UNC Family Medicine

Please note the hours of operation for the Martin Luther King, Jr. Holiday on Monday, January 20th, for The UNC Family Medicine Centers at Chapel Hill, Carraway Village, Durham, and South Durham. We look forward to spending the holiday in reflection and service.

Chineme Enyioha, MD, MPH, and colleagues recently published a study in BMC Public Health focused on developing effective communication strategies to support health warning labels (HWLs) on little cigars and cigarillos (LCCs), which are increasingly popular among young adults, especially in Black communities. With nearly 9 million adults in the U.S. using cigars, targeted health communication is essential to address the significant health risks associated with LCCs. The study identified four types of messages for the HWLs: explanatory, testimonial, inquisitive, and recommendation. Online focus groups with young LCC users (ages 18-25) revealed key insights: 1. Credibility: Factual, unbiased messages from health professionals were seen as most trustworthy, prompting participants to consider the health risks of LCC use. 2. Personal Relevance: Messages that included personal experiences engaged participants emotionally, motivating them to reflect on their tobacco use. 3. New Information: There was a strong preference for messages that highlighted lesser-known health risks, such as links to esophageal and colon cancers, indicating a need for fresh and impactful content. 4. Tone and Language: Participants favored straightforward, neutral language over coercive messaging, emphasizing the need for authentic communication that empowers informed choices. These findings suggest the importance of credible and relatable messaging in health campaigns, especially for young adults. Tailored strategies can significantly enhance public understanding of LCC risks and promote healthier choices. The department's UNC Tobacco Prevention and Evaluation Program colleagues Sonia Clark, MHA; Kristen Jarman, MSPH; and Adam Goldstein, MD, MPH; former UNC undergraduate student Remi Philips; former UNC graduate student Selena Kleber, MPH; and University of South Carolina’s James F. Thrasher, PhD, MA, MS, contributed to the study. Read more: https://lnkd.in/e4Ar2MqS

*WINTER WEATHER UPDATE* We are expecting inclement weather this afternoon (Friday, January 10th). To keep everyone safe, we will close our clinics at The UNC Family Medicine Centers at Chapel Hill, Carraway Village, Durham, and South Durham at 3:00PM. The UNC Family Medicine Center at Chapel Hill will open its Saturday, January 11th same-day clinic at 10:00AM. We hope everyone stays safe and warm!

Michael Baca-Atlas, MD, was featured on ABC11 WTVD-TV, discussing the significance of recent research linking weight loss medications and drug addiction. Recent studies suggest that medications like Ozempic, originally for type 2 diabetes and weight loss, may also help people with addiction. Published in the journal Addiction and Psychiatry, the research found that those on Ozempic or similar GLP-1 medications had a 50% lower rate of binge drinking and a 40% lower rate of opioid overdoses. These medications mimic hormones that regulate blood sugar and create a sense of satisfaction, potentially reducing cravings for addictive substances. "I think this is something for primary care clinicians as well as specialists to kind of be mindful of, to see that this could be something that emerges and makes a really significant impact. I can't understate the value of our community support networks, groups that are out there supporting individuals. I think that (weight loss medications to treat addiction) would sort of be one additional thing that could really help, but I cannot overstate the importance of our therapists in the community or mutual support groups like AA," Baca-Atlas states, adding, "These are really critical for folks that are either working on recovery or in recovery themselves for a long time. And again, this would just be maybe one other thing that we could add, that could really help to slow down the severity of someone's substance use and their substance use disorder. But definitely something I'm paying attention to." Baca-Atlas highlighted the need for further research to fully understand Ozempic or similar GLP-1 medications' potential for addiction treatment, with several clinical trials underway. His expertise working at the intersection of physical and mental health, addiction, and caring for underserved populations in NC serves as his motivation to see these outpatient services enhanced statewide. He is Medical Director of UNC REACH Enhanced Primary Care, a practice that serves the basic primary care needs of people with Severe Mental Illness, which our faculty help operate along with the UNC Department of Psychiatry. He is also involved in the UNC Family Medicine Residency Training in Mental and Behavioral Health program, training future doctors to serve at these intersections of care. Read & watch: go.unc.edu/WLD-Addiction

