A5043182178- Musculoskeletal pain and rehabilitation
- Fibromyalgia and Chronic Fatigue Syndrome Research
- HIV/AIDS Research and Interventions
- Health Systems, Economic Evaluations, Quality of Life
- Mindfulness and Compassion Interventions
- Complementary and Alternative Medicine Studies
- HIV, Drug Use, Sexual Risk
- Chronic Disease Management Strategies
- Dementia and Cognitive Impairment Research
- HIV-related health complications and treatments
- Spine and Intervertebral Disc Pathology
- Sleep and related disorders
- Interprofessional Education and Collaboration
- Balance, Gait, and Falls Prevention
- Frailty in Older Adults
- Pharmaceutical Practices and Patient Outcomes
- Geriatric Care and Nursing Homes
- Health, psychology, and well-being
- Palliative Care and End-of-Life Issues
- Pneumocystis jirovecii pneumonia detection and treatment
- Pain Management and Placebo Effect
- Pain Management and Opioid Use
- HIV Research and Treatment
- Digital Mental Health Interventions
- Opioid Use Disorder Treatment
Kaiser Permanente Washington Health Research Institute
2013-2024
Seattle University
2007-2023
Kaiser Permanente
2021
Group Health Cooperative
2004-2012
Health Center
2009
University of Washington
2007
Oklahoma State University
1997-2000
<h3>Importance</h3> Mindfulness-based stress reduction (MBSR) has not been rigorously evaluated for young and middle-aged adults with chronic low back pain. <h3>Objective</h3> To evaluate the effectiveness pain of MBSR vs cognitive behavioral therapy (CBT) or usual care. <h3>Design, Setting, Participants</h3> Randomized, interviewer-blind, clinical trial in an integrated health care system Washington State 342 aged 20 to 70 years enrolled between September 2012 April 2014 randomly assigned...
Cognitive behavioral therapy (CBT) is believed to improve chronic pain problems by decreasing patient catastrophizing and increasing self-efficacy for managing pain. Mindfulness-based stress reduction (MBSR) benefit patients with mindfulness acceptance. However, little known about how these therapeutic mechanism variables relate each other or whether they are differentially impacted MBSR vs CBT. In a randomized controlled trial comparing MBSR, CBT, usual care (UC) adults aged 20 70 years low...
Importance Modifiable risk factors are hypothesized to account for 30% 40% of dementia; yet, few trials have demonstrated that risk-reduction interventions, especially multidomain, efficacious. Objective To determine if a personalized, multidomain reduction intervention improves cognition and dementia profile among older adults. Design, Setting, Participants The Systematic Multi-Domain Alzheimer Risk Reduction Trial was randomized clinical trial with 2-year intervention. A total 172 adults...
The population of persons living with HIV (PLWH) is growing older and more prone to developing other chronic health conditions. Disease progression has been shown be related quality life (QoL). However, descriptions comorbid illnesses the unique QoL challenges adults are not well understood have examined in multiple geographic locations. About 452 PLWH aged 50 years or were recruited from AIDS Service Organizations nine states. Participants completed a telephone survey that included measures...
To assess whether older persons with osteoarthritis (OA) pain and insomnia receiving cognitive-behavioral therapy for (CBT-PI), a coping skills intervention (CBT-P), an education-only control (EOC) differed in sleep outcomes.Double-blind, cluster-randomized controlled trial 9-month follow-up.Group Health University of Washington, 2009 to 2011.Three hundred sixty-seven adults OA insomnia.Six weekly group sessions CBT-PI, CBT-P, or EOC delivered participants' primary care clinics.Primary...
Pre-exposure prophylaxis (PrEP), the antiretroviral treatment regimen for HIV-negative people at high risk of acquiring HIV, has demonstrated efficacy across clinical trials in several patient populations. The Centers Disease Control (CDC) have released detailed guidelines to aid providers prescribing PrEP their high-risk patients, including men who sex with (MSM), heterosexuals, and injection drug users (IDUs). Given that much attention focused on MSM present study used an online survey...
In primary care and physical therapy settings, we evaluated an intervention for chronic back pain patients which incorporated fear reducing activating techniques. Primary seen in were screened to identify persons with significant activity limitations 8–10 weeks after their visit. Eligible willing randomized (N=240). A brief, individualized program reduce increase levels was delivered by a psychologist therapists. Over 2 year follow-up period, reported greater reductions pain-related...
