A5014194171- Musculoskeletal pain and rehabilitation
- Opioid Use Disorder Treatment
- Diabetes Management and Education
- Obesity, Physical Activity, Diet
- Mobile Health and mHealth Applications
- Pain Management and Opioid Use
- Medication Adherence and Compliance
- Child Nutrition and Feeding Issues
- Obesity and Health Practices
- Breastfeeding Practices and Influences
- Chronic Disease Management Strategies
- Food Security and Health in Diverse Populations
- Children's Physical and Motor Development
- Digital Mental Health Interventions
- Diabetes Management and Research
- Diabetes Treatment and Management
- Dietetics, Nutrition, and Education
- Nutrition, Health and Food Behavior
- Neuroendocrine regulation and behavior
- Stress Responses and Cortisol
- Meta-analysis and systematic reviews
- Fibromyalgia and Chronic Fatigue Syndrome Research
- Clinical practice guidelines implementation
- Suicide and Self-Harm Studies
- Sexuality, Behavior, and Technology
Kaiser Permanente Center for Health Research
2017-2024
St George’s University Hospitals NHS Foundation Trust
2023
Ochin
2022
Oregon Health & Science University
2022
Kaiser Permanente Washington Health Research Institute
2020
Icahn School of Medicine at Mount Sinai
2020
Duke University
2016
Duke University Hospital
2015
Duke Medical Center
2014-2015
Harvard University
2015
Objective: Cognitive-behavioral therapy (CBT) has shown efficacy in the treatment of eating disorders. The authors conducted a randomized controlled telemedicine trial CBT-guided self-help (CBT-GSH) assisted with smartphone app, Noom Monitor, for binge or without purging. They hypothesized that coach-delivered CBT-GSH sessions plus Monitor would yield greater reductions symptoms eating, purging, and disorders compared standard care. Methods: Fifty-two-week outcomes (N=114) were care (N=111)...
Chronic pain is one of the most common, disabling, and expensive public health problems in United States. Interdisciplinary management treatments that employ behavioral approaches have been successful helping patients with chronic reduce symptoms regain functioning. However, lack access to such treatments. We are conducting a pragmatic clinical trial test hypothesis who receive an interdisciplinary biopsychosocial intervention, Pain Program for Active Coping Training (PPACT), at their...
**background** The national and international epidemic of chronic disease, including among children, is largely fueled by increasing obesity. It recommended that primary care play a key role in the treatment pediatric **methods** A written survey was administered to providers staff at 13 practices across North Carolina, assessing perceptions on multiple dimensions obesity knowledge dietitian services. **results** response rate for 66.9% (*n* = 273). Although reported feeling comfortable...
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)...
Chronic pain is common, disabling, and costly. Few clinical trials have examined cognitive behavioral therapy (CBT) interventions embedded in primary care settings to improve chronic among those receiving long-term opioid therapy.To determine the effectiveness of a group-based CBT intervention for pain.Pragmatic, cluster randomized controlled trial. (ClinicalTrials.gov: NCT02113592).Kaiser Permanente health systems Georgia, Hawaii, Northwest.Adults (aged ≥18 years) with mixed conditions...
Policies supporting breastfeeding vary by state, but little is known about the geographical aspects of this variation. This study describes state licensing and administrative regulations targeting child care settings, compares with national standards, examines spatial patterning clustering these throughout United States (US). We compared for centers (centers) family homes (homes) standards for: (1) general support; (2) designated place breastfeeding; (3) no solids before infants are four...
Beginning around 2011, innumerable policies have aimed to improve pain treatment while minimizing harms from excessive use of opioids. It is not known whether changing insurance coverage for specific conditions an effective strategy. We describe and assess the effect innovative Oregon Medicaid back/neck policy on opioid prescribing patterns.This retrospective cohort study uses electronic health record data a network community centers (CHCs) in analyze prescription dose changes among patients...
Abstract Objective The Graded Chronic Pain Scale (GCPS) is frequently used in pain research and treatment to classify mild, bothersome, high impact chronic pain. This study’s objective was validate the revised version of GCPS (GCPS-R) a US Veterans Affairs (VA) healthcare sample support its use this high-risk population. Methods Data were collected from (n = 794) via self-report (GCPS-R relevant health questionnaires) electronic record extraction (demographics opioid prescriptions). Logistic...
Intervention adherence and trial retention are challenging for clinical trials testing intensive behavioral interventions. Operational constraints or designs may preclude using effective strategies such as financial incentives. We examined whether implementing pre-enrollment orientation sessions was associated with higher intervention in a pragmatic trial.The tested an patients chronic pain on long-term opioids. Orientation were implemented two years into recruitment at one site. Held before...
Implementation of a Diabetes Prevention Program (DPP) in both in-person and digital health-care settings has been increasing. The purpose this article is to describe the protocol mixed-methods, natural experiment study designed evaluate implementation DPP large, integrated health system.
Chronic pain is prevalent and costly; cost-effective nonpharmacological approaches that reduce improve patient functioning are needed.Report the incremental cost-effectiveness ratio (ICER), compared with usual care, of cognitive behavioral therapy aimed at improving among patients chronic on long-term opioid treatment.Economic evaluation conducted alongside a pragmatic cluster randomized trial.Adults treatment (N=814).A intervention teaching self-management skills in 12 weekly, 90-minute...
Background: Young children’s physical activity (PA) is influenced by their child care environment. This study assessed PA practices in centers from Massachusetts (MA) and Rhode Island (RI), compared them to best practice recommendations, differences between states center profit status. We also weather-related practices. Methods: Sixty percent of MA 54% RI directors returned a survey, for total 254. Recommendations were 1) daily outdoor play, 2) providing play area, 3) limiting fixed...
Abstract Objective Given the effectiveness of both in‐person and digital diabetes prevention programs (DPPs), participants have an opportunity to select a delivery mode based on their needs preferences. The objective this study was understand compare participants’ experiences with DPPs identify factors that affected how useful perceived these two program modes. Methods Semi‐structured interviews who were enrolled in as either ( n = 23) or 20) within one health care system conducted. Data...
Multisite chronic pain (MSCP) is associated with increased impact, but methods for identifying MSCP epidemiological research have not been evaluated.We assessed the validity of using electronic health care data compared survey questionnaires.Stratified random samples adults served by Kaiser Permanente Northwest and Washington (N = 2,059) were drawn a survey, oversampling persons frequent use pain. single-site identified two methods, self-report common conditions questionnaire. Analyses...
The purpose of this natural experiment study was to assess the effectiveness a 12-month digital Diabetes Prevention Program (DPP) for adults aged 65-75 years with prediabetes and obesity within large, integrated health care system. Adjusting propensity scores covariates, patients who enrolled participated in DPP had mean weight loss 8.6 lb over 12 months 5.7 by 24 months, compared steady, minimal 1.3 2.8 among not enrolled. There significant difference change A1C between nonenrolled...
Despite increased reimbursement for registered dietitian nutritionists (RDNs), few studies have assessed the potential of integrating them into primary care clinics to support pediatric weight management. To assess feasibility and effectiveness this approach, RDNs were introduced 8 practices in North Carolina. This mixed-methods study combined (1) interviews focus groups with clinic personnel, (2) comparison change body mass index (BMI) z-score historical groups, (3) analysis behavior BMI...