Primary Source Of Health Care Research Articles

Potential of Bioresource Usage in The Tropical Area of Southeast Asia for Human Mental Well-Being

Human health and well-being depend on lifestyle, and current unhealthy lifestyles cause many health problems, including mental health problems. Therefore, people are searching for natural remedies to overcome such well-being problems. Medicinal plants have been used as a primary source of health care and treatments for many diseases. However, the recent search for valuable plants concentrates on human physical well-being. This attention needs to shift to mental well-being as the current limited and poor diet and modern lifestyle adversely affect people's mental health. Southeast Asia consists of tropical countries with abundant bioresources for potential medicinal plants and various food crops. Many underutilized plants have vast marginalized medicinal potentials and have yet to be fully exploited. The traditional knowledge of the application of medicinal plants for mental well-being and in superstitions and healing rituals in Southeast Asia is described in this paper. Scientific exploration of many traditional healing and magic practices in Southeast Asia will benefit in understanding the application of medicinal plants. The incorporation of advanced technologies in detecting beneficial plant compounds from such traditional practices in Southeast Asia will aid humans in finding remedies for modern health problems. This review focuses on the usage of potential plants available in Southeast Asia for human mental well-being and the application of herbals in superstitions and healing rituals.

Private practitioners' practices for tuberculosis management in a city largely served by the private health sector in Uganda.

Globally, tuberculosis (TB) remains a significant cause of morbidity and mortality having caused 1.6 million deaths in 2021. Uganda is a high TB burden country with a large private sector that serves close to 60% of the urban population. However, private for-profit health facilities' involvement with the National TB and Leprosy Program (NTLP) activities remains poor. This study evaluated the practices of diagnosis and treatment of pulmonary tuberculosis (PTB) and associated factors among practitioners in private for-profit (PFP) healthcare facilities in Kampala, Uganda. We conducted a cross-sectional study among randomly selected private practitioners in Uganda's largest city, Kampala. A structured questionnaire was used for data collection. Descriptive statistics and generalized linear models with log Poisson link were used to analyze data. Practices were graded as standard or substandard. Of the 630 private practitioners studied, 46.2% (95% confidence interval (CI): 26.6 to 67.1) had overall standard practices. Being a laboratory technician (prevalence ratio (PR) = 2.7, p< 0.001) or doctor (PR = 1.2, p< 0.001), a bachelor's degree level of qualification (PR = 1.1, p = 0.021), quarterly supervision by the national TB program (PR = 1.3, p = 0.023), and acceptable knowledge of the practitioner about TB (PR = 1.8, p<0.001) were significantly associated with standard practices. The practices of TB management for practitioners from the PFP facilities in Kampala are suboptimal and this poses a challenge for the fight against TB given that these practitioners are a major source of primary health care in the city.

Influence of Traditional Medicine as Initiative for Rural Tourism and Poverty Reduction Strategy Tanzania: A Case of Kisarawe District

Despite recent scientific advancement and globalization, traditional medicines and complementary/alternative medicine are still primary sources of health care, livelihoods and income generation among local communities falling under Rural Tourism (RT). This study assessed the influence of traditional medicine initiative as a rural tourism strategy inter alia for poverty reduction in Kisarawe district in Tanzania. The main objective was to examine the local community perception on traditional medicine administered by traditional healers whether it has impact in promoting community health compared to modern medicines; but also, as eco-tourism strategy for poverty reduction; while sustaining environmental protection and conservation of various bio-diversities. The study employed mixed methods included structured questionnaires, key informants’ interviews, application of Likert scale range from 1 to 7 in data collection from a sample size of 100 respondents. Other methods entailed direct field observation and reviews of relevant literature. SPSS software version 20 was used to analyze multivariate analysis. Results showed willingness of community members to undergo training on improvement of knowledge on traditional medicines supported by tourism programmes, government policies and regulations for sustainable RT, poverty reduction, environmental protection and conservation. The study concluded that, community perception on traditional medicine positively moderates the relationship between rural tourism development and poverty reduction; however, there was limited co-ordination of tourism activities; and insufficient collaboration between the public and private sector. It recommended that; future research should network with traditional healers in order to know more indigenous medicinal plant species in order to formalize their application in public health while promoting eco-tourism for social economic development of local communities in Kisarawe district.

A National Study of Expedited Partner Therapy Use in Emergency Departments: A Survey of Medical Director Knowledge, Attitudes, and Practices.

