Category: Health Promotion

Free Lyft to the Pharmacy

Blue Cross and Blue Shield Institute has started a partnership with the ride sharing company Lyft to provide their members with free rides to pick up their medications. The Blue Cross Blue Shield Institute is a new organization that’s mission is to reduce the barriers of accessing healthcare. One of the largest identified barriers to accessing healthcare is transportation. Last year, their big initiative was a similar program with Lyft to provide free transportation for their patients to their doctors’ appointments. By investing in these types of programs, the organization is hoping to reduce costs in the long -term and improve the health outcomes of their consumers. With this newest imitative they are also partnering with pharmaceutical organization such as CVS Health and Walgreens to increase medication adherence. These programs are still under pilot testing and are currently funded by CVS and Walgreens in Chicago and Pittsburgh with patients who are living in “transportation deserts”. These types of unique partnerships are allowing for creative solutions and addressing the social determinants of health in order to solve the most dire healthcare problems. Let’s hope to see more of these types of collaborations in the future.

References

https://www.forbes.com/sites/brucejapsen/2018/03/14/cvs-and-walgreens-partner-with-lyft-to-get-blue-cross-patients-to-pharmacies/#34f4fa0f76c8

https://www.bcbs.com/news/press-releases/blue-cross-and-blue-shield-and-lyft-join-forces-increase-access-health-care

RICE your knees…How to care for a sports injury

As the weather is starting to warm up, many of us are thinking about getting outside and getting active.  With this increased movement, it’s no wonder that a search of google trends from 2004-2016 showed that April of each year is the most common month for searches related to knee injuries (1).

The R.I.C.E. method is one of the most commonly recommended ways to treat sports injuries to joints and muscles.  It has even received a stamp of approval from the American Orthopaedic Foot and Ankle Society (2).  This method has 4 steps:

 

R is for Rest  Try to avoid using the injured area and putting weight on it for 24-48 hours if possible (3)

I is for Ice Every 4 hours, put rice on the injury for 20 minutes at a time (3).  For comfort, you can place a thin cloth between the ice bag and your skin (2).

C is for Compression Wrap the area with a bandage, like an ACE wrap, in order to gently compress the injured area.  This will help control swelling.  Just be careful not to wrap it too tight and cut of your blood flow (3).

E is for Elevation This is your opportunity to sit and prop your feet (or other injured spot) up.  Use pillows or other comfortable items to try to keep the area above the level of your heart.  This can reduce swelling (3).

 

Once you start feeling better, you can SLOWLY and GENTLY start using the injured area again.  Also, if you’re not sure how bad you’ve hurt yourself, be sure to get it checked out by a medical provider.

 

References

  1. Using Google Trends To Assess For Seasonal Variation In Knee Injuries. Dewan, Varun and Sur, Hartej. February 21, 2018, Journal of Arthroscopy and Joint Surgery.
  2. American Academy of Orthopaedic Surgeons. How to Care for a Sprained Ankle. American Orhopaedic Foot and Ankle Society. [Online] http://www.aofas.org/footcaremd/how-to/foot-injury/Pages/How%20to%20Care%20for%20a%20Sprained%20Ankle.aspx.
  3. Sports Medicine at the University of Pennsylvania Medical Center. How to Use the R.I.C.E Method for Treating Injuries. UPMC Health Beat. [Online] August 27, 2014. https://share.upmc.com/2014/08/rice-method-for-treating-injury/.

 

 

What you need to know about SESTA and the recent seizure of Backpage

Late last week, classified ad website Backpage.com went offline after being seized and disabled due to an “enforcement action by the Federal Bureau of Investigation, the U.S. Postal Inspection Service, and the Internal Revenue Service Criminal Investigation Division”. Backpage.com is known for personal ads, and was considered by many to be the dominant online platform for sex workers to advertise their services.

Various websites have been shutting down their personal ads section in response to the Stop Enabling Sex Trafficking Act (SESTA), which has taken aim at online platforms as a playing a perceived role in sex trafficking and prostitution. While many advocates have been fighting SESTA for a large part of the year, awareness seems to be low of the laws implications among the general population.

