{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T15:53:54Z","timestamp":1786982034098,"version":"build-2736575974"},"reference-count":92,"publisher":"Springer Science and Business Media LLC","issue":"12","license":[{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T00:00:00Z","timestamp":1733961600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/100000026","name":"National Institute on Drug Abuse","doi-asserted-by":"publisher","award":["R34DA057160"],"award-info":[{"award-number":["R34DA057160"]}],"id":[{"id":"10.13039\/100000026","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J GEN INTERN MED"],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Rural communities have been significantly affected by opioid use disorder (OUD) and related harms but have less access to evidence-based medications for opioid use disorder (MOUD), such as buprenorphine. Given the shortage of specialists in these areas, rural primary care is an important setting to expand buprenorphine access, but implementation is limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To explore implementation climate factors that support or hinder buprenorphine implementation in rural primary care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>A qualitative study design using in-depth interviews.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Primary care physicians, nurse practitioners (NPs), and physician associates (PAs) practicing in rural Ohio counties.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Approach<\/jats:title>\n                    <jats:p>Between December 2022 and March 2023, we interviewed participants about their perspectives on buprenorphine prescribing, including using rural primary care as an implementation setting for buprenorphine. Using a deductive, framework-based approach, codes were grouped based on the Consolidated Framework for Implementation Research (CFIR) inner setting factors that contribute to a positive implementation climate for an intervention.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Key Results<\/jats:title>\n                    <jats:p>Three implementation climate constructs emerged as decision points for whether to implement buprenorphine in rural primary care: (1) relative priority: the extent to which OUD treatment should be prioritized over other chronic diseases; (2) compatibility: whether buprenorphine prescribing protocols are compatible with the rural primary care setting; (3) tension for change: the extent to which current buprenorphine access shortages in rural communities can be tolerated. Participants expressed mixed perspectives on whether the implementation climate in rural primary care currently supports buprenorphine prescribing.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Implementation strategies targeted toward the implementation climate are critical to support buprenorphine prescribing in rural primary care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1007\/s11606-024-09260-1","type":"journal-article","created":{"date-parts":[[2024,12,12]],"date-time":"2024-12-12T15:49:15Z","timestamp":1734018555000},"page":"2879-2889","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":5,"title":["The Implementation Climate for Integrating Buprenorphine Prescribing into Rural Primary Care"],"prefix":"10.1007","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7150-5810","authenticated-orcid":false,"given":"Cheyenne","family":"Fenstemaker","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth A.","family":"Abrams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"King","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benjamin","family":"Obringer","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel L.","family":"Brook","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vivian","family":"Go","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C.","family":"Miller","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lindsay Y.","family":"Dhanani","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Berkeley","family":"Franz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,12,12]]},"reference":[{"key":"9260_CR1","unstructured":"Drug Overdose in Rural America as a Public Health Issue | Rural Health | CDC. https:\/\/www.cdc.gov\/rural-health\/php\/public-health-strategy\/public-health-considerations-for-drug-overdose-in-rural-america.html. Accessed 11 September 2024."},{"issue":"1","key":"9260_CR2","doi-asserted-by":"publisher","first-page":"38","DOI":"10.1186\/S13722-022-00322-5\/TABLES\/4","volume":"17","author":"RA Jenkins","year":"2022","unstructured":"Jenkins RA, Whitney BM, Nance RM, et al. The rural opioid initiative consortium description: providing evidence to Understand the Fourth Wave of the Opioid Crisis. Addict Sci Clin Pract. 2022;17(1):38. https:\/\/doi.org\/10.1186\/S13722-022-00322-5\/TABLES\/4","journal-title":"Addict Sci Clin Pract."},{"issue":"7","key":"9260_CR3","doi-asserted-by":"publisher","first-page":"2341","DOI":"10.1007\/S10461-012-0371-2","volume":"17","author":"AM Young","year":"2013","unstructured":"Young AM, Jonas AB, Mullins UL, Halgin DS, Havens JR. Network structure and the risk for HIV transmission among rural drug users. AIDS Behav. 