433 research outputs found
Sketches from outside the margins, 2016-2018 : Stories from Seattle/King County Clinic
No full textThe Seattle/King County Clinic brings together healthcare organizations, civic agencies, non-profits, private businesses and volunteers from across the State of Washington to produce a giant free health clinic in KeyArena at the Seattle Center. The four-day volunteer-driven clinic provides a full range of free dental, vision and medical care to underserved and vulnerable populations in the region. Local cartoonists gathered stories from patients about the reasons they sought healthcare there. The comics they created from these stories offer intimate and often touching accounts of what it's like to negotiate the healthcare system as a person in need. Sketches from Outside the Margins is a collection of these storie
New Life Wellness Clinic for the Homeless Community
No full textPurpose/Aims: The overall purpose of this project is to improve the effectiveness of an existing nursing clinic that serves the homeless community in the Seattle metropolitan area. The specific aims are to: (1) Conduct a literature review to critically analyze unique health care needs and experiences of the homeless, and to 2) review best practice for foot care; (3) Describe and analyze clinic services in regards to safety, efficiency, effectiveness of delivery, as well as address dignity and psychosocial aspects of care; and (4) Create a handbook for volunteers to safely administer care, and provide community referrals, as well and for clients to perform self-care. Background/Problem: An annual point estimate of homeless persons in King County, Washington, at the One Night Count January 2010 was 8,937 individuals. In Seattle, there are not enough shelters or services to accommodate the homeless population. Since 1999, the Seattle First Presbyterian Church has operated a weekly shelter for 50 men. Since 2009, it has also supported a volunteer nursing clinic during evening hours at the shelter. Using donated supplies, volunteer nurses and nursing students provide foot care, health assessments, and wound care, and also distribute basic over-the-counter medications, vitamins, and supplements. Based on the author\u27s two years of experiences at this clinic, the services provided by volunteer nurses are essential to teaching preventative care and they encourage patients to voice concerns to ease their mental stress about health issues. In this manner small health concerns are addressed before they become chronic health problems. Clients vote with their feet for these services, and many return every week. Significance: The men served by the clinic will benefit from the critical analysis of existing needs and services. This project is designed to create improved resources for volunteers as well as to improve care through evidence-based practice guidelines. By focusing on wellness, hygiene, and education, the overall goal of the clinic is to improve health outcomes for a target group of homeless individuals. The results of this project can serve as a guide for others to replicate the care model in other facilities for the homeless
Characterizing Sociodemographic, Behavioral Correlates, and Trends in Reported Gender Identity Among Non-binary/genderqueer Patients at Public Health – Seattle and King County Sexual Health Clinic
No full textThesis (Master's)--University of Washington, 2024Title: Characterizing Sociodemographic and Behavioral Correlates and Trends in Reported Gender Identity Among Non-binary/genderqueer Patients at Public Health – Seattle and King County Sexual Health Clinic Background: Non-binary/genderqueer (NB/GQ) individuals are a distinct but understudied population within the LGBTQ+ community. We sought to characterize sociodemographic behaviors and STI outcomes for NB/GQ patients attending the Sexual Health Clinic (SHC) and examine how gender identity among SHC patients has evolved over time. Methods: We used Public Health Seattle-King County (PHSKC) SHC data from 2016-2023 to examine temporal changes in gender identity. We compared sociodemographic characteristics among cisgender (men and women), transgender, and NB/GQ patients using chi-squared tests to determine statistical significance. We used generalized estimating equations to compare the prevalence of syphilis, urogenital gonorrhea, rectal chlamydia, methamphetamine use, and non-prescribed injection drug use in NB/GQ patients to that in both cisgender men who have sex with men (MSM) and transgender patients. Results: Of 82,384 visits between 2016-2023, 1672 (2.0%), 867 (1.1%), and 79,845 (96.9%) were among NB/GQ, transgender, and cisgender patients, respectively. The proportion of visits among NB/GQ and transgender patients increased over time, from 0.7% to 3.5% and 0.7% to 1.7%, respectively (p-trend<0.001). NB/GQ identity was more frequent among patients assigned female vs. male sex at birth (3.2% vs 1.8%, P<0.001), younger vs older patients (14-25 years: 3.1% vs 46+: 0.2%, p<0.001), and patients