Emergency departments (EDs) are the primary source of health care for many patients diagnosed with sexually transmitted infections (STIs). Expedited partner therapy (EPT), treating the partner of patients with STIs, is an evidence-based practice for patients who might not otherwise seek care. Little is known about the use of EPT in the ED. In a national survey, we describe ED medical directors' knowledge, attitudes, and practices of EPT. A cross-sectional survey of medical directors from academic EDs was conducted from July to September 2020 using the Academy of Academic Administrators of Emergency Medicine Benchmarking Group. Primary outcomes were EPT awareness, support, and use. The survey also examined barriers and facilitators. Forty-eight of 70 medical directors (69%) responded. Seventy-three percent were aware of EPT, but fewer knew how to prescribe it (38%), and only 19% of EDs had implemented EPT. Seventy-nine percent supported EPT and were more likely to if they were aware of EPT (89% vs. 54%; P = 0.01). Of nonimplementers, 41% thought EPT was feasible, and 56% thought departmental support would be likely. Emergency department directors were most concerned about legal liability, but a large proportion (44%) viewed preventing sequelae of untreated STIs as "extremely important." Emergency department medical directors expressed strong support for EPT and reasonable levels of feasibility for implementation but low utilization. Our findings highlight the need to identify mechanisms for EPT implementation in EDs.

Contraceptive counseling for adolescents in the emergency department: A novel curriculum for nurse practitioners and physician assistants.

Many adolescents use the emergency department (ED) as their primary source of health care. As a result, the ED serves as a unique opportunity to reach adolescents. Although many adolescent visits to the ED are related to reproductive health, ED providers report barriers to providing this care, including lack of training. Nurse practitioners (NPs) and physician assistants (PAs) serve a vital role in the provision of consistent care to adolescents in the ED. The purpose of this study was to create a curriculum to train NPs and PAs at two pediatric institutions to provide patient-centered contraceptive counseling to adolescents in the pediatric ED regardless of their chief complaint. To do this, we created a four-part webinar followed by an in-person training session. Participants completed training and then conducted counseling sessions with adolescents in the ED. Counseling sessions were recorded and reviewed for fidelity to delineated counseling principles, and data from post-counseling surveys were collected. 27 NPs and PAs completed the training and conducted 99 counseling sessions. Nearly all sessions incorporated essential content and communication principles such as shared decision making (90%) and teach-back methods (75%). All NPs and PAs who participated reported satisfaction and subjective improvement in knowledge and competence from the training. This curriculum offers a novel and feasible approach to train NPs and PAs to deliver patient-centered contraception counseling to adolescents in the ED setting, and it can serve as a model for how to educate different providers to incorporate reproductive health education into the busy ED visit.

Protective Effects of Medicinal Plant-Based Foods against Diabetes: A Review on Pharmacology, Phytochemistry, and Molecular Mechanisms.

Diabetes mellitus (DM) comprises a range of metabolic disorders characterized by high blood glucose levels caused by defects in insulin release, insulin action, or both. DM is a widespread condition that affects a substantial portion of the global population, causing high morbidity and mortality rates. The prevalence of this major public health crisis is predicted to increase in the forthcoming years. Although several drugs are available to manage DM, these are associated with adverse side effects, which limits their use. In underdeveloped countries, where such drugs are often costly and not widely available, many people continue to rely on alternative traditional medicine, including medicinal plants. The latter serves as a source of primary healthcare and plant-based foods in many low- and middle-income countries. Interestingly, many of the phytochemicals they contain have been demonstrated to possess antidiabetic activity such as lowering blood glucose levels, stimulating insulin secretion, and alleviating diabetic complications. Therefore, such plants may provide protective effects that could be used in the management of DM. The purpose of this article was to review the medicinal plant-based foods traditionally used for the management of DM, including their therapeutic effects, pharmacologically active phytoconstituents, and antidiabetic mode of action at the molecular level. It also presents future avenues for research in this field.

Conservation of medicinal plants: challenges and opportunities

Medicinal plants have been used for centuries as a primary source of healthcare and healing. However, the increasing demand for medicinal plants, coupled with habitat loss and unsustainable harvesting practices, has led to the depletion of many species. This research paper examines the challenges and opportunities in the conservation of medicinal plants. It explores the threats faced by these plants, the importance of their conservation, and various strategies and initiatives that can be implemented to ensure their long-term survival. By addressing these challenges and capitalizing on the opportunities, it is possible to safeguard the rich biodiversity of medicinal plants and preserve their invaluable contributions to human health.

