Receipt Of Preventive Health Services Research Articles

Perceptions of Primary Care Among Women in Treatment for Opioid Use Disorder: A Qualitative Study.

Underutilization of primary care and receipt of preventive health services have been reported among women with opioid use disorder. The aim of this study was to describe perceptions of primary care among women in treatment for opioid use disorder. Between May and June 2022, 27 women who were receiving treatment for opioid use disorder from one opioid treatment program participated in this study. Participants completed one data collection session which involved a brief questionnaire followed by a semi-structured interview. Participants were asked questions about their overall experience with primary care as well as perceived facilitators and barriers to primary care utilization and quality. Interview transcripts were analyzed using an inductive thematic approach. Three themes emerged from the interviews within the domain of "Facilitators to Primary Care," including: (1) coordination of care, (2) continuity of care, and (3) relationship with health care providers. Four themes emerged from the interviews within the domain of "Barriers to Primary Care," including: (1) perceived judgment from health care providers, (2) childcare needs, (3) issues related to location, and (4) issues related to time. Approaches to primary care that help alleviate barriers to care and highlight the aspects of care that are valued may improve quality and utilization of care, thus enhancing the health and well-being of a vulnerable population.

Gender-Affirming Hormone Therapy and Cervical Cancer Screening Rates in Transgender Men and Nonbinary People: A Cross-Sectional Study from a Boston Community Health Center.

Purpose: Clinical monitoring for patients receiving gender-affirming hormone therapy (GAHT) has the potential to facilitate their receipt of preventive health services. We aimed to determine whether GAHT is associated with increased utilization of cervical cancer screening among transgender men (TM) and nonbinary persons assigned female at birth (NB-AFAB). Methods: We conducted a cross-sectional observational study of a single community health center in Boston. Persons of all gender identities eligible for cervical cancer screening during 2008-2019 were assessed. The outcome of interest was receipt of cervical cancer screening based on U.S. Preventive Services Task Force recommendations. We compared the proportion of persons who received cervical cancer screening by prescription of GAHT. Results: We identified 13,267 eligible persons. This cohort included 10,547 (79.5%) cisgender women, 1547 (11.7%) TM, and 1173 (8.8%) NB-AFAB persons. Among all persons eligible for cervical cancer screening, TM and NB-AFAB persons were less likely to receive screening than cisgender women (56.2% and 56.1% vs. 60.5% respectively; odds ratio [OR] = 0.84; 95% confidence interval [CI] = 0.75-0.93; OR = 0.84; 95% CI = 0.74-0.94, respectively). Among TM, those prescribed testosterone were more likely to receive cervical cancer screening than those not prescribed testosterone (57.9% vs. 48.2%, OR = 1.47; 95% CI = 1.14-1.92). Among NB-AFAB adults, those prescribed testosterone were more likely to receive cervical cancer screening than those not prescribed testosterone (61.9% vs. 51.5%, OR = 1.53; 95% CI = 1.21-1.93). Conclusions: The benefits of engagement in care to access GAHT may extend beyond the hormonal intervention to preventive health services.

Health Status and Preventive Health Services Among Reproductive-Aged Women in Treatment for Opioid Use Disorder.

To assess the utilization of preventive health services and the prevalence of chronic health conditions among a cohort of women in treatment for opioid use disorder (OUD). Ninety-seven women who were receiving treatment for OUD from a single urban treatment program completed a self-administered anonymous online questionnaire that asked about demographics, health, receipt of preventive health services, and utilization of health care. Descriptive statistics were used to describe data. More than one-third of respondents reported that their health was fair or poor, whereas one-quarter were very concerned with their health. Most participants (59%) reported at least one chronic health condition; nearly 1 in 5 reported two or more conditions. Less than half of respondents had received a routine medical examination in the past year. Vaccine uptake was low; 56% received the coronavirus disease 2019 vaccine and 36% received the annual influenza vaccine. Women in treatment for OUD could benefit from enhanced health care to address the high rates of chronic diseases and risk factors and underutilization of recommended preventive health services. Interventions and models of care that aim to enhance utilization of such services, and ultimately improve the health of this vulnerable population, may be worth exploring.

