Topics in Community Health and Ambulatory Care: Past and Present

We are pleased to share our latest JACM issue: "Topics in Community Health and Ambulatory Care: Past and Present." This quarter's issue comes at a celebratory time for JACM, as we've received our first-ever impact factor: 2.3. The receipt of this impact factor is a testament to decades of work from former editors, especially Norbert Goldfield, from authors, from editorial board members, and from journal reviewers, all of whom have made important contributions to the journal in supporting its success. To commemorate this impact, in this issue, we highlight 3 important articles that have stood out in their metrics of success during the Journal's tenure to date.

First, in 2007, Mosen et al published an article, titled "Is Patient Activation Associated With Outcomes of Care for Adults With Chronic Conditions?" which stands as JACM's top-cited article of all time. In this article, the authors found that, among adults with chronic conditions, the patient activation measure (PAM)-a patient-reported assessment of patient personal knowledge, skill, and confidence in managing their own health care-was positively associated with key process and health outcome measures such as self-management behaviors, medication adherence, patient satisfaction, quality of life, and physical and mental functional status. Since publication, this article has been cited 588 times, including by many highly influential articles in the field.

Second, also in 2007, Shi and Stevens explored "The Role of Community Health Centers [CHCs] in Delivering Primary Care to the Underserved: Experiences of the Uninsured and Medicaid Insured," which stands among JACM's top-cited CHC-focused articles. Using 2002 data, these authors were among the first ever to show the critical role of US CHCs in delivering accessible, high-quality care to patient populations who would otherwise lack it. They also found that even within CHC populations, having Medicaid coverage (vs no insurance) was still an important factor in maximizing care experience and outcomes. In the 2 decades that have since passed, CHCs remain more important than ever in the delivery of primary care, now serving about 2.5 times as many patients, many of whom have since gained Medicaid coverage (Health Resources and Services Administration, 2023).

Third, Brownstein et al's 2011 article, titled "Community Health Workers [CHWs] "101" for Primary Care Providers and Other Stakeholders in Health Care Systems," is among JACM's top-cited CHW-focused articles. Although written more than a decade ago, this article still provides a valuable starting point for understanding CHW core roles and competencies (see more at http://c3project.org) and exploring examples of CHWs in ambulatory care settings. The authors also make a case for the importance of CHWs in interprofessional teams. Finally, it sheds light on developments across the United States that led to the establishment of the National CHW Association (http://nachw.org), now serving as a unifying voice for the CHW field.

All 3 of these "top" articles have been republished in this issue as Editor's picks and are temporarily accessible at no cost.

Finally, we are pleased to share 4 new articles in this issue, which cover topics at the intersections of ambulatory care management and community health. Hill et al describe pediatric burnout rates among different types of providers at CHCs, finding that primary care providers report higher rates of emotional exhaustion than behavioral health clinicians and CHWs. Reinschmidt et al developed and evaluated a promising "train the trainer" curriculum for CHWs, which trains CHWs to address dementia in culturally appropriate ways. Miller et al find that, through an "Engage to Sustain" intervention, shifting patient screening responsibilities from physicians and advanced practitioners to licensed practical nurses (LPNs) and certified medical assistants (CMAs) improved screening rates for depression, fall risk, and tobacco use and counseling. Finally, Keister et al explore the use of the "Appointment Pathways" tool for outpatient care at Mayo Clinic, where Pathways is used in yield management to anticipate patients' future appointments and to provide insights into staffing needs based on anticipated demand.

We hope you enjoy exploring the articles in this issue, old and new, that share the measurement tools and methods, the data, and the stories that are driving innovation in community health and ambulatory care settings. We also recognize the importance of the health workforce in enhancing and sustaining excellence across these settings.

-Megan B. Cole Brahim, PhD, MPH

-E. Lee Rosenthal, PhD, MS, MPH

Co-Editors

-Durrell J. Fox, BS, CHW

Deputy-Editor

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