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When people must flee their homes due to persecution or conflict, they embark on a journey from loss toward safety that is a global concern and the resettlement country's responsibility. Refugees experience stressors as they secure basic needs such as adequate nutrition, healthcare, transportation, housing, education, and income-generating activities. For refugee women, these stressors are further exacerbated by gender-related roles and experiences. Addressing the unique healthcare needs of refugee women is vital to their well-being as they resettle into life in the United States. Access to care that is provided with cultural humility and fosters trust is critical. Policies are needed that expand health literacy programs and interpreting services, grow, diversify, and train the physical healthcare workforce, grow and diversify the mental healthcare workforce, expand Medicaid coverage in all 50 states, develop and fund peer-to-peer education programs for refugee women, finance access to care and programmatic services, and expand federal funding toward refugee health research., Competing Interests: Declaration of Competing Interest The authors declare no conflicts of interest., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objective: To understand rural older farmers' perspectives and attitudes toward skin cancer risk and prevention., Design and Sample: This study used a grounded theory approach and semi-structured interviews with 12 rural older farmers (farm owners, farmworkers ages 50 years or older) in Washington. Participants' perspectives were explored relative to Health Belief Model constructs. Inductive and deductive analyses were used to generate relevant themes. COREQ guidelines were followed., Results: The findings fit well and extended the Health Belief Model, which was used to arrange key themes identified in relation to skin cancer risk and prevention, specifically participants' perceived barriers to accessing primary care and protection when outdoors, perceived benefits of sun-protective behaviors, perceived hereditary susceptibility to skin cancer, perceived severity of the increased skin cancer risk, and cues to action for skin checks. A new construct of hope was identified to emphasize the importance of establishing emotional, instrumental, and informational support systems for promoting skin cancer prevention. Participants also indicated their hope of raising awareness of skin cancer prevention among all ages., Conclusions: Findings highlighted the importance of integrating skin cancer prevention services for rural older farmers and across the lifespan. Public health approaches are needed to enhance the awareness of and access to preventive care in these underserved populations., (© 2024 Wiley Periodicals LLC.)

Background: Advance care planning (ACP) is the process of having conversations with patients to ensure preferences are known and support patient healthcare goals. ACP and the Age-Friendly Health Systems (AFHS) Initiative's, "What Matters," are synergistic approaches to patient-centered conversations. Implementation and measurement of ACP in primary care (PC) are variables in quality and consistency. We examined whether participation in an ACP learning collaborative (LC) would improve knowledge and ability to conduct ACP discussions and increase the frequency of documented ACP in participating practices., Methods: The WWAMI (Washington, Wyoming, Alaska, Montana, and Idaho) region Practice and Research Network (WPRN) and the Northwest Geriatrics Workforce Enhancement Center collaboratively organized a 9-month virtual LC. It consisted of 4 synchronous, 1.5-h sessions, technical support, and a panel of ACP experts. A Wilcoxon rank sum test assessed differences in knowledge from a pre-post survey. Documentation of ACP in the EHR was collected after at least one plan-do-study-act cycle., Results: We enrolled 17 participants from 6 PC practices (3 hospital-affiliated; 3 Federally Qualified Health Centers) from the WPRN. Two practices did not complete all LC activities. There was a trend toward increased ACP knowledge and skills overall especially in having discussions patients and families (pre-mean 2.9 [SD = 0.7]/post-mean 4.0[SD = 1.1], p < 0.05). 4/6 practices observed an increase in EHR documentation post-collaborative (median 16.3%, IQR 1.3%-36.9%)., Conclusions: The LC increased PC providers knowledge and skills of ACP and AFHS's What Matters, reported ACP EHR documentation, and contributed to practice change., (© 2024 The Author(s). Journal of the American Geriatrics Society published by Wiley Periodicals LLC on behalf of The American Geriatrics Society.)