{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T13:15:41Z","timestamp":1768569341124,"version":"3.49.0"},"posted":{"date-parts":[[2025,9,21]]},"group-title":"Health Systems and Quality Improvement","reference-count":25,"publisher":"openRxiv","license":[{"start":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T00:00:00Z","timestamp":1758412800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.medrxiv.org\/about\/FAQ#license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2025,9,21]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                <jats:sec>\n                  <jats:title>Purpose<\/jats:title>\n                  <jats:p>Although Medicare Annual Wellness Visits (AWVs) offer many potential benefits to older adults, racial and ethnic minorities have lower rates of AWV completion. Our objective was to understand older minority patients\u2019 attitudes and preferences related to preventive care and AWVs.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Between June and October 2024, we conducted four focus groups at two urban primary care settings\u2014one academic health system, and one federally qualified health center\u2014among Medicare enrollees aged \u226566 with \u22651 primary care encounter at a participating organization in the prior year. We recruited patients with Black race or Hispanic ethnicity as documented in the electronic health record. Domains of interest were communication preferences, attitudes about preventive care and AWVs, and barriers to care. Focus groups were audio recorded, and transcripts were coded into key themes using a template analysis approach.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>There were 45 participants, who had a mean age of 71 years (standard deviation, 4); most were female and identified as Black. Participants reported varying forms of preferred communication, including the patient portal, phone calls, and mailed letters. Five themes emerged: 1) The value placed on participants\u2019 health and preventive care; 2) The value placed on relationships with trusted primary care physicians; 3) Barriers to scheduling and attending doctors\u2019 visits; 4) Confusion or uncertainty about terminology describing preventive visits, and; 5) Lack of trust due to historical discrimination.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Interventions to increase Medicare AWV uptake in racial and ethnic minority patients must address and overcome barriers such as those identified here.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2025.09.19.25336216","type":"posted-content","created":{"date-parts":[[2025,9,21]],"date-time":"2025-09-21T18:00:28Z","timestamp":1758477628000},"source":"Crossref","is-referenced-by-count":0,"title":["Older racial and ethnic minority patients\u2019 perceptions of Medicare Annual Wellness Visits: a qualitative study"],"prefix":"10.64898","author":[{"given":"Tiffany","family":"Brown","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tahniat","family":"Nadeem","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Carla","family":"Salazar","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jeffrey A.","family":"Linder","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gayle","family":"Kricke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5505-2922","authenticated-orcid":false,"given":"David T.","family":"Liss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"54368","reference":[{"key":"2025092400150766000_2025.09.19.25336216v1.1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2021.6524"},{"key":"2025092400150766000_2025.09.19.25336216v1.2","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199504000-00001"},{"issue":"4","key":"2025092400150766000_2025.09.19.25336216v1.3","first-page":"25","article-title":"Cost and outcomes of Medicare reimbursement for HMO preventive services","volume":"20","year":"1999","journal-title":"Health Care Financ Rev"},{"key":"2025092400150766000_2025.09.19.25336216v1.4","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.85.3.379"},{"key":"2025092400150766000_2025.09.19.25336216v1.5","doi-asserted-by":"publisher","DOI":"10.1097\/00005650-199711000-00006"},{"key":"2025092400150766000_2025.09.19.25336216v1.6","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(17)32250-X"},{"key":"2025092400150766000_2025.09.19.25336216v1.7","doi-asserted-by":"publisher","DOI":"10.1377\/hlthaff.2017.1130"},{"key":"2025092400150766000_2025.09.19.25336216v1.8","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-025-09773-3"},{"key":"2025092400150766000_2025.09.19.25336216v1.9","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000000962"},{"key":"2025092400150766000_2025.09.19.25336216v1.10","doi-asserted-by":"publisher","DOI":"10.7326\/l15-5145"},{"key":"2025092400150766000_2025.09.19.25336216v1.11","doi-asserted-by":"publisher","DOI":"10.1097\/MLR.0000000000001229"},{"key":"2025092400150766000_2025.09.19.25336216v1.12","doi-asserted-by":"publisher","DOI":"10.1097\/jhq.0000000000000273"},{"key":"2025092400150766000_2025.09.19.25336216v1.13","unstructured":"AllianceChicago. 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