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Promising Practices that show evidence of effectiveness in improving public health outcomes in a specific real-life setting, as indicated by achievement of aims consistent with the objectives of the activities, and are suitable for adaptation by other communities.
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Case Study
This article summarizes COVID-19 harm reduction approaches taken by a family medicine/OBGYN residency program serving rural, western North Carolina for patients with an opioid use disorder. To meet patient needs, low acuity patients were offered telehealth options and digital prescriptions for buprenorphine/naloxone. For higher acuity patients, in=person visits were maintained and the risk/benefits were weighed on a continuous basis.
Emerging Practices that show potential to achieve desirable public health outcomes in a specific real-life setting and produce early results that are consistent with the objectives of the activities and thus indicate effectiveness.
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Case Study
This article summarizes the lessons learned from implementing telehealth in rural environments over the past 3 years and how to expand these efforts in the context of COVID-19. The needs of elderly populations in rural environments are also addressed. It provides 5 strategies for implementing telehealth in this context: (1) Preparation and Training; 2) Standardize and Expedite Credentialing; (3) Technology; (4) Broadband; and (5) Feedback and Rapid Improvement.
Best Practices that show evidence of effectiveness in improving public health outcomes when implemented in multiple real-life settings, as indicated by achievement of aims consistent with the objectives of the activities.
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Peer Review Study
This multidisciplinary vaccine delivery strategy was implemented by the Puget Sound Veterans Affairs (VA) facility to mitigate inequities in COVID-19 vaccination among veterans. The practice, which followed the Equitable Vaccine Framework, was put in place in the VA Puget Sound Health Care System and entailed targeted outreach to individual patients based on a score consisting of the sum of risk factors for severe COVID-19 disease and high-risk race or ethnicity. The strategy included four main domains: allocation, outreach, delivery, and monitoring. The care system conducted sequential outreach using multiple communication modalities, worked with community partners to publicize and deploy mobile clinics to underserved areas, and monitored vaccination coverage rates by age, race, sex, and rural status at prespecified intervals and adjusted operations to ensure equity. During the vaccine drive, vaccination rates were higher among Black, multiracial, and Hispanic veterans, compared with white veterans.