2013;17(7):2341. https:\/\/doi.org\/10.1007\/S10461-012-0371-2","journal-title":"AIDS Behav."},{"key":"9260_CR4","unstructured":"Department of Health U, Services H, for Disease Control C, et al. Managing HIV and Hepatitis C Outbreaks Among People Who Inject Drugs\u2014A Guide for State and Local Health Departments. March 2018, Version 1.0. Published online 2018."},{"key":"9260_CR5","unstructured":"Increases in Hepatitis C Virus Infection Related to Injection Drug Use Among Persons Aged \u226430 Years \u2014 Kentucky, Tennessee, Virginia, and West Virginia, 2006\u20132012. https:\/\/www.cdc.gov\/mmwr\/preview\/mmwrhtml\/mm6417a2.htm. Accessed 29 January 2024."},{"issue":"5","key":"9260_CR6","doi-asserted-by":"publisher","first-page":"788","DOI":"10.1111\/1475-6773.13694","volume":"56","author":"KEM Miller","year":"2021","unstructured":"Miller KEM, Miller KL, Knocke K, Pink GH, Holmes GM, Kaufman BG. Access to outpatient services in rural communities changes after hospital closure. Health Serv Res. 2021;56(5):788. https:\/\/doi.org\/10.1111\/1475-6773.13694","journal-title":"Health Serv Res."},{"issue":"2","key":"9260_CR7","doi-asserted-by":"publisher","first-page":"188","DOI":"10.1016\/j.jval.2020.08.2098","volume":"24","author":"S Amiri","year":"2021","unstructured":"Amiri S, McDonell MG, Denney JT, Buchwald D, Amram O. Disparities in Access to Opioid Treatment Programs and Office-Based Buprenorphine Treatment Across the Rural-Urban and Area Deprivation Continua: A US Nationwide Small Area Analysis. Value Health. 2021;24(2):188-195. https:\/\/doi.org\/10.1016\/j.jval.2020.08.2098","journal-title":"Value Health."},{"issue":"8","key":"9260_CR8","doi-asserted-by":"publisher","first-page":"e2014045","DOI":"10.1001\/JAMANETWORKOPEN.2020.14045","volume":"3","author":"A Duncan","year":"2020","unstructured":"Duncan A, Anderman J, Deseran T, Reynolds I, Stein BD. Monthly Patient Volumes of Buprenorphine-Waivered Clinicians in the US. JAMA Netw Open. 2020;3(8):e2014045-e2014045. https:\/\/doi.org\/10.1001\/JAMANETWORKOPEN.2020.14045","journal-title":"JAMA Netw Open."},{"issue":"6","key":"9260_CR9","doi-asserted-by":"publisher","first-page":"S208","DOI":"10.1016\/J.AMEPRE.2018.02.006","volume":"54","author":"CHA Andrilla","year":"2018","unstructured":"Andrilla CHA, Coulthard C, Patterson DG. Prescribing Practices of Rural Physicians Waivered to Prescribe Buprenorphine. Am J Prev Med. 2018;54(6):S208-S214. https:\/\/doi.org\/10.1016\/J.AMEPRE.2018.02.006","journal-title":"Am J Prev Med."},{"issue":"1","key":"9260_CR10","doi-asserted-by":"publisher","first-page":"102","DOI":"10.1111\/JRH.12178","volume":"33","author":"KA Hirchak","year":"2017","unstructured":"Hirchak KA, Murphy SM. Assessing Differences in the Availability of Opioid Addiction Therapy Options: Rural Versus Urban and American Indian Reservation Versus Non-Reservation. J Rural Health. 2017;33(1):102. https:\/\/doi.org\/10.1111\/JRH.12178","journal-title":"J Rural Health."},{"issue":"6","key":"9260_CR11","doi-asserted-by":"publisher","first-page":"1028","DOI":"10.1377\/HLTHAFF.2014.1205","volume":"34","author":"AW Dick","year":"2015","unstructured":"Dick AW, Pacula RL, Gordon AJ, et al. Growth In Buprenorphine Waivers For Physicians Increased Potential Access To Opioid Agonist Treatment, 2002-11. Health Aff (Millwood). 2015;34(6):1028-1034. https:\/\/doi.org\/10.1377\/HLTHAFF.2014.1205","journal-title":"Health Aff (Millwood)."},{"key":"9260_CR12","doi-asserted-by":"publisher","first-page":"107968","DOI":"10.1016\/J.DRUGALCDEP.2020.107968","volume":"211","author":"PJ Joudrey","year":"2020","unstructured":"Joudrey PJ, Chadi N, Roy P, et al. Pharmacy-based methadone dispensing and drive time to methadone treatment in five states within the United States: A cross-sectional study. Drug Alcohol Depend. 2020;211:107968. https:\/\/doi.org\/10.1016\/J.DRUGALCDEP.2020.107968","journal-title":"Drug Alcohol Depend."},{"key":"9260_CR13","doi-asserted-by":"publisher","unstructured":"Rosenblum A, Cleland CM, Fong C, Kayman DJ, Tempalski B, Parrino M. Distance traveled and cross-state commuting to opioid treatment programs in the United States. J Environ Public Health. 2011;2011. https:\/\/doi.org\/10.1155\/2011\/948789","DOI":"10.1155\/2011\/948789"},{"key":"9260_CR14","unstructured":"Removal of DATA Waiver (X-Waiver) Requirement | SAMHSA. https:\/\/www.samhsa.gov\/medications-substance-use-disorders\/removal-data-waiver-requirement. Accessed 11 April 2023."},{"key":"9260_CR15","doi-asserted-by":"publisher","unstructured":"Roy PJ, Suda K, Luo J, et al. Buprenorphine dispensing before and after the April 2021 X-Waiver exemptions: An interrupted time series analysis. Int J Drug Policy. 2024;126. https:\/\/doi.org\/10.1016\/J.DRUGPO.2024.104381","DOI":"10.1016\/J.DRUGPO.2024.104381"},{"key":"9260_CR16","doi-asserted-by":"publisher","unstructured":"Cloutier RM, Cole ES, McDonough BL, et al. Strategies to recruit rural primary care providers to implement a medication for opioid use disorder (MOUD) focused integrated care model. Implement Res Pract. 