31 results match your criteria: "Kaiser Permanente Institute for Health Research[Affiliation]"

Introduction: Food insecurity (FI) is common in families with young children. People experiencing FI have worse health outcomes related to behaviors (obesity, diabetes management, etc) than people who are food secure. This study explores strategies that parents on limited incomes use to feed their children, their understanding of nutrition for their children, and the social factors contributing to or alleviating FI.

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Purpose: Because social conditions such as food insecurity and housing instability shape health outcomes, health systems are increasingly screening for and addressing patients' social risks. This study documented the prevalence of social risks and examined the desire for assistance in addressing those risks in a US-based integrated delivery system.

Methods: A survey was administered to Kaiser Permanente members on subsidized exchange health insurance plans (2018-2019).

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Embedded pragmatic clinical trials (ePCTs) and quality improvement (QI) activities often occur simultaneously within healthcare systems (HCSs). Embedded PCTs within HCSs are conducted to test interventions and provide evidence that may impact public health, health system operations, and quality of care. They are larger and more broadly generalizable than QI initiatives, and may generate what is considered high-quality evidence for potential use in care and clinical practice guidelines.

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Background: Team-based models of care are efficacious in improving outcomes for patients with mental and physical illnesses. However, primary care clinics have been slow to adopt these models. We used iterative stakeholder engagement to develop an intervention to improve the implementation of team-based care for this complex population.

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Background: Febrile seizures are associated with the first dose of measles-containing vaccines and the risk increases with chronologic age during the second year of life. We used the Vaccine Safety Datalink (VSD) to determine if the relative increase in risk of seizures following receipt of measles-containing vaccine differs by gestational age at birth.

Methods: Children were eligible if they received their first dose of measles-containing vaccine at age 12 through 23 months from January 2003 through September 2015.

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This study examined whether, among Veterans Health Administration (VHA) patients, veterans with recent or current justice involvement have equal receipt of pharmacotherapy for alcohol use disorder compared to veterans with no justice involvement. Using national VHA records, we calculated the overall and facility rates of receipt as the number of patients who received pharmacotherapy for alcohol use disorder divided by the number of patients diagnosed with an alcohol use disorder. Using a mixed-effects logistic regression model, we tested whether justice involvement was associated with pharmacotherapy receipt.

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Estimating the Impact of Diabetes Mellitus on Worker Productivity Using Self-Report, Electronic Health Record and Human Resource Data.

J Occup Environ Med

November 2018

Kaiser Permanente Institute for Health Research, Denver, Colorado (Tabano, Drs Ritzwoller, Beck, Carroll); University of Colorado Skaggs School of Pharmacy and Pharmaceutical Sciences, Aurora, Colorado (Tabano); Kaiser Permanente Washington Health Research Institute, Seattle, Washington (Drs Anderson, Fishman, Grossman); Department of Health Services University of Washington, Seattle, Washington (Drs Fishman, Grossman).

Objective: We assessed the relationship between diabetes mellitus (DM) and measures of worker productivity, direct health care costs, and costs associated with lost productivity (LP) among health care industry workers across two integrated health care systems.

Methods: We used data from the Value Based Benefit Design Health and Wellness Study Phase II (VBD), a prospective study of employees surveyed across health systems. Survey and health care utilization data were linked to estimate LP and health care utilization costs.

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Reduction in Cardiovascular Risk Among Latino Participants in a Community-Based Intervention Linked With Clinical Care.

Am J Prev Med

August 2017

Colorado Prevention Center, Community Health Department, Aurora, Colorado; Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, Colorado; Ambulatory Care Services, Denver Health and Hospital Authority, Denver, Colorado. Electronic address:

Introduction: Community Heart Health Actions for Latinos at Risk is a community health worker-led cardiovascular disease risk reduction program targeting low-income urban Latinos. The impact of community programs linked with clinical care has not been well characterized.

Methods: Community Heart Health Actions for Latinos at Risk provided 12 weeks of lifestyle education.

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Traceback: A Proposed Framework to Increase Identification and Genetic Counseling of BRCA1 and BRCA2 Mutation Carriers Through Family-Based Outreach.

