Behavioural and psychosocial factors associated with 5-year weight trajectories within the PORTAL Overweight/Obesity Cohort.

Objective: The purpose of this study was to model weight trajectories over a 5-year time period (2012-2016) and their association with behavioural and psychosocial characteristics and health care-related experiences using data from the Patient Outcomes Research to Advance Learning (PORTAL) overweight/obesity cohort.

Methods: Weight trajectories for each eligible patient in the PORTAL overweight/obesity cohort ( = 2864) were identified first using growth modelling; trajectories were then grouped using a hierarchical cluster analysis. Weight trajectory clusters that emerged were compared on demographics, and predictors of cluster membership were examined.

Antiobesity Medication Use in 2.2 Million Adults Across Eight Large Health Care Organizations: 2009-2015.

Objective: The aim of this study was to examine the prescribing patterns and use of antiobesity medications in a large cohort of patients using data from electronic health records.

Methods: Pharmacy- and patient-level electronic health record data were obtained on 2,248,407 adults eligible for weight-loss medications from eight geographically dispersed health care organizations.

Results: A total of 29,964 patients (1.

Impact of Financial Incentives on Health Outcomes and Costs of Care among Medicaid Beneficiaries with Diabetes in Hawai'i.

The Hawai'i Patient Reward And Incentives to Support Empowerment (HI-PRAISE) project, part of the Medicaid Incentives for Prevention of Chronic Diseases program of the Affordable Care Act, examined the impact of financial incentives on Medicaid beneficiaries with diabetes. It included an observational pre-post study which was conducted at nine Federally Qualified Health Centers (FQHCs) between 2013 to 2015. The observational study enrolled 2,003 participants.

Treatment Initiation for New Episodes of Depression in Primary Care Settings.

Background: Depression is prevalent and costly, but despite effective treatments, is often untreated. Recent efforts to improve depression care have focused on primary care settings. Disparities in treatment initiation for depression have been reported, with fewer minority and older individuals starting treatment.

Increasing Prevalence of Primary Biliary Cholangitis and Reduced Mortality With Treatment.

Background & Aims: There are few data from longitudinal studies of trends in primary biliary cholangitis (PBC) among patients under routine clinical care in the United States. We collected data from the Fibrotic Liver Disease consortium to investigate changes in the incidence and prevalence of PBC and the effects of patient demographics, clinical features, and treatment on mortality.

Methods: We collected demographic and clinical data for the general patient population as well as PBC patients receiving care from 11 health systems in different regions of the United States (Northeast, Midwest, Northwest, and South) from January 1, 2003, through December 31, 2014.

Financial Incentives for Medicaid Beneficiaries With Diabetes: Lessons Learned From HI-PRAISE, an Observational Study and Randomized Controlled Trial.

Purpose: The Hawaii Patient Reward and Incentives to Support Empowerment (HI-PRAISE) project examined the impact of financial incentives on Medicaid beneficiaries with diabetes.

Design: Observational pre-post study and randomized controlled trial (RCT).

Setting: Federally qualified health centers (FQHCs) and Hawaii Kaiser Permanente.

Factors Associated With Prevalence and Treatment of Primary Biliary Cholangitis in United States Health Systems.

Background & Aims: Reported prevalence of primary biliary cholangitis (PBC) varies widely. Demographic features and treatment patterns are not well characterized in the United States (US). We analyzed data from the Fibrotic Liver Disease (FOLD) Consortium, drawn from 11 geographically diverse health systems, to investigate epidemiologic factors and treatment of PBC in the US.

Interacting effects of obesity, race, ethnicity and sex on the incidence and control of adult-onset asthma.

Background: To improve care and control for patients with adult-onset asthma, a better understanding of determinants of their risk and outcomes is important. We investigated how associations between asthma, asthma control and obesity may be modified by patient demographic characteristics.

Methods: This retrospective study of adults enrolled in several health plans across the U.

Race/Ethnic Differences in Birth Size, Infant Growth, and Body Mass Index at Age Five Years in Children in Hawaii.

