Self-reported data about the interval since last cancer screening are often used to determine whether individuals due for periodic and monitor adherence guidelines early detection. In a study conducted within Kaiser Perma-nente Medical Care Program, we examined concordance of self-reported information medical record documentation recency reasons six procedures We also assessed population-level estimates rates based on these two sources. Data were obtained from mailed questionnaire or...

Background: Patients are being encouraged to go online obtain health information and interact with their care systems. However, a 2014 survey found that less than 60% of American adults aged 65 older use the Internet, much lower usage among black Latino seniors compared non-Hispanic white seniors, versus younger seniors. Objective: Our aims were (1) identify race/ethnic age cohort disparities in plan's patient portal, (2) determine whether exist access digital devices preferences for using...

The Kaiser Permanente Northern California (KPNC) Member Health Survey (MHS) is used to describe sociodemographic and health-related characteristics of the adult membership this large, integrated health care delivery system monitor trends over time, identify disparities, conduct research.

Online access to health records and the ability exchange secure messages with physicians can improve patient engagement outcomes; however, digital divide could limit web-based portals among disadvantaged groups.To understand whether sociodemographic differences in portal use for messaging be explained by internet care preferences.Cross-sectional survey examine association between characteristics preferences; then, message without adjusting preference.One thousand forty-one patients chronic...

Abstract Background Few large cohort studies have examined the prevalence of diabetes mellitus (DM), hypertension (HTN), coronary artery disease (CAD), obesity, and smoking among middle-aged older adults in major Asian-American ethnic groups Native Hawaiian/Pacific Islanders (PIs). The aim this study was to evaluate how these conditions risk factors differs across PI compares with an aggregated All racial group. Methods This used a 1.4 million aged 45 84 who were Kaiser Permanente Northern...

This study examined access to digital technologies, skills and experience, preferences for using web-based other technologies obtain health information advice among older adults in a large plan. A primary aim was assess the extent which divides by race/ethnicity age group might affect ability of percentage seniors, especially those vulnerable groups, engage with online modalities (eHIA) mobile (mHealth) monitoring tools. mailed survey conducted age-sex stratified random samples...

Data from the National Center for Health Statistics Survey of Personal Practices and Consequences were analyzed to determine impact variable shift schedules on health-related behaviors persons in United States labor force. Twenty-six per cent men 18 women US force reported working a Spring 1980. As compared non-variable work schedules, those shifts exhibited higher rates heavy drinking, job stress, emotional problems. Female workers sleeping pill, tranquilizer, alcohol use, as well lower...

OBJECTIVES: This study compared the prevalence of cigarette smoking and alcohol use among lesbians bisexual women with that heterosexual women. METHODS: Logistic regression models were created data from an extensive member health survey at a large maintenance organization. Sexual orientation was primary predictor, consumption outcomes. RESULTS: Lesbians younger than 50 years more likely to smoke cigarettes drink heavily. aged 20 34 reported higher weekly less abstinence older CONCLUSIONS:...

To compare the effectiveness of diabetes prevention strategies addressing postpartum weight retention for women with gestational mellitus (GDM) delivered at health system level: mailed recommendations (usual care) versus usual care plus a Diabetes Prevention Program (DPP)-derived lifestyle intervention.This study was cluster randomized controlled trial 44 medical facilities (including 2,280 GDM) to intervention or care. The included gain 13 telephone sessions between 6 weeks and months...

Background: Health information, patient education, and self-management (health information advice, HIA) tools are increasingly being made available to adults with chronic health conditions through internet-based mobile (mHealth) digital technologies. However, there is limited about preferences for using specific types of advice resources how usage differ by age group education.

Abstract Background Despite evidence of adverse health consequences inadequate restorative sleep for older adults, assessment quantity, quality, and use aids is not routinely done. We aimed to characterize problems, risks, advice received about in a community-dwelling adult population, overall subgroups with conditions functional difficulties. Methods This cross-sectional study used weighted self-report data 5074 Kaiser Permanente Northern California members aged 65-79y who responded 2017 or...