J Clin Oncol

July 2017

Goli Samimi, Charlisse F. Caga-anan, Michael Dean, Leah E. Mechanic, Lori M. Minasian, and Mark E. Sherman, National Cancer Institute; Lawrence C. Brody, National Human Genome Research Institute, Bethesda, MD; Marcus Q. Bernardini, Stephanie Lheureux, Patricia A. Shaw, Princess Margaret Cancer Centre, Toronto, Ontario; Janice S. Kwon, University of British Columbia; British Columbia Cancer Agency, Vancouver, British Columbia, Canada; Ian G. Campbell, Paul A. James, Masataka Takenaka, and David D. Bowtell, Peter MacCallum Cancer Centre; David D. Bowtell, University of Melbourne, Melbourne, Victoria; Georgia Chenevix-Trench, QIMR Berghofer Medical Research Institute, Brisbane, Queensland; Michael Friedlander, The Prince of Wales Hospital; Susan J. Ramus, University of New South Wales; Susan J. Ramus and David D. Bowtell, Garvan Institute of Medical Research, Sydney, New South Wales, Australia; Fergus J. Couch, Mayo Clinic, Rochester, MN; Joanne A. de Hullu and Marline G. Harmsen, Radboud University Medical Center, Nijmegen, the Netherlands; Susan M. Domchek and Ronny Drapkin, University of Pennsylvania, Philadelphia; Phuong L. Mai, Magee-Women's Hospital of the University of Pittsburgh Medical Center, Pittsburgh, PA; Heather Spencer Feigelson, Kaiser Permanente Institute for Health Research, Denver, CO; Mia M. Gaudet, American Cancer Society, Atlanta, GA; Karen Hurley and Mark E. Robson, Memorial Sloan Kettering Cancer Center; Mark E. Robson, Weill Cornell Medical College, New York, NY; Felicitas Lacbawan, Quest Diagnostics Nichols Institute, San Juan Capistrano; Thomas P. Slavin, City of Hope, Duarte, CA; Evan R. Myers, Duke University Medical Center, Durham, NC; Lisa F. Rezende, FORCE: Facing Our Risk of Cancer Empowered, Tampa; Mark E. Sherman, Mayo Clinic, Jacksonville, FL; and Elizabeth M. Swisher, University of Washington Medical Center, Seattle, WA.

In May 2016, the Division of Cancer Prevention and the Division of Cancer Control and Population Sciences, National Cancer Institute, convened a workshop to discuss a conceptual framework for identifying and genetically testing previously diagnosed but unreferred patients with ovarian cancer and other unrecognized BRCA1 or BRCA2 mutation carriers to improve the detection of families at risk for breast or ovarian cancer. The concept, designated Traceback, was prompted by the recognition that although BRCA1 and BRCA2 mutations are frequent in women with ovarian cancer, many such women have not been tested, especially if their diagnosis predated changes in testing guidelines. The failure to identify mutation carriers among probands represents a lost opportunity to prevent cancer in unsuspecting relatives through risk-reduction intervention in mutation carriers and to provide appropriate reassurances to noncarriers.

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Importance: Within 10 years after breast cancer diagnosis, roughly 5% of patients develop contralateral breast cancer (CBC). Randomized trials have found that therapy including tamoxifen citrate and aromatase inhibitors (AIs) reduces CBC risk. But little is known about the magnitude and duration of protective associations within the context of real-world clinical management settings, where varying durations of and gaps in treatment are common.

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Information technology (IT) in healthcare, also referred to as eHealth technologies, may offer a promising solution to the provision of better care and support for people who have multiple conditions and complex care needs, and their caregivers. eHealth technologies can include electronic medical records, telemonitoring systems and web-based portals, and mobile health (mHealth) technologies that enable information sharing between providers, patients, clients and their families. IT often acts as an enabler of improved care delivery, rather than being an intervention per se.

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Objectives: To clarify the neuropsychiatric phenotype of fragile X-associated tremor/ataxia syndrome (FXTAS), and assess the extent to which it is mediated by the dysexecutive syndrome that is a major feature of the disorder.

Methods: We examined the prevalence of clinically meaningful psychiatric symptoms among male carriers of the fragile X premutation, with and without FXTAS, in comparison with men with a normal allele. Measures included the Neuropsychiatric Inventory (NPI), Symptom Checklist-90-R (SCL-90-R), and the Behavioral Dyscontrol Scale, a measure of executive functioning.