Background: Factors at birth and infancy may increase risk of being overweight in childhood. The aim of this study was to examine the relationship of birth size and infant growth (2-24 months) with BMI at age 5 years in a multiethnic population.

Methods: This was a retrospective study (using electronic medical records of a health maintenance organization in Hawaii) of singleton children born in 2004-2005, with linked maternal and birth information, infant weights (n = 597) and lengths (n = 473) in the first 2 years, and BMI measures at age 5 years (n = 894).

Temporal trends in lipid screening and therapy among youth from 2002 to 2012.

Background: Pediatric lipid management recommendations have evolved from selective screening to universal screening to identify and target therapy for genetic dyslipidemias. Data on the success of the selective screening guidelines for lipid testing, dyslipidemia detection, and lipid management are conflicting.

Objective: To determine temporal trends in lipid testing, dyslipidemia categories and pharmacotherapy in a cohort of 653,642 individual youth aged 2 to 20 years from 2002 to 2012.

Medication Adherence Does Not Explain Black-White Differences in Cardiometabolic Risk Factor Control among Insured Patients with Diabetes.

Background: Among patients with diabetes, racial differences in cardiometabolic risk factor control are common. The extent to which differences in medication adherence contribute to such disparities is not known. We examined whether medication adherence, controlling for treatment intensification, could explain differences in risk factor control between black and white patients with diabetes.

A Big Five approach to self-regulation: personality traits and health trajectories in the Hawaii longitudinal study of personality and health.

Self-regulatory processes influencing health outcomes may have their origins in childhood personality traits. The Big Five approach to personality was used here to investigate the associations between childhood traits, trait-related regulatory processes and changes in health across middle age. Participants (N = 1176) were members of the Hawaii longitudinal study of personality and health.

Comparative Effectiveness of Statin Therapy in Chronic Kidney Disease and Acute Myocardial Infarction: A Retrospective Cohort Study.

Background: Whether there is a kidney function threshold to statin effectiveness in patients with acute myocardial infarction is poorly understood. Our study sought to help fill this gap in clinical knowledge.

Methods: We undertook a new-user cohort study of the effectiveness of statin therapy by level of estimated glomerular filtration rate (eGFR) in adults who were hospitalized for myocardial infarction between 2000 and 2008.

Personal health record use for children and health care utilization: propensity score-matched cohort analysis.

Objectives: To examine the association between caregiver personal health record (PHR) use and health care utilization by pediatric patients.

Design, Setting, And Participants: We conducted a retrospective observational cohort study of 2286 pediatric members aged six months to 2.5 years of Kaiser Permanente Hawaii and Northwest Regions in 2007-2011, using propensity score matching methods and t and chi-square tests to examine associations between PHR use and health care utilization.

A life-span behavioral mechanism relating childhood conscientiousness to adult clinical health.

Objective: To investigate a life-span health-behavior mechanism relating childhood personality to adult clinical health.

Methods: Childhood Big Five personality traits at mean age 10, adult Big Five personality traits, adult clinically assessed dysregulation at mean age 51 (a summary of dysregulated blood glucose, blood pressure, and lipids), and a retrospective, cumulative measure of life-span health-damaging behavior (lifetime smoking, physical inactivity, and body mass index from age 20) were assessed in the Hawaii Personality and Health Cohort (N = 759). Structural equation modeling was used to test the conceptual model with direct and indirect paths from a childhood Conscientiousness factor to an adult Conscientiousness factor, life-span health-damaging behaviors, educational attainment, adult cognitive ability, and adult clinical health.

Hepatitis B virus infection testing and prevalence among Asian and Pacific Islanders.

Objectives: Asian and Pacific Islanders (APIs) constitute less than 6% of the US population, but account for more than half of Americans with chronic hepatitis B virus (HBV) infection. We sought to examine the effect of country of origin on HBV testing and chronic HBV infection prevalence among APIs.

Methods: We analyzed demographic and clinical data collected for adults from Kaiser Permanente Hawaii with 1 or more healthcare encounters during 2006 to 2008, 12 months or more of follow-up before 2009, and no HBV-related diagnosis within 6 months of enrollment.

