A cohort study of statin prescribing among the uninitiated pre and post the 2013 ACC/AHA guideline change by race, ethnicity and language.

Introduction: The 2013 American College of Cardiology (ACC)/ American Heart Association (AHA) guidelines to manage atherosclerotic cardiovascular disease (ASCVD) expanded eligibility for medication. To better understand the guidelines' impact on those who should have been on a statin all along, we performed a cohort study of patients eligible-for-but-never-prescribed statins before the guideline change, evaluating statin eligibility or prescription after the guideline change by race, ethnicity, and preferred language.

Methods: We used 2012-2020 electronic health record data from low-income patients in community health centers (CHCs) in 14 states to evaluate statin eligibility and prescriptions in patients aged 40-75 years, using multivariable generalized estimating equation logistic regression, accounting for clustering of patients within clinics, adjusted for patient demographics, overall healthcare utilization, and comorbidities.

Association Between Nativity and Preventive Mammography Among Latina Community Health Center Patients.

Background: In the United States, Latina women have delayed mammography utilization, yet it is unknown how use varies among patients who receive primary care from community health centers who serve a disproportionately high number of Latina patients.

Methods: We used data (2013-2022) from a nationwide network of primary care organizations. The main outcome of interest, mammography among females over the age of 50, was analyzed in two different ways: (1) being up to date on mammography and (2) time to first mammogram after age 50.

Diabetes Monitoring in Foreign-Born and US-Born Latino Adults in US Community Health Centers.

Introduction: The Latino population is the largest ethnic group in the United States and has a higher prevalence of diabetes mellitus than non-Latino Whites. The objective of this article is to assess if glycohemoglobin (HbA1c) monitoring rates vary across Latino patients by subgroup and nativity compared with their non-Latino White counterparts.

Methods: Our sample included 43,593 adults (18 to 79 years) with Type-2 diabetes extracted from electronic health record (EHR) data from Community Health Centers (CHCs) across 16 US states, linked with neighborhood-level Latino subgroup data within the study period 2012 to 2020.

Sanctuary policies and type 2 diabetes medication prescription trends among community health center patients.

Immigrants in the United States are at increased risk of diabetes-related complications due to delayed diagnoses compared with US-born individuals. Immigration-related federal policies may support immigration enforcement activities and restrict some immigrants' access to health insurance and other publicly funded resources. Conversely, state and county-level sanctuary policies may reduce the fear of deportation and increase mobility in the community, improving the accessibility of essential pharmacological treatment for type 2 diabetes patients.

Ethnicity, Language, and HIV Screening in Older Adult Safety-Net Patients.

Introduction: HIV screening should occur for all adults at least once by age 65 years. Older adults have low screening rates. Latinos, with historically low screening rates, have worse HIV outcomes than non-Hispanic White patients.

Before and During Pandemic Telemedicine Use: An Analysis of Rural and Urban Safety-Net Clinics.

Introduction: Differences in face-to-face and telemedicine visits before and during the COVID-19 pandemic among rural and urban safety-net clinic patients were evaluated. In addition, this study investigated whether rural patients were as likely to utilize telemedicine for primary care during the pandemic as urban patients.

Methods: Using electronic health record data from safety-net clinics, patients aged ≥18 years with ≥1 visit before or during the COVID-19 pandemic, March 1, 2019-March 31, 2021, were identified, and trends in face-to-face and telemedicine (phone and video) visits for patients by rurality using Rural‒Urban Commuting Area codes were characterized.

Smoking-Cessation Assistance Among Older Adults by Ethnicity/Language Preference.

Introduction: Although smoking prevalence is lower among Hispanic adults than among non-Hispanic White adults, smoking remains a leading cause of preventable death among older Hispanics. This study examines the differences in tobacco assessment and smoking-cessation assistance among older patients seen in community health centers by ethnicity and language preference.

Methods: Electronic health record data were extracted from the Accelerating Data Value Across a National Community Health Center Network of community health centers from patients aged 55‒80 years with ≥1 primary care visit between January 1, 2017 and December 31, 2018.