reporting White (2.3%) vs Black (1.0%) race (p<0.001). We found no significant differences in injectable drug and methamphetamine use across NB/GQ, cisgender MSM, and transgender patients. In models adjusted for age, sex assigned at birth, race, ethnicity, insurance, and housing status, we observed a marginally lower prevalence of syphilis among NB/GQ patients compared to cisgender MSM, with an adjusted prevalence ratio (aPR) of 0.98 (95% CI: 0.97-0.99). Additionally, we observed a lower prevalence of rectal chlamydia infection and urogenital gonorrhea infection among NG/GQ patients compared to cisgender MSM. For rectal chlamydia, the aPR was 0.40 (95% CI: 0.19, 0.82), and for urogenital gonorrhea, the aPR was 0.35 (95% CI: 0.16, 0.77). STI outcomes did not differ between NB/GQ and transgender patients. Conclusion: Given the rapidly increasing gender diversity among clinic attendees, our findings indicate that NB/GQ patients exhibited a lower prevalence of bacterial STIs, such as syphilis, rectal chlamydia, and urogenital gonorrhea, compared to cisgender MSM. This underscores the need for continued monitoring of behaviors and STI outcomes in distinct gender-diverse groups. Such data is imperative to tailor STI and HIV prevention strategies appropriately
Evaluation of Household Water Quality in King George County, Virginia, January-February 2009
No full textIn January and February of 2009, 69 residents of King George County participated in a drinking water clinic sponsored by the local Virginia Cooperative Extension (VCE) office and the Virginia Household Water Quality Program
Sexually transmitted infection risk exposure among black and minority ethnic youth in northwest London: findings from a study translating a sexually transmitted infection risk-reduction intervention to the UK setting.
No full textOBJECTIVES: Young black women are disproportionately affected by sexually transmitted infections (STI) in the UK, but effective interventions to address this are lacking. The Young Brent Project explored the nature and context of sexual risk-taking in young people to inform the translation of an effective clinic-based STI reduction intervention (Project SAFE) from the USA to the UK. METHODS: One-to-one in-depth interviews (n = 37) and group discussions (n = 10) were conducted among men and women aged 15-27 years from different ethnic backgrounds recruited from youth and genitourinary medicine clinic settings in Brent, London. The interviews explored the context within which STI-related risks were assessed, experienced and avoided, the skills needed to recognise risk and the barriers to behaviour change. RESULTS: Concurrent sexual partnerships, mismatched perceptions and expectations, and barriers to condom use contributed to STI risk exposure and difficulties in implementing risk-reduction strategies. Women attempted to achieve monogamy, but experienced complex and fluid sexual relationships. Low risk awareness, flawed partner risk assessments, negative perceptions of condoms and lack of control hindered condom use. Whereas men made conscious decisions, women experienced persuasion, deceit and difficulty in requesting condom use, particularly with older partners. CONCLUSIONS: Knowledge of STI and condom use skills is not enough to equip young people with the means to reduce STI risk. Interventions with young women need to place greater emphasis on: entering and maintaining healthy relationships; awareness of risks attached to different forms of concurrency and how concurrency arises; skills to redress power imbalances and building self-esteem
The need for innovative sexually transmitted infection screening initiatives for young men: evidence from genitourinary medicine clinics across England.
No full textThe study objectives were to ascertain behavioural, access-related, health-seeking factors and sexually transmitted infection (STI) prevalence in young men (<25 years) attending genitourinary (GU) medicine clinics and compare them with older men (≥ 25 years) and young women (<25 years). Between October 2004 and March 2005, 4600 new attendees at seven sociodemographically and geographically contrasting GU medicine clinics across England completed questionnaires, which were linked to routine clinical data. Young men waited significantly less time to be seen in clinic compared with older men and young women. They were less likely to report symptoms than older men (P = 0.021) yet more likely to be diagnosed with chlamydia (P = 0.001) and gonorrhoea (P = 0.007). They were also more likely to be diagnosed with an acute STI relative to young women (P = 0.007). Our data confirm the need to make comprehensive STI screening readily available for young men and to develop effective and innovative screening strategies in different settings
Signs Ready To Boost Okfuskee Clinic On Cattle
No full textPhotograph taken for a story in the Oklahoma Times newspaper. Caption: "Okfuskee county livestock producers are planning the first livestock marketing clinic for the county in October .
