Update to Internet-only Tables: NAMCS Community Health Centers

This report provides estimates of ambulatory care visits made to both physicians and nonphysician clinicians at community health centers in the United States.

Update to Internet-only Tables: NAMCS Community Health Centers

This report provides estimates of ambulatory care visits made to both physicians and nonphysician clinicians at community health centers in the United States.

Racial Bias Correlates with States Having Fewer Health Professional Shortage Areas and Fewer Federally Qualified Community Health Center Sites

Federally Qualified Community Health Centers (FQHCs), serving Health Professional Shortage Areas (HPSAs), are fixtures of the healthcare safety net and are central to healthcare delivery for African Americans and other marginalized Americans. Anti-African American bias, tied to anti- “welfare” sentiment and to a belief in African Americans’ supposed safety net dependency, can suppress states’ willingness to identify HPSAs and to apply for and operate FQHCs. Drawing on data from n = 1,084,553 non-Hispanic White Project Implicit respondents from 2013–2018, we investigated associations between state-level implicit and explicit racial bias and availability of FQHCs and with HPSA designations. After controlling for states’ sociopolitical conservatism, wealth, health status, and acceptance of the Affordable Care Act’s Medicaid expansion, greater racial bias was correlated with fewer FQHC delivery sites and fewer HPSA designations. White’s bias against African Americans is associated with fewer FQHC opportunities for care and fewer identifications of treatment need for African Americans and other low-income people lacking healthcare options, reflecting bias-influenced neglect.

Pelatihan Manajemen Stress Kepada Penderita Penyakit Kronis di Desa Warisa

ABSTRAK Penyakit kronis yang telah diderita selama bertahun-tahun dapat mengganggu pada semua aspek kehidupan penderitanya seperti masalah finansial, Karir, gangguan peran, termasuk masalah psikososial, akibatnya, penderita penyakit kronis seringkali juga mengalami stress kronis yang selanjutnya dapat memperburuk penyakit dan menurunkan kualitas hidup penderitanya. Di Desa Warisa didapatkan jumlah penderita penyakit kronis sebanyak 83 Orang hanya dari 3 jaga (lingkungan). Tujuan Pengabdian Kepada Masyarakat ini adalah untuk meningkatkan pengetahuan dan kemampuan penderita penyakit kronis di Desa Warisa terkait manajemen stress melalui kegiatan pelatihan. Kegiatan ini dilakukan dengan memberikan penyuluhan terkait manajamen stress yang baik dilanjutkan dengan pelatihan manajemen stress dengan relaksasi napas dalam dan relaksasi otot progresif. Kegiatan ini diikuti oleh 29 peserta termasuk 2 kader dan dari hasil evaluasi didapatkan peningkatan pengetahuan peserta sebesar 22.4% yaitu sebelum penyuluhan (63%) dan setelah penyuluhan (85.4%). Dari hasil observasi juga didapatkan sebagian besar peserta mampu melakukan kembali gerakan latihan relaksasi otot progresif secara mandiri namun, ada 5 Peserta yang belum mampu melakukan gerakan latihan secara mandiri yang kemudian diberikan pendampingan lanjutan. Hasil dari kegiatan ini diharapkan dapat menjadi dasar pembentukan program kesehatan jiwa di puskesmas khususnya terkait pelayanan psikososial bagi penderita penyakit kronis. Kata Kunci: Manajemen stress, Penyakit kronis, Relaksasi otot progresif ABSTRACT Chronic illness that has been suffered for years can interfere with all aspects of people with chronic illness such as financial problems, career, role performance, and psychosocial aspects. as a result, People who suffer from chronic diseases often experience chronic stress that worsens disease severity and reduces the quality of life. In Warisa Village, there were 83 people who were identified with chronic diseases from only 3 hamlets. The purpose of this Community Service was to increase the knowledge and ability of People with chronic disease in Warisa Village regarding stress management through training. This activity was carried out by delivering health education related to positive stress management followed by stress management training with deep breathing relaxation and Progressive Muscle Relaxation (PMR). This activity was attended by 29 participants including 2 Cadres and from the evaluation process, it was found that the participants' knowledge increased by 22.4% in which before counseling (63%) and after counseling (85.4%). From the observations, it was also found that most of the participants were able to perform PMR independently, however, there were 5 participants who had not been able to perform PMR independently and were then given further assistance. The results of this activity are expected to be the first step to developing mental health programs in Community Health Centers, especially related to psychosocial services for people with chronic diseases. Keywords: Stress management, Chronic illness, Progressive Muscle Relaxation

Impact of dermoscopy-aided pediatric teledermatology program on the accessibility and efficiency of dermatology care at community health centers

Background There are few studies focusing on pediatric teledermatology, and the impact of a large-scale pediatric teledermatology program on the accessibility and efficiency of dermatology care remains unclear. This study evaluated the impact of a state-wide implementation of a store-and-forward teledermatology program augmented by the incorporation of dermoscopy in pediatric patients visiting community health centers. Methods It was a descriptive, retrospective cohort study of 876 pediatric dermatology referrals. Results In the traditional referral system, only 60 patients (17.6%) were seen by dermatologists with average waiting times of 75 days due to limited access. In comparison, with an implementation of dermoscopy-aided teledermatology, all 536 teledermatology referrals received dermatological care within 24 h, of which only 64 (12%) patients requires face-to-face (F2F) consultation. Patients referred for F2F consultation via eConsults had a much lower no-show rate as compared to the traditional referral system (39% vs. 71%). Side by side comparison between general population and pediatric population has demonstrated shared features in efficiency and access improvement but revealed specific characteristics of pediatric teledermatology in terms of diagnosis and treatment. Conclusion Coordinated store-and-forward teledermatology platform with incorporation of dermoscopy between large community care network and dermatology provider can greatly improve access to pediatric dermatology care especially in underserved population. The efficiency of teledermatology in access improvement for pediatric population is comparable with adult population in eConsults. There are also unique features and challenges in pediatric teledermatology that require further research.

Covid-19 Vaccination Maternal Services for Pregnant Women in the Work Area of Telaga Community Health Centers

This study aims to provide an overview of how the covid-19 vaccination service for pregnant women in the work area of the Telaga Health Center. This study uses a qualitative method that focuses on ANC services with in-depth interview techniques, data analysis is carried out descriptively and presented in narrative form. This research was carried out in the working area of the Telaga Health Center from September 2021 to November 2022. The informants in this study were pregnant women in the Telaga Health Center working area as many as 7 participants and 2 key informants were the program coordinator midwives. With a snowball sampling technique. The results of the study found that there were 5 themes that described Covid-19 vaccination services for pregnant women, namely Socialization of Covid-19 Vaccination for pregnant women, Issue of KIPI for Covid-19 Vaccination, Supporting Factors for Successful Vaccination in Pregnant Women, Body Response of Pregnant Women after Covid-19 Vaccination. 19, and Covid-19 Vaccination Requirements for Pregnant Women. The mandatory output in this research is the publication of research results in one of the international journals.