2023;4. https:\/\/doi.org\/10.1177\/26334895231152808\/ASSET\/IMAGES\/LARGE\/10.1177_26334895231152808-FIG1.JPEG","DOI":"10.1177\/26334895231152808\/ASSET\/IMAGES\/LARGE\/10.1177_26334895231152808-FIG1.JPEG"},{"issue":"2","key":"9260_CR17","doi-asserted-by":"publisher","first-page":"152","DOI":"10.1111\/AJAD.13260","volume":"31","author":"AJ Gordon","year":"2022","unstructured":"Gordon AJ, Kenny M, Dungan M, et al. Are x-waiver trainings enough? Facilitators and barriers to buprenorphine prescribing after x-waiver trainings. Am J Addict. 2022;31(2):152-158. https:\/\/doi.org\/10.1111\/AJAD.13260","journal-title":"Am J Addict."},{"issue":"1","key":"9260_CR18","doi-asserted-by":"publisher","first-page":"23","DOI":"10.1370\/AFM.1735","volume":"13","author":"RA Rosenblatt","year":"2015","unstructured":"Rosenblatt RA, Andrilla CHA, Catlin M, Larson EH. Geographic and specialty distribution of US physicians trained to treat opioid use disorder. Ann Fam Med. 2015;13(1):23-26. https:\/\/doi.org\/10.1370\/AFM.1735","journal-title":"Ann Fam Med."},{"issue":"5","key":"9260_CR19","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1007\/S11920-020-01149-0\/METRICS","volume":"22","author":"JH Donroe","year":"2020","unstructured":"Donroe JH, Bhatraju EP, Tsui JI, Edelman EJ. Identification and Management of Opioid Use Disorder in Primary Care: an Update. Curr Psychiatry Rep. 2020;22(5):1-11. https:\/\/doi.org\/10.1007\/S11920-020-01149-0\/METRICS","journal-title":"Curr Psychiatry Rep."},{"issue":"4","key":"9260_CR20","doi-asserted-by":"publisher","first-page":"494","DOI":"10.1177\/15598276221111047","volume":"17","author":"L Nakaishi","year":"2023","unstructured":"Nakaishi L, Sugden SG, Merlo G. Primary Care at the Intersection of Lifestyle Interventions and Unhealthy Substance Use. Am J Lifestyle Med. 2023;17(4):494. https:\/\/doi.org\/10.1177\/15598276221111047","journal-title":"Am J Lifestyle Med."},{"key":"9260_CR21","unstructured":"Rep. Connolly GE [D V 11]. H.R.2617 - 117th Congress (2021\u20132022): Consolidated Appropriations Act, 2023. Published online 2022. https:\/\/www.congress.gov\/bill\/117th-congress\/house-bill\/2617. Accessed 10 September 2024."},{"issue":"2","key":"9260_CR22","doi-asserted-by":"publisher","first-page":"160","DOI":"10.7326\/M19-3975","volume":"173","author":"EE McGinty","year":"2020","unstructured":"McGinty EE, Stone EM, Kennedy-Hendricks A, Bachhuber MA, Barry CL. Medication for Opioid Use Disorder: A National Survey of Primary Care Physicians. Ann Intern Med. 2020;173(2):160. https:\/\/doi.org\/10.7326\/M19-3975","journal-title":"Ann Intern Med."},{"key":"9260_CR23","doi-asserted-by":"publisher","unstructured":"Gregory HM, Hill VM, Parker RW. Implications of Increased Access to Buprenorphine for Medical Providers in Rural Areas: A Review of the Literature and Future Directions. Cureus. 2021;13(11). https:\/\/doi.org\/10.7759\/CUREUS.19870","DOI":"10.7759\/CUREUS.19870"},{"issue":"1","key":"9260_CR24","doi-asserted-by":"publisher","first-page":"2399316","DOI":"10.1080\/07853890.2024.2399316","volume":"56","author":"H Piscalko","year":"2024","unstructured":"Piscalko H, D Brook, Trent Hall O, et al. Knowledge of Medications for Opioid Use Disorder and Associated Stigma among Primary Care Professionals. Ann Med. 2024;56(1):2399316.","journal-title":"Ann Med."},{"issue":"3","key":"9260_CR25","doi-asserted-by":"publisher","first-page":"389","DOI":"10.1177\/00220426221076800","volume":"52","author":"G Victor","year":"2022","unstructured":"Victor G, Lee G, Pozo B del, et al. Medications for Opioid Use Disorder in the Criminal\/Legal System: Knowledge, Beliefs, and Attitudes Among Rural Community-Based Stakeholders. J Drug Issues. 2022;52(3):389-405. https:\/\/doi.org\/10.1177\/00220426221076800","journal-title":"J Drug Issues"},{"issue":"1","key":"9260_CR26","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/S13722-023-00386-X\/TABLES\/3","volume":"18","author":"A Jakubowski","year":"2023","unstructured":"Jakubowski A, Singh-Tan S, Torres-Lockhart K, et al. Hospital-based clinicians lack knowledge and comfort in initiating medications for opioid use disorder: opportunities for training innovation. Addict Sci Clin Pract. 2023;18(1):1-12. https:\/\/doi.org\/10.1186\/S13722-023-00386-X\/TABLES\/3","journal-title":"Addict Sci Clin Pract."},{"key":"9260_CR27","doi-asserted-by":"publisher","first-page":"110873","DOI":"10.1016\/J.DRUGALCDEP.2023.110873","volume":"249","author":"H Judd","year":"2023","unstructured":"Judd H, Yaugher AC, O\u2019Shay S, Meier CL. Understanding stigma through the lived experiences of people with opioid use disorder. Drug Alcohol Depend. 2023;249:110873. https:\/\/doi.org\/10.1016\/J.DRUGALCDEP.2023.110873","journal-title":"Drug Alcohol Depend."},{"issue":"8","key":"9260_CR28","doi-asserted-by":"publisher","first-page":"1332","DOI":"10.1080\/10826084.2022.2079133","volume":"57","author":"R Garett","year":"2022","unstructured":"Garett R, Young SD. The Role of Misinformation and Stigma in Opioid Use Disorder Treatment Uptake. Subst Use Misuse. 2022;57(8):1332-1336. https:\/\/doi.org\/10.1080\/10826084.2022.2079133","journal-title":"Subst Use Misuse."