Nancy P. Gordon , ScD

nancy.gordon@kp.org

Nancy Gordon, ScD, has been a research scientist and program evaluation consultant in the Health Care Effectiveness group at the Kaiser Permanente Northern California Division of Research since 1985. She has a master’s degree in counseling psychology from the University of California, Santa Barbara; and a doctor of science in applied behavioral sciences from the Harvard School of Public Health. Dr. Gordon’s experience includes being director of the triennial Kaiser Permanente Northern California Adult Member Health Survey and serving as an evaluation consultant/director for many patient education/health promotion and innovative primary care health services sponsored by the Kaiser Permanente Medical Care Program. She has also frequently served as a consultant for the evaluation of programs aimed at improving knowledge and practices of clinical staff.

Current Positions

Research Scientist II, Division of Research, Kaiser Permanente Northern California
Consultant, Kaiser Permanente Care Management Institute, Center for Population Health

Section Affiliations

Health Care Delivery and Policy

Primary Research Interests

Disparities in health behaviors, psychosocial health risks, social determinants of health, and health status related to age, gender, race/ethnicity, and education
Trends in and demographic characteristics associated with adult use of and interest in using eHealth technologies and patient portals
Health behaviors and health/functional status of older adults
Member and physician surveys
Evaluation of health services and health education programs, with special focus on who uses them, how effective they are, and whether they are more effective for some types of people than others

Related Websites

Kaiser Permanente Adult Member Health Survey

Studies

Do health and health care indicators differ by preferred language in Latinx and Chinese Adults? A health and health care disparities study.

Limited English proficiency may be an important social determinant of health and health care access. This study will use electronic health record data to describe and compare health risks, chronic health conditions, quality metrics, and health care use by language preference for 2 cohorts of adults aged 25-84 who were KPNC members during calendar year 2019: Latino adults with Spanish vs. English spoken language preference and Chinese adults with Chinese dialect vs. English spoken language preference. Study results will improve understanding of whether and how limited English proficiency contributes to disparities in health and health care utilization in these 2 ethnic groups in a health care delivery system that has made extensive efforts to mitigate language barriers to care delivery.

Investigator: Gordon, Nancy

Funder: KP National Office of Community Health

Women’s Multi-Ethnic Health and Lifestyle Survey

We propose to survey White, Black, Latina, Filipina, Chinese, South Asian, Vietnamese, and Japanese women aged 35-79 to characterize and compare these racial/ethnic groups on behaviors and risks related to 7 lifestyle medicine domains (diet, physical activity, sleep, stress management, tobacco avoidance, limited alcohol use, positive social connections) and 1 mental health domain (feelings of depression and anxiety). We will also collect data about potential facilitators and barriers to having a healthy lifestyle, including socioeconomic factors (education, income), social risks (financial strain, psychosocial stressors, experienced discrimination/harassment, social support), familiarity with and interest in plant-based diets, and beliefs about the extent to which different lifestyle practices can improve health and longevity. Survey data will be linked with EHR data to describe subgroups of women who already have prediabetes and selected chronic conditions.

Investigator: Gordon, Nancy

Funder: Northern California Community Benefit Programs

Building an Evidence Case for Capturing Educational Attainment in the EHR as a Social Determinant of Health

Educational attainment is an important social determinant of health, but it is not included in the electronic health records of a majority of adults. When the information is available, it is frequently not captured in a way that makes it easy to use in large data-only studies. This study will build evidence for the value of including educational attainment as a discrete categorical variable in electronic health records by examining the association of educational attainment with prevalence of chronic health conditions, obesity and smoking, quality metrics, and use of health care services and the patient portal among Medicaid enrollees aged 25-64 and a cohort of Medicare-aged (65-89 years) adults. The study will also examine differences by education across and within race/ethnic groups and within age groups, adjusted for sex and race/ethnicity. Lastly, we will evaluate different cut-points for educational attainment to make recommendations on ways to dichotomize education as a risk predictor.

Investigator: Gordon, Nancy

Funder: Northern California Community Benefit Programs

Use of Digital Information Technologies and Health Information Resources by Limited English Proficient Latino and Chinese Adult Members

The
goal of this research is to learn about use of digital information
technologies (DIT) and the kp.org website and patient portal, preferred
modalities for receiving health information and advice, and social
determinants of DIT use and health information preferences by members by
limited English proficient (LEP) Spanish and Chinese patients. Study data
will be collected using anonymous self-administered questionnaires
distributed and collected by line staff in dedicated La Salud and Chinese
modules in several Kaiser Permanente Northern California medical facilities.
We will also compare use of the patient portal during a 12-month period prior
to the survey by LEP Spanish and Chinese speakers who receive care in
dedicated bilingual modules vs. at-large modules to evaluate generalizability
of survey results.

