Although psychological interventions can be used to improve chronic pain management, underserved individuals (i.e., racially minoritized and socioeconomically disadvantaged) may be less likely to engage in such services. The purpose of this study was to examine whether offering a psychological intervention for chronic pain in a primary care clinic could be a method in which to successfully engage underserved patients.

There were 220 patients with chronic pain in a primary care clinic located in a socioeconomically and racially diverse city who were approached to discuss enrolment in a pilot randomized controlled trial of a five-session psychological intervention for chronic pain. Patients were introduced to the study by their primary care provider using the warm handoff model. We compared whether there were sociodemographic differences between those who enrolled in the study and those who declined to enrol.

There were no differences between those who enrolled and those who declined enrolment with regard to race, age, insurance type, and household income. However, females were more likely to enrol in the study compared to males.

Recruiting patients to participate in a trial of a psychological intervention for chronic pain in a primary care clinic appeared to be effective for engaging Black patients, patients with lower income, and those with government insurance. Thus, offering a psychological intervention for chronic pain in a primary care clinic may encourage engagement among racially minoritized individuals and those with lower socioeconomic status.

With the ongoing expansion of palliative care services throughout the United States, meeting the needs of socioeconomically marginalized populations, as in all domains of healthcare, continues to be a challenge. Our specific aim here was to help meet some of these needs through expanding delivery of pain and palliative care services by establishing a new clinic for underserved patients and collecting descriptive data about its operation.

In November of 2014, the National Institutes of Health Clinical Center's Pain and Palliative Care Service (PPCS) launched a bimonthly offsite pain and palliative care outpatient clinic in collaboration with Mobile Medical Care Inc. (MobileMed), a private not-for-profit primary care provider in Montgomery County, Maryland, serving underserved area residents since 1968. Staffed by NIH hospice and palliative medicine clinical fellows and faculty, the clinic provides specialty pain and palliative care consultation services to patients referred by their primary care healthcare providers. A patient log was maintained, charts reviewed, and referring providers surveyed on their satisfaction with the service.

The clinic had 27 patient encounters with 10 patients (6 males, 4 females, aged 23–67) during its first 7 months of operation. The reason for referral for all but one patient was chronic pain of multiple etiologies. Patients had numerous psychosocial stressors and comorbidities. All primary care providers who returned surveys (n = 4) rated their level of satisfaction with the consultation service as “very satisfied” or “extremely satisfied.”

This brief descriptive report outlines the steps taken and logistical issues addressed to launch and continue the clinic, the characteristics of patients treated, and the results of quality-improvement projects. Lessons learned are highlighted and future directions suggested for the clinic and others that may come along like it.

The emphasis in school nutrition policy has been on vending and competitive items. Our study was designed to characterize and quantify the amount and source of other foods and beverages on school campuses.

A cross-sectional observational study was conducted using a specially designed objective nutrition observation system.

One low-income school district in southern California with six elementary and two middle schools.

Data were not collected from individual children. A total of 4033 students, 42 % of whom were Hispanic/Latino, 26 % African American and 21 % non-Hispanic white, were observed across school settings.

Data were collected continuously from 9 January 2008 to 16 June 2010. Healthy foods had, per serving, total energy ≤732 kJ (≤175 kcal), total fat content ≤35 %, total saturated fat ≤10 %, sugar less ≤15 g, sodium <200 mg and trans-fat ≤0·5 g. Healthy beverages were only 100 % juice or water, and unflavoured non-fat, 1 %, 2 % milk and soya or rice milk. The system had high inter-rater reliability (r = 0·78 to 0·99), percentage agreement (83 % to 100 %) and test–retest reliability (r = 0·81 to 0·98). Significantly more unhealthy foods and beverages than healthy items were observed on all campuses (P < 0·001). An average of 1·26 (sd 0·46) items per student per week was found with an average of 0·86 (sd 0·34) unhealthy items per child per week.

There were substantial amounts of unhealthy foods and beverages brought onto campuses for classroom rewards, celebrations and fundraising that should be targeted for intervention.