Receipt of preventive health services and current cannabis users

Substance use is associated with greater barriers and reduced access to care. Little research, however, has examined the relationship between cannabis use and receipt of preventive health services. Using data from the 2017 Behavioral Risk Factor Surveillance System, we examined the association between current cannabis use and receipt of 12 preventive health services, adjusting for sociodemographic characteristics and access to care. In analyses that adjusted for sociodemographic factors and access to care, participants with current cannabis use had lower odds of being vaccinated for influenza (AOR = 0.67, 95% CI = 0.54–0.83) and higher odds of ever receiving HPV vaccination (AOR = 1.77, 95% CI = 1.06–2.96) and HIV screening (AOR = 2.34, 95% CI = 1.88–2.92) compared with those without cannabis use. Among the 12 preventive services examined, we found three differences in receipt of preventive services by cannabis use status. Cannabis use does not appear to be associated with significant underuse of preventive services.

Sustaining Successful Clinical-community Partnerships in Medically Underserved Urban Areas: A Qualitative Case Study

ABSTRACT Clinical-community partnerships can improve access and receipt of preventive health services in community settings. Understanding how to sustain their potential benefits is warranted. Qualitative case-study of the Faith Community Health Partnership (FCHP), a collaboration between faith-community nurses and community organizations sustained over 25 years. We used content analysis principles to report on partnership sustainability themes identified through semi-structured interviews with FCHP partners (n = 18). Factors supporting partnership sustainability: Maintaining partners’ commitment over time; strategic resource-sharing; facilitating engagement; and preserving partnership flexibility. Sustaining clinical-community partnerships is a dynamic and continuous process requiring significant time, effort, and resources on behalf of partners.

Recommendations for Preventive Pediatric Health Care

The objective of this study was to compare the receipt of preventive health services for children with and without special health care needs and to identify predictors of these health services for children with special health care needs using nationally representative data. Data from the 2002 and 2003 Medical Expenditure Panel Surveys were analyzed. A total of 18 279 children aged 3 to 17 years were included in our study. The Child Preventive Health Supplement was used to identify caregiver recall of specific health screening measures and anticipatory guidance during the previous 12 months. Odds ratios were calculated for predictive factors of preventive services for children with special health care needs.

Abstract P535: Receipt of Preventive Health Services Among Current Marijuana Users

Introduction: The associations between marijuana use and various health-related behaviors, including receipt of preventive health services, have not been widely examined. Hypothesis: Given the known adverse cognitive effects of tetrahydrocannabinol (THC), we hypothesized that current marijuana users were less likely than non-users to receive recommended preventive health services. Methods: The Behavioral Risk Factor Surveillance System (BRFSS) is an ongoing telephone survey that collects data on health-related risk behaviors, chronic health conditions, and use of preventive services by non-institutionalized U.S. adults ≥18 years of age from the 50 U.S. states, the District of Columbia, Puerto Rico, the U.S. Virgin Islands, Guam, American Samoa, and Palau. In 2017, there were 10 U.S. states that administered the BRFSS Marijuana Module. We identified survey respondents that were eligible for receipt of each recommended preventive health service. Using chi square statistics, we examined the rates of receipt of recommended preventive services among eligible users compared to non-users in these 10 states. Results: In 2017, among 45,655,241 participants, 10.7% used marijuana in the past 30 days, and 69.3% of those used it daily. The predominant method of marijuana use was smoking (90.4%). Compared to non-users, marijuana users were more likely to be 18-29 years of age (39.7% vs 17.4%, p<0.0001) and male (61.6% vs 46.4%, p<0.0001). Marijuana users were less likely to be Hispanic (18.2% vs 21.5%) or Asian, Native Hawaiian, or Pacific Islander (5.3% vs 9.5%) compared to non-users (p<0.0001). Participants who used marijuana were more likely to be employed (63.8% vs 56%) and to have graduated high school (28.8% vs 24.8%) compared to those who did not use marijuana (p<0.0001). Marijuana users were less likely than non-users to be married (27.9% vs 54%, p<0.0001). Among all participants, fewer marijuana users than non-users received an influenza vaccination within the past year (25.4% vs 41.5%, p<0.0001). Additionally, among age-eligible participants, those who used marijuana were less likely to have received serum cholesterol screenings in the past five years (79.5% vs 83%) and regularly take aspirin as a method of cardiovascular risk reduction (36.6% vs 44.9%) compared to non-users (p<0.0001). Among participants with diabetes, fewer marijuana users received an eye examination (48.8% vs 57.8%) or an influenza vaccination (35.9% vs 56.9%) within the last year compared to non-users (p<0.0001). Conclusion: Marijuana users were less likely to receive an influenza vaccination and preventive services recommended for cardiovascular risk reduction. Users may need more targeted interventions to receive needed care.

