Completed Research Projects

Walking Obesity Research Study

Obesity is one of the nation’s leading and growing health problems.  Moderate exercise, such as walking, can benefit individuals who are obese or overweight. This study was designed to shed light on how the characteristics of the neighborhood environment influence the physical activity and walking behaviors of individuals who are obese or overweight.

ASPN Referral Study

Each year primary care physicians (PCPs) refer 16 million new patients to specialists. Appropriate referral can improve the quality of healthcare through prompt recognition of a health problem, and treatment of a patient's health problem that may have been out of the expertise of the PCP. This completed multi-site descriptive study examined the frequency and reasons for referral, as well as the satisfaction rate of referred patients.

Family Practice Use of 'Back-Up' Antibiotic Prescriptions in URI

Current literature indicates a general tendency among physicians to over-prescribe antibiotics to patients who present with complaints of upper respiratory infection. While many studies have been done in this area, our particular interest is the impact of what is called the "back-up" prescription. This is a practice which entails a written prescription given to a patient along with instructions to fill the prescription only if symptoms progress or do not resolve within a predefined period of time. The purpose of this completed cross-sectional study was to determine the frequency with which family physicians use the strategy and the satisfaction rate among patients.

Healthy Lifestyles Headache Initiative: Migraine Disease Management Program

One in every nine individuals is affected by migraine disease, which is a chronic condition that is characterized by acute episodes of intense, disabling pain and associated symptoms. The Healthy Lifestyles Migraine Disease Management Program utilizes patient and healthcare provider-based resources with the intent to educate migraineurs about their migraines, provide physicians with information regarding patient migraine perceptions and co-morbidities, and thereby improve migraine treatment. This project was designed to evaluate the effectiveness of migraine patient education in improving patient quality of life, productivity and satisfaction and to determine the program's impact on healthcare resource utilization.

E-mail Communication

Access to primary care is essential for any good medical system. Patients must have ready access to medical personnel for urgent medical problems but more and more patients expect very prompt responses to medication refill requests, lab results and appointment scheduling issues. With the growing acceptance and use of e-mail, many physicians and patients are exploring the use of this technology to address medical issues. In theory, this mode of asynchronous communication is well suited to meet many of the needs of patients, for example, prescription refills, some diagnostic test results and appointment scheduling. E-mail communication may have the potential to reduce office overhead costs while improving patient services and satisfaction.

To assess the proportion of our patients with access to e-mail, and their willingness to utilize this technology to expedite communication, a pilot survey was conducted at one of our clinics. In the survey, we determined the percentage of patients who would use e-mail and what their expectations were for timeliness of responses to a variety of medical applications. We then expanded the survey beyond one clinic before major efforts would be expended to establish a network-wide medical e-mail system for our patients.

Open Access

Inadequate access to their primary care physician remains one of the major reasons of patients' dissatisfaction in ambulatory primary care. In the United States, the waiting period for a routine appointment is at least three weeks on the average. The concept of open access for appointments has been identified as one of the ways to accommodate patients' urgent healthcare needs while at the same time provide continuity of care and routine care to patients.

Open access is the practice in the scheduling of patient appointments whereby some appointment slots are left vacant for later access on demand. The aim of the concept is to provide patients, if they wish, an appointment on the same day that they call to make one. The basis of the open access concept is the assumption that demand for same-day appointment is predictable in any practice. In general, an open access appointment system should result in an improvement. The goal of this project was to evaluate the degree of prediction in using the open access concept for appointments, determine the level of patient, staff and physician satisfaction, as well as determine the overall cost-effectiveness of the concept in one of 17 clinics in the Scott & White healthcare system.

Physician Dictation

To improve the completeness and legibility of medical records, dictation systems have been advocated in medical practice for quite some time. Since family practice involves a wide variety of patients with diverse health problems spanning all ages and both sexes, the volume or cost of medical dictation transcription should also vary widely. In this project, we study the determinants of the average length of physicians' dictated notes, determine whether there is a direct correlation with physicians' average charging behavior and estimate the cost of transcription as part of the overhead.

Evidence Based Medicine And Complementary Alternative Medicine

Evidence-Based Medicine (EBM) and Complementary & Alternative Medicine (CAM) have been integrated into the six-week Family Practice clerkship during the third year at the Texas A&M University System Health Science Center College of Medicine in the 2000-2001 academic year. Three sessions of nine hours duration of interactive instruction are being provided to the students introducing the principles of epidemiology, methods of epidemiology, basic biostatistics, EBM and CAM.

Students are being introduced to skills in:

  1. Assessing relevance and validity of journal articles
  2. Detecting research design flaws
  3. MEDLINE and internet search for relevant information
  4. Critical appraisal of various types of journal articles, including clinical trials on CAM and other therapeutic measures and procedures

The specific aims of this project are to:

  • Assess the students’ before and after knowledge and attitudes toward the new curriculum
  • Evaluate the effectiveness of the new curriculum in equipping the students with the requisite skills to review, analyze and critique the medical literature through self reports.

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