A5050426701- Diabetes Management and Research
- Mobile Health and mHealth Applications
- Diabetes Management and Education
- Digital Mental Health Interventions
- Health Literacy and Information Accessibility
- Adolescent and Pediatric Healthcare
- Diabetes and associated disorders
- Pancreatic function and diabetes
- COVID-19 Clinical Research Studies
- Medication Adherence and Compliance
- Childhood Cancer Survivors' Quality of Life
- Technology Use by Older Adults
- Health and Lifestyle Studies
- Chronic Disease Management Strategies
- Advanced Neuroimaging Techniques and Applications
- Bipolar Disorder and Treatment
- Advanced MRI Techniques and Applications
- Neonatal and fetal brain pathology
- Diet and metabolism studies
- Impact of Technology on Adolescents
- Heavy Metal Exposure and Toxicity
- Primary Care and Health Outcomes
- Neurological and metabolic disorders
- Environmental Justice and Health Disparities
- Ethics in Clinical Research
Vanderbilt University
2020-2025
Vanderbilt University Medical Center
2018-2023
Prevention of Organ Failure
2022
Nashville Oncology Associates
2019
During the past 45 years, exposure to lead has declined dramatically in United States. This sustained decline is measured by blood and environmental levels achieved through control of sources, emission reductions, federal regulations, applied public health efforts.Explore regulatory factors that contributed decrease among US population since 1970.We present historical information about sources reduction emissions selected efforts, which have decreases Sources exposure, pathways,...
To quantify and contextualize the risk for coronavirus disease 2019 (COVID-19)-related hospitalization illness severity in type 1 diabetes.
OBJECTIVE Text messaging interventions have high potential for scalability and reductions in health disparities. However, more rigorous, long-term trials are needed. We examined the efficacy mechanisms of a tailored text intervention. RESEARCH DESIGN AND METHODS Adults with type 2 diabetes participated parallel-groups, 15-month randomized controlled trial were assigned to receive Rapid Education/Encouragement Communications Health (REACH) 12 months or control. REACH included interactive...
Iatrogenic peripheral hyperinsulinemia, resulting from insulin administration in type 1 diabetes, may increase resistance and impair endothelial function. We hypothesized that lowering iatrogenic hyperinsulinemia via a one-week, reduced-carbohydrate diet (RCD) would improve sensitivity function compared with an isocaloric standard carbohydrate (SCD). In this randomized, single-blinded, crossover trial, we studied 12 adults diabetes. Participants completed both one-week RCD SCD, separated by...
Text message-delivered interventions are a feasible and scalable approach for improving chronic disease self-care reducing health disparities; however, information on long-term user engagement with these is limited.The aim of this study to examine in 12-month text intervention supporting diabetes self-care, called REACH (Rapid Education/Encouragement And Communications Health), among racially socioeconomically diverse patients type 2 (T2D). We explored time trends engagement, associations...
Abstract Objective Diabetes distress (DD) is a negative emotional response related to the burdens of living with type 1 diabetes (T1D) and linked outcomes, such as hemoglobin A1c (A1c). Yet, less known about how other glycemic indicators, average blood glucose time in range, relate DD, which demographic characteristics are associated higher DD. Methods In total, 369 teens (Mage 15.6 ± 1.4, 51% female, MT1D duration 6.7 3.8 years) screened for DD using The Problem Areas Diabetes—Teen Version...
<h3>BACKGROUND AND PURPOSE:</h3> Type 1 diabetes affects over 200,000 children in the United States and is associated with an increased risk of cognitive dysfunction. Prior single-site, single-voxel MRS case reports studies have identified associations between reduced NAA/Cr, a marker neuroaxonal loss, type diabetes. However, NAA/Cr differences among various disease complications or across different brain tissues remain unclear. To better understand this phenomenon role characterizing it, we...
Abstract Background Positive psychology interventions demonstrate improvements in diabetes self-management and quality of life among adults with chronic health conditions, but few for adolescents use this approach. Objective This study describes engagement a positive intervention delivered via automated SMS text messages aimed at treating distress improving outcomes. In addition, demographic clinical predictors were examined. Methods Adolescents type 1 (ages 13-17 years) who reported least...
Abstract THR1VE! is an ongoing multisite randomized clinical trial of a positive psychology intervention designed to treat diabetes distress and improve glycemic outcomes in teens with type 1 diabetes. Due the COVID-19 pandemic restrictions on research changes care, was adapted from in-person enrollment protocol remote through series development testing strategies. We discuss process transitioning demonstrated feasibility recruitment, enrollment, retention outcomes. These findings offer...
Abstract Objective Previous research in families of children with type 1 diabetes demonstrates that maternal depressive symptoms are a known risk factor for poor outcomes. We sought to examine whether relationship distress or were more strongly associated adolescent glycemic Methods Analyses conducted using data from mothers who consented screen behavioral intervention. The screener included the Patient Health Questionnaire and Parent Diabetes Distress Scale, Parent/Teen Relationship...
Text message-delivered interventions for chronic disease self-management have potential to reduce health disparities, yet limited research has explored implementing these into clinical care. We partnered with safety net clinics evaluate a texting intervention type 2 diabetes called REACH (Rapid Encouragement/Education And Communications Health) in randomized controlled trial. Following evaluation, we implementation determinants and recommended strategies.We interviewed clinic staff (n = 14)...
Medication nonadherence and suboptimal glycemia are common among adults with T2D, particularly minorities people low SES. Text messaging is used ubiquitously without disparities. REACH (Rapid Education/Encouragement And Communications for Health) a theory-based text intervention that iteratively personalizes content to participants’ diabetes medicines barriers adherence. All participants have completed 6-month follow-up of 15-month pragmatic RCT evaluating REACH. Adults (N=512) T2D were...
<i>Objective: To quantify and contextualize the risk for COVID-19 related hospitalization illness severity in type 1 diabetes.</i> <p> </p> <p><i>Research Design Methods: We conducted a prospective cohort study to identify cases across regional healthcare network of 137 service locations. Using an electronic health record query, chart review, patient contact, we identified clinical factors influencing severity. </i></p>...
Abstract Background Mobile health (mHealth) has the potential to radically improve behaviors and quality of life; however, there are still key gaps in understanding how optimize mHealth engagement. Most engagement research reports only on system use without consideration whether user is reflecting content cognitively. Although interactions with critical, cognitive investment may also be important for meaningful behavior change. Notably, that designed request too much reflection could result...
Despite smartphone ownership becoming ubiquitous, it is unclear whether and where disparities persist in experience using health apps. In 2 diverse samples of adults with type diabetes collected 2017-2018 2020-2021, we examined adjusted app use by age, gender, race, education, annual household income, insurance status, literacy, hemoglobin A1c. the earlier sample (N = 422), 87% owned a 49% those had ever used app. Participants lower income or limited literacy ≥50% odds owning smartphone....
Type 1 diabetes (T1D) affects over 200,000 children and is associated with an increased risk of cognitive dysfunction. Prior imaging studies suggest the neurological changes underlying this are multifactorial, including macrostructural, microstructural, inflammatory changes. However, these have yet to be integrated, limiting investigation into how phenomena interact. To better understand complex mechanisms brain injury, a well-powered, prospective, multisite, multimodal neuroimaging study...
<sec> <title>BACKGROUND</title> mHealth has the potential to radically improve health behaviors and quality of life; however, there are still key gaps in understanding how optimize engagement. Most engagement research reports only on system use without consideration whether user is reflecting content cognitively. Although interactions with critical, cognitive investment also important for meaningful behavior change. Importantly, designed request too much reflection, may lead users disengage....