Utility of Functional MRI in Pediatric Neurology

The objective of this study was to compare the receipt of preventive health services for children with and without special health care needs and to identify predictors of these health services for children with special health care needs using nationally representative data. Data from the 2002 and 2003 Medical Expenditure Panel Surveys were analyzed. A total of 18 279 children aged 3 to 17 years were included in our study. The Child Preventive Health Supplement was used to identify caregiver recall of specific health screening measures and anticipatory guidance during the previous 12 months. Odds ratios were calculated for predictive factors of preventive services for children with special health care needs

Receipt of Selected Preventive Health Services for Women and Men of Reproductive Age - United States, 2011-2013.

Receipt of Selected Preventive Health Services for Women and Men of Reproductive Age - United States, 2011-2013.

Racial disparities in the utilization of preventive health services among older women with early-stage endometrial cancer enrolled in Medicare.

To assess differences in the receipt of preventive health services by race/ethnicity among older women with endometrial cancer enrolled in Medicare, we conducted a retrospective population‐based cohort study of women diagnosed with endometrial cancer from 2001 to 2011 in the Surveillance Epidemiology and End Results (SEER)‐Medicare database. Women with stage I or II endometrial cancer of epithelial origin were included. The exposure was race/ethnicity (Non‐Hispanic [NH] White, NH Black, Hispanic, and NH Asian/Pacific Islander [PI]). The services examined were receipt of influenza vaccination and screening tests for diabetes mellitus, hyperlipidemia, and breast cancer. We used multivariate logistic regression to estimate odds ratios with 95% confidence intervals (CI) adjusted for age, region, and year of diagnosis. A total of 13,054 women were included. In the 2 years after diagnosis, receipt of any influenza vaccine ranged from 45% among NH Black women to 67% among NH White women; receipt of a mammogram ranged from 65% among NH Black women to 74% among NH White women. Relative to NH White women, NH Black women had a lower likelihood of receiving both influenza vaccination (adjusted odds ratio [aOR] 0.40, 95% CI 0.33–0.44) and screening mammography (aOR 0.64, 95% CI 0.52–0.79). Hispanic women also were less likely to receive influenza vaccination than NH White women (aOR 0.61, 95% CI 0.51–0.72). There were no significant differences across racial groups for diabetes or cholesterol screening services. Among older women with early‐stage endometrial cancer, racial disparities exist in the utilization of some preventive services.

A national examination of pharmacy-based immunization statutes and their association with influenza vaccinations and preventive health

BackgroundA series of state-level statute changes have allowed pharmacists to provide influenza vaccinations in community pharmacies. The study aim was to estimate the effects of pharmacy-based immunization statutes changes on per capita influenza vaccine prescriptions, adult vaccination rates, and the utilization of other preventive health services. MethodsA quasi-experimental study that compares vaccination outcomes over time before and after states allowed pharmacy-based immunization. Measures of per capita pharmacy prescriptions for influenza vaccines in each state came from a proprietary pharmacy prescription database. Data on adult vaccination rates and preventive health utilization were studied using multiple waves of the Behavioral Risk Factor Surveillance System (BRFSS). The primary outcomes were changes in per capita influenza vaccine pharmacy prescriptions, adult vaccination rates, and preventive health interventions following changes. ResultsBetween 2007 and 2013, the number of influenza vaccinations dispensed in community pharmacies increased from 3.2 to 20.9 million. After one year, adopting pharmacist immunization statutes increased per capita influenza vaccine prescriptions by an absolute difference (AD) of 2.6% (95% CI: 1.1–4.2). Adopting statutes did not lead to a significant absolute increase in adult vaccination rates (AD 0.9%, 95% CI: −0.3, 2.2). There also was no observed difference in adult vaccination rates among adults at high-risk of influenza complications (AD 0.8%, 95% CI: −0.2, 1.8) or among standard demographic subgroups. There also was no observed difference in the receipt of preventive health services, including routine physician office visits (AD −1.9%, 95% CI: −4.9, 1.1). ConclusionsPharmacists are providing millions of influenza vaccines as a consequence of immunization statutes, but we do not observe significant differences in adult influenza vaccination rates. The main gains from pharmacy-based immunization may be in providing a more convenient way to obtain an important health service.