Medication for Opioid Use Disorder in a Community Mental Health Clinic
Full text linkBackground: Over 100,000 people died from opioid-related overdoses in the United States in 2023. People experiencing homelessness (PEH) are at especially high risk of co-occurring mental illness and substance use disorder, and face added barriers to accessing medical and psychiatric care. Buprenorphine is a life-saving medication used to treat opioid use disorder (OUD).
Objective: This project assessed the feasibility of altering prescribing practices at a community mental health clinic in King County, Washington to incorporate medication for opioid use disorder (MOUD) into standard clinic procedures.
Methods: This project was a mixed-methods, formative evaluation that assessed the need for and barriers to implementing MOUD at the community mental health clinic.
Results: Between 13-22% of patients at the clinic are diagnosed with OUD. The main barriers to implementation included staffing and reimbursement. Administrative and clinical staff recognize the need for and support implementation of MOUD.
Conclusions: It is possible to overcome administrative barriers to support psychiatric NPs who are willing and able to prescribe MOUD.
Implications for Nursing: Organization change is a complex and collaborative process. Nurse practitioners are well-suited to advocate for and spearhead change within their practice sites to increase patients’ access to medical care
Barriers to Lead Screening Among Pediatric Providers in King County, WA
No full textThesis (Master's)--University of Washington, 2019Pediatric care guidelines recommend assessment of children for lead exposure during routine child care in the first two years of life. In Washington State, pediatric lead screening rates are among the lowest in the nation. This investigation sought to describe pediatric lead screening practices and barriers in King County, WA. King County providers were invited to complete a web-based survey regarding their lead screening practices between October 2018 and April 2019. Follow up semi-structured interviews (SSI) were conducted with 13 volunteer respondents. Respondents were characterized as high versus low screeners based on responses. Reported knowledge, practice, and barriers were compared for the two groups. Grounded theory methodology was used to identify provider attitudes and practices from SSIs. 246 providers who saw patients under the age of 6 years participated in the survey. Sixty six percent agreed or strongly agreed with the statement “Primary care for all children aged 12 to 24 months in King County should include a lead exposure history,” while only 39% reported always conducting a lead exposure history at least once during early childhood visits. Lower frequency screeners were more likely to report uncertainty about when to perform an exposure history and when to order a blood lead test. They were also more likely to report lack of a clinic system or policy to prompt them to conduct an exposure history. SSIs revealed a large variety in practices and barriers between clinics, suggesting that it will require a number of strategies to increase lead screening rates in King County. Strategies to improve lead screening rates in this community should include provider education on recommended screening practice, promoting standardized clinic policies, and working to partner with other early childhood development initiatives to promote lead screening, such as building collaborations with Early Head Start programs
Saying "Yes" to PrEP: Examining PrEP acceptance among urban men who have sex with men (MSM) at a Seattle public sexual health clinic.
No full textThesis (Master's)--University of Washington, 2025Pre-exposure prophylaxis (PrEP) is extremely effective at preventing HIV, but uptake has been below targets. PrEP acceptance and uptake are commonly examined through hypothetical acceptability and active use, but the act of accepting a PrEP recommendation from a clinical provider is under-studied. This cross-sectional study used patient survey data and health records from the Public Health—Seattle & King County Sexual Health Clinic in Seattle, WA to examine how PrEP acceptance differed by key covariates among men who have sex with men (MSM). Among 1721 patient visits where a provider recommended PrEP to an MSM, PrEP was accepted at 1168 (68%) visits. Prevalence of PrEP acceptance was lower among patients aged 25 years or older compared to patients under age 25 (PR = 0.92, 95% CI = 0.85, 0.99) and higher among patients who reported greater numbers of recent sexual partners compared to those reporting one or fewer (PR = 1.38 95% CI = 1.13-1.68), but was lower among Black patients compared to White patients (61%, PR = 0.85, 95% CI = 0.76-0.96) and patients identifying as bisexual compared to those identifying as gay (PR = 0.84, 95% CI = 0.75-0.93). According to visit notes recorded by providers, patients who declined commonly believed their risk of HIV exposure was too low to warrant daily PrEP, were concerned about side effects, or preferred to discuss with their primary care provider, while some preferred to abstain from sex altogether following the HIV/STI exposure which brought them to the clinic. To increase PrEP uptake, future work should identify and test strategies to maximally support some MSM who have an indication for but less often accept PrEP
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