Abstract Background Asian adults develop Type 2 diabetes at a lower body mass index (BMI) compared to other racial/ethnic groups. We examined the variation in prevalence of prediabetes and among ethnic groups within weight strata by comparing middle-aged Chinese, Filipino, South Asian, White receiving care same integrated healthcare delivery system. Methods Our retrospective cross-sectional U.S. study data from 283,110 (non-Hispanic) White, 33,263 38,766 17,959 aged 45–64 years who were...

Health care organizations are increasingly using electronic health (eHealth) platforms to provide and exchange information advice (HIA). There is limited about how factors beyond internet access affect use of eHealth resources by middle-aged older adults.We aimed estimate prevalence the internet, plan patient portal, Web-based HIA among adults; investigate whether similar sociodemographic-related disparities in resource found examine sociodemographic drive adults who internet.We analyzed...

The National Academy of Medicine has recommended incorporating information on social and behavioral factors associated with health, such as educational level exercise, into electronic health records, but questions remain about the clinical value doing so.To examine whether Medicine-recommended risk factor domains are earlier onset hypertension and/or diabetes in a population.This prospective cohort study used data collected from April 1, 2005, to December 31, 2016, population-based sample 41...

To evaluate whether providing doulas during hospital-based labor affects mode of delivery, epidural use, breast-feeding, and postpartum perceptions the birth, self-esteem, depression.This was a randomized study nullipara enrollees in group-model health maintenance organization who delivered one three organization-managed hospitals; 149 had doulas, 165 usual care. Study data were obtained from mothers' medical charts, intake forms, phone interviews conducted 4-6 weeks postpartum.Women...

To estimate the proportion of seniors in a large health maintenance organization (HMO) who had been asked about their end-of-life care preferences (EOLCPs) by clinician and completed an advance directive (AD). examine association having EOLCP discussion AD completion.A random sample HMO members aged 65 years or older were to complete mailed survey health-related issues 1996. Data provided 5117 (80% response rate) used prevalence among overall specific risk groups. Bivariate multiple logistic...

Objective. To assess the impacts of characteristics quality improvement (QI) teams and their environments on team success in designing implementing highquality, enduring depression care programs primary (PC) practices. Study Setting/Data Sources. Two nonprofit managed organizations sponsored five QI tasked with improving for large PC Data is from observer process notes, national expert ratings, administrative data, interviews. Design. Comparative formative evaluation duration implementation...

Women with gestational diabetes (GDM) are at high risk of developing later in life. After a GDM diagnosis, women receive prenatal care to control their blood glucose levels via diet, physical activity and medications. Continuing such lifestyle skills into early motherhood may reduce the this population. In Gestational Diabetes' Effects on Moms (GEM) study, we evaluating comparative effectiveness prevention strategies for weight management designed pregnant/postpartum delivered health system...

Frailty is a condition of increasing importance, given the aging adult population. With an anticipated shortage geriatricians, primary care physicians will increasingly need to manage for frail adults with complex functional risks and social-economic circumstances. We used cross-sectional data from 4551 ages 65–90 who responded 2014/2015 cycle Kaiser Permanente Northern California Member Health Survey (MHS), self-administered survey that covers multiple health social characteristics, create...

Medication misadventures resulting in visits to the emergency department of a health maintenance organization (HMO) were studied. The records patients who visited at California HMO between August 1992 and 1993 evaluated for evidence medication brought department. definition misadventure included noncompliance inappropriate prescribing but excluded intentional overdoses substance abuse. If it seemed probable that occurred, pharmacist interviewed patient by telephone. During 12-month study,...

Objectives. This study explored whether type of outpatient health coverage affected the likelihood men and women aged 20 to 64 years receiving recommended cancer screening procedures. Methods. Data from 1989 1990 California Behavioral Risk Factor Surveillance Surveys were used compare Pap smear, mammogram, fecal occult blood test, proctoscopic examination rates for adults with three different types private care (Group/staff model maintenance organization, Independent Practice Association...

Tobacco and alcohol use related morbidity mortality are critical public health problems. Results of several, but not all, studies suggest that lesbians gay men at elevated risk for smoking tobacco misuse. Data from random sample general surveys adult members a large Northern California Health Plan conducted in 1999 2002 were analyzed using gender-based multivariate logistic regression models to assess whether (n = 210) 331) aged 20–65 more likely than similarly heterosexual women 12,188)...