Investigator: Gordon, Nancy

Funder: Garfield Memorial Fund

Healthy Eating as a Means for Active Living in Heart Failure (HEAL-HF) Study

There is an unmet clinical need to better understand the impact of lifestyle choices with respect to diet and nutrition in high-risk heart failure patients who have been recently hospitalized. We will conduct a survey-based project using a combination of questionnaires to assess 4 clinically relevant domains: food access and security, dietary composition and quality, nutritional awareness and understanding, and attitudes toward nutrition-related research. The survey itself will take no more than 15 to 30 minutes to complete and will be administered via telephone to 1,000 consecutive patients recently hospitalized with a primary diagnosis of heart failure who are responsible for their own meal planning. In addition to the survey elements, outcomes of interest will include subsequent heart failure hospitalization, all-cause hospitalization, and mortality occurring within 30 days. These outcomes will be passively collected via Kaiser Permanente HealthConnect electronic health records.

Investigator: Go, Alan; Ambrosy, Andrew; Gordon, Nancy

Funder: Northern California Community Benefit Programs

Similarities and Differences in Health Indicators and Health Care Use Among Asian Ethnic Groups

This study will examine whether significant differences across Asian ethnic groups in prevalence of chronic diseases, behavioral/psychosocial risk factors, preventive service use, and patient portal use are masked when statistics are reported for “Asians.” It will utilize electronic health records and clinical/administrative data for a cohort of adults aged 20 to 89 who were Kaiser Permanente Northern California (KPNC) members throughout 2016 to compare six Asian ethnic groups (Filipino, Chinese, Korean, Japanese, South Asian, and Southeast Asian) on prevalence of chronic health conditions, obesity, and smoking status; Healthcare Effectiveness Data and Information Set (HEDIS) quality indicators of chronic disease management and cancer screening; and patient portal use during 2016. Pooled data weighted from the 2011, 2014/2015, and 2017 KPNC Member Health Surveys will also be used to compare the Asian ethnic groups on sociodemographic characteristics, health status, health behaviors, and information technology (IT) use. Asian ethnic groups will also be compared with non-Hispanic whites, blacks, and Latinos.

Investigator: Gordon, Nancy

Funder: Northern California Community Benefit Programs

Does Information about Members’ Social Determinants of Health Improve Prediction of Risk for Hospitalization, Emergency Department Visits, and Outpatient Utilization?

The new Kaiser Permanente Your Current Life Situation (YCLS) screening questionnaire will be mailed to a random sample of 7,000 adult members of Kaiser Permanente Northern California (KPNC), oversampling patients at low to medium risk for hospitalization. After receiving responses, YCLS data will be linked with existing variables known to be predictors of utilization, including age, sex, COPS2 (COmorbidity Point Score, version 2), abLAPS (abbreviated Laboratory-based Acute Physiology Score), other composite indices currently available in KPNC electronic databases, and U.S. census-derived socioeconomic status data. The linked data will be analyzed to determine the extent to which the YCLS data improves prediction of hospitalization, emergency department use, and total outpatient utilization, and, if improvement in prediction is found after incorporating YCLS data, which specific items from the YCLS have the greatest impact. Responses to the YCLS survey, weighted to the adult membership, will also be used to estimate prevalence of KPNC adult members’ social and economic needs.

Investigator: Gordon, Nancy; Escobar, Gabriel

Funder: Kaiser Permanente Program Offices

Does Combining Asians Into One Group Mask Important Ethnic Group Differences in Health and Health Care Use?

This study will examine whether significant differences across Asian ethnic groups in prevalence of chronic diseases, behavioral and psychosocial risk factors, preventive service use, and patient-portal use are masked when statistics are reported for Asians. We will use a very large cohort of adults aged 20 to 90 who were members of Kaiser Permanente Northern California for two or more years as of December 2016 to compare six Asian ethnic groups (Filipino, Chinese, Korean, Japanese, South Asian, and Southeast Asian). Electronic health record and clinical and administrative data linked to the cohort will be used to compare prevalence of chronic conditions, HEDIS (Healthcare Effectiveness Data and Information Set) performance on chronic disease management and cancer screening, frequency of smoking, frequency of obesity and exercise, and patient-portal use. Pooled data from the 2011 and 2014-15 Member Health Surveys will be used to compare Asian ethnic groups on sociodemographic characteristics, health status, and health behavior and psychosocial risks. Asian ethnic groups will also be compared with non-Hispanic white, black, and Latino adults.