Medico-Ethon-Botanical Study of Indigenous and Migrated Medicinal Plants Diversity at Kothi Village in Kangra District of Himachal Pradesh in India: A Cross-Sectional Survey

Ayurveda and medicinal plants of folklore are the primary sources of health care in rural areas of India. Medicinal plants are the basis of Ayurveda drugs. Kothi village at an elevation of around 1,100m from the sea level is a hamlet in Kangra District of Himachal Pradesh and it has a good diversity of medicinal plants. The medicinal plants' diversity in this village is not studied to date. This cross-sectional survey study (observational study of descriptive and analytical type) was conducted to discover the diversity of medicinal plants in the Kothi village. The medicinal plant diversity at RGGPGAC&amp;H territory was the sample chosen for this study. The total diversity of medicinal plants in the Kothi village was considered as the population of the study. Questionnaire based interviews and discussions with local villagers and sellers were used as a method for medicinal plants sample collection from the sample area. The sample medicinal plants were then verified by the faculty of PGDD at RGGPGAC&amp;H. After verification, samples were cross-verified with authoritative publications by the government of Himachal Pradesh and India. A total of 151 different indigenous cum migrated medicinal plant diversity belonging to 69 families is found occurring in the Kothi village.

Understanding traditional healer utilisation for hypertension care using the Andersen model: A qualitative study in Mwanza, Tanzania

ABSTRACT Hypertension disproportionately affects people living in African countries, where there are many challenges to appropriate diagnosis and treatment, and many people with hypertension utilise traditional healers as their primary source of healthcare. In this study, we sought to understand factors driving healer utilisation among people with hypertension. We conducted 52 semi-structured interviews with traditional healers, patients and healthcare providers in the Mwanza region of Tanzania. We used the Andersen model of healthcare utilisation to organise our findings on factors driving utilisation of traditional healers for hypertension care. Traditional healers routinely provide care to hypertensive patients and are a critical component of the healthcare landscape. However, healers also operate independently of the biomedical healthcare system, and biomedical providers may hold negative perceptions of healers. Further, healers were described as preferential by patients due to the convenient locations of their practices and perceived improvement of hypertension symptoms with traditional treatment. Finally, healers expressed a desire for more formal collaboration with biomedicine to improve patient care. Our findings may guide future interventions in Tanzanian communities and elsewhere where traditional healers may act as partners to allopathic providers and patients in the continuum of hypertension care.

Ethnomedicinal plants used for controlling hypertension by the people of Churachandpur district Manipur

Hypertension, also called high blood pressure is a transitory or excessive elevation of the blood pressure in the arteries, i.e., the systolic and diastolic pressure. A hypertensive crisis is defined as a systolic rate over 180 mmHg or a diastolic rate above 120 mmHg. In India, hypertension affects all ages especially people from lower social economic groups and more common in older people around and above the age of 45 years. Most blood pressure medicine has side effects. Herbal medicines are in great demand both in developed and developing countries. Herbal medicines have been in use for thousands of years. It is estimated that 80% of the world population depend on herbal medicinal products as a primary source of healthcare and traditional medical practices. The choice of herbal medicines for treatment is due to its less side effects, cheap prices and availability of the material within their reach. Churachandpur district is situated in the southern part of Manipur and is inhabited by various communities with common ancestor, sharing similar language, culture, tradition and food habits. These indigenous people are rich in traditional knowledge, but economically backward. Despite the advancement in modern pharmaceutical medicines, many rural and urban people still depend upon traditional ethno medicinal plants for their treatment. They used different types of plants for treating different types of ailments and diseases. But their traditional knowledge on herbal medicine is yet to be documented. Therefore, the aim of this research work is to document the plants used by the people of Churachandpur district for treatment and controlling hypertension.

