Access to patient-centered medical home among Ohio's Children with Special Health Care Needs.

Medical homes deliver primary care that is accessible, continuous, comprehensive, family centered, coordinated, compassionate and culturally effective. Children with special health care needs (CSHCN) require a wide range of support to maintain health, making medical home access particularly important. We sought to understand independent risk factors for lacking access. We analyzed Ohio, USA data from the National Survey of Children with Special Health Care Needs (2005-2006). Among CSHCN, 55.6% had medical home access. The proportion achieving each medical home component was highest for having a personal doctor/nurse and lowest for receiving coordinated care, family-centered care and referrals. Specific subsets of CSHCN were significantly and independently more likely to lack medical home access: Hispanic (AOR=3.08), moderate/high severity of difficulty (AOR=2.84), and any public insurance (AOR=1.60). Efforts to advance medical home access must give special attention to these CSHCN populations and improvements must be made to referral access, family-centered care, and care coordination.

A family history demonstration project among women in an urban Appalachian community.

BACKGROUND: Family health history (FHH) is promoted to consumers by the Surgeon General as a tool to improve health and prevent disease. However, few FHH resources exist for medically underserved populations such as the urban Appalachian community in Southwest Ohio. OBJECTIVES: To engage and educate urban Appalachian women about the importance and collection of their own FHH. METHODS: Researchers partnered with six community organizations to develop a model Family History Demonstration Project. Focus groups were held with urban Appalachian women to determine how they would like to learn about their FHH. Resources and an educational intervention were developed based on focus group findings with input from the academic and community partners. Participants in the project recorded their family history and evaluated the education sessions and materials. RESULTS: Eleven fact sheets and four educational presentations were developed based on feedback from the target community. One hundred women participated in two family history education sessions. Learning objectives for both education sessions were met. All participants recorded their family history electronically or on paper and 91% of participants found the first education session (ES1) very helpful at teaching the importance of FHH. CONCLUSIONS: Community organizations and university researchers partnered to develop a model Family History Demonstration Project with input from community members. Evaluations of the project were positive. Future efforts should focus on sustainable dissemination of the educational programs and resulting health outcomes.