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Introduction/objective: The objective of this study was to develop an algorithm to identify Kaiser Permanente Colorado (KPCO) members with a history of cancer.

Background: Tumor registries are used with high precision to identify incident cancer, but are not designed to capture prevalent cancer within a population. We sought to identify a cohort of adults with no history of cancer, and thus, we could not rely solely on the tumor registry.

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Background: Complex patients are increasingly common in primary care and often have poor clinical outcomes. Healthcare system barriers to effective care for complex patients have been previously described, but less is known about the potential impact and meaning of caring for complex patients on a daily basis for primary care providers (PCPs). Our objective was to describe PCPs' experiences providing care for complex patients, including their experiences of health system barriers and facilitators and their strategies to enhance provision of effective care.

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Receipt of pharmacotherapy for opioid use disorder by justice-involved U.S. Veterans Health Administration patients.

Drug Alcohol Depend

March 2016

Kaiser Permanente Institute for Health Research, 10065 E Harvard Ave., Suite 300, Denver, CO 80231, USA; Division of General Internal Medicine, University of Colorado School of Medicine, 12631 E. 17th Ave., Aurora, CO 80204, USA. Electronic address:

Background: Pharmacotherapy - methadone, buprenorphine, or naltrexone - is an evidence-based treatment for opioid use disorder, but little is known about receipt of these medications among veterans involved in the justice system. The current study examines receipt of pharmacotherapy for opioid use disorder among veterans with a history of justice involvement at U.S.

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The Veterans Health Administration (VA) Health Care for Reentry Veterans (HCRV) program links veterans exiting prison with treatment. Among veterans served by HCRV, national VA clinical data were used to describe contact with VA health care, and mental health and substance use disorder diagnoses and treatment use. Of veterans seen for an HCRV outreach visit, 56 % had contact with VA health care.

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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.

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Building Data Infrastructure to Evaluate and Improve Quality: PCORnet.

J Oncol Pract

May 2015

Kaiser Permanente Northern California, Oakland; Kaiser Permanente Center for Effectiveness and Safety Research, Pasadena, CA; and Kaiser Permanente Institute for Health Research, Denver, CO.

The goal of PCORnet is to create a community of research that includes patients, clinicians, and health care delivery systems to improve the nation's ability to conduct comparative-effectiveness research.

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Aims: The aim of this study was to examine the relationship between a specific glycated haemoglobin (HbA1c) measurement and a pharmaceutical dispensings-based measure of adherence calculated over the 90 days before each HbA1c measure among patients who have newly initiated metformin therapy.

Methods: We identified 3109 people with type 2 diabetes who initiated metformin as their first-ever antihyperglycaemic drug, analysing all 9918 HbA1c measurements that were taken over the next 2 years. We used an adaptation of the 'proportion of days covered' method for assessing medication adherence that corresponded to an ∼90-day interval preceding an HbA1c measurement, terming the adaptation the 'biological response-based proportion of days covered' (BRB-PDC).

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Objective: The objective of this study was to assess the incidence of major cardiovascular (CV) hospitalization events and all-cause deaths among adults with diabetes with or without CV disease (CVD) associated with inadequately controlled glycated hemoglobin (A1C), high LDL cholesterol (LDL-C), high blood pressure (BP), and current smoking.

Research Design And Methods: Study subjects included 859,617 adults with diabetes enrolled for more than 6 months during 2005-2011 in a network of 11 U.S.

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Background: Mindfulness-based stress reduction (MBSR) programs have demonstrated clinical effectiveness for both mental and physical health conditions. Less research exists on health services utilization, self-efficacy, or work productivity outcomes.

Objective: To assess one-year outcomes of MBSR in patients with chronic pain, chronic illness, or stress-related problems, measuring functional status, pain, self-efficacy, depression, anxiety, somatization, psychological distress, work productivity, and changes in health services utilization.

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Objectives: To describe changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), and body mass index (BMI) associated with initiation and continued use of combined oral contraceptives (COCs) in healthy adolescents.

Study Design: This observational, matched cohort study was conducted in 2 large health systems. Utilizing claims and electronic medical records, we identified adolescents 14-17.

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