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Objective: Research has suggested that congruence between patient characteristics and contextual characteristics is a more robust predictor of outcomes than either patient or context characteristics alone. The goal of the present study was to examine the degree of congruence between patient preferences for the clinical encounter and reports of analogous dimensions of provider behavior and the effects of this congruence on patient outcomes. Design: Two hundred eighteen patients with diabetes (predominately Type II) completed measures of preference for and ratings of perceived provider behavior in three domains (1) information sharing, (2) behavioral involvement, and (3) socioemotional support. Main Outcome Measures: Patient satisfaction, self-reported adherence, and a clinical marker of diabetic control (hemoglobin A1c) were the outcomes of interest. Results: Congruence in information sharing and congruence in behavioral involvement were predictive of glycemic control and self-reported adherence, respectively. Congruence in behavioral involvement and congruence in socioemotional support were predictive of greater patient satisfaction. Conclusion: These findings provide further support for the importance of congruence between patient characteristics and contextual characteristics in predicting patient outcomes.

This paper examines blood pressure (BP) control after 6 months of an intensive pharmacist‐managed intervention in a mixed‐methods randomized controlled trial conducted at the Iowa City Veteran Affairs Health Care System and two community‐based outreach clinics. Patients received the pharmacist intervention for the first 6 months. The study coordinator conducted a summative evaluation with 37 patients 18 to 24 months following the initial 6‐month intervention period. BP was significantly reduced in diabetic patients following an intensive pharmacist intervention (−8.0/−4.0±14.4/9.1 mm Hg systolic/diastolic, P<.001 and P=.001, respectively). BP was reduced even more in nondiabetic patients (−14.0/−5.0±1.9/10.0 mm Hg, P<.001). Medication adherence significantly improved from baseline to 6 months (P=.017). BPs were significantly lower at 6 months following an intensive pharmacist intervention. Patients also expressed a high level of satisfaction with and preference for co‐management of their hypertension, as well as other chronic diseases.

Introduction:The aim of this study was to assess Veterans' and primary care clinic staff's knowledge about, and experiences with, tobacco cessation services available through their Department of Veterans Affairs (VA) medical facility.Methods:Qualitative, semi-structured, in-depth interviews and surveys were conducted with 7 patients and 12 providers/clinic staff members at three VA primary care clinics serving large numbers of rural Veterans. Interviews were transcribed and coded for the- matic content.Results:Five primary themes emerged: (1) lack of knowledge about available cessation services, (2) smoking cessation services provided to patients, (3) perceived barriers to cessation and the provision of treatment, (4) patient receptiveness to treatment and primary care provider involvement, (5) recommended strategies for improving smoking cessation services.Discussion:Our findings suggest there is a considerable lack of knowledge regarding available tobacco cessation services in VA primary care clinics serving rural Veterans. While many patients expressed the opinion that VA was providing adequate care for nicotine dependence, they also identified important barriers to cessation and offered opinions regarding what more could be done to help them to quit smoking. Clinicians/staff also provided insight into barriers they encounter in the delivery of cessation services. Future work should focus on attempting to address these barriers.

The significant clustering of weight control and eating disorder behavior in U.S. high school students confirms evidence of a social contagion effect of eating disorders.

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<p><strong>Objective:</strong> Research has suggested that congruence between patient characteristics and contextual characteristics is a more robust predictor of outcomes than either patient or context characteristics alone. The goal of the present study was to examine the degree of congruence between patient preferences for the clinical encounter and reports of analogous dimensions of provider behavior and the effects of this congruence on patient outcomes. <strong>Design:</strong> 218 patients with diabetes (predominately type 2) completed measures of preference for and ratings of perceived provider behavior in three domains (1) information sharing, (2) behavioral involvement, and (3) socioemotional support. <strong>Main Outcome Measures:</strong> Patient satisfaction, self-reported adherence, and a clinical marker of diabetic control (hemoglobin A1c) were the outcomes of interest. <strong>Results:</strong> Congruence in information sharing and congruence in behavioral involvement were predictive of glycemic control and self-reported adherence, respectively. Congruence in behavioral involvement and congruence in socioemotional support were predictive of greater patient satisfaction. <strong>Conclusion:</strong> These findings provide further support for the importance of congruence between patient characteristics and contextual characteristics in predicting patient outcomes.</p>