-speaking adults from a gender-affirming surgery clinic and urology clinic from November 2022 to April 2023. All surveys were completed in the office. Patients also answered five feedback questions and 15 questions from the Patient-Reported Outcomes Measurement Information System Sexual Function and Satisfaction (PROMIS-SexFS) survey as a validated comparator. Results: One hundred patients aged 19–86 years representing an array of racial/ethnic groups, gender identities, and sexuality completed the study. Forms of sexual contact varied widely and included all possible combinations asked by the SHI. Feedback questions were answered favorably in domains of clinical utility, inclusiveness of identity and anatomy, and comprehensiveness of forms of sexual behavior. The SHI captured more positive responses than PROMIS-SexFS in corresponding questions about specific types of sexual activity. The SHI also asks about forms of sexual contact that are not addressed by PROMIS-SexFS, such as penis-to-clitoris. Conclusions: SHI is an inclusive, patient-directed tool to aid sexual history taking without cisnormative or heteronormative biases. The form was well received by a diverse group of participants and can be considered for use in the clinical setting.