Group Medical Visits Using an Empowerment-based Model as Treatment for Women with Chronic Pain in an Underserved Community

Geller, Jeffrey S.; Kulla, Jill; Shoemaker, Alena

doi:10.7453/gahmj.2015.057

Cited by 21 publications

(17 citation statements)

References 17 publications

(26 reference statements)

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“…Our findings indicate considerable interest in and enthusiasm for this model of care among clinicians around the country and demonstrate that IGMVs include a wide range of complementary health approaches to treat patients with a variety of chronic conditions, including diabetes and chronic pain. Consistent with the growing body of research on integrative health services in safety-net settings, 22,32–34 clinicians in our study reported that IMGVs are providing access to integrative care and peer support, benefiting patients in multiple ways.…”

Section: Discussionsupporting

confidence: 83%

Integrative Group Medical Visits: A National Scoping Survey of Safety-Net Clinics

2019

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Purpose: Integrative group medical visits (IGMVs) aim to increase access to complementary and integrative health care, which is particularly relevant for low-income people. We sought to describe IGMV programs in US safety-net clinics through a survey of providers.Methods: An online and paper survey was conducted to collect data on the use of complementary health approaches and characteristics of IGMV programs. We recruited a purposive sample of safety-net clinicians via national meetings and listservs.Results: Fifty-seven clinicians reported on group medical visits. Forty percent worked in federally qualified health centers, 57% in safety-net or teaching hospitals, 23% in other settings such as free clinics. Thirty-seven respondents in 11 states provided care in IGMVs, most commonly for chronic pain and diabetes. Nutrition (70%), mindfulness/meditation/breathing (59%), and tai chi/yoga/other movement practices (51%) were the most common treatment approaches in IGMVs.Conclusion: Safety-net institutions in 11 states offered IGMVs to treat a range of chronic conditions. IGMVs are an innovative model to improve access to non-pharmacologic approaches to chronic illness care and health promotion. They may advance health equity by serving patients negatively impacted by health and health care disparities.

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Section: Discussionsupporting

confidence: 83%

Integrative Group Medical Visits: A National Scoping Survey of Safety-Net Clinics

2019

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“…These group visits could foster a patient-provider trust, a sense of community, and support among individuals experiencing PI. 44 Finally, policy makers should support policies that (1) reduce incarceration rates by addressing aggressive incarceration policies that lead to mass incarceration, disproportionately affecting minority and poor individuals, and (2) maintain a child's contact with an incarcerated parent, when appropriate. Addressing PI is critical because the long-term consequences may impact future generations to come.…”

Section: Discussionmentioning

confidence: 99%

Health Care Use and Health Behaviors Among Young Adults With History of Parental Incarceration

et al. 2018

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OBJECTIVES:To determine if longitudinal associations exist between parental incarceration (PI) and health care use or health behaviors among a national sample of young adults. METHODS:We used the National Longitudinal Survey of Adolescent to Adult Health to examine associations between history of mother incarceration (MI) and father incarceration (FI), health care use, and 3 dimensions of health behaviors (eg, general health behaviors, substance use, and other risky behaviors) (N = 13 084). Multivariable logistic regression models accounted for individual, family, and geographic factors and generated adjusted odds ratios (aORs). RESULTS:Over 10% of the sample had a history of PI before the age of 18. History of MI and FI were both associated with forgone health care (aOR = 1 CONCLUSIONS:The effects of incarceration extend beyond incarcerated individuals. PI histories are associated with lower health care use and unhealthy behaviors in young adulthood. By addressing barriers to health care and health-harming behaviors, health care providers and policy makers may reduce health disparities among this population. Dr Heard-Garris conceived and designed the study, acquired data, conducted data analysis and interpretation, and drafted the initial manuscript; Dr Winkelman conceived and designed the study, acquired data, conducted data analysis and interpretation, and provided critical revisions to the manuscript; Dr Choi assisted in data analysis and interpretation and provided critical revisions to the manuscript; Mr Miller conducted the literature review for the study and provided critical revisions to the manuscript; Dr Kan conceived and designed the study, acquired and interpreted data, and provided critical revisions to the manuscript; Dr Shlafer interpreted data and provided critical revisions to the manuscript; Dr Davis interpreted data, provided critical PEDIATRICS Volume 142, number 2, August 2018:e20174314 WHAT'S KNOWN ON THIS SUBJECT:A history of parental incarceration (PI) is associated with poor physical and mental health outcomes into adulthood. However, the relationship between PI and health care use and multidimensional health behaviors has been understudied. WHAT THIS STUDY ADDS:Young adults with PI histories are less likely to use health care and more likely to engage in unhealthy behaviors compared with peers without PI. PI has been identified as 1 of several adverse childhood experiences (ACEs), a group of traumatic or persistent childhood experiences associated with poor physical and mental health across the life course. 8 -11 PI is associated with learning delays and behavioral problems, 12 -15 perhaps because of the traumatic separation from a parent, the loss of parental resources, and the lack of social support. 7,12 The authors of a growing body of literature indicate that PI is detrimental to health in childhood and adulthood. The prevalence of asthma, HIV and AIDS, depression, anxiety, and posttraumatic stress disorder is higher among individuals with a history of PI. 16,17 In contrast to wha...

