A5020661057- Vaccine Coverage and Hesitancy
- Palliative Care and End-of-Life Issues
- Misinformation and Its Impacts
- Physical Activity and Health
- COVID-19 epidemiological studies
- Cancer survivorship and care
- Frailty in Older Adults
- Childhood Cancer Survivors' Quality of Life
- Mobile Health and mHealth Applications
- Chronic Disease Management Strategies
- SARS-CoV-2 and COVID-19 Research
- Blood donation and transfusion practices
- Blood Pressure and Hypertension Studies
- Cardiac Health and Mental Health
- Health disparities and outcomes
- Cardiovascular and exercise physiology
- Diabetes Management and Research
- Diabetes, Cardiovascular Risks, and Lipoproteins
- BRCA gene mutations in cancer
- Healthcare Policy and Management
- Pharmacy and Medical Practices
- Influenza Virus Research Studies
- COVID-19 and Mental Health
- Diabetes Management and Education
- Community Health and Development
University of Pennsylvania
2018-2023
University of Pennsylvania Health System
2018-2022
Penn Center for AIDS Research
2020-2022
Many Americans fail to get life-saving vaccines each year, and the availability of a vaccine for COVID-19 makes challenge encouraging vaccination more urgent than ever. We present large field experiment ( N = 47,306) testing 19 nudges delivered patients via text message designed boost adoption influenza vaccine. Our findings suggest that messages sent prior primary care visit can rates by an average 5%. Overall, interventions performed better when they were 1) framed as reminders flu shots...
Serious illness conversations (SICs) are structured between clinicians and patients about prognosis, treatment goals, end-of-life preferences. Interventions that increase the rate of SICs oncology may improve goal-concordant care patient outcomes.To determine effect a clinician-directed intervention integrating machine learning mortality predictions with behavioral nudges on motivating clinician-patient SICs.This stepped-wedge cluster randomized clinical trial was conducted across 20 weeks...
Significance Encouraging vaccination is a pressing policy problem. Our megastudy with 689,693 Walmart pharmacy customers demonstrates that text-based reminders can encourage and establishes what kinds of messages work best. We tested 22 different text using variety behavioral science principles to nudge flu vaccination. Reminder texts increased rates by an average 2.0 percentage points (6.8%) over business-as-usual control condition. The most-effective reminded patients shot was waiting for...
Serious illness conversations (SICs) between oncology clinicians and patients are associated with improved quality of life may reduce aggressive end-of-life care. However, most cancer die without a documented SIC.To test the impact behavioral nudges to prompt SICs on SIC rate outcomes among at high risk death within 180 days (high-risk patients) as identified by machine learning algorithm.This prespecified 40-week analysis stepped-wedge randomized clinical trial conducted June 17, 2019,...
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Purpose To evaluate if nudges delivered by text message prior to an upcoming primary care visit can increase influenza vaccination rates. Design Randomized, controlled trial. Setting Two health systems in the Northeastern US between September 2020 and March 2021. Subjects 74,811 adults. Interventions Patients 19 intervention arms received 1-2 messages 3 days preceding their appointment that varied format, interactivity, content. Measures Influenza vaccination. Analysis Intention-to-treat....
<h3>Importance</h3> Hepatitis C virus (HCV) screening has been recommended for patients born between 1945 and 1965, but rates remain low. <h3>Objective</h3> To evaluate whether a default order within the admission set increases HCV compared with preexisting alert electronic health record. <h3>Design, Setting, Participants</h3> This stepped-wedge randomized clinical trial was conducted from June 23, 2020, to April 10, 2021, at 2 hospitals an academic medical center. Hospitalized 1965 no...
<h3>Importance</h3> Gamification is increasingly being used for health promotion but has not been well tested with financial incentives or among veterans. <h3>Objective</h3> To test the effectiveness of gamification social support, and without a loss-framed incentive, to increase physical activity veterans classified as having overweight obesity. <h3>Design, Setting, Participants</h3> This 3-group randomized clinical trial had 12-week intervention period an 8-week follow-up period....
This secondary analysis of a randomized clinical trial compares smartphones with wearable devices for remotely monitoring the duration physical activity patients after hospital discharge to home.
Abstract Hospital readmission prediction models often perform poorly, but most only use information collected until the time of hospital discharge. In this clinical trial, we randomly assigned 500 patients discharged from to home either a smartphone or wearable device collect and transmit remote patient monitoring (RPM) data on activity patterns after Analyses were conducted at patient-day level using discrete-time survival analysis. Each arm was split into training testing folds. The set...
The Comprehensive Cancer Network (NCCN) recommends genetic cancer risk assessment (GCRA) referral to women at high of hereditary breast and ovarian cancer. Latinas affected by have the second highest prevalence BRCA1/2 mutations after Ashkenazi Jews. Compared non-Hispanic Whites, lower GCRA uptake. While some studies identified barriers for use in this population, few focused on health care providers' perspectives. purpose study was examine perceptions facilitators at-risk Latina participate...
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The use of wearables is increasing and data from these devices could improve the prediction changes in glycemic control. We conducted a randomized trial with adults prediabetes who were given either waist-worn or wrist-worn wearable to track activity patterns. collected baseline information on demographics, medical history, laboratory testing. tested three models that predicted hemoglobin A1c continuous, improved control by 5% worsened 5%. Consistently all models, when (a) machine learning...
12002 Background: Most patients with cancer die without a documented serious illness conversation (SIC) about prognosis and goals. Interventions that increase SICs between oncology clinicians may improve goal-concordant care end-of-life outcomes. Methods: In this stepped-wedge cluster randomized trial (NCT03984773), we tested the effect of an intervention delivering machine learning-based mortality estimates behavioral nudges to oncologists among cancer. The clinician-focused consisted 1)...
This randomized clinical trial examines the effect of an opt-out recruitment strategy vs a conventional opt-in on enrollment and initial adherence to COVID-19 surveillance testing program.
Physical activity is known to contribute good health, but most adults in the United States do not meet recommended physical guidelines. Social incentive interventions that leverage insights from behavioral economics have increased short-term trials, there limited evidence of their effectiveness community settings or long-term effectiveness. The STEP Together study a Hybrid Type 1 effectiveness-implementation address these and implementation gaps. This paper describes process adapting...
2009 Background: Oncologists accurately identify only 35% of patients with cancer who will die in six months. There is an urgent need for automated, accurate prognostic systems to inform treatment and advance care planning oncology. We assessed the prospective performance a previously described ML algorithm (Parikh et al, JAMA Netw Open, 2019) predict short-term mortality cohort general oncology outpatients. Methods: Our consisted aged ≥18 years had medical or gynecologic encounter between...
109 Background: Early serious illness conversations (SICs) between oncology clinicians and patients are associated with improved mood, quality of life, end-of-life (EOL) care. Yet, most cancer die without a documented SIC. We report on pre-specified 40-week SIC EOL outcomes from stepped-wedge randomized clinical trial (NCT03984773) testing the impact clinician-directed behavioral nudges to prompt SICs among at high risk mortality based machine learning algorithm. Methods: Our sample...