Tukhme Alsi (Linum Usitatissimum) Linn: An Important Drug of Unani Medicine

Due to its cultural acceptance, superior compatibility with the human body, and less side effects, traditional medicine serves as the source of primary healthcare. Tukhme Alsi is an important medicinal plant in the Unani system of medicine (USM) due to its multiple therapeutic properties. In Unani system of medicine, it is either used as a single drug or as an ingredient in many Unani formulations which are used in the treatment of various ailments of the body. The review has been reviewed, compiled, and analyzed using references from major databases like classical text and indexed journals. The plant is known to treat different systemic ailments due to the presence of 30‐40% of fixed oil, 6% of Mucilage 25% of protein and small quantities of the cyanogenetic glucosides linaamarin and lotaustralin. In USM, the pharmacological actions of Tukhme Alsi are Habis-i-Dam (Hemostyptic), Mudirr-i-Bawl (Diuretic), Mudirr-i-Laban (Galactogogue), Mudirr-i-Hayd (Emmenogogue), Mu‘arriq (Diaphoretic), Maqawwi-e-Bah (Aphrodisiac), Mufattit-i-Hasah (Lithotropic)12,14 Musakkin-i-Alam (Analgesic) etc. Many pharmacological activities mentioned in Unani medicine are validated and many activities need further exploration due to the immense therapeutic scope in this drug Keywords: Unani System of Medicine, Tukhme Alsi, Formulations, Medicinal Plant

Primary sources of health care among LGBTQ+ veterans: Findings from the Behavioral Risk Factor Surveillance System.

This study examined the primary source of health care between veterans with lesbian, gay, bisexual, queer and similar identities (LGBTQ+) and non-LGBTQ+ veterans. Veterans (N=20,497) from 17 states who completed the CDC's Behavioral Risk Factor Surveillance System from 2016 to 2020, including the Sexual Orientation and Gender Identity and Health Care Access modules. We used survey-weighted multiple logistic regression to estimate average marginal effects of the prevalence of utilization of Veteran's Health Administration (VHA)/military health care reported between LGBTQ+ and non-LGBTQ+ veterans. Prevalence estimates were adjusted for age group, sex, race and ethnicity, marital status, educational attainment, employment status, survey year, and US state. Study data were gathered via computer-assisted telephone interviews with probability-based samples of adults aged 18 and over. Data are publicly available. Overall, there was not a statistically significant difference in estimated adjusted prevalence of primary use of VHA/military health care between LGBTQ+ and non-LGBTQ+ veterans (20% vs. 23%, respectively, p=0.13). When examined by age group, LGBTQ+ veterans aged 34 and younger were significantly less likely to report primary use of VHA/military health care compared to non-LGBTQ+ veterans (25% vs. 44%, respectively; p=0.009). Similarly, in sex-stratified analyses, fewer female LGBTQ+ veterans than female non-LGBTQ+ veterans reported VHA/military health care as their primary source of care (13% vs. 29%, respectively, p=0.003). Implications and limitations to these findings are discussed. Female and younger LGBTQ+ veterans appear far less likely to use VHA/military for health care compared to their cisgender, heterosexual peers; however, because of small sample sizes, estimates may be imprecise. Future research should corroborate these findings and identify potential reasons for these disparities.

RESEARCH ON VIETNAMESE MEDICINAL PLANTS WITH POTENTIAL IN THE TREATMENT OF COVID-19 DISEASE

Natural products have been considered the primary source of healthcare among the majority of the world’s population. In the therapeutic management of Covid-19, products of natural origin are a promising and potential medicinal source to treat this disease. Our research methodology is based on a review of recent articles reporting on the effect of medicinal plants on Covid-19. In this review, literature searches on medicinal plants which used to treat and prevent Covid-19 disease were conducted. From this research, several medicinal plants have received much research attention such as Astragalus mongholicus Bunge; Astragalus membranaceus (Fisch.) Bunge; Atractylodes lancea (Thunb.) DC.; Atractylodes chinensis (DC.) Koidz.; Atractylodes japonica Koidz.; and Atractylodes macrocephala Koidz.; Andrographis paniculata; Lonicera japonica; Scutellaria baicalensis Georgi. However, the definitive roles of these medicinal plants in cytokine storms and post-infection complications still need further investigation. And then, quality control and standardisation of medicinal plants-based products also need to be emphasized. Further investigations on differential effects as well as the quality and safety of herbal medicines should be required to ascertain their role in Covid-19 therapeutic management. Furthermore, herbal mixtures, medicinal plants, natural products, or their combination with possible anti-SARS-CoV-2 effects may hold promise and effectiveness in preventive and therapeutic support for Covid-19.

235 COVID-19 Booster Vaccine Hesitancy in the Emergency Department

While numerous investigators have described hesitancy to receive initial doses of COVID-19 vaccines, little is known about hesitancy to receive COVID-19 booster vaccines. Booster vaccines are critically important for vulnerable populations who are not only disproportionately impacted by the pandemic, but who also often use the emergency department (ED) as their primary source of health care. We sought to describe the prevalence of and reasons for booster vaccine hesitancy in vaccinated adult ED populations.