Investigator: Gordon, Nancy

Funder: Northern California Community Benefit Programs

Barriers to Health Care in a Latino Population with Autism Spectrum Disorder

This study will identify barriers to the use of recommended assessment, diagnostic, and treatment services among Latino children and adolescents with autism spectrum disorder. The study population will comprise Kaiser Permanente Northern California Latino members, and comparisons will be made between commercially insured versus federally insured (Medicaid) patients, and English versus Spanish speakers.

Investigator: Croen, Lisa; Gordon, Nancy

Funder: Northern California Community Benefit Programs

Publications

Advance Directives for Patients With Breast Cancer: Applying the Right Info/Right Care/Right Patient/Right Time Oncology Model

Authors: Ossowski, Stephanie;Linehan, Elizabeth;Ravelo, Arliene;Liu, Raymond;et al.

Perm J. 2023 Sep 15;27(3):30-36. Epub 2023-06-16.

Nancy P. Gordon , ScD

Current Positions

Section Affiliations

Primary Research Interests

Related Websites

Studies

Do health and health care indicators differ by preferred language in Latinx and Chinese Adults? A health and health care disparities study.

Women’s Multi-Ethnic Health and Lifestyle Survey

Building an Evidence Case for Capturing Educational Attainment in the EHR as a Social Determinant of Health

Use of Digital Information Technologies and Health Information Resources by Limited English Proficient Latino and Chinese Adult Members

Healthy Eating as a Means for Active Living in Heart Failure (HEAL-HF) Study

Similarities and Differences in Health Indicators and Health Care Use Among Asian Ethnic Groups

Does Information about Members’ Social Determinants of Health Improve Prediction of Risk for Hospitalization, Emergency Department Visits, and Outpatient Utilization?

Does Combining Asians Into One Group Mask Important Ethnic Group Differences in Health and Health Care Use?

Barriers to Health Care in a Latino Population with Autism Spectrum Disorder

Publications

Advance Directives for Patients With Breast Cancer: Applying the Right Info/Right Care/Right Patient/Right Time Oncology Model

Social Risks, Social Needs, and Attitudes Toward Social Health Screening 1 Year Into the COVID-19 Pandemic: Survey of Adults in an Integrated Health Care Delivery System

Differences in proximal humerus and wrist fracture incidence among US Asian subgroups

Cannabis use for medical reasons among patients in a large California health care system after legalization of non-medical use

TRENDS IN SMOKING-SPECIFIC LUNG CANCER INCIDENCE RATES WITHIN A U.S. INTEGRATED HEALTH SYSTEM, 2007-2018

Sex- and ethnic-specific patterns in the incidence of hip fracture among older US Asian and non-Hispanic White adults

Fostering a High-Functioning Team in Cancer Care Using the 4R Oncology Model: Assessment in a Large Health System and a Blueprint for Other Institutions

Cardiovascular Disease Risk Factors Among Middle-Aged and Older Adult Vietnamese American Members of a Northern California Health Plan

Prevalence of sleep-related problems and risks in a community-dwelling older adult population: a cross-sectional survey-based study

Prevalence of prediabetes and diabetes vary by ethnicity among U.S. Asian adults at healthy weight, overweight, and obesity ranges: an electronic health record study

Reach, acceptability, and perceived success of a telehealth diabetes prevention program among racially and ethnically diverse patients with gestational diabetes: the GEM cluster-randomized trial

Prospective evaluation of social risks, physical function, and cognitive function in prediction of non-elective rehospitalization and post-discharge mortality

Differences in Health Characteristics of Geographic Subgroups of Arab Americans in a Northern California Health Plan

Differential Cardiometabolic Risk Factor Clustering Across U.S. Asian Ethnic Groups

Oral Health Care: A Missing Pillar of Total Health Care?