Evaluating the unique effects of cognitive ability and parental socioeconomic status on adult dietary behaviors and receipt of preventive health services

Some research has shown that both cognitive ability and parental socioeconomic status (parental SES) predict dietary behaviors and receipt of preventive health services later in life. However, previous research has not attempted to disentangle these effects while also examining important mediators such as education level and income. Based on a sample of 4078 individuals drawn from the National Longitudinal Survey of Youth 1979, we examined the unique effects of g and parental SES on adult dietary behaviors and receipt of preventive health services. Overall, the results suggest that there is essentially little direct unique effect of cognitive ability or parental SES on adult dietary behaviors and receipt of preventive health services. However, the total effects of cognitive ability and parental SES on adult dietary behaviors and receipt of preventive health services showed that higher levels of cognitive ability and parental SES were associated with healthier dietary habits and receipt of health services due to their effects on educational attainment and adult income. The findings may have implications for health education materials and access to healthcare.

Preventive health care among HIV positive women in a Utah HIV/AIDS clinic: a retrospective cohort study

BackgroundDespite evidence that HIV positive women may suffer higher rates of heart disease, diabetes, human papillomavirus infection, and some types of cancer, the provision of preventive health services to HIV positive women is unknown. Preventive health services recommended for such women include breast, colorectal and cervical cancer screening, sexually transmitted infection (STI) testing, vaccinations, and patient counseling on a number of issues including sexual behaviors.MethodsThis retrospective cohort study utilized medical record reviews of 192 HIV positive women who were patients at the University of Utah Infectious Diseases Clinic in 2009. Medical records were reviewed for all encounters during 2009 using a standardized data collection form; data were collected on patient demographics and a variety of preventive health services. Chi squared tests were used to assess receipt of preventive health services by demographic factors, and multivariable logistic regression was used to determine predictors of receiving select services.ResultsThe most commonly recorded preventive services included blood pressure screening, screening for Hepatitis A and B, Tetanus-Diphtheria-Pertussis vaccination, Pneumococcal pneumonia vaccination, substance abuse screening, and mental health screening. STI testing and safe sex counseling were documented in the medical records of only 37% and 33.9% of women, respectively. Documentation of cancer screening was also low, with cervical cancer screening documented for 56.8% of women, mammography for 65% (N = 26/40) of women, and colorectal cancer screening for 10% (N = 4/40) of women, where indicated. In multivariable models, women with private health insurance were less likely to have documented STI testing (OR 0.20; 95% CI 0.08 - 0.52), and, Hispanic women were less likely to have documented safe-sex counseling (OR 0.26; 95% CI 0.07 - 0.94).ConclusionsHIV/AIDS providers should focus on the needs of all women for preventive care services, including those with fewer socio-demographic risk factors (i.e., insured, stable housing etc.). In addition, failure to provide STI testing, cancer screening, or safe sex counseling to all patients represents a missed opportunity for provision of services that are important from both a clinical and public health perspective.