The Global Revival of Interest in the Herbal Medicine

Herbal medicines and nutraceuticals are becoming increasingly popular and more and more individuals are turning to these products to tackle a wide range of health-related issues. In the last 10 years alone, the use of herbal medicine has spiked significantly in the world, where herbal and natural drug preparations have made their way into drug stores, food stores, and supermarkets. About 70% of the global population which make up about 4 billion people see herbal medicines as the primary source of health care. Orthodox medicinal practice and the use of herbs is an essential part of the culture of these communities The United Kingdom, North America, Europe, and Australia are also beginning to recognize the benefits of herbal remedies and are working to bring Complementary and Alternative Medicine (CAM) into mainstream therapeutics. UK and Europe, interestingly, have a well-reported history when it comes to the use of traditional herbal medicines. The primary school of thought behind the uplift in the use of herbal medicines is that it will promote a healthier lifestyle among the population of rich countries where obesity and sedentary lifestyle are bigger problems. Considered a moderate approach to healing, people in developed countries spend billions on herbal medicines as traditional home remedies and over-the-counter drugs. Henceforth, it is reasonable to conclude that the sales of traditional medicines will rise and this boom will allow herbal products to make a substantial chunk of the international drug market With the advent of herbal medicines and their use becoming increasingly common, questions with regard to their safety are also being raised. Herbal medicines, even today, remain untested and most of their use goes unregulated despite the fact that they bear significant therapeutic potential. Henceforth, there is little information about the potentially harmful effects of these products and how their use can be rationalized. The safety of these traditional therapies is further questioned due to the absence of quality control, poor labeling, and insufficient patient information. It is vital that healthcare professionals and the general public both be made aware of the traditional medicines in order to ensure maximum health benefits for them as well as enhance the quality of these herbal products. However, challenges remain to tackle matters pertaining to the toxicity of herbal medicines as well as the factors that are associated with increasing/decreasing them. It is time to ensure the safety of these traditional herbal products by drawing the attention of the regulatory bodies to the need of making sure appropriate safety of public health.

Commentary to the paper V.D. Tran, D.T. Pham, T.T.N. Cao, M. Bahlol, R.S. Dewey, M.H. Le, V.A. Nguyen. Perspectives on COVID-19 prevention and treatment using herbal medicine in Vietnam: a cross-sectional study (Ann Ig. 2022 Sept-Oct; 34(5): 515-531. doi: 10.7416/ai.2021.2484. E-pub Dec 9).

The current COVID-19 pandemic has brought to attention the potential benefit of botanical drugs and supplements, although controversial efficacy claims are a concern (1) The lack of treatment options for COVID- 19 has led to many attempts to find alternative selfcare measures and unconventional remedies to prevent the transmission of the disease or to mitigate the progression of the infection (2). The use of medicinal plants, herbal products and food supplements has increased during the COVID-19 pandemic as a private behaviour, with the risk of misinformation and misuse (3). This is true especially for lower-middle income countries, where traditional medicine is integral part of the culture and is more used than allopathic or western medicine: for these countries, medical plants are the primary source of healthcare, often selfadministered. About 80% of developing countries' populations still rely on traditional medicines (4).

A Study of the Traditional Health Care Practices in Ancient Tamil Nadu – An Assessment

India is known around the world for its diverse civilizations and mystical rituals. Scholars and philosophers of the time formed a century-old tradition in the depths of this culture. Despite a long history of being viewed as unscientific, scientists and doctors are now aware of the benefits of traditional Indian health care. Many investigations on traditional medicine and its apparently magical qualities in the treatment of terminal diseases are currently being done. Home remedies are used all around the world, but they are recognized as science in India only. Two traditional Indian medicinal traditions: Ayurveda and Siddha are progressively gaining traction in the global healthcare business. In this article, some of India's most odd and effective medicinal practices, as well as the benefits of each therapy will be reviewed. Throughout history, traditional medicines were the only source of primary healthcare, and they made a substantial contribution. Knowledge of how to use medicinal plants to treat various ailments was highly valued by ancient cultures. Until the mid-nineteenth century, plants were the principal therapeutic agents used by humans, and they continue to play an important role in pharmaceutical formulations. Traditional medicine is used by around 80 percent of people in undeveloped countries for their primary health care needs because of its low prices, effectiveness, frequently restricted availability of modern medicine, and cultural and religious preferences. Plant research in the traditional system of medicine is becoming increasingly significant in the development of global healthcare and conservation efforts. Traditional medicine systems are being used to uncover biologically active chemicals that are useful to the pharmaceutical industry. To this end, as much information possible is presented about these areas in this article. There are a number of geographically specific traditional health behaviors and are well reviewed in this paper

Ethnobotanical investigation of medicinal plants used in Lingchuan county, Shanxi, China.