Economic evaluation alongside a randomized trial of cognitive-behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR) versus usual care alone (UC) for chronic low back pain (CLBP).To determine 1-year cost-effectiveness CBT MBSR compared to 33 UC.CLBP is expensive in terms healthcare costs lost productivity. Mind-body interventions have been found effective pain, but their unexplored.A total 342 adults an integrated system with CLBP were receive (n = 116), 113), or UC 113)....
Evaluate long-term effects of group interventions on sleep and pain outcomes in a primary care population older adults with osteoarthritis disturbance. Double-blind, cluster-randomized controlled trial 18-mo follow-up. Group Health University Washington, Seattle, WA, from 2009 to 2011. Three hundred sixty-seven age 60 y older, insomnia symptoms. Six weekly sessions cognitive behavioral therapy for (CBT-PI), alone (CBT-P), education-only control (EOC) delivered patients' clinics. There were...
The self-reported health and functional status of persons with back pain in the United States have declined recent years, despite greatly increased medical expenditures due to this problem. Although patient psychosocial factors such as pain-related beliefs, thoughts coping behaviors been demonstrated affect how well patients respond treatments for pain, few receive that address these factors. Cognitive-behavioral therapy (CBT), which addresses factors, has found be effective but access...
To support implementation of effective treatments for back pain that can be delivered to a range people, we summarize learnings from our process evaluation the MATCH trial's an adaptation STarT Back risk-stratified care model.
OBJECTIVES: To assess the effect of a team geriatrics specialists on practice style primary care providers (PCPs) and functioning their patients aged 75 older. DESIGN: Randomized, controlled trial. SETTING: Two clinics in Seattle, Washington, area. PARTICIPANTS: Thirty‐one PCPs 874 INTERVENTION: An interdisciplinary worked with to enhance geriatric focus care. MEASUREMENTS: Main outcomes were reflecting orientation patient scores physical affect subscales Arthritis Impact Measurement Scale...
Background: Despite the success of antiretroviral therapy (ART), HIV-infected older African Americans experience higher mortality rates compared to their white counterparts. This disparity may be partly attributable differences in ART adherence by different racial and gender groups. The purpose this study was describe demographic, psychosocial, HIV disease-related factors that influence determine whether race impact among adults aged 50 years older. Methods: descriptive involved a secondary...
Despite numerous options for treating back pain and the increasing healthcare resources devoted to this problem, prevalence impact of pain-related disability has not improved. It is now recognized that psychosocial factors, as well physical are important predictors poor outcomes pain. A promising new approach matches treatments obstacles recovery, STarT Back risk stratification approach, improved patients' function while reducing costs care in United Kingdom (UK). This trial evaluates...
Importance High-risk medications that contribute to adverse health outcomes are frequently prescribed older adults. Deprescribing interventions reduce their use, but studies often not designed examine effects on patient-relevant outcomes. Objective To test the effect of a system–embedded deprescribing intervention targeting adults and primary care clinicians for reducing use central nervous system–active drugs preventing medically treated falls. Design, Setting, Participants In this cluster...
Uptake of preexposure prophylaxis (PrEP) has been slow, but is increasing. Although PrEP indicated for many patients, it concentrated among men who have sex with (MSM). Awareness limited non-MSM individuals, and some MSM. As such, individuals at risk HIV are unaware must rely on their medical providers to initiate conversations about PrEP. Members a national professional organization specialists prescribing privileges, including physicians, nurse practitioners, physician assistants,...
Abstract Background Cognitive behavioral therapy for chronic pain (CBT-CP) is an effective but underused treatment high-impact pain. Increased access to CBT-CP services of critical public health importance, particularly rural and medically underserved populations who have limited due these being concentrated in urban high income areas. Making widely available more affordable could reduce barriers use. Methods As part the National Institutes Health Helping End Addiction Long-term® (NIH HEAL)...
Alcohol use, and particularly unhealthy alcohol is associated with poor human immunodeficiency virus (HIV)-related outcomes among persons living HIV (PLWH). Despite a rapidly growing proportion of PLWH ≥50 years, use its characteristics are underdescribed in this population. The authors describe severity, using data from sample years who participated trial telephone-based intervention to improve adherence antiretroviral therapy (ART).Participants were recruited acquired syndrome (AIDS)...
In a pair of randomized controlled trials in the Kaiser Permanente delivery system Colorado 1990s, group visits for older adults (monthly non-disease-specific medical appointments cohort patients led by primary care teams) were proven to reduce costs, decrease hospitalizations, and improve patient provider satisfaction. As part translational effort, this visit intervention was replicated Seattle, Washington, log total healthcare costs measured first year intervention. Utilization physician...