Emily Hawes, PharmD, deputy director of the University of North Carolina-based Rural Residency Planning and Development Technical Assistance Center (RuralGME), was featured in Rural Health Information Hub discussing RuralGME's collaborative work in increasing the rural health workforce. In October 2023, the Bureau of Healthcare Workforce (BHW) projected a 6% physician shortage in metro areas and a 56% shortage in rural America by 2036. Historically, rural areas have always faced physician shortages. Graduate Medical Education (GME) funding through Medicare and Medicaid initially benefited urban hospitals, leading to a concentration of training programs in cities. This urban focus overshadowed the need for rural physician distribution. In response, the "rural training track" (RTT) was developed in the mid-1980s, combining urban and rural training to address this imbalance. By 2015, only 1% of physician trainees were in rural areas, highlighting the challenges of starting rural training programs due to high costs. However, new research emphasized the importance of retaining rural trainees. Congressional support in 2018 led to the establishment of a rural residency planning and development technical assistance center, providing funding and support for new rural GME residencies starting in 2019. Hawes emphasized the effectiveness of the previous efforts by others to expand GME. "It's important to acknowledge that the success of our RRPD cohorts is due to previous decades of work by many rural stakeholders, GME educators, and Congressional and federal agency representatives," she said. "It was their collaboration, their tenacity, their research, and the stories of these pioneers in rural place-based education that allowed this program to make the needed difference for our rural physician workforce." RuralGME was launched by UNC Family Medicine in 2018, providing overall program leadership and houses the Eastern Hub. The grant that awarded UNC as the main hub was due in large part to our partnership with Piedmont Health Services Inc (PHS), a stellar Federally Qualified Health Center (FQHC) where our faculty and "FQHC Track" residents learn and care for patients.

Researchers from UNC Family Medicine - Professor Leah Ranney, PhD, MA, Assistant Professor Sarah D. Kowitt, PhD, MPH, and authors Sonia A. Clark, MHA, and Kristen L. Jarman, MSPH, have published a pivotal study in a special issue of the American Journal of Public Health. The study, titled “Regulatory Landscape of Cannabis Warning Labels in US States with Legal Retail Nonmedical Cannabis,” with first-author Caroline J. Meek, MPH, who was a student in the UNC Gillings School of Global Public Health at the time of this study, provides a comprehensive analysis of the current state of cannabis warning label regulations across the United States. The research reveals significant inconsistencies in the content and design of these labels. Notably, only 10% of states require warnings about mental health risks and high-potency products. There are no mandates for placing warnings on the front of packages, and only 20% of states encourage the use of contrasting colors for visibility. The labels often suffer from being overly wordy and vague and lack standardized font sizes, which can diminish their effectiveness. The findings suggest a pressing need for standardized, clear warning labels to better inform consumers about the risks of cannabis use, stressing the importance of prioritizing public health as cannabis legalization expands and highlighting the need for accessible information about potential harms. Overall, this research aims to inform policy decisions and improve public health and safety through better labeling practices. Read more: https://lnkd.in/eYUhS_ja

In September, Zhanè Washington (pictured right in 1st photo), a third-year medical student at UNC Chapel Hill, along with the support of Nailah Adams Morancie, MD, MS, CAQSM, FAAFP (pictured left), Assistant Professor in the Department of Family Medicine and Director of the UNC Primary Care Sports Medicine Fellowship, hosted "Sports Medicine Invitational," an on-campus mentoring event. Members of the girls’ basketball team from Southern School for Energy and Sustainability (Durham) were treated to an afternoon of immersion into various aspects of Sports Medicine. Accompanied by their coach and Physical Education teacher, Megan McDonald, the girls were taught simulated joint injections at the state-of-the-art Simulation, Experiential Learning, and Training (SET) Center at the University of North Carolina at Chapel Hill School of Medicine's Roper Hall. The athletes were then taken on a campus tour, which ended at the Carolina Club, where they had dinner and conversation with women leaders at UNC, including Dr. Shannelle Campbell (Surgery), Dr. Deidra Charity (Physical Therapy), Nina Walker (Associate Head Athletic Trainer), Symone Lyles (Athletics Mental Health Counselor), Briana Singleton (Assistant Director of Student-Athlete Development), and Dr. Adams. Team USA 400m sprinter Jada Griffin served as the guest of honor and inspired the girls with her incredible journey through balancing academics and elite athletics. Washington commented, "This event reminded me that It is never too early to start thinking about the type of person you want to be in the future. Not just a career; but the impact you want to have on those you are honored to connect with and what that looks like. For me, that answer was to become a physician and I hope this event allowed some of the athletes to feel that way too." The program was graciously funded by an Agostini Medical Student Community Outreach Grant from the American Medical Society for Sports Medicine, which Washington won in April 2024, with Dr. Adams serving as her faculty mentor.