},{"issue":"11","key":"9260_CR29","doi-asserted-by":"publisher","first-page":"e1002969","DOI":"10.1371\/JOURNAL.PMED.1002969","volume":"16","author":"AC Tsai","year":"2019","unstructured":"Tsai AC, Kiang M V., Barnett ML, et al. Stigma as a fundamental hindrance to the United States opioid overdose crisis response. PLoS Med. 2019;16(11):e1002969. https:\/\/doi.org\/10.1371\/JOURNAL.PMED.1002969","journal-title":"PLoS Med."},{"issue":"4","key":"9260_CR30","doi-asserted-by":"publisher","first-page":"459","DOI":"10.1080\/08897077.2019.1640833","volume":"40","author":"B Allen","year":"2019","unstructured":"Allen B, Nolan ML, Paone D. Underutilization of medications to treat opioid use disorder: What role does stigma play? Subst Abus. 2019;40(4):459-465. https:\/\/doi.org\/10.1080\/08897077.2019.1640833","journal-title":"Subst Abus."},{"issue":"4","key":"9260_CR31","doi-asserted-by":"publisher","first-page":"466","DOI":"10.1080\/08897077.2021.1901172","volume":"42","author":"LY Dhanani","year":"2021","unstructured":"Dhanani LY, Franz B. Attitudes Toward and Experiences Working with Patients who Misuse Opioids among Board Certified Physicians in Ohio. Subst Abus. 2021;42(4):466-470. https:\/\/doi.org\/10.1080\/08897077.2021.1901172","journal-title":"Subst Abus."},{"issue":"1","key":"9260_CR32","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/S13012-022-01245-0","volume":"17","author":"LJ Damschroder","year":"2022","unstructured":"Damschroder LJ, Reardon CM, Widerquist MAO, Lowery J. The updated Consolidated Framework for Implementation Research based on user feedback. Implement Sci. 2022;17(1):1-16. https:\/\/doi.org\/10.1186\/S13012-022-01245-0","journal-title":"Implement Sci."},{"issue":"4","key":"9260_CR33","doi-asserted-by":"publisher","first-page":"439","DOI":"10.1007\/S11414-020-09706-4","volume":"47","author":"N Jacobson","year":"2020","unstructured":"Jacobson N, Horst J, Wilcox-Warren L, et al. Organizational Facilitators and Barriers to Medication for Opioid Use Disorder Capacity Expansion and Use. J Behav Health Serv Res. 2020;47(4):439. https:\/\/doi.org\/10.1007\/S11414-020-09706-4","journal-title":"J Behav Health Serv Res."},{"issue":"4","key":"9260_CR34","doi-asserted-by":"publisher","first-page":"359","DOI":"10.1370\/AFM.2099","volume":"15","author":"CHA Andrilla","year":"2017","unstructured":"Andrilla CHA, Coulthard C, Larson EH. Barriers Rural Physicians Face Prescribing Buprenorphine for Opioid Use Disorder. Ann Fam Med. 2017;15(4):359. https:\/\/doi.org\/10.1370\/AFM.2099","journal-title":"Ann Fam Med."},{"issue":"6","key":"9260_CR35","doi-asserted-by":"publisher","first-page":"1176","DOI":"10.1377\/HLTHAFF.2011.0278","volume":"30","author":"S Arora","year":"2011","unstructured":"Arora S, Kalishman S, Dion D, et al. Partnering Urban Academic Medical Centers And Rural Primary Care Clinicians To Provide Complex Chronic Disease Care. Health Aff (Millwood). 2011;30(6):1176-1184. https:\/\/doi.org\/10.1377\/HLTHAFF.2011.0278","journal-title":"Health Aff (Millwood)."},{"key":"9260_CR36","doi-asserted-by":"publisher","unstructured":"Klein KJ. The Challenge of Implementation. Article in Academy of Management Review. Published online 1996. https:\/\/doi.org\/10.5465\/AMR.1996.9704071863","DOI":"10.5465\/AMR.1996.9704071863"},{"issue":"1","key":"9260_CR37","doi-asserted-by":"publisher","first-page":"157","DOI":"10.1186\/S13012-014-0157-1\/TABLES\/7","volume":"9","author":"MG Ehrhart","year":"2014","unstructured":"Ehrhart MG, Aarons GA, Farahnak LR. Assessing the organizational context for EBP implementation: the development and validity testing of the Implementation Climate Scale (ICS). Implement Sci. 2014;9(1):157. https:\/\/doi.org\/10.1186\/S13012-014-0157-1\/TABLES\/7","journal-title":"Implement Sci."},{"issue":"1","key":"9260_CR38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/S12875-019-1047-Z\/PEER-REVIEW","volume":"20","author":"DL Louie","year":"2019","unstructured":"Louie DL, Assefa MT, McGovern MP. Attitudes of primary care physicians toward prescribing buprenorphine: A narrative review. BMC Fam Pract. 2019;20(1):1-8. https:\/\/doi.org\/10.1186\/S12875-019-1047-Z\/PEER-REVIEW","journal-title":"BMC Fam Pract."},{"issue":"1","key":"9260_CR39","doi-asserted-by":"publisher","first-page":"222","DOI":"10.1080\/08897077.2021.1931633\/ASSET\/IMAGES\/LARGE\/10.1080_08897077.2021.1931633-FIG3.JPEG","volume":"43","author":"JB Anderson","year":"2022","unstructured":"Anderson JB, Martin SA, Gadomski A, et al. Project ECHO and primary care buprenorphine treatment for opioid use disorder: Implementation and clinical outcomes. Subst Abus. 2022;43(1):222-230. https:\/\/doi.org\/10.1080\/08897077.2021.1931633\/ASSET\/IMAGES\/LARGE\/10.1080_08897077.2021.1931633-FIG3.JPEG","journal-title":"Subst Abus."},{"issue":"1","key":"9260_CR40","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1370\/AFM.2757","volume":"20","author":"L Zittleman","year":"2022","unstructured":"Zittleman L, Curcija K, Nease DE, et al. Increasing Capacity for Treatment of Opioid Use Disorder in Rural Primary Care Practices. Ann Fam Med. 2022;20(1):18. https:\/\/doi.org\/10.1370\/AFM.2757","journal-title":"Ann Fam Med."