Receipt of Preventive Health Services in Young Adults

To examine self-reported rates and disparities in delivery of preventive services to young adults. A population-based cross-sectional analysis, of 3,670 and 3,621 young adults aged 18-26 years who responded to California Health Interview Survey (CHIS) in 2005 and CHIS 2007, respectively. The main outcome measures were self-reported receipt of flu vaccination, sexually transmitted disease (STD) screening, cholesterol screening, diet counseling, exercise counseling, and emotional health screening. Multivariate logistic regression was used to examine how age, gender, race/ethnicity, income, insurance, and usual source of care influence the receipt of preventive services. Delivery rates ranged from 16.7% (flu vaccine) to 50.6% (cholesterol screening). Being female and having a usual source of care significantly increased receipt of services, with female participants more likely to receive STD screening (p < .001), cholesterol screening (p < .01), emotional health screening (p < .001), diet counseling (p < .01), and exercise counseling (p < .05) than male participants after controlling for age, race/ethnicity, income, insurance, and usual source of care. Young adults with a usual source of care were more likely to receive a flu vaccine (p < .05), STD screening (p < .01), cholesterol screening (p < .001), diet counseling (p < .05), and exercise counseling (p < .05) than those without a usual source of care after adjusting for age, race/ethnicity, income, and insurance. Rates of preventive services delivery are generally low. Greater efforts are needed to develop guidelines for young adults to increase the delivery of preventive care to this age-group, and to address the gender and ethnic/racial disparities in preventive services delivery.

Receipt of preventive health services by IBD patients is significantly lower than by primary care patients

Persons with chronic diseases often do not receive preventive care at the same rate as the general population. Reasons for this are not clear. We conducted a cross-sectional survey of patients with inflammatory bowel disease (IBD) and controls to assess receipt of 10 preventive health services. From March through October 2006, IBD outpatients and primary care outpatients at the University of Kentucky (UK) were surveyed by trained clinicians, using chart data to augment patient response. A second sample of IBD patients from the University of Chicago was studied with a self-administered survey. One hundred and seventeen IBD subjects were enrolled at UK, 125 IBD subjects were enrolled at UCH, and 100 control subjects were recruited from UK primary care clinics. The overall age-/sex-adjusted screening rate, as measured by the screening index, was significantly lower in UK IBD subjects than in UK controls (75.1% versus 83.9%, P = 0.0002). The UCH data showed a 67% overall age-/sex-adjusted screening rate. After adjusting for insurance status, the difference in screening rates was still lower for IBD patients than for controls (71% versus 78%; P = 0.022). Neither disease type nor disease control rating predicted screening rate. Our data suggest IBD patients do not receive preventive services at the same rate as general medical patients. Preventive care is a facet of global IBD management that deserves further study.

Relationships between level of disability and receipt of preventive health services

Diab ME, Johnston MV. Relationships between level of disability and receipt of preventive health services. Arch Phys Med Rehabil 2004;85:749-57. Objectives To examine relationships between level of disability and receipt of certain preventive health services, including demographic and systems variables that may explain or confound these relationships. Design Analysis of recent (1998 and 2000) data from the Behavioral Risk Factor Surveillance System, a nationwide telephone survey. Setting States reporting data on disability (13 in 1998, 18 in 2000). Participants Noninstitutionalized persons living in the community. Interventions Not applicable. Main outcome measures Frequency of receipt of recommended preventive health services, including colorectal, cervical, and breast cancer screening, and influenza and pneumococcal vaccination. An ordinal index of disability severity was constructed from questions on activity limitations. Results In 2000, people with mild and moderate disability received influenza and pneumonia vaccinations somewhat more frequently than people without disabilities, but people with the most severe disabilities least frequently received vaccinations that year. Disabled women received fewer Papanicolaou tests and clinical breast examinations, but significant differences did not occur for mammograms in 2000. Fewer differences as a function of disability level were apparent in 2000 than 1998. Demographic variables affected receipt of most preventive services. Access to routine checkups affected all preventive services independent of disability level in both years. Conclusions Severity of disability is related to receipt of certain preventive services but not necessarily in a simple or unidirectional way. Regardless of disability, receipt of a checkup was an important determinant of receipt of preventive health services. For almost all services and groups studied, preventive care remained below targeted goals for Healthy People 2010.

From the Centers for Disease Control and Prevention. Health insurance coverage and receipt of preventive health services--United States, 1993

From the Centers for Disease Control and Prevention. Health insurance coverage and receipt of preventive health services--United States, 1993