A5066137092- Primary Care and Health Outcomes
- Diabetes Management and Education
- Diabetes Management and Research
- Healthcare Policy and Management
- Chronic Disease Management Strategies
- Mobile Health and mHealth Applications
- Patient Satisfaction in Healthcare
- Health Systems, Economic Evaluations, Quality of Life
- Food Security and Health in Diverse Populations
- Global Health Workforce Issues
- Health disparities and outcomes
- Adolescent and Pediatric Healthcare
- Geriatric Care and Nursing Homes
- Obesity, Physical Activity, Diet
- Health Policy Implementation Science
- Emergency and Acute Care Studies
- Medication Adherence and Compliance
- Healthcare cost, quality, practices
- Viral-associated cancers and disorders
- Patient-Provider Communication in Healthcare
- Childhood Cancer Survivors' Quality of Life
- Health Literacy and Information Accessibility
- Healthcare Systems and Technology
- Diabetes Treatment and Management
- Nutritional Studies and Diet
University of Pennsylvania
2016-2025
Philadelphia VA Medical Center
2016-2025
The Bronx Defenders
2021
VA Healthcare-VISN 4
2016-2020
Philadelphia University
2018
Children's Hospital of Philadelphia
2016
Children's Hospital of Los Angeles
2016
University of Pennsylvania Health System
2016
London North West Healthcare NHS Trust
2016
University of Charleston
2016
Patients with low socioeconomic status (SES) use more acute hospital care and less primary than patients high status. This low-value pattern of is harmful to these patients' health costly the system. Many current policy initiatives, such as creation accountable organizations, aim improve both outcomes cost-effectiveness services. Achieving those goals requires understanding what drives use. We conducted qualitative interviews forty urban low-SES explore why they prefer care. They perceive it...
Background: Compared with white persons, African Americans have a greater incidence of diabetes, decreased control, and higher rates microvascular complications. A peer mentorship model could be scalable approach to improving control in this population reducing disparities diabetic outcomes. Objective: To determine whether mentors or financial incentives are superior usual care helping American veterans decrease their hemoglobin A1c (HbA1c) levels. Design: 6-month randomized, controlled...
To determine whether a community health worker (CHW) intervention improved outcomes in low-income population with multiple chronic conditions.
Addressing the social determinants of health has been difficult for systems to operationalize.To assess a standardized intervention, Individualized Management Patient-Centered Targets (IMPaCT), delivered by community workers (CHWs) across 3 systems.This 2-armed, single-blind, multicenter randomized clinical trial recruited patients from primary care facilities in Philadelphia, Pennsylvania, between January 28, 2015, and March 2016. Patients who resided high-poverty zip code, were uninsured...
Abstract Context Minority young adults (YA) currently represent the largest growing population with type 1 diabetes (T1D) and experience very poor outcomes. Modifiable drivers of disparities need to be identified, but are not well-studied. Objective To describe racial-ethnic among YA T1D identify glycemic disparity other than socioeconomic status (SES). Design Cross-sectional multicenter collection patient chart-reported variables, including SES, social determinants health, diabetes-specific...
To identify promoters of and barriers to fruit, vegetable, fast-food consumption, we interviewed low-income African Americans in Philadelphia. Salient were distinct from each other differed by food type: taste was a promoter cost barrier all foods; convenience, cravings, preferences promoted consumption fast health concerns fruits vegetables avoidance foods. Promoters gender age. Strategies for dietary change should consider type, gender,
Background: Recent studies highlight racial-ethnic disparities in insulin pump and continuous glucose monitor (CGM) use people with type 1 diabetes (T1D), but drivers of remain poorly understood beyond socioeconomic status (SES). Methods: We recruited a diverse sample young adults (YA) T1D from six centers across the United States, enrolling equal numbers non-Hispanic (NH) White, NH Black, Hispanic YA. used multivariate logistic regression to examine what extent SES, demographics, health...
Abstract Objective To measure the prevalence of cooking dinner at home in USA and test whether preparation habits are associated with socio-economic status, race/ethnicity, country birth family structure. Design Cross-sectional analysis. The primary outcome, self-reported frequency home, was divided into three categories: 0–1 dinners cooked per week (‘never’), 2–5 (‘sometimes’) 6–7 (‘always’). We used bivariable multivariable regression analyses to for associations between factors interest....
Public libraries are not usually included in discussions about improving population health. They are, however, well positioned to be partners building a culture of health through programming that addresses the social determinants The Healthy Library Initiative, partnership between University Pennsylvania and Free Philadelphia (the public library system serves city), has undertaken such efforts Philadelphia. In this article we report findings from an assessment how ten highly subscribed...
Abstract Objective To examine the relationship between food insecurity and coping strategies (actions taken to manage economic stress) hypothesized worsen glucose control in patients with diabetes. Design Using a cross-sectional telephone survey clinical data, we compared food-insecure food-secure individuals their use of strategies. logistic regression models, then examined association poor (glycated Hb, HbA1c≥8·0 %), Setting An urban medical centre, June December 2013. Subjects Four...
Abstract BACKGROUND: Hospital leaders have had mixed success reducing readmissions Little is known about the readmitted patient's perspective. METHODS: A cross‐sectional 36‐item survey was administered to 1084 inpatients of The University Pennsylvania (an urban academic medical center) and Penn Presbyterian Medical Center community hospital) between November 10, 2010 July 5, 2011. response rate 32.9%. RESULTS: most commonly reported issues contributing readmission were: 1) feeling unprepared...
Background: Racial-ethnic disparities in diabetes technology use are well documented young adults (YA) with type 1 (T1D), but modifiable targets for intervention still need to be identified. Our objective was explore YA perspectives on access and support routine clinical care. Materials Methods: Participants were T1D of Hispanic or non-Hispanic Black race-ethnicity from pediatric adult endocrinology clinics the Bronx, NY. We conducted semistructured individual interviews how health care...
HIV-infected individuals with non-AIDS-defining cancers are less likely to receive cancer treatment compared uninfected individuals. We sought identify provider-level factors influencing the delivery of oncology care patients.A survey was mailed 500 randomly selected US medical and radiation oncologists. The primary outcome standard treatment, assessed by responses three specialty-specific management questions. used χ(2) test evaluate associations between provider demographics, perceptions...
Purpose The purpose of the study was to evaluate an adult health care program model for emerging adults with type 1 diabetes transitioning from pediatric care. Methods Evaluation Pediatric Adult Diabetes Transition Clinic at University Pennsylvania included a cohort 72 diabetes, ages 18 25 years. Data were extracted transfer summaries and electronic medical record, including sociodemographic, clinical, follow-up characteristics. Pre- postprogram assessment 6 months mean daily blood glucose...
To analyze the effects of a standardized community health worker (CHW) intervention on hospitalization.Pooled data from three randomized clinical trials (n = 1340) conducted between 2011 and 2016.The in this pooled analysis were across diseases settings, with common study design, intervention, outcome measures. Participants patients living high-poverty regions Philadelphia predominantly Medicaid insured. They randomly assigned to receive usual care versus IMPaCT, an which CHWs provide...