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  1. AU="Aboelata, Noha"
  2. AU="Chiang, Sarah N"
  3. AU="Wessel, Kristin M"
  4. AU="Wilson, Jenna M"
  5. AU="Goines, Paula"
  6. AU=Ippolito Mariachiara AU=Ippolito Mariachiara
  7. AU="Jose Chauca"
  8. AU="Asih, Puji B S"
  9. AU="Dsane-Selby, Lydia"
  10. AU="Tolossa, Tadesse"
  11. AU="Erdal Bedir"

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  1. Artikel ; Online: Intensity and Variation of Health Navigator Support: Addressing Medical and Social Needs of Diabetes Patients in East Oakland.

    Peek, Monica E / Tanumihardjo, Jacob P / O'Neal, Yolanda / Grady, Breanne / Aboelata, Noha / Gunter, Kathryn E / Gauthier, Rich

    Journal of general internal medicine

    2024  

    Abstract: Background: Healthcare systems are increasingly screening and referring patients for unmet social needs (e.g., food insecurity). Little is known about the intensity of support necessary to address unmet needs, how this support may vary by circumstance ... ...

    Abstract Background: Healthcare systems are increasingly screening and referring patients for unmet social needs (e.g., food insecurity). Little is known about the intensity of support necessary to address unmet needs, how this support may vary by circumstance or time (duration), or the factors that may contribute to this variation.
    Objective: Describe health navigator services and the effort required to support patients with complex needs at a community health center in East Oakland, CA.
    Design: Retrospective analysis of de-identified patient contact notes (e.g., progress notes).
    Participants: Convenience sample of patients (n = 27) enrolled in diabetes education and referred to health navigators.
    Interventions: Navigators provide education on managing conditions (e.g., diabetes), initiate and track medical and social needs referrals, and navigate patients to medical and social care organizations.
    Main measures: Descriptive statistics for prevalence, mean, median, and range values of patient contacts and navigation services. We described patterns and variation in navigation utilization (both contacts and navigation services) based on types of need.
    Key results: We identified 811 unmet social and medical needs that occurred over 710 contacts with health navigators; 722 navigation services were used to address these needs. Patients were supported by navigators for a median of 9 months; approximately 25% of patients received support for > 1 year. We categorized patients into 3 different levels of social risk, accounting for patient complexity and resource needs. The top tertile (n = 9; 33%) accounted for the majority of resource utilization, based on health navigator contacts (68%) and navigation services (75%).
    Conclusions: The required intensity and support given to meet patients' medical and social needs is substantial and has significant variation. Meeting the needs of complex patients will require considerable investments in human capital, and a risk stratification system to help identify those most in need of services.
    Sprache Englisch
    Erscheinungsdatum 2024-02-12
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 639008-0
    ISSN 1525-1497 ; 0884-8734
    ISSN (online) 1525-1497
    ISSN 0884-8734
    DOI 10.1007/s11606-023-08590-w
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Racial Disparities in Pulse Oximeter Device Inaccuracy and Estimated Clinical Impact on COVID-19 Treatment Course.

    Sudat, Sylvia E K / Wesson, Paul / Rhoads, Kim F / Brown, Stephanie / Aboelata, Noha / Pressman, Alice R / Mani, Aravind / Azar, Kristen M J

    American journal of epidemiology

    2022  Band 192, Heft 5, Seite(n) 703–713

    Abstract: Arterial blood oxygen saturation as measured by pulse oximetry (peripheral oxygen saturation (SpO2)) may be differentially less accurate for people with darker skin pigmentation, which could potentially affect the course of coronavirus disease 2019 ( ... ...

