Journal of General Internal Medicine最新文献

Background: Personal characteristics may be associated with believing misinformation and not believing in best practices to protect oneself from COVID-19.

Objective: To examine the associations of a person's age, race/ethnicity, education, residence, health literacy, medical mistrust level, and sources of health-related information with their COVID-19 health and conspiracy myth beliefs.

Design: We surveyed adults with hypertension in Maryland and Pennsylvania between August 2020 and March 2021. Incorrect responses were summed for eight health (mean = 0.68; range 0-5) and two conspiracy (mean = 0.92; range 0-2) COVID-19 questions. Higher scores indicated more incorrect responses. Statistical analyses included two-sample t-tests, Spearman's correlation, and log binomial regression.

Participants: In total, 561 primary care patients (mean age = 62.3 years, 60.2% female, 46.0% Black, 10.2% Hispanic, 28.2% with a Bachelor's degree or higher, 42.8% with annual household income less than $60,000) with a diagnosis of hypertension and at least one of five commonly associated conditions.

Main measures: Sociodemographic characteristics, health literacy, medical mistrust level, source of health-related information, and COVID-19 conspiracy and health myth beliefs.

Key results: In multivariable analyses, participants who did not get information from medical professional sources (prevalence ratio (PR) = 1.28; 95% CI = 1.06-1.55), had less than a bachelor's degree (PR = 1.49; 95% CI = 1.12-1.99), were less confident filling out medical forms (PR = 1.24; 95% CI = 1.02-1.50), and had higher medical mistrust (PR = 1.34; 95% CI = 1.05-1.69) were more likely to believe any health myths. Participants who had less than a bachelor's degree (PR = 1.22; 95% CI = 1.02-1.45), were less confident filling out medical forms (PR = 1.21; 95% CI = 1.09-1.34), and had higher medical mistrust (PR = 1.72; 95% CI = 1.43-2.06) were more likely to believe any conspiracy myths.

Conclusions: Lower educational attainment and health literacy, greater medical mistrust, and certain sources of health information are associated with misinformed COVID-19 beliefs. Programs addressing misinformation should focus on groups affected by these social determinants of health by encouraging reliance on scientific sources.

Background: Understanding health equity is critical for the development of patient-centered physicians, but few avenues exist for medical students to participate in experiential learning related to social determinants of health (SDOH).

Aim: To create and evaluate the PennHealthX SDOH Accelerator Program, which pairs students with health equity startups.

Setting: The program matches medical students at our institution with startups focused on SDOH for voluntary, part-time internships.

Participants: Medical students of all years are eligible to apply. Startups are typically early-stage (≤ 10 employees).

Program description: Two pre-clinical students lead the program. Startups are sourced via alumni networking, partnerships with venture capital firms, and cold outreach. Startups and students apply and are matched based on project goals and student backgrounds/skills. Upon completion, feedback is gathered through open-ended interviews with all students.

Program evaluation: Twenty medical students were matched with 11 startups. In post-program interviews, students expressed high satisfaction. Students specifically valued the opportunity to learn about SDOH in a hands-on and solution-oriented way.

Discussion: This program gives students the opportunity to impact their communities and learn about addressing SDOH with innovative solutions. We are continuing to build the program at our institution and expand its impact to other medical schools.

Background: Weight bias is characterised by negative attitudes towards people with a higher weight and is widespread in healthcare. Primary care professionals sometimes avoid discussing weight with patients due to concerns about upsetting them, insufficient training, resources, or referral pathways. There is, however, a responsibility for primary care professionals to address the health needs of patients, which may require discussing weight.

Objective: The current study aimed to understand primary care professionals and trainee perceptions of the appropriateness of weight-centric, weight-inclusive/holistic, and avoidant approaches for discussing weight with higher weight individuals when patients were and were not seeking weight management advice.

Design: Mixed methods design.

Participants: Primary care professionals and trainees (N = 112) within Australia.

Approach: Participants first completed an online survey and provided demographic data and completed measures of implicit and explicit weight bias. Secondly, participants viewed simulated patient consultations, reflecting each of the three approaches (weight-centric, weight-inclusive/holistic, and avoidant) in a weight-related and non-weight related context. Participants then evaluated the appropriateness of the language and strategies used.

Key results: The participants showed, on average, low to moderate levels of explicit weight bias but high levels of implicit weight bias. For the consultations, language and strategies of the holistic approach were considered the most appropriate in both contexts. In the weight-related consultation, language used in the weight-centric and avoidant approaches were deemed equally inappropriate. However, weight-centric strategies were considered more appropriate than avoidant strategies. In the non-weight related consultation, the language and strategies of the avoidant approach were considered more appropriate than those of the weight-centric approach.

Conclusions: Primary care professionals and trainees favoured the holistic approach to discussing weight when patients presented with weight-related or non-weight related concerns. These findings have potential practical implications for health professional education.