Medicinal plants are the primary sources of healthcare among the people of developing countries in villages and local towns. Documenting and reporting the traditional knowledge of medicinal plants may contribute to pharmaceutical research development. For this reason, we present our findings on ethnomedicinal plants from Lingchuan County, Shanxi, China, an unexplored area rich in medicinal plant resources. Information of ethnomedicinal plants were collected through questionnaire/semi-structured interviews from 180 informants, including traditional healers. Field surveys were conducted in 53 villages of Lingchuan County from 2017 to 2018. Informed consent was obtained from each participant before conducting the interview process. Quantitative analysis was performed for each recorded species, such as Relative Frequency Citation (RFC), Use Value (UV), and Factor of Informant Consensus (FIC). Diseases were categorized into twelve groups. A total 138 species of medicinal plants were recorded, belonging to 123 genera of 58 families. Asteraceae was the dominant plant family with 19 species, followed by Rosaceae and Fabaceae. Herbs were dominant among plant life-forms with 96 species, followed by shrubs and trees (15 species each). Roots were the most commonly used plant parts with 58 species, followed by whole plants and fruits (28 species each). Most plant species were reported non-toxic (84, 60%), followed by unknown toxicity (35, 25%), poisonous, and less toxic (19, 14%). Quantitative analysis revealed that Forsythia suspensa was with higher (0.33) RFC value, and Scutellaria baicalensis was recorded with a higher (0.91) UV. Treated diseases were categorized in 12 groups and evaluated by their FIC value, in which gynecological diseases have higher (0.93) FIC value followed by urinary system diseases. Most medicinal plants are used to clear away heat and relieve the surface. The present study revealed that local people of Lingchuan County confidently use ethnomedicinal plants for their healthcare needs. The higher indices value of a plant species resulted from quantitative analysis warrants further investigation, which may possess valuable phytochemical compounds that may result in new drugs for treating various human disorders.

Findings from a Qualitative Needs Assessment of Equal Access Birmingham, a Student-Run Free Clinic in the Southern United States

Background: Student-run free clinics (SRFCs) are becoming increasingly common across the United States. To better understand clientele and improve these organizations, it is important to assess patient feedback about SRFC services. This study is based on Equal Access Birmingham (EAB), a SRFC that aims to provide and improve quality healthcare for underserved populations in central Alabama. A qualitative needs assessment of patients receiving care at EAB has not yet been performed. The purpose of this study was to identify and explore EAB clients’ perceived health needs, health-related behaviors, and access to healthcare.&#x0D; Methods: Clients were recruited to participate in semi-structured qualitative interviews at EAB. Major themes included barriers to healthcare, primary health concerns, individual health behaviors, and patterns of clinic utilization.&#x0D; Results: The study analyzed 16 patient interviews. Participants stated that cost, transportation, and housing were barriers to healthcare. Their main health concerns were hypertension (cited by 21% of participants), diabetes (21%), pain (21%), and mental health management (21%). Ninety-four percent of study participants reported relying on EAB to obtain medication refills. Respondents also reported accessing the clinic for mental health issues, and many used EAB as their primary care provider. &#x0D; Conclusions: Despite numerous barriers, EAB was the source of primary healthcare and medications for many respondents. This qualitative investigation identified specific concerns and noteworthy strengths that may extend to other SRFCs.

Which Children Use School-Based Health Services as a Primary Source of Care?

School-based health centers (SBHCs) offer primary and preventive health care for children and adolescents. Using nationally representative data, we aimed to examine which child and family characteristics are associated with using school-based health care providers as the primary source of health care, and whether care received from these providers met the criteria for a medical home. Using data from the 2016-2018 National Survey of Children's Health (NSCH), we analyzed children's usual source of care (school-based provider, doctor's office or clinic, other location, or none), and whether they received care meeting medical home criteria. Based on a sample of 64,710 children, 0.5% identified school-based providers as their primary source of health care. Children who were older, uninsured, or living in the Northeast were significantly more likely to report school-based providers as their usual source of care. Children whose usual source of care was a school-based provider were less likely to receive care meeting medical home criteria than children who usually received care at a doctor's office. While SBHCs improve access to care, our findings indicate potential challenges with establishing a medical home for children who usually receive health care from a school-based provider.