},{"key":"9260_CR41","doi-asserted-by":"publisher","DOI":"10.1111\/1475-6773.14346","author":"JJ Wyse","year":"2024","unstructured":"Wyse JJ, Mackey K, Kauzlarich KA, et al. Improving access to buprenorphine for rural veterans in a learning health care system. Health Serv Res. Published online 2024. https:\/\/doi.org\/10.1111\/1475-6773.14346","journal-title":"Health Serv Res. Published online"},{"issue":"1","key":"9260_CR42","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/S13722-019-0154-4\/TABLES\/2","volume":"14","author":"G Cochran","year":"2019","unstructured":"Cochran G, Cole ES, Warwick J, et al. Rural access to MAT in Pennsylvania (RAMP): a hybrid implementation study protocol for medication assisted treatment adoption among rural primary care providers. Addict Sci Clin Pract. 2019;14(1):25. https:\/\/doi.org\/10.1186\/S13722-019-0154-4\/TABLES\/2","journal-title":"Addict Sci Clin Pract."},{"issue":"1","key":"9260_CR43","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1748-5908-6-78\/FIGURES\/1","volume":"6","author":"BJ Weiner","year":"2011","unstructured":"Weiner BJ, Belden CM, Bergmire DM, Johnston M. The meaning and measurement of implementation climate. Implement Sci. 2011;6(1):1-12. https:\/\/doi.org\/10.1186\/1748-5908-6-78\/FIGURES\/1","journal-title":"Implement Sci."},{"issue":"1","key":"9260_CR44","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1111\/JRH.12328","volume":"35","author":"CHA Andrilla","year":"2019","unstructured":"Andrilla CHA, Moore TE, Patterson DG. Overcoming Barriers to Prescribing Buprenorphine for the Treatment of Opioid Use Disorder: Recommendations from Rural Physicians. J Rural Health. 2019;35(1):113-121. https:\/\/doi.org\/10.1111\/JRH.12328","journal-title":"J Rural Health."},{"key":"9260_CR45","doi-asserted-by":"publisher","first-page":"102704","DOI":"10.1016\/J.DRUGPO.2020.102704","volume":"85","author":"EL Richard","year":"2020","unstructured":"Richard EL, Schalkoff CA, Piscalko HM, et al. \u201cYou are not clean until you\u2019re not on anything\u201d: Perceptions of medication-assisted treatment in rural Appalachia. Int J Drug Policy. 2020;85:102704. https:\/\/doi.org\/10.1016\/J.DRUGPO.2020.102704","journal-title":"Int J Drug Policy."},{"issue":"1","key":"9260_CR46","doi-asserted-by":"publisher","first-page":"148","DOI":"10.1214\/AOMS\/1177705148","volume":"32","author":"LA Goodman","year":"1961","unstructured":"Goodman LA. Snowball Sampling. Ann Math Stat. 1961;32(1):148-170. https:\/\/doi.org\/10.1214\/AOMS\/1177705148","journal-title":"Ann Math Stat"},{"key":"9260_CR47","unstructured":"Charmaz K. Constructing Grounded Theory: A practical guide through Qualitative. Published online 2014:379."},{"issue":"1","key":"9260_CR48","doi-asserted-by":"publisher","first-page":"129","DOI":"10.4300\/JGME-D-16-00693.1","volume":"9","author":"C Watling","year":"2017","unstructured":"Watling C, Cristancho S, Wright S, Varpio L. Necessary Groundwork: Planning a Strong Grounded Theory Study. J Grad Med Educ. 2017;9(1):129. https:\/\/doi.org\/10.4300\/JGME-D-16-00693.1","journal-title":"J Grad Med Educ."},{"issue":"4","key":"9260_CR49","doi-asserted-by":"publisher","first-page":"1893","DOI":"10.1007\/S11135-017-0574-8","volume":"52","author":"B Saunders","year":"2018","unstructured":"Saunders B, Sim J, Kingstone T, et al. Saturation in qualitative research: exploring its conceptualization and operationalization. Qual Quant. 2018;52(4):1893. https:\/\/doi.org\/10.1007\/S11135-017-0574-8","journal-title":"Qual Quant."},{"key":"9260_CR50","unstructured":"Appendix Userguide | Dedoose. https:\/\/www.dedoose.com\/userguide\/appendix. Accessed 10 September 2023."},{"issue":"1","key":"9260_CR51","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1471-2288-13-117\/METRICS","volume":"13","author":"NK Gale","year":"2013","unstructured":"Gale NK, Heath G, Cameron E, Rashid S, Redwood S. Using the framework method for the analysis of qualitative data in multi-disciplinary health research. BMC Med Res Methodol. 2013;13(1):1-8. https:\/\/doi.org\/10.1186\/1471-2288-13-117\/METRICS","journal-title":"BMC Med Res Methodol."},{"key":"9260_CR52","unstructured":"Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups | EQUATOR Network. https:\/\/www.equator-network.org\/reporting-guidelines\/coreq\/. Accessed 2 April 2024."},{"key":"9260_CR53","unstructured":"Ohio Rural Health Improvement Plan - Ohio Rural Health Association. https:\/\/www.ohioruralhealth.org\/ohio-rural-health-improvement-plan. Accessed 26 February 2024."},{"key":"9260_CR54","unstructured":"Bliss Institute: \u2019The Five Ohios\u2019\u202f: The University of Akron, Ohio. Accessed September 11, 2024. https:\/\/www.uakron.edu\/bliss\/research\/biop-2-the-five-ohios.dot"},{"key":"9260_CR55","doi-asserted-by":"publisher","unstructured":"Louie DL, Assefa MT, McGovern MP. Attitudes of primary care physicians toward prescribing buprenorphine: a narrative review. BMC Fam Pract. 2019;20(1). https:\/\/doi.org\/10.1186\/S12875-019-1047-Z","DOI":"10.1186\/S12875-019-1047-Z"},{"issue":"3","key":"9260_CR56","doi-asserted-by":"publisher","first-page":"273","DOI":"10.1080\/00952990.2019.1694536","volume":"46","author":"JJ Lister","year":"2020","unstructured":"Lister JJ, Weaver A, Ellis JD, Himle JA, Ledgerwood DM. A systematic review of rural-specific barriers to medication treatment for opioid use disorder in the United States. Am J Drug Alcohol Abuse. 