A5087128029- Health Policy Implementation Science
- Mental Health and Patient Involvement
- Global Cancer Incidence and Screening
- Health Systems, Economic Evaluations, Quality of Life
- Global Health Workforce Issues
- Primary Care and Health Outcomes
- Digital Mental Health Interventions
- Lung Cancer Diagnosis and Treatment
- Geriatric Care and Nursing Homes
- Community Health and Development
- Healthcare Systems and Technology
- Healthcare cost, quality, practices
- Psychiatric care and mental health services
- Mindfulness and Compassion Interventions
- Patient-Provider Communication in Healthcare
- Mobile Health and mHealth Applications
- Chronic Disease Management Strategies
- Dementia and Cognitive Impairment Research
- Social Media in Health Education
- Behavioral Health and Interventions
- Evaluation and Performance Assessment
- Patient Satisfaction in Healthcare
- Religion, Spirituality, and Psychology
- Health Literacy and Information Accessibility
- Reproductive Health and Technologies
Kaiser Permanente Washington Health Research Institute
2017-2024
Fred Hutch Cancer Center
2020-2022
University of Washington
2003-2022
Stanford University
2020
Oregon Research Institute
2020
Washington University in St. Louis
2020
RTI International
2017
Group Health Cooperative
2017
Trillium Health Centre
2017
University of South Florida
1993
Background Implementation strategies are theorized to work well when carefully matched implementation determinants and factors—preconditions, moderators, etc.—that influence strategy effectiveness prospectively identified addressed. Existing methods for selection either imprecise or require significant technical expertise resources, undermining their utility. This article outlines refinements causal pathway diagrams (CPDs), a method articulating the process through which offers illustrations...
ABSTRACT: Methods: This study compares characteristics of rural and urban registered nurses (RNs) in the United States using data from 2000 National Sample Survey Registered Nurses. RNs 3 types areas are examined rural‐urban commuting area taxonomy. Findings: Rural similar age sex; nonwhites Hispanics underrepresented both groups. have less nursing education, likely to work hospitals, more full time public/community health than RNs. The an RN's residence, he/she commutes another for lower...
Tailoring implementation strategies and adapting treatments to better fit the local context may improve their effectiveness. However, there is a dearth of valid, reliable, pragmatic measures that allow for prospective tracking adaptations according reporting recommendations. This study describes development pilot testing three tools be designed serve this purpose.Measure was informed by two systematic reviews literature (implementation treatment adaptation). The resulting vary with respect...
Abstract Background Experts recommend that treatment for substance use disorder (SUD) be integrated into primary care. The Digital Therapeutics Opioids and Other SUD (DIGITS) Trial tests strategies implementing reSET® reSET-O®, which are prescription digital therapeutics opioid disorder, respectively, include the community reinforcement approach, contingency management, fluency training to reinforce concept mastery. This purpose of this trial is test whether two implementation improve...
Objective. To quantify the total contribution to generalist care made by nurse practitioners (NPs) and physician assistants (PAs) in Washington State. Data Sources. State professional licensure renewal survey data from 1998–1999. Study Design. Cross‐sectional. on medical specialty, place of practice, outpatient visits performed were used estimate productivity physicians, NPs, PAs. Provider head counts adjusted for missing specialty converted into family full‐time equivalents (FTEs)...
Multiple sclerosis (MS) is associated with high total health care cost, the majority of which attributable to medications. Patients MS are less likely experience relapses, emergency department (ED) visits, and hospitalizations when they adherent disease-modifying treatments. Disease management programs hypothesized improve medication adherence thereby improving clinical economic outcomes.To evaluate effects a specialty pharmacy chronic disease program for patients from plan perspective.This...
Background Delivering prescription digital therapeutics (ie, evidence-based interventions designed to treat, manage, or prevent disorders via websites smartphone apps) in primary care could increase patient access substance use disorder (SUD) treatments. However, the optimal approach implementing remains unknown. Objective This pilot study is a precursor larger trial test whether implementation strategies (practice facilitation [PF] and health coaching [HC]) improve delivery of for SUDs...
Abstract Background Early detection of dementia may improve patient care and quality life, yet up to half people with are undiagnosed. Electronic health record (EHR) data could be used help identify individuals at risk having undiagnosed for outreach assessment, but acceptability caregivers is unknown. Methods We conducted five focus groups Kaiser Permanente Washington (KPWA), an integrated healthcare system in State, explore people’s feelings about timing diagnosis, use EHR-based tools...
Background: Clinician champions are front-line clinicians who advocate for and influence practice change in their local context. The strategies they use when leading efforts to reduce the of low-value care have not been well described. purpose this study is identify describe used by six clinician led a initiative clinical setting. Methods: Qualitative data collected during an overuse reduction were strategies, guided Expert Recommendations Implementing Change compilation strategies. asked...
Limited evidence-based implementation strategies exist for maintaining lung cancer screening. We evaluated the Lung Cancer Screening Program at Kaiser Permanente Washington (KPWA) to develop multilevel interventions improve screening adherence.We conducted a concurrent mixed-methods study 1) measure adherence repeat with low-dose computed tomography (LDCT); 2) interview KPWA stakeholders understand Program; and 3) conduct codesign workshops members researchers. used descriptive statistics...
For youth receiving care in community mental health centers, comorbidities are the rule rather than exception. Using measurement-based (MBC), or routine evaluation of symptoms to inform decisions, as foundation treatment for with comorbid problems significantly improves impact psychotherapy by focusing and building engagement alliance. MBC increases rate symptom improvement, detects clients who would otherwise deteriorate, alerts clinicians non-responders. Despite its demonstrated utility,...
Chronic low back pain is a common and sometimes disabling condition, mindfulness-based stress reduction recommended as first line of therapy. This study tested whether different descriptions mindfulness training altered based on influential intervention characteristics increased adoption intentions.People with chronic (n = 452) were randomized to review one four in an online survey using 2 × factorial design. The factor was evidence strength quality relative advantage (ER). second...
<sec> <title>BACKGROUND</title> Delivering prescription digital therapeutics (ie, evidence-based interventions designed to treat, manage, or prevent disorders via websites smartphone apps) in primary care could increase patient access substance use disorder (SUD) treatments. However, the optimal approach implementing remains unknown. </sec> <title>OBJECTIVE</title> This pilot study is a precursor larger trial test whether implementation strategies (practice facilitation [PF] and health...
Abstract Lung cancer is the leading cause of morbidity and mortality in United States. Annual screening with low-dose computed tomography (LDCT) reduces lung mortality. However, annual adherence to suboptimal. To improve (LCS), additional patient education beyond shared-decision making needed normalize process. Interventions which leverage digital modes delivery might have broad reach, but only if patients actively engage messages from clinical providers. Furthermore, there may be...
Background Substance use disorders (SUDs) result in individual and societal burden. However, most individuals with SUD receive no treatment. Implementing interventions primary care could address this population's treatment needs. In the USA, reSET ® reSET-O were first prescription digital therapeutics (PDTs) for SUDs opioid disorder (OUD), respectively. The Digital Treatments Use Disorder (DIGITS) study tested effectiveness of practice facilitation health coaching strategies to support...
The mortality disadvantage of African Americans is well documented, but previous studies have not considered its implications for population theory in the general case industrialized nation states with high levels income inequality. This paper examines relevance classic epidemiological to extremes and observed Chicago, one America's most racially divided cities. We analyze cause-specific death rates black non-black male populations residing Chicago's community areas by using linked data from...