Advocates against SESTA argue that the act will do more harm than good in regards to the safety of sex workers. Online platforms for sex work have been viewed as safer than street based sex work, allowing for screening of potential clients. Others have argued that SESTA would limit online free speech, arguing that it would require platforms to put strong restrictions on users’ speech, extending beyond the space of personal ads. If you’re interested in seeing what you can do stop SESTA, check out https://stopsesta.org for more information on how to contact your elected officials.

 

Sources – Buzzfeed News: Backpage Has Been Taken Down By The US Government And Sex Workers Aren’t Happy – https://www.buzzfeed.com/blakemontgomery/backpage-service-disruption?utm_term=.mceyodXp#.bkjAQmNK

App Grindr under scrutiny over privacy concerns

In an article published yesterday by BuzzFeed News, it was released that Gay Dating App Grindr has been sharing its users’ HIV status with two outside companies, a move which many consider dangerous to the queer community that the app claims to serve.

The sites, Apptimize and Localytics, work with Grindr to optimize the app and user experience. While it has been noted that these companies do not share information with third parties, there are still concerns with the sharing of sensitive information of a historically vulnerable population. This could raise flags for users sharing their HIV status on the app, which could negatively impact public health interventions that work to reduce HIV transmission and stigma.

Grindr recently announced that they would remind users to get tested for HIV every three to six months, offering a cue to action for users to be more aware of their HIV status. Knowing ones status is a crucial component for reducing the number of new HIV infections, such as by offering the opportunity to those who are living with HIV to be connected to care and achieve viral suppression.

 

Sources:

BuzzFeed News: Grindr Is Sharing The HIV Status Of Its Users With Other Companies –https://www.buzzfeed.com/azeenghorayshi/grindr-hiv-status-privacy?bfsplash&utm_term=.eu9v16ZaQ#.akvOQgNJj

What’s going on with the HPV vaccine?

HPV is the most common STI, and 9 of every 10 people will have an infection at some point in their lives (1).  This virus can cause cancers in the cervix, penis, mouth, and oropharynx (2), and it also causes genital warts (3).  Even though a vaccine exists against HPV, less than half of teens are up to date on all of their doses of these shots (2).

Part of the reason behind these low vaccination rates are due to parents concerns regarding vaccine safety and fear that vaccination will encourage sexual activity (4).  Though all vaccines, including this one, have potential side effects, the HPV vaccine is considered safe (4). Additionally, studies have shown that the HPV vaccine does not make teens more likely to start having sex (4).

The way providers approach talking about the HPV has also influenced vaccine rates, and strong provider endorsement seems to improve vaccinations (5).  On Monday, March 19, Chris Noronha spoke with the Interdisciplinary Health Communications Class about the work he is doing with Noel Brewer on provider communication regarding the HPV vaccine.  They have found that when providers mention the HPV vaccine in the same list as other vaccines that are due at age 11, vaccination rates increase.

If you’re interested in the HPV vaccine, it may not be too late.  You can receive the series through age 26 (1).  Contact your provider if you’re interested.

 

Works Cited
  1. Centers for Disease Control and Prevention. Human Papillomavirus (HPV) Vaccine Safety. Centers for Disease Control and Prevention. [Online] January 30, 2018. https://www.cdc.gov/vaccinesafety/vaccines/hpv-vaccine.html.
  2. Aubrey, Allison. This Vaccine Can Prevent Cancer, But Many Teenagers Still Don’t Get It. National Public Radio. [Online] February 19, 2018. https://www.npr.org/sections/health-shots/2018/02/19/586494027/this-vaccine-can-prevent-cancer-but-many-teenagers-still-dont-get-it.
  3. Centers for Disease Control and Prevention. What is HPV. Centers for Disease Control and Prevention. [Online] December 20, 2016. https://www.cdc.gov/hpv/parents/whatishpv.html.
  4. —. Talking to Parents About HPV vaccine. Centers for Disease Control and Prevention. [Online] December 2016. https://www.cdc.gov/hpv/hcp/for-hcp-tipsheet-hpv.pdf.
  5. Narula, Tara. HPV vaccine: Why aren’t children getting it? CBS News. [Online] July 23, 2017. https://www.cbsnews.com/news/hpv-vaccination-cancer-prevention-dr-tara-narula/.