Disparities in Colorectal Cancer Screening in Latinos and Non-Hispanic Whites.

Introduction: Colorectal cancer is the second leading cause of cancer deaths in Latinos in the U.S., but it is unclear, from previous research, whether Latinos have differing rates of colorectal cancer screening methods from those of non-Hispanic Whites.

Healthcare-associated urinary tract infections with onset post hospital discharge.

Objective: Current surveillance for healthcare-associated (HA) urinary tract infection (UTI) is focused on catheter-associated infection with hospital onset (HO-CAUTI), yet this surveillance does not represent the full burden of HA-UTI to patients. Our objective was to measure the incidence of potentially HA, community-onset (CO) UTI in a retrospective cohort of hospitalized patients.

Design: Retrospective cohort study.

Smoking-Cessation Assistance: Before and After Stage 1 Meaningful Use Implementation.

Introduction: Brief smoking-cessation interventions in primary care settings are effective, but delivery of these services remains low. The Centers for Medicare and Medicaid Services' Meaningful Use (MU) of Electronic Health Record (EHR) Incentive Program could increase rates of smoking assessment and cessation assistance among vulnerable populations. This study examined whether smoking status assessment, cessation assistance, and odds of being a current smoker changed after Stage 1 MU implementation.

Lack of Lipid Screening Disparities in Obese Latino Adults at Health Centers.

Introduction: In cross-sectional survey studies, obese Latinos are less likely to be screened for elevated serum cholesterol, despite their higher risk for hyperlipidemia and coronary artery disease. This study evaluated insurance and racial/ethnic disparities in lipid screening receipt between obese Latino and non-Hispanic white patients in Oregon community health centers (CHCs) over 5 years, using electronic health record data.

Methods: This retrospective cohort study evaluated obese (BMI ≥30), low-income, adult patients (aged 21-79 years) with at least one visit at an Oregon CHC during 2009-2013 (n=11,095).

Measuring Preventive Care Delivery: Comparing Rates Across Three Data Sources.

Introduction: Preventive care delivery is an important quality outcome, and electronic data reports are being used increasingly to track these services. It is highly informative when electronic data sources are compared to information manually extracted from medical charts to assess validity and completeness.

Methods: This cross-sectional study used a random sample of Medicaid-insured patients seen at 43 community health centers in 2011 to calculate standard measures of correspondence between manual chart review and two automated sources (electronic health records [EHRs] and Medicaid claims), comparing documentation of orders for and receipt of ten preventive services (n=150 patients/service).

The association of type and number of chronic diseases with breast, cervical, and colorectal cancer screening.

Purpose: The purpose of this study was to examine associations between the number and types of patients' chronic diseases and being up to date for breast, cervical, and colorectal cancer screening.

Methods: Data were abstracted from medical charts at 4 primary care clinics located in 2 rural Oregon communities. Eligibility criteria included being at least 55 years old and having at least 1 clinic visit in the past 2 years.

Association between documented family history of cancer and screening for breast and colorectal cancer.

Background: Previous research on ascertainment of cancer family history and cancer screening has been conducted in urban settings.

Purpose: To examine whether documented family history of breast or colorectal cancer is associated with breast or colorectal cancer screening.

Methods: Medical record reviews were conducted on 3433 patients aged 55 and older from four primary care practices in two rural Oregon communities.

Language preference and perceptions of healthcare providers' communication and autonomy making behaviors among Hispanics.

Background: To examine influence of language preference-English versus Spanish-on Hispanics' perceptions of their healthcare providers' communication behaviors.

Methods: Using the 2005 Medical Expenditure Panel Survey (MEPS), we observed non-institutionalized Hispanics (n = 5197; US population estimate = 27,070,906), aged >or=18 years, reporting visiting a healthcare provider within the past 12 months.

Results: When compared to Spanish responders (reference group), English responders were more likely to report that their healthcare provider "always" listened to them carefully (adjusted odds ratio (OR) = 1.