2020;46(3):273-288. https:\/\/doi.org\/10.1080\/00952990.2019.1694536","journal-title":"Am J Drug Alcohol Abuse."},{"issue":"2","key":"9260_CR57","doi-asserted-by":"publisher","first-page":"128","DOI":"10.1370\/AFM.1595","volume":"12","author":"E Hutchinson","year":"2014","unstructured":"Hutchinson E, Catlin M, Andrilla CHA, Baldwin LM, Rosenblatt RA. Barriers to Primary Care Physicians Prescribing Buprenorphine. Ann Fam Med. 2014;12(2):128-133. https:\/\/doi.org\/10.1370\/AFM.1595","journal-title":"Ann Fam Med."},{"key":"9260_CR58","doi-asserted-by":"publisher","unstructured":"Lai B, Croghan I, Ebbert JO. Buprenorphine Waiver Attitudes Among Primary Care Providers. J Prim Care Community Health. 2022;13. https:\/\/doi.org\/10.1177\/21501319221112272","DOI":"10.1177\/21501319221112272"},{"key":"9260_CR59","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1016\/J.DRUGALCDEP.2016.05.010","volume":"165","author":"A Kennedy-Hendricks","year":"2016","unstructured":"Kennedy-Hendricks A, Busch SH, McGinty EE, et al. Primary care physicians\u2019 perspectives on the prescription opioid epidemic. Drug Alcohol Depend. 2016;165:61-70. https:\/\/doi.org\/10.1016\/J.DRUGALCDEP.2016.05.010","journal-title":"Drug Alcohol Depend."},{"issue":"1","key":"9260_CR60","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1056\/NEJMP1802741\/SUPPL_FILE\/NEJMP1802741_DISCLOSURES.PDF","volume":"379","author":"SE Wakeman","year":"2018","unstructured":"Wakeman SE, Barnett ML. Primary Care and the Opioid-Overdose Crisis \u2014 Buprenorphine Myths and Realities. N Engl J Med. 2018;379(1):1-4. https:\/\/doi.org\/10.1056\/NEJMP1802741\/SUPPL_FILE\/NEJMP1802741_DISCLOSURES.PDF","journal-title":"N Engl J Med."},{"key":"9260_CR61","doi-asserted-by":"publisher","unstructured":"Harder VS, Villanti AC, Heil SH, et al. Opioid use disorder treatment in rural settings: The primary care perspective. Prev Med (Baltim). 2021;152(Pt 2). https:\/\/doi.org\/10.1016\/J.YPMED.2021.106765","DOI":"10.1016\/J.YPMED.2021.106765"},{"issue":"5","key":"9260_CR62","doi-asserted-by":"publisher","first-page":"425","DOI":"10.1017\/CTS.2019.448","volume":"4","author":"ML Parchman","year":"2020","unstructured":"Parchman ML, Ike B, Osterhage KP, Baldwin LM, Stephens KA, Sutton S. Barriers and facilitators to implementing changes in opioid prescribing in rural primary care clinics. J Clin Transl Sci. 2020;4(5):425-430. https:\/\/doi.org\/10.1017\/CTS.2019.448","journal-title":"J Clin Transl Sci."},{"key":"9260_CR63","doi-asserted-by":"publisher","first-page":"209133","DOI":"10.1016\/J.JOSAT.2023.209133","volume":"154","author":"NC Bridges","year":"2023","unstructured":"Bridges NC, Taber R, Foulds AL, et al. Medications for opioid use disorder in rural primary care practices: Patient and provider experiences. J Subst Use Addict Treat. 2023;154:209133. https:\/\/doi.org\/10.1016\/J.JOSAT.2023.209133","journal-title":"J Subst Use Addict Treat."},{"issue":"1","key":"9260_CR64","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/S13012-019-0900-8\/TABLES\/5","volume":"14","author":"JE Squires","year":"2019","unstructured":"Squires JE, Aloisio LD, Grimshaw JM, et al. Attributes of context relevant to healthcare professionals\u2019 use of research evidence in clinical practice: A multi-study analysis. Implement Sci. 2019;14(1):1-14. https:\/\/doi.org\/10.1186\/S13012-019-0900-8\/TABLES\/5","journal-title":"Implement Sci."},{"issue":"1","key":"9260_CR65","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/S12875-019-1047-Z\/PEER-REVIEW","volume":"20","author":"DL Louie","year":"2019","unstructured":"Louie DL, Assefa MT, McGovern MP. Attitudes of primary care physicians toward prescribing buprenorphine: A narrative review. BMC Fam Pract. 2019;20(1):1-8. https:\/\/doi.org\/10.1186\/S12875-019-1047-Z\/PEER-REVIEW","journal-title":"BMC Fam Pract."},{"issue":"2","key":"9260_CR66","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1111\/JRH.12404","volume":"36","author":"CHA Andrilla","year":"2020","unstructured":"Andrilla CHA, Jones KC, Patterson DG. Prescribing Practices of Nurse Practitioners and Physician Assistants Waivered to Prescribe Buprenorphine and the Barriers They Experience Prescribing Buprenorphine. J Rural Health. 2020;36(2):187-195. https:\/\/doi.org\/10.1111\/JRH.12404","journal-title":"J Rural Health."},{"key":"9260_CR67","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/J.JSAT.2017.04.005","volume":"78","author":"AS Huhn","year":"2017","unstructured":"Huhn AS, Dunn KE. Why aren\u2019t physicians prescribing more buprenorphine? J Subst Abuse Treat. 2017;78:1-7. https:\/\/doi.org\/10.1016\/J.JSAT.2017.04.005","journal-title":"J Subst Abuse Treat."},{"issue":"7","key":"9260_CR68","doi-asserted-by":"publisher","first-page":"e2420837","DOI":"10.1001\/JAMANETWORKOPEN.2024.20837","volume":"7","author":"M Campopiano Von Klimo","year":"2024","unstructured":"Campopiano Von Klimo M, Nolan L, Corbin M, et al. Physician Reluctance to Intervene in Addiction: A Systematic Review. JAMA Netw Open. 2024;7(7):e2420837-e2420837. https:\/\/doi.org\/10.1001\/JAMANETWORKOPEN.2024.20837","journal-title":"JAMA Netw Open."