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“…Additional studies have tried to measure the level of empowerment in patients with RA; however, empowerment has been measured in a subjective manner. Geller et al [ 18 ] used an empowerment program for 6 months in patients with chronic pain (six of them had RA) and assessed the quality of life, but did not quantitatively measure the level of empowerment. Allam et al [ 36 ] tested the effects of online social support and gamification on health outcomes in 157 RA patients; empowerment levels changed over time, more so in the groups having access to online support or a gamified experience of the website.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies assessed empowerment in RA patients and its association with patient-related outcomes. In the first one, performed in the USA, RA patients found an association between enhancing patients’ empowerment (no validated scale was used) and improvement in some 36-item Short Form (SF-36) categories [ 18 ]. The second one was performed in Swedish patients with rheumatic diseases (including RA) and showed an association between patients’ empowerment, as assessed according to a scale that was validated in the same study, and better self-reported health [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Psychometric validation of an empowerment scale for Spanish-speaking patients with rheumatoid arthritis

Contreras-Yáñez

Ruiz-Medrano

Hernández³

et al. 2018

Arthritis Res Ther

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BackgroundRheumatoid arthritis (RA) knowledge has been constructed with studies performed in Caucasians patients; Latin American patients present unique characteristics. Empowerment is a social multidimensional construct that has been associated to better health-related quality of life in RA. There is no validated instrument for use with Spanish-speaking patients. The objective of the study was to adapt the Spanish version of the Health Empowerment Scale (S-HES), which was selected for its psychometric properties and suitability for low-literacy populations, for RA Hispanic patients (RAEH), and to perform its psychometric validation.MethodsRAEH adaptation, pilot testing, and psychometric validation were performed. Three convenience samples of RA outpatients from a national tertiary care level center were used. For RAEH adaptation, the word “health” was substituted with “RA” in the original S-HES, integrated by 8 items. Pilot testing (in 50 patients) assessed feasibility. Psychometric validation included content validity (nine experts rated item convenience, clarity, and cultural semantic accuracy), internal consistency (in 200 patients, Cronbach’s alpha) and test–retest (in a subsample of 50 patients, ICC and 95% CI), construct validity (factor analysis), and face validity (in 20 patients, % of agreement). Patients gave written informed consent.ResultsPatients were primarily middle-aged females and had typical long-standing disease, although early disease was represented. In the psychometric validation sample, the majority of the outpatients had autoantibodies; meanwhile, half of them had no evidence of disease activity, with acute reactants phase determinations within normal range. Patients with comorbidities and joint replacement were also included.Experts agreed upon the attributes of content validity: 83–100% considered the item was essential, 100% agreed on the item’s clarity and 80–100% on the cultural semantic accuracy. In the pilot sample, ≥ 80% of the patients agreed with the item’s clarity and format.In the psychometric validation sample, mean RAEH was 34 (maximum possible score: 40 = highest score). RAEH had a good internal consistency, Cronbach’s α = 0.86, and moderately good reliability (ICC [95% CI] test–retest: 0.79 [0.62–0.88]). Factor analysis for construct validity showed a single factor explaining 52% of the variance.Patients agreed with each item content validity (85–100%) and clarity (75–100%).ConclusionsRAEH was valid and reliable to evaluate empowerment in Spanish-speaking RA patients.Electronic supplementary materialThe online version of this article (10.1186/s13075-018-1741-6) contains supplementary material, which is available to authorized users.

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Group Medical Visits Using an Empowerment-based Model as Treatment for Women with Chronic Pain in an Underserved Community

Cited by 21 publications

References 17 publications

Integrative Group Medical Visits: A National Scoping Survey of Safety-Net Clinics

Integrative Group Medical Visits: A National Scoping Survey of Safety-Net Clinics

Health Care Use and Health Behaviors Among Young Adults With History of Parental Incarceration

Psychometric validation of an empowerment scale for Spanish-speaking patients with rheumatoid arthritis

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