 

 

“The Angelina Effect”

In this day of age celebrities dominate our world. They hold elected office, they are activists, they are social media entrepreneurs, they are everywhere. Whether we like to believe it or not they have influence over our behaviors and how we make decisions. I’m guilty that most of the accounts I follow on Instagram are former Bachelor contestants and catch myself wanting to mimic their fashion and fitness routines. In fact, there has been research that has examined this phenomenon. Back in 2013, esteemed actress Angelina Jolie announced that she carries the a genetic mutation that greatly increases your risk of breast and ovarian cancer (BRCA1). In her New York Times opt ed piece, Jolie reveals that she lost her mom, aunt and grandmother to cancer and that influence her decision to undergo preventive surgery to remove both of her breasts (mastectomy) and ovaries. After this announcement, several researchers explored what came to be known as “The Angelina Effect” and how her decision influenced other women’s decisions about their own health. In a study published in Health Services Research journal, hospital data from both New York and the UK revealed that three months after Jolie’s announcement there was a significant increase in preventive mastectomies prior to the announcement. This trend has been seen with other celebrities after announcements of diagnoses and provides incentives for both public figures and healthcare providers to use these instances as teachable moments and bring awareness to employ preventive healthcare.

To learn more about the BRCA1 gene visit the following site: https://www.cancer.gov/about-cancer/causes-prevention/genetics/brca-fact-sheet#q1

 

 

 

SNAPFresh Without the Fresh

This week the Trump administration released their proposed change to the longstanding SNAP (Supplemental Nutrition Assistance Program) which some would equate to delivery meal services such as HelloFresh, Blue Apron and Purple Carrot. These new delivery meal services have been tremendously popular and my first reaction was this might actually be a good idea. This type of service is more convenient and having groceries delivered without the hassle of going to a grocery store would be a nice perk for program shoppers. I further explored the details of this program and my mind quickly changed when I read about what was included in the boxes and more importantly what was not. These boxes would not contain fresh foods (milk, eggs, fruits and vegetables) and instead would provide canned fruits and vegetables and shelf milk. To be honest I had to do a quick web search to see what was actually shelf milk. Additionally, these Americans would have little to no say over what is included in the boxes versus the current program where they are issued a card and can purchase what they choose to at participating stores. While I could see benefit in this type of service as an OPTION for SNAP shoppers there is a lot of improvements that should be made before bringing this proposed idea into actual implementation particularly thinking about the foods included and would this truly be something that current SNAP shoppers find feasible and/or pragmatic.

References

https://www.npr.org/sections/thesalt/2018/02/12/585130274/trump-administration-wants-to-decide-what-food-snap-recipients-will-get?utm_campaign=storyshare&utm_source=facebook.com&utm_medium=social

Just Trust Me (Part II)

“Dr. X, or whoever she was, she must have been experimenting on me…she left a big scar on my neck … I don’t want that lady to ever touch me again. I don’t like her and I don’t trust her.

Last week, I introduced the issue of trust in the medical setting and how it may vary across scenarios and patient characteristics. But to truly understand why some patients don’t trust the healthcare system, we absolutely cannot ignore the history of their oppression by its hands.

The most well-known medical violation under the guise of research in the U.S. is the Tuskegee “study,” a 40-year-long theft of human rights that, brilliantly and viciously, utilized both government and community-level networks to recruit black men in Macon County, AL. Most had syphilis. The participants, many of whom had never seen a physician, were not made aware of the dangers, causes, and treatment options for their disease. They were not offered informed consent, nor the option to leave the study, and many died.

