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rsmjournals.com

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jabfm.org

Background: In 2020, the state of California started financially incentivizing primary care practices to screen for adverse childhood events (ACEs). In its current Medicaid 1115 waiver, the state also has encouraged health care teams to screen for social risks (SR) − (eg, food, housing, and transportation insecurity). In this qualitative study, we explore community health center (CHC) staff and patient perspectives about opportunities and barriers to integrating adult screening for ACEs and SR. Methods: We identified eligible California CHCs through Medicaid claims data on ACEs screening and/or participation in ACEs or SR-related learning collaboratives. Staff and/or patients in 12 clinics participated in semistructured interviews exploring opportunities and barriers to integrated ACEs and SR screening. Interviews were analyzed using a rapid qualitative data analysis approach. Results: Thirty-nine clinic staff (including clinic leaders, allied health professionals, licensed clinicians) and 10 patients participated. While staff and patients often conceptually endorsed integrated ACEs and SR screening, they identified substantial practical barriers to integration. Barriers primarily related to different screening frequencies and workflows. Other barriers reflected broader primary care time constraints and workforce shortages. Participants shared multiple recommendations to improve screening programs, including strategies for combining ACEs and SR screening. Discussion: California CHC staff and patients described several conceptual benefits of integrating ACEs and SR screening, but longstanding primary care challenges make it complicated to integrate these activities. Standardizing the integration of ACEs and SR screening will require institutional and structural shifts to overcome common barriers to providing whole person care.

medical-library.org

An educational comparison of retatrutide price and cost, evaluating research peptide suppliers based on quality, transparency, and documentation.

medsci.org

international refereed journal publishes leading research papers in all areas of medical sciences from basic research to clinical and experimental work.

mja.com.au

Welcome to this podcast from the Medical Journal of Australia.My name is Sally Block, the MJA’s news and online editor.“The MJA acknowledges the Traditional Owners and Custodians of the land on which we live and work across Australia.  This podcast was recorded on the lands of the Gadigal people of the Eora Nation. I pay my respects to their Elders past and present.”Today we will be talking about a type of trauma that generally can’t be seen by the eye. Complex trauma is defined as repeated, ongoing, and often extreme interpersonal trauma (between people) –  and it can involve violence, abuse, neglect or exploitation experienced as a child, young person and adult.The Blue Knot Foundation is a National Centre of Excellence for Complex Trauma.Joining me today is the Foundation’s President and Managing Director Dr. Cathy Kezelman AM to talk about complex trauma and how clinicians can help patients who are affected by it.