The development, implementation, and evaluation of a literacy-promotion program in pediatric dental care in a rural Wisconsin federally qualified health center

The present project details the development, implementation, and evaluation of a literacypromotion program in pediatric dental care, for Scenic Bluffs Community Health Centers’ main clinic in Cashton, WI. The development and implementation of the literacy-promotion program in Scenic Bluffs’ Dental Department adapted the principles of the highly successful Reach Out and Read program. The pilot program targeted pediatric dental patients ages six months to five years old and took place during annual dental hygiene appointments. Trained dental hygienists presented the pediatric patient with an age-appropriate children’s book at each appointment, communicated the importance of reading to both children and caregiver present, and offered in-person anticipatory guidance to caregivers regarding the benefits of reading to their children during the patient’s appointment. Findings from this project support the consistent positive findings that the body of literature on literacy-promotion programs in a healthcare setting regularly reported in the pediatric patient population. Recommendations were drawn from the findings and conclusions of the program and suggestions were made to utilize the quality improvement plan-do-study-act (PDSA) model as part of future literacy-promotion programs at Scenic Bluffs Community Health Centers to ensure the highest quality outcome is achieved

Health care costs among adolescent young adults with cancer at a community-based hospital.

e18857 Background: Adolescent Young Adults (AYAs) are likely to live for decades after a cancer diagnosis and thus have the potential to accumulate high healthcare costs. Prior research has shown high costs can be associated with increased risk of morbidity and mortality. However, there is limited understanding of how costs impact AYAs, especially in a community hospital. The purpose of this study is to 1) understand total community hospital healthcare costs for AYA patients with cancer, 2) identify risk factors for high costs, and 3) assess the impact of costs on survival. Methods: AYA patients (ages 15-29) treated at a community hospital were identified. Data collected included patient demographics, cancer characteristics, treatments (chemotherapy, radiation, surgery, immunotherapy, hormone therapy), support services (financial counseling, social work, survivorship), hospital admissions, miles from the hospital (great-circle distance), and all healthcare charges from one year prior to cancer diagnosis until last follow-up between 2000-2020. Multivariate logistic regression analyses were used to identify patients with costs greater than the median ($125K). Cox Proportional Hazard (CPH) regression models were used to identify factors associated with the risk of all-cause mortality. Results: A total of 388 AYA patients were identified with a median follow-up of 9 years and 97$123K (range, $73K-$215K). In adjusted analysis, patients with higher than median healthcare cost ( &gt; 125K) had greater odds of hospital admission (odds ratio [OR] = 1.5, p < .001) and chemotherapy treatment (OR = 3.4, p = .005) as well as lower odds of living further from the hospital per one mile (OR = 0.3, p = .049) and being uninsured/unknown insurance (OR = 0.1, p = .047). In adjusted analysis, increased risk of death was associated with receiving radiation therapy (HR = 7.8, p = .02) and higher healthcare costs per 125K (HR = 3.8, p = .001). Conclusions: High costs of healthcare among AYA patients with cancer are related to chemotherapy, hospital admissions, and hospital proximity. High healthcare costs and radiation therapy may be associated with increased risk of death in the AYA population. This data may guide physician decision making for AYA patients ensuring mindfulness of high costs of care and how it relates to poor survival outcomes in community hospitals. </jats:p

Group-based positive psychotherapy for people living with acquired brain injury: a protocol for a feasibility study

Abstract Background Acquired brain injury (ABI) and other chronic conditions are placing unprecedented pressure on healthcare systems. In the UK, 1.3 million people live with the effects of brain injury, costing the UK economy approximately £15 billion per year. As a result, there is an urgent need to adapt existing healthcare delivery to meet increasing current and future demands. A focus on wellbeing may provide an innovative opportunity to reduce the pressure on healthcare services while also supporting patients to live more meaningful lives. The overarching aims of the study are as follows: (1) evaluate the feasibility of conducting a positive psychotherapy intervention for individuals with ABI and (2) ascertain under what conditions such an intervention would merit a fully powered randomised controlled trial (RCT) compared to a standard control group (TAU). Methods and analysis A randomised, two-arm feasibility trial involving allocation of patients to either a treatment group (positive psychotherapy) or control group (treatment as usual) group, according to a 1:1 ratio. A total of 60 participants at three sites will be recruited including 20 participants at each site. Assessments will be conducted at baseline, on completion of the 8-week intervention and 3 months following completion. These will include a range of questionnaire-based measures, psychophysiology and qualitative outcomes focusing on feasibility outcomes and participant experience. This study has been approved by the Wales Research Ethics Committee (IRAS project ID: 271,251, REC reference: 19/WA/0336). Discussion This study will be the first to examine the feasibility of an innovative, holistic positive psychotherapy intervention for people living with ABI, focused on individual, collective and planetary wellbeing, and will enable us to determine whether to proceed to a full randomised controlled trial. Trial registration ISRCTN12690685 , registered 11th November 2020