But Tuskegee is only the tip of the iceberg. Henrietta Lacks’ cells were cultured without her consent during her battle with cervical cancer in 1951 and are still widely used today. Gynecologist J. Marion Sims ran “practice runs” of his procedures on enslaved women. A common belief in the 20th century was that those who could not pay for medical care, many of them poor minorities and immigrants, “owed their bodies” to science. Harry Laughlin performed forced sterilizations on “socially inadequate” Puerto Rican women until the 1970s. The list could go on.

Today, this unfathomable history is manifested in mistrust in healthcare and scientific research. Evidence suggests that black patients are less likely to trust physicians, are more worried about medical privacy and experimentation than are white patients, and are less likely to participate in clinical trials. Some patients are not fully aware of the history to their mistrust – it is a cultural feeling that has been passed down through generations. This is called historical trauma. In addition, racism is still rampant in the healthcare system, both intentional and subconscious, which I will delve into in Part III. These features make this issue even more difficult to address.

Read Part III here.

Crash or DASH- choosing the right diet

February is heart month.  We’re often told that in order to keep our hearts healthy we should maintain a healthy weight.  Many people try to do this by dieting, but do diets really make us healthier?

New research has emerged that meal replacement crash diets (typically consuming only 600 to 800 calories each day) can temporarily worsen heart function [1].  This means that if you have heart problems, these diets could actually make your health worse instead of better.  If you’re looking for a healthy way to lose weight, you may want to check out the National Heart, Lung, and Blood institute’s DASH diet.  In January, U.S. News and World Report ranked the DASH diet as the best overall diet plan for the eighth year in a row [2].  The DASH diet also claimed first place in the healthy eating and heart disease prevention categories.

If you feel like dieting, stop and ask yourself why you’re doing it.  If you’re trying to get your heart in shape, you may want to rethink that overly restrictive diet.

 

References

[1]   European Society of Cardiology (ESC). “Crash diets can cause transient deterioration in heart function.” ScienceDaily. ScienceDaily, 2 February 2018. www.sciencedaily.com/releases/2018/02/180202123836.htm

[2]  National Heart, Lung, and Blood Institute. (2018, January 3). DASH ranked Best Diet Overall for eighth year in a row by U.S. News and World Report. Retrieved from National Heart, Lung, and Blood Institute: https://www.nhlbi.nih.gov/news/2018/dash-ranked-best-diet-overall-eighth-year-row-us-news-and-world-report

 

Just Trust Me (Part I)

Well I’m not trained medically, so I’m taking a lot of what they say on faith.”

This was the response of a 47-year-old man, whose interview was part of a study on patients’ trust in hospitals.

There is no universal definition of trust that will apply to every scenario. Physician training, patient’s racial and cultural background, personalities, and expectations all come into play as their relationship evolves. One recurring theme in the study cited above was “sensing that you are in good hands.” Some mentioned that their trust developed from knowing the sheer amount of training required to be a medical provider. Other patients pointed out that being desperate, or having few other options, accelerates the formation of trust.

The Trust Project at Northwestern emphasizes the role that vulnerability plays in forming trust. Generally, once we come to trust someone, we open up to them; we expose vulnerability. In the healthcare system, it works backwards: being sick, worried, or simply confused by jargon (this is called information asymmetry), the patient often begins her relationship with her provider in a state of vulnerability.

Trust can also vary in different facets of the healthcare system. When we say that a patient has mistrust in the healthcare system, are we referring to his relationship with his provider, institutions like his hospital and insurance company, or the notion of Western medicine to begin with? One study suggests that repeated interactions are a key to building trust, and that patients do not see their providers as interchangeable. These findings suggest that we should enhance continuity, not just access.

Patients with low health literacy may reveal trust in a number of ways. One extreme is blind faith in the expertise of the provider, and another is mistrust and suspicion. One study found that blind trust in physicians was stronger in patients who were older, perceived their prognosis to be uncertain, or sometimes of low SES. Trust in the healthcare system tends to be lower among racial minorities, due to a history of unethical treatment. Could race moderate the relationship between SES and trust? Can these two extremes be reconciled, or even coexist in a single patient?

Read Part II here.