Publications by authors named "Molly Conroy"

Background: Discharge communication between hospitalists and primary care clinicians is essential to improve care coordination, minimize adverse events, and decrease unplanned health services use. Health-related social needs are key drivers of health, and hospitalists and primary care clinicians value communicating social needs at discharge.

Objective: To 1) characterize the current state of discharge communications between an academic medical center hospital and primary care clinicians at associated clinics; 2) seek feedback about the potential usefulness of discharge readiness information to primary care clinicians.

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Background: The increasing prevalence of obesity necessitates innovative interventions to address this grave public health concern. Standard behavioral therapy has been the mainstay for promoting weight loss, but its access and uptake are limited. The SMARTER randomized controlled trial aimed to explore the effects of self-monitoring with real-time, remotely delivered tailored feedback to recorded physical activity (PA) on weight loss.

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Article Synopsis
  • - Maintaining a healthy weight after intentional weight loss is vital for preventing chronic health problems, but many people struggle with regaining weight; integrating electronic health record (EHR) portals into primary care may help in managing this issue.
  • - A training program was developed and evaluated for clinical staff to improve their coaching abilities and support weight maintenance, based on previous findings that showed coaching with self-monitoring is more effective than monitoring alone.
  • - Despite challenges posed by the COVID-19 pandemic, 39 clinicians were trained, with 34 coaching patients successfully, and they reported high satisfaction and readiness to implement coaching, demonstrating the potential for a sustainable weight management intervention in primary care settings.
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  • This study explored whether decreasing sedentary behavior (SB) in desk workers could lower blood pressure (BP) and pulse wave velocity (PWV), as previous research linked SB to cardiovascular risk.* -
  • Over 3 months, 271 participants were divided into an SB reduction group and a control group, using tools like activity prompts and sit-stand desks, but the intervention didn't yield significant changes in BP or PWV.* -
  • While the intervention group reduced SB and increased active time during work hours, these changes didn't lead to the anticipated health benefits, although some reduction in resting diastolic BP was noted.*
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The integration of health and activity data from various wearable devices into research studies presents technical and operational challenges. The Awesome Data Acquisition Method (ADAM) is a versatile, web-based system that was designed for integrating data from various sources and managing a large-scale multiphase research study. As a data collecting system, ADAM allows real-time data collection from wearable devices through the device's application programmable interface and the mobile app's adaptive real-time questionnaires.

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Article Synopsis
  • This paper talks about creating and using technology to help doctors and staff manage patients' weight through online tools.
  • They looked at what was needed to make these tools work and how to track their success.
  • The study found that using technology in healthcare can really help with keeping track of patients' weight and activities, but it needs careful planning and teamwork to make it happen well.
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In the few weight loss studies assessing diet quality, improvements have been minimal and recommended calculation methods have not been used. This secondary analysis of a parallel group randomised trial (regsitered: https://clinicaltrials.gov/ct2/show/NCT03367936) assessed whether self-monitoring with feedback (SM + FB) .

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Background: Social determinants of health (SDoH) have been associated with disparate outcomes among those with metabolic dysfunction-associated steatotic liver disease (MASLD) and its risk factors. To address SDoH among this population, real-time SDoH screening in clinical settings is required, yet optimal screening methods are unclear. We performed a scoping review to describe the current literature on SDoH screening conducted in the clinical setting among individuals with MASLD and MASLD risk factors.

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Background: There is need for interventions that can assist with long-term maintenance of healthy body weight and be sustainably integrated into existing primary care teams. The goal of MAINTAIN PRIME (Promoting Real (World) IMplEmentation) is to evaluate whether a successful electronic health record (EHR)-based weight maintenance intervention can be adapted to a new clinical setting with primary care staff serving as coaches.

Methods: EHR tools include tracking tools, standardized surveys, and standardized "SmartPhrases" for coaching.

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Hypertension control remains poor. Multiple barriers at the level of patients, providers, and health systems interfere with implementation of hypertension guidelines and effective lowering of BP. Some strategies such as self-measured blood pressure (SMBP) and remote management by pharmacists are safe and effectively lower BP but have not been effectively implemented.

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Objective: Asthma is one of the most common chronic conditions in developed countries. We examined whether physical activity (PA) is related to asthma control and body mass index (BMI) in asthma patients.

Methods: Cross-sectional data collected on PA (ActiGraph GT3X-BT), asthma control (the Asthma Control Questionnaire; ACQ), and BMI were examined in 206 adults (mean[sd] age 47.