},{"issue":"2","key":"9260_CR69","doi-asserted-by":"publisher","first-page":"55","DOI":"10.1097\/ADM.0B013E318166AF74","volume":"2","author":"R Saitz","year":"2008","unstructured":"Saitz R, Larson MJ, Labelle C, Richardson J, Samet JH. The Case for Chronic Disease Management for Addiction. J Addict Med. 2008;2(2):55. https:\/\/doi.org\/10.1097\/ADM.0B013E318166AF74","journal-title":"J Addict Med."},{"key":"9260_CR70","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jsat.2015.06.024","volume":"58","author":"RL DuPont","year":"2015","unstructured":"DuPont RL, Compton WM, McLellan AT. Five-Year Recovery: A New Standard for Assessing Effectiveness of Substance Use Disorder Treatment. J Subst Abuse Treat. 2015;58:1-5. https:\/\/doi.org\/10.1016\/j.jsat.2015.06.024","journal-title":"J Subst Abuse Treat."},{"key":"9260_CR71","unstructured":"What is the Definition of Addiction? https:\/\/www.asam.org\/quality-care\/definition-of-addiction. Accessed 16 April 2024."},{"key":"9260_CR72","doi-asserted-by":"publisher","unstructured":"Des Jarlais DC. Harm reduction in the USA: the research perspective and an archive to David Purchase. Harm Reduct J. 2017;14(1). https:\/\/doi.org\/10.1186\/S12954-017-0178-6","DOI":"10.1186\/S12954-017-0178-6"},{"issue":"6","key":"9260_CR73","doi-asserted-by":"publisher","first-page":"779","DOI":"10.1016\/0306-4603(96)00042-1","volume":"21","author":"GA Marlatt","year":"1996","unstructured":"Marlatt GA. Harm reduction: Come as you are. Addict Behav. 1996;21(6):779-788. https:\/\/doi.org\/10.1016\/0306-4603(96)00042-1","journal-title":"Addict Behav."},{"key":"9260_CR74","doi-asserted-by":"publisher","first-page":"103080","DOI":"10.1016\/J.DRUGPO.2020.103080","volume":"90","author":"E Childs","year":"2021","unstructured":"Childs E, Biello KB, Valente PK, et al. Implementing harm reduction in non-urban communities affected by opioids and polysubstance use: A qualitative study exploring challenges and mitigating strategies. Int J Drug Policy. 2021;90:103080. https:\/\/doi.org\/10.1016\/J.DRUGPO.2020.103080","journal-title":"Int J Drug Policy."},{"key":"9260_CR75","doi-asserted-by":"publisher","first-page":"3299","DOI":"10.2147\/JPR.S231948","volume":"12","author":"JV Pergolizzi","year":"2019","unstructured":"Pergolizzi J V., Raffa RB. Safety And Efficacy Of The Unique Opioid Buprenorphine For The Treatment Of Chronic Pain. J Pain Res. 2019;12:3299. https:\/\/doi.org\/10.2147\/JPR.S231948","journal-title":"J Pain Res."},{"issue":"6","key":"9260_CR76","doi-asserted-by":"publisher","first-page":"675","DOI":"10.1016\/J.AMJMS.2022.06.025","volume":"364","author":"C Brandt","year":"2022","unstructured":"Brandt C, Atkinson TJ. A review of the safety of buprenorphine in special populations. Am J Med Sci. 2022;364(6):675-684. https:\/\/doi.org\/10.1016\/J.AMJMS.2022.06.025","journal-title":"Am J Med Sci."},{"key":"9260_CR77","unstructured":"Zoorob R, Kowalchuk A, Grubb MM de. Buprenorphine Therapy for Opioid Use Disorder. Am Fam Physician. 2018;97(5):313\u2013320. https:\/\/www.aafp.org\/pubs\/afp\/issues\/2018\/0301\/p313.html. Accessed 16 April 2024."},{"issue":"3","key":"9260_CR78","doi-asserted-by":"publisher","first-page":"249","DOI":"10.1007\/S00127-017-1341-9\/TABLES\/2","volume":"52","author":"PC Gronholm","year":"2017","unstructured":"Gronholm PC, Henderson C, Deb T, Thornicroft G. Interventions to reduce discrimination and stigma: the state of the art. Soc Psychiatry Psychiatr Epidemiol. 2017;52(3):249-258. https:\/\/doi.org\/10.1007\/S00127-017-1341-9\/TABLES\/2","journal-title":"Soc Psychiatry Psychiatr Epidemiol."},{"issue":"10","key":"9260_CR79","doi-asserted-by":"publisher","first-page":"1269","DOI":"10.1176\/APPI.PS.201400140","volume":"65","author":"CL Barry","year":"2014","unstructured":"Barry CL, McGinty EE, Pescosolido BA, Goldman HH. Stigma, discrimination, treatment effectiveness, and policy: public views about drug addiction and mental illness. Psychiatr Serv. 2014;65(10):1269-1272. https:\/\/doi.org\/10.1176\/APPI.PS.201400140","journal-title":"Psychiatr Serv."},{"key":"9260_CR80","doi-asserted-by":"publisher","first-page":"100161","DOI":"10.1016\/J.SSMQR.2022.100161","volume":"2","author":"EF Madden","year":"2022","unstructured":"Madden EF, Barker KK, Guerra J, Villanueva C, Sulzer SH. Variation in intervention stigma among medications for opioid use disorder. SSM - Qual Res Health. 2022;2:100161. https:\/\/doi.org\/10.1016\/J.SSMQR.2022.100161","journal-title":"SSM - Qual Res Health."},{"issue":"9","key":"9260_CR81","doi-asserted-by":"publisher","first-page":"1300","DOI":"10.1037\/AMP0000744","volume":"75","author":"VA Earnshaw","year":"2020","unstructured":"Earnshaw VA. Stigma and substance use disorders: A clinical, research, and advocacy agenda. Am Psychol. 2020;75(9):1300. https:\/\/doi.org\/10.1037\/AMP0000744","journal-title":"Am Psychol."