Racial/ethnic, gender, and age group differences in cardiometabolic risks among adults in a Northern California health plan: a cross-sectional study

Understanding differences within ethnic group designation: comparing risk factors and health indicators between Iranian and Arab Americans in Northern California

The Risks of Polycystic Ovary Syndrome and Diabetes Vary by Ethnic Subgroup Among Young Asian Women

Health Risks and Chronic Health Conditions among Arab American and White Adults in Northern California

Understanding the Uptake of Digital Technologies for Health-Related Purposes in Frail Older Adults

Racial-ethnic differences in prevalence of social determinants of health and social risks among middle-aged and older adults in a Northern California health plan

Aggregation of Asian-American subgroups masks meaningful differences in health and health risks among Asian ethnicities: an electronic health record based cohort study

Association of Social and Behavioral Risk Factors With Earlier Onset of Adult Hypertension and Diabetes

Digital Information Technology Use and Patient Preferences for Internet-Based Health Education Modalities: Cross-Sectional Survey Study of Middle-Aged and Older Adults With Chronic Health Conditions

Prevalence and Factors Influencing Use of Internet and Electronic Health Resources by Middle-Aged and Older Adults in a US Health Plan Population: Cross-Sectional Survey Study

Sexual Orientation Disparities in Physical Activity: Results From Insured Adults in California

Sociodemographic Determinants of Health and Well-Being Among Adults Residing in the Combined Kaiser Permanente Regions

Understanding functional and social risk characteristics of frail older adults: a cross-sectional survey study

Older adults’ readiness to engage with eHealth patient education and self-care resources: a cross-sectional survey

Racial-Ethnic Differences in Fall Prevalence among Older Women: A Cross-Sectional Survey Study

The Digital Divide and Patient Portals: Internet Access Explained Differences in Patient Portal Use for Secure Messaging by Age, Race, and Income

Obesity Severity, Dietary Behaviors, and Lifestyle Risks Vary by Race/Ethnicity and Age in a Northern California Cohort of Children with Obesity

Differences in Access to and Preferences for Using Patient Portals and Other eHealth Technologies Based on Race, Ethnicity, and Age: A Database and Survey Study of Seniors in a Large Health Plan

The Kaiser Permanente Northern California Adult Member Health Survey

Patient-initiated e-mails to providers: associations with out-of-pocket visit costs, and impact on care-seeking and health

Factors associated with use and non-use of the Fecal Immunochemical Test (FIT) kit for Colorectal Cancer Screening in Response to a 2012 outreach screening program: a survey study

Accuracy of parent-reported information for estimating prevalence of overweight and obesity in a race-ethnically diverse pediatric clinic population aged 3 to 12

A pragmatic cluster randomized clinical trial of diabetes prevention strategies for women with gestational diabetes: design and rationale of the Gestational Diabetes’ Effects on Moms (GEM) study

Patients’ attitudes about the use of placebo treatments: telephone survey

Variation in vitamin D supplementation among adults in a multi-race/ethnic health plan population, 2008

Oral health considerations in older women receiving oral bisphosphonate therapy

Prevalence of osteonecrosis of the jaw in patients with oral bisphosphonate exposure

Ethnic disparities in accessing treatment for depression and substance use disorders in an integrated health plan

Differences in reproductive risk factors for breast cancer in middle-aged women in Marin County, California and a sociodemographically similar area of Northern California

Health-related characteristics and preferred methods of receiving health education according to dominant language among Latinos aged 25 to 64 in a large Northern California health plan

Race/ethnicity and validity of self-reported pneumococcal vaccination

Alcohol consumption, medical conditions, and health behavior in older adults

Impacts of evidence-based quality improvement on depression in primary care: a randomized experiment

Gay/Lesbian sexual orientation increases risk for cigarette smoking and heavy drinking among members of a large Northern California health plan

Tobacco-cessation services and patient satisfaction in nine nonprofit HMOs

Use of dietary supplements by female seniors in a large Northern California health plan

Relationship between tobacco control policies and the delivery of smoking cessation services in nonprofit HMOs

Use of complementary and alternative medicine by the adult membership of a large northern California health maintenance organization, 1999

Nonvitamin, nonmineral supplement use over a 12-month period by adult members of a large health maintenance organization

Patient knowledge and awareness of hypertension is suboptimal: results from a large health maintenance organization

Understanding team-based quality improvement for depression in primary care

Tobacco-control policies in 11 leading managed care organizations: progress and challenges

Patterns of cigarette smoking and alcohol use among lesbians and bisexual women enrolled in a large health maintenance organization

Advance directives are more likely among seniors asked about end-of-life care preferences

Effects of providing hospital-based doulas in health maintenance organization hospitals

Use of and interest in alternative therapies among adult primary care clinicians and adult members in a large health maintenance organization

Type of health care coverage and the likelihood of being screened for cancer

Related Stories

Chronic disease prevalence varies by Asian subgroup, Kaiser Permanente research finds