    Abstract Arterial blood oxygen saturation as measured by pulse oximetry (peripheral oxygen saturation (SpO2)) may be differentially less accurate for people with darker skin pigmentation, which could potentially affect the course of coronavirus disease 2019 (COVID-19) treatment. We analyzed pulse oximeter accuracy and its association with COVID-19 treatment outcomes using electronic health record data from Sutter Health, a large, mixed-payer, integrated health-care delivery system in Northern California. We analyzed 2 cohorts: 1) 43,753 non-Hispanic White (NHW) or non-Hispanic Black/African-American (NHB) adults with concurrent arterial blood gas oxygen saturation/SpO2 measurements taken between January 2020 and February 2021; and 2) 8,735 adults who went to a hospital emergency department with COVID-19 between July 2020 and February 2021. Pulse oximetry systematically overestimated blood oxygenation by 1% more in NHB individuals than in NHW individuals. For people with COVID-19, this was associated with lower admission probability (-3.1 percentage points), dexamethasone treatment (-3.1 percentage points), and supplemental oxygen treatment (-4.5 percentage points), as well as increased time to treatment: 37.2 minutes before dexamethasone initiation and 278.5 minutes before initiation of supplemental oxygen. These results call for additional investigation of pulse oximeters and suggest that current guidelines for development, testing, and calibration of these devices should be revisited, investigated, and revised.
    Mesh-Begriff(e) Adult ; Humans ; COVID-19/therapy ; COVID-19 Drug Treatment ; Dexamethasone/therapeutic use ; Oximetry/methods ; Oxygen/therapeutic use ; Healthcare Disparities ; Electronic Health Records ; Health Equity
    Chemische Substanzen Dexamethasone (7S5I7G3JQL) ; Oxygen (S88TT14065)
    Sprache Englisch
    Erscheinungsdatum 2022-09-30
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2937-3
    ISSN 1476-6256 ; 0002-9262
    ISSN (online) 1476-6256
    ISSN 0002-9262
    DOI 10.1093/aje/kwac164
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Building Bridges Between Community Health Centers and Academic Medical Centers in a COVID-19 Pandemic.

    Taylor, Nicholas Kenji / Aboelata, Noha / Mahoney, Megan / Seay-Morrison, Timothy / Singh, Baldeep / Chang, Sang-Ick / Asch, Steven M / Shaw, Jonathan G

    Journal of the American Board of Family Medicine : JABFM

    2021  Band 34, Heft Suppl, Seite(n) S229–S232

    Abstract: The threat to the public health of the United States from the COVID-19 pandemic is causing rapid, unprecedented shifts in the health care landscape. Community health centers serve the patient populations most vulnerable to the disease yet often have ... ...

    Abstract The threat to the public health of the United States from the COVID-19 pandemic is causing rapid, unprecedented shifts in the health care landscape. Community health centers serve the patient populations most vulnerable to the disease yet often have inadequate resources to combat it. Academic medical centers do not always have the community connections needed for the most effective population health approaches. We describe how a bridge between a community health center partner (Roots Community Health Center) and a large academic medical center (Stanford Medicine) brought complementary strengths together to address the regional public health crisis. The 2 institutions began the crisis with an overlapping clinical and research faculty member (NKT). Building on that foundation, we worked in 3 areas. First, we partnered to reach underserved populations with the academic center's newly developed COVID test. Second, we developed and distributed evidence-based resources to these same communities via a large community health navigator team. Third, as telemedicine became the norm for medical consultation, the 2 institutions began to research how reducing the digital divide could help improve access to care. We continue to think about how best to create enduring partnerships forged through ongoing deeper relationships beyond the pandemic.
    Mesh-Begriff(e) Academic Medical Centers/organization & administration ; COVID-19/epidemiology ; California/epidemiology ; Community Health Centers/organization & administration ; Cooperative Behavior ; Humans ; Pandemics ; Primary Health Care/methods ; SARS-CoV-2 ; Telemedicine/organization & administration
    Sprache Englisch
    Erscheinungsdatum 2021-02-23
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2239939-2
    ISSN 1558-7118 ; 1557-2625
    ISSN (online) 1558-7118
    ISSN 1557-2625
    DOI 10.3122/jabfm.2021.S1.200182
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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