The UNC Center for Health Equity Research (CHER) recently recognized assistant professor Ben Kaplan, MD, MPH, and resident Emma Tayloe, MD, for their impactful work as alumni of the Community Research Summer Program (CRSP). This program, which operated from 2016 to 2019, provided UNC School of Medicine students with hands-on opportunities to engage in community-based research aimed at enhancing health outcomes in North Carolina. CHER plans to relaunch the CRSP program soon. In 2016, Kaplan received a CRSP award to conduct a Photovoice project centered on patients with complex care needs. This work addressed the challenges faced by individuals with multiple chronic conditions and socioeconomic barriers, influencing his decision to become a family doctor. The project highlighted the cycle of emergency room visits experienced by these patients, often without meaningful health improvements. Now a faculty member, Kaplan emphasizes the importance of clinical research and community engagement. He is involved in LGBTQ+ health advocacy and collaborates with local organizations. His career in primary care, teaching, research, and mentorship is deeply informed by the experiences and skills gained during his CRSP fellowship. Tayloe, a resident in our Federally Qualified Health Center (FQHC) Track at Piedmont Health Services Inc's Prospect Hill Community Health Center, previously worked at a non-profit clinic in Charlotte, assisting uninsured patients with financial assistance applications. This role revealed the challenges these patients face and underscored the importance of support systems for healthcare access. As a medical student at UNC, she evaluated the effectiveness of UNC’s financial assistance program. With support from Dr. Gaurav Dave, Dr. Sue Estroff, and her classmate Meera Nagaraj, she initiated a student-led research project. With guidance from CHER faculty, Tayloe conducted interviews and is currently drafting a publication. This project has significantly developed her skills in project management, qualitative research, and health equity advocacy. Read more: go.unc.edu/Kaplan-reflects go.unc.edu/Tayloe-reflects

Amy Denham, MD, MPH, penned a moving reflection in Annals of Family Medicine on the complexities of caring for medically and psychosocially vulnerable patients. Denham shares the story of “Ervin,” a 70-year-old man with multiple chronic conditions and intellectual disabilities. Over five years at the Piedmont Health Services Inc program PACE (Program of All-Inclusive Care for the Elderly), Denham and her team navigated the challenges of Ervin's care, highlighting the ethical dilemmas faced when a patient lacks decision-making capacity without family support. Ervin's experience underscores the need for alternative care models that prioritize human connection and team-based approaches over traditional fee-for-service models. Despite being medically complex, Ervin was independently living until his condition deteriorated, leading to hospitalization for a pulmonary embolism and subsequent complications. Denham emphasizes the importance of implementing robust social safety nets to prevent the medicalization of social issues, advocating for a healthcare system that addresses broader social needs. Ultimately, Ervin's journey illustrates the deep relationships formed in caregiving, as health professionals became his family during his final moments, reinforcing the idea that compassion and connection are at the heart of healthcare. https://lnkd.in/g9eg7wua

Thanksgiving and the winter holidays are right around the corner! Here are the holiday hours for The UNC Family Medicine Centers at Chapel Hill, Carraway Village, Durham (Mayfair St.), & South Durham (Fayetteville Rd.). We wish everyone a happy and safe holiday season!