},{"issue":"14","key":"9260_CR82","doi-asserted-by":"publisher","first-page":"2181","DOI":"10.1080\/10826084.2021.1975749","volume":"56","author":"EF Madden","year":"2021","unstructured":"Madden EF, Prevedel S, Light T, Sulzer SH. Intervention Stigma toward Medications for Opioid Use Disorder: A Systematic Review. Subst Use Misuse. 2021;56(14):2181-2201. https:\/\/doi.org\/10.1080\/10826084.2021.1975749","journal-title":"Subst Use Misuse."},{"key":"9260_CR83","unstructured":"What is a Case Manager? - CMSA. https:\/\/cmsa.org\/who-we-are\/what-is-a-case-manager\/. Accessed 16 April 2024."},{"key":"9260_CR84","doi-asserted-by":"publisher","unstructured":"Hesse M, Vanderplasschen W, Rapp RC, Broekaert E, Fridell M. Case management for persons with substance use disorders. Cochrane Database Syst Rev. 2007;(4). https:\/\/doi.org\/10.1002\/14651858.CD006265.PUB2","DOI":"10.1002\/14651858.CD006265.PUB2"},{"issue":"4","key":"9260_CR85","doi-asserted-by":"publisher","first-page":"605","DOI":"10.1037\/A0036750","volume":"82","author":"RC Rapp","year":"2014","unstructured":"Rapp RC, Van Den Noortgate W, Broekaert E, Vanderplasschen W. The efficacy of case management with persons who have substance abuse problems: a three-level meta-analysis of outcomes. J Consult Clin Psychol. 2014;82(4):605-618. https:\/\/doi.org\/10.1037\/A0036750","journal-title":"J Consult Clin Psychol."},{"issue":"4","key":"9260_CR86","doi-asserted-by":"publisher","first-page":"780","DOI":"10.1111\/JRH.12760","volume":"39","author":"YI Hser","year":"2023","unstructured":"Hser YI, Mooney LJ, Baldwin LM, et al. Care coordination between rural primary care and telemedicine to expand medication treatment for opioid use disorder: Results from a single-arm, multisite feasibility study. J Rural Health. 2023;39(4):780-788. https:\/\/doi.org\/10.1111\/JRH.12760","journal-title":"J Rural Health."},{"issue":"5","key":"9260_CR87","doi-asserted-by":"publisher","first-page":"256","DOI":"10.1097\/NCM.0000000000000309","volume":"23","author":"C Sortedahl","year":"2018","unstructured":"Sortedahl C, Krsnak J, Crook MM, Scotton L. Case Managers on the Front Lines of Opioid Epidemic Response: Advocacy, Education, and Empowerment for Users of Medical and Nonmedical Opioids. Prof Case Manag. 2018;23(5):256-263. https:\/\/doi.org\/10.1097\/NCM.0000000000000309","journal-title":"Prof Case Manag."},{"key":"9260_CR88","unstructured":"Opioid Overdoses Policy Brief | CSELS | Rural Health | CDC. https:\/\/www.cdc.gov\/ruralhealth\/drug-overdose\/policybrief.html#r2. Accessed 16 April 024."},{"key":"9260_CR89","doi-asserted-by":"publisher","unstructured":"Hedegaard H, Spencer MR. Urban\u2013rural differences in drug overdose deaths rates, 1999\u20132019. Published online March 17, 2021. https:\/\/doi.org\/10.15620\/CDC:102891","DOI":"10.15620\/CDC:102891"},{"issue":"6","key":"9260_CR90","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1086\/432888","volume":"41","author":"LE Sullivan","year":"2005","unstructured":"Sullivan LE, Fiellin DA. Buprenorphine: Its Role in Preventing HIV Transmission and Improving the Care of HIV-Infected Patients with Opioid Dependence. Clin Infect Dis. 2005;41(6):891-896. https:\/\/doi.org\/10.1086\/432888","journal-title":"Clin Infect Dis."},{"key":"9260_CR91","doi-asserted-by":"publisher","unstructured":"Mcnamara KF, Biondi BE, Hern\u00e1ndez-Ram\u00edrez RU, Taweh N, Grimshaw AA, Springer SA. A Systematic Review and Meta-Analysis of Studies Evaluating the Effect of Medication Treatment for Opioid Use Disorder on Infectious Disease Outcomes. Open Forum Infect Dis. 2021;8(8). https:\/\/doi.org\/10.1093\/OFID\/OFAB289","DOI":"10.1093\/OFID\/OFAB289"},{"issue":"1","key":"9260_CR92","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/1940-0640-7-22\/TABLES\/2","volume":"7","author":"TA Rowe","year":"2012","unstructured":"Rowe TA, Jacapraro JS, Rastegar DA. Entry into primary care-based buprenorphine treatment is associated with identification and treatment of other chronic medical problems. Addict Sci Clin Pract. 2012;7(1):1-5. https:\/\/doi.org\/10.1186\/1940-0640-7-22\/TABLES\/2","journal-title":"Addict Sci Clin Pract."}],"container-title":["Journal of General Internal Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-024-09260-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11606-024-09260-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11606-024-09260-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,9,25]],"date-time":"2025-09-25T16:02:43Z","timestamp":1758816163000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11606-024-09260-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,12,12]]},"references-count":92,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2025,9]]}},"alternative-id":["9260"],"URL":"https:\/\/doi.org\/10.1007\/s11606-024-09260-1","relation":{},"ISSN":["0884-8734","1525-1497"],"issn-type":[{"value":"0884-8734","type":"print"},{"value":"1525-1497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,12,12]]},"assertion":[{"value":"23 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"26 November 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"12 December 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations:"}},{"value":"None.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of Interest:"}}]}}