ACU Columns

In each issue of the Journal of Health Care for the Poor and Underserved, ACU contributes an invited column on some aspect of health care for the underserved. ACU members and subscribers to the Journal can read these columns online. Others can download a PDF version of each article using the links provided.

HIV Management Returning to Primary Care Providers*
Ronald D. Wilcox, MD, FAAP and Donna M. Gallagher, APRN-C, MS, ANP, FAAN, MA
A 32-year old uninsured woman, living in a rural town in the Deep South, presents to the emergency room at a local hospital with complaints of cough and fever. She is diagnosed with pneumonia and given a prescription for an antibiotic. It takes a few days to raise the money for the prescription but she eventually fills it and improves with treatment. Over the next several months, she goes to three different free-care clinics for vaginal yeast infections. One year after the initial episode of pneumonia, she returns to the same hospital with gradually increasing shortness of breath, a non-productive cough, and a low-grade fever.
Read full text (PDF)

The Role of Clinicians to Empower Communities through Utilization of the Built Environment*
Sarah Kureshi, MD, MPH, Kim Bullock, MD, August 2011

In recent years there has been a growing awareness about the impact of built environments on individual behavior, health and disease risk, morbidity, and mortality. The authors describe three pioneering clinicians who have worked to improve community health by improving the infrastructure to support healthy eating and active lifestyles.
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Trans-disciplinary Care: A New Approach to Improving the Effectiveness of Tobacco Use Interventions*
Robert Hoffmann, MA, Virna Little, PsyD, LCSW-r, SAP, May 2011

Tobacco use disorder devastate lies and financial well-being, and constitute one of the largest public health problems the world faces today. One of the news ways to increase effectiveness of tobacco intervention is the utilization of trans-disciplinary teams.
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Street Medicine: An Example of Reality-based Health Care*
Jim Withers, MD, February 2011

Street medicine, an emerging field of medicine in the United States, is the provision of health care directly to those living on the streets of our communities. As such, it represents a trend in both health care delivery and medical education in which the reality of those we serve is central.
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Transdisciplinary Care: Opportunities and Challenges for Behavioral Health Providers*
Virna Little, PsyD, LCSW-r, SAP, November 2010

The transdisciplinary model of care is an important new tool for improving physical and mental health outcomes. It is an essential approach to combating some of the major chronic illnesses such as depression and diabetes and other co-morbid conditions that cripple many communities. Its potential as a successful approach to improving community health should be recognized and embraced by the behavioral health community.
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A Childhood Obesity Program in Federally Qualified Community Health Centers*
Erica L. McClaskey, MD, MS, August 2010

As the prevalence of childhood obesity reaches a new high, efforts must be made to reverse and protect children from this preventable disease. This column will describe how two federally qualified health centers used a modified version of a nationally known obesity prevention program called We Can to implement childhood obesity clinics.
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The State of Health Care Services for Mobile Poor Populations: History, Current Status, and Future Challenges* 
Candace Kugel, FNP, CNM, MS, Edward L. Zuroweste, MD, May 2010

The migrant workers of the United States in 2010 are members of diverse populations moving rapidly between sending and receiving locations. The migrant’s temporary social and physical environments affect his or her health and well-being. The occupations engaged in by migrants, as well as the fundamental factor of mobility itself, combine to create a lifestyle that carries multiple health risks. A review of the history and current status of health care services for United States migrant workers provides a glimpse into the efforts of a few to tend to the unique needs of an otherwise disenfranchised
population. Read  full text (PDF)

Transdisciplinary Health Care Education: Training Team Players*
Deepa Rani Nandiwada, Christine Dang-Vu, February 2010, pp. 26-34 (Article)

Transdisciplinary health care involves reaching into the spaces between the disciplines to create positive health outcomes through collaboration. This model of care effectively integrates clinicians such as physicians, nurses, social workers, physical therapists, complementary and alternative medicine practitioners, physician assistants, community health workers, and other health care providers to create a team that provides comprehensive preventative primary care. Read full text (PDF)

The Primary Care Crisis and Health Care Reform*
Peter Sherman, MD, Susan Moscou, FNP, MPH, PhD and Christine Dang-Vu, November 2009, pp. 944-950

Primary care crisis is a phrase we have heard many times. Often, it reflects not just a societal circumstance but the reality for health care professionals working first-hand with the medically underserved or vulnerable populations. These professionals are considered safety net providers because they deliver health care to uninsured patients, underinsured patients, and Medicaid patients. Safety net providers work in community health centers, federally qualified health centers, public hospitals, school-based clinics, teaching and community hospitals, and local public health clinics. Read full text (PDF)
 

Health Information Technology: Addressing Health Disparity by Improving Quality, Increasing Access, and Developing Workforce*
Ricardo Custodio, MD, MPH, Anna M. Gard, MSN, FNP-BC, Garth Graham, MD, MPH, May 2009

Health IT is a vital tool in achieving the goals of health care reform to increase health care access, improve care delivery systems, engage in culturally competent outreach and education, and enhance workforce development and training. The first national survey of federally funded community health centers shows that although 26% reported some electronic health record (EHR) capacity and 13% have the minimal set of EHR functionalities, the centers serving the most poor and uninsured patients were less likely to have a functional EHR system. Read full text (PDF)

Nurse Practitioners in Community Health Settings Today*
Lois A. Wessel, RN, MS, CFNP

An NP is an essential part of a transdisciplinary health team. The combination of medical skills and nursing care provide a unique role that can fill gaps in many primary care settings, and improve patient outcomes. Read full text (PDF)

Health Literacy: Improving Quality of Care in Primary Care Settings*
Sharon E. Barrett, MS, Doctoral Candidate, MSUPHP, Jennifer Sheen Puryear, MPH

The Social Worker on the Medical Transdisciplinary Team*
Margaret Dawson Hobbs, MSW

Primary Care in Public Housing: Voices of Clinicians*
Kathie Culhane-Pera, MD, Dillard Ellmore, DO, and Lois A. Wessel, RN, CFNP

*Reprinted with permission from Meharry Medical College, the copyright holder for the Journal of Health Care for the Poor and Underserved.