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Richard W. Grant, MD, MPH

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Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

(510) 891-5993 (phone)
richard.w.grant@kp.org
Kaiser Permanente Researcher Profiles


 
Richard W. Grant, MD, MPH is a research scientist at the Division of Research, Kaiser Permanente Northern California. Dr. Grant is a board-certified primary care physician. He received his medical degree from University of California San Francisco, completed his medical residency training at Massachusetts General Hospital, and received his MPH from the Harvard School of Public Health. His research focuses on identifying and overcoming barriers to effective primary care in patients with complex diseases. He has a special interest in type 2 diabetes and related chronic conditions. Dr. Grant has published over 120 peer-reviewed scientific papers and is a Deputy Editor for the Journal of General Internal Medicine. He is the past chair of the American Diabetes Association's Profession Practice Committee and has served on the editorial board for Diabetes Care.

Current Position(s):

Section Affiliations:

Primary Research Interests:

  • Type 2 diabetes and pre-diabetes
  • Primary care redesign
  • Health information technology
  • Clinical application of genomic data

Related Website(s):

Pre-Visit Prioritization for Complex Primary Care Patients with Diabetes

Patients with type 2 diabetes are increasingly living with multiple concurrent conditions and complicated medical regimens. For these patients, diabetes management decisions and treatment goals must be addressed within the larger context of other competing health concerns. In parallel, clinical advances have led to a substantial increase in the number of tasks that primary care providers must perform during each visit. These twin trends present a formidable challenge to effective diabetes primary care. This study addresses the hypothesis that among complex patients not meeting diabetes management goals, an approach to help patients explicitly prioritize all health issues (both related and unrelated to diabetes) prior to each primary care visit will result in more effective diabetes management over time. To test this hypothesis, the project will involve design, implementation, and evaluation of a web-based tool linked to electronic health records that will enable complex patients to easily define care priorities from an inclusive list.
Investigator: Grant, Richard
Funder: National Institute of Diabetes and Digestive and Kidney Diseases

CTSI Institutