BACKGROUND: Health care-based food assistance programs show promise but are underutilized. Strict eligibility requirements and program scheduling may dampen reach and outcomes.
OBJECTIVE: To explore factors associated with uptake of a health center-based mobile produce market with no eligibility requirements and few barriers to entry.
METHODS: A cross-sectional analysis of medical record, sociodemographic, environmental, and market attendance data was used.
METHODS: The study sample consisted of 3071 adults (18+ years) who were patients of an urban health center in eastern Massachusetts and registered for the mobile market during the study period of August 2016 to February 2020.
METHODS: The main outcome measure was monthly market attendance over the study period.
METHODS: T-tests and χ2 tests were used to compare market users and never-users. Multiple logistic regression was used to analyze variables associated with market attendance each month.
RESULTS: In multiple variable analyses, Supplemental Nutrition Assistance Program enrollment was associated with slightly less frequent monthly market use (odds ratio [OR], 0.989; 95% CI, 0.984-0.994). Day-of, on-site market registration was associated with more frequent monthly use than self-registration on nonmarket days (OR, 1.08; 95% CI, 1.07-1.08). Having a psychiatric or substance use disorder diagnosis was associated with slightly less frequent market attendance (OR, 0.99; 95% CI, 0.98-0.99; and OR, 0.96; 95% CI, 0.95-0.97, respectively) compared with registrants without these diagnoses.
CONCLUSIONS: Individual, community-level, and organizational factors are associated with uptake of a free mobile produce market and should be considered when designing programs.

Federally Qualified Health Centers are charged with providing comprehensive health care in traditionally underserved areas, underscoring their importance in caring for and promoting health equity for the large portion of historically marginalized communities in this setting. There is a significant need to ensure Federally Qualified Health Centers are equipped to appropriately address the immense behavioral health needs common among patients served. Care coordination is an evidence-based model that is increasingly utilized in Federally Qualified Health Centers to improve care equity and outcomes. Addressing and supporting behavioral health needs is a key aspect of such care coordination models. Context-specific considerations and programmatic supports, particularly those that address the needs of care coordinators and the complex patients they serve, are needed to ensure such models can appropriately meet and address the behavioral health concerns of the diverse populations served. The goal of this study was to present a mixed-methods case study that systematically applies implementation frameworks to conduct a needs and context assessment to inform the development and testing of evidence-based practice strategies and implementation support as part of a care coordination program within a partnered Federally Qualified Health Center.

UNASSIGNED: Chronic unreduced shoulder dislocations (CUSDs) are rare with a prevalence of 0.10-0.18%, usually occurring after car crashes, falls, assaults, getting out of bed, and seizures. Management is often open reduction and fixation. Most cases have been reported in countries with inadequate resources and access to care often leading to misdiagnosis and poor management. We report a case of a patient with a CUSD presenting to a chiropractor within a federally qualified health center (FQHC).
UNASSIGNED: A 55-year-old, Spanish-speaking, uninsured, female was referred from her primary care provider to a chiropractor within a FQHC with right shoulder pain and reduced range of motion. The patient reported two incidences of right shoulder dislocation, the first being a closed reduction 1 year before presentation and the second occurring 5 months before presentation without any management. Radiographs demonstrated an unreduced right anterior shoulder dislocation. The patient was referred to an orthopedist who treats patients on a sliding scale according to their income.
UNASSIGNED: Because the patient was uninsured and did not have the necessary financial resources, she was unable to receive a shoulder reduction. These barriers often contribute to the misdiagnosis and increase morbidity associated with this pathology. Exercise therapy was not advised out of concern for further structural damage and neurovascular compromise. The recommended management is with topical pain creams and corticosteroid injections as directed by their primary care. Clinicians working with this population should be aware of the diagnosis, both typical and urgent features, complications, and the standard of care in this condition.

The Collaborative Care (CC) model of integrated care is an evidence-based, systematic approach in which primary care and behavioral health teams work together to deliver effective treatment for depression and other common mental illnesses in primary care settings. Because people experiencing homelessness have high rates of chronic medical conditions, mental illness and substance use disorders, interventions that integrate the physical, mental and social determinants of health have been shown to be effective to provide healthcare for this population in primary care outpatient settings. In this article we describe the implementation of a collaborative care program to treat depression in a population of adults experiencing homelessness and receiving primary care in a Federally Qualified Health Center (FQHC) located in Downtown Miami, Florida. We present three case studies that highlight key concepts, potential benefits and limitations in using this model to treat patients experiencing depression and homelessness in urban areas.