Longitudinal associations between sex, diabetes self-care, and health-related quality of life among youth with type 1 or type 2 diabetes mellitus.

Objective: To examine the longitudinal associations between sex, diabetes self-care, and the health-related quality of life (HRQL) of children and adolescents with type 1 or type 2 diabetes.

Study Design: The sample included 910 participants with type 1 and 241 participants with type 2, ages 10-22 years at baseline, from the SEARCH for Diabetes in Youth Study, a longitudinal observational study. The primary outcome measure was the Pediatric Quality of Life Inventory.

Prevalence of and disparities in barriers to care experienced by youth with type 1 diabetes.

Objective: To describe the prevalence of access and process barriers to health care and to examine their relationship to sociodemographic and disease factors in a large and diverse cohort of US youth with type 1 diabetes.

Study Design: A cross-sectional analysis of 780 youth who participated in the SEARCH for Diabetes in Youth Study and were diagnosed with type 1 diabetes in 2002-2005. Experience of barriers to care was collected from parent report on questionnaires.

Personal health record use and association with immunizations and well-child care visits recommendations.

Objective: To determine the association of parental use of integrated personal health records (PHRs) with children's adherence to immunization and well-child care (WCC) visit recommendations.

Study Design: For the immunization and WCC visit measures, we retrospectively analyzed, respectively, 766 and 639 matched pairs at Kaiser Permanente (KP) Hawaii and 2795 and 2448 pairs at KP Northwest who were ≤ 31 days old at enrollment and continuously enrolled for 2 years between January 2007 and July 2011. The independent variable (≥ 1 PHR feature used vs none) was matched using propensity scores on parental and children characteristics.

Mortality rates and cause-of-death patterns in a vaccinated population.

Background: Determining the baseline mortality rate in a vaccinated population is necessary to be able to identify any unusual increases in deaths following vaccine administration. Background rates are particularly useful during mass immunization campaigns and in the evaluation of new vaccines.

Purpose: Provide background mortality rates and describe causes of death following vaccination in the Vaccine Safety Datalink (VSD).

Integrated personal health record use: association with parent-reported care experiences.

Objective: To examine integrated personal health record (PHR) use patterns among parents of children with chronic disease and compare ratings of care experiences between integrated PHR users and nonusers.

Methods: A survey was mailed to 600 randomly selected parents of children with chronic disease ≤ 5 years old and enrolled at Group Health for ≥ 1 year. Respondents reported integrated PHR use in the past 12 months, types of services used, or reasons for nonuse.

Missed well-child care visits, low continuity of care, and risk of ambulatory care-sensitive hospitalizations in young children.

Objectives: To determine if adherence to the recommended well-child care (WCC) visit schedule, independent of continuity of care (COC), is associated with lower risk of ambulatory care-sensitive hospitalizations (ACSH) and whether this association varies by chronic disease status.

Design: Population-based, retrospective cohort study.

Setting: Hawaii's largest health plan from 1999 to 2006.

The Pacific Tracker (PacTrac): Development of a dietary assessment instrument for the Pacific.

The Pacific Tracker (PacTrac) is a new dietary assessment program that can be used to evaluate dietary data for nutrition studies in the Pacific Islands. PacTrac is a modification of the Interactive Healthy Eating Index (IHEI) developed by the US Department of Agriculture's Center for Nutrition Policy and Promotion as an online interactive dietary assessment tool for use by the public. Creation of PacTrac required several modifications to the IHEI, including a function to save data to allow for later access and addition of Pacific Island foods.

Electronic medical records and prevention quality: the prevention index.

Background: The Prevention Index is a methodology for using electronic medical records to identify and evaluate practice variations in the delivery of preventive care.

Methods: The Prevention Index was used to evaluate the provision of 10 recommended adult preventive services using electronic medical record data for the years 1999 through 2002 among the 450,000 members of a large Northwest integrated care system. The analyses were conducted in 2005.