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Background: Short sleep duration, defined as < 7 h sleep on weeknights, affects 40% of the US adult population, contributing to the increased risk for cardiometabolic diseases, decreased safety, and poorer mental health. Despite the prevalence of short sleep duration, few studies have tested interventions to extend sleep duration. The objective of this study is to test the effects of a behavioral sleep extension intervention on sleep duration, blood pressure, and other measures of cardiometabolic health among adults with elevated blood pressure or hypertension.

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Article Synopsis
  • Recent research examined how posture (standing, moving, or seated) affects average daytime blood pressure during ambulatory BP monitoring (ABPM) in desk workers with mild hypertension.
  • The study found that individuals' blood pressure readings were significantly higher after standing or moving compared to after sitting, with substantial variability explained by their activity levels prior to measurements.
  • These findings suggest that posture and activity before blood pressure assessments can impact the diagnosis of hypertension, highlighting the need for standardized recommendations regarding seating during BP monitoring.
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Purpose: Participant engagement in an online physical activity (PA) intervention is described and baseline factors related to engagement are identified.

Design: Longitudinal Study Within Randomized Controlled Trial.

Setting: Online/Internet.

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Introduction/purpose: Weight maintenance following intentional weight loss is challenging and often unsuccessful. Physical activity and self-monitoring are strategies associated with successful weight loss maintenance. However, less is known about the type and number of lifestyle strategies used following intentional weight loss.

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Background: Single-pill combination (SPC) antihypertensive products improve blood pressure control and medication adherence among patients with hypertension. It is unknown to what degree commercially available SPC products could be used to target an intensive systolic blood pressure goal of <120 mm Hg.

Methods: This cross-sectional analysis included participants randomized to the intensive treatment arm (goal systolic blood pressure <120 mm Hg) of the Systolic Blood Pressure Intervention Trial (SPRINT) using ≥2 antihypertensive medication classes at the 12-month postrandomization visit.

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Background Fixed-dose combination (FDC) antihypertensive products improve blood pressure control and adherence among patients with hypertension. It is unknown to what degree commercially available FDC products meet the current hypertension management prescription patterns in the United States. Methods and Results This cross-sectional analysis of the National Health and Nutrition Examination Surveys 2015 to March 2020 included participants with hypertension taking ≥2 antihypertensive medications (N=2451).

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Background: Morbid obesity is becoming more prevalent and is a known risk factor for esophageal cancer. Esophagectomy in this population is technically more challenging than the non-obese, thus increasing the risks of surgery. This study hypothesizes that higher body mass index (BMI) is associated with higher anastomotic leak rates after esophagectomy.

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Introduction/purpose: Sedentary behavior (SB) is common in desk-based work and prolonged periods of SB are associated with negative health outcomes. This study assessed associations between workplace characteristics and setting and movement patterns during working hours.

Methods: This secondary analysis used baseline data from the Reducing Sedentary Behavior to Decrease Blood Pressure (RESET BP) clinical trial which enrolled inactive, desk-based workers with elevated blood pressure (=271; mean age: 45.

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The diet quality of US adults is poor and cross-sectional analyses suggest self-perception of healthful dietary intake may be overestimated. This analysis assessed the concordance between calculated and perceived diet quality and changes in diet quality among adults seeking weight loss and enrolled in a 12-month randomized behavioral trial. Healthy Eating Index-2015 diet quality (HEI) was calculated from self-administered 24-hour recalls.

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Objective: This study aimed to evaluate whether coaching features were successfully transmitted via electronic health record (EHR) communication and to evaluate their relationship with weight change in a previously tested EHR-based coaching intervention.

Methods: A secondary analysis from the Maintaining Activity and Nutrition through Technology-Assisted Innovation in Primary Care (MAINTAIN-pc) study randomized clinical trial was conducted in nine primary care practices and one specialty practice (endocrinology) affiliated with the University of Pittsburgh Medical Center. Eligibility included age 18 to 75 years, intentional 5% weight loss in the previous 2 years, access to an internet-connected computer, and receipt of care from a University of Pittsburgh Medical Center primary care provider.

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Importance: Bariatric surgery is the most effective treatment for severe obesity; yet it is unclear whether the long-term safety and comparative effectiveness of these operations differ across racial and ethnic groups.

Objective: To compare outcomes of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) across racial and ethnic groups in the National Patient-Centered Clinical Research Network (PCORnet) Bariatric Study.

Design, Setting, And Participants: This was a retrospective, observational, comparative effectiveness cohort study that comprised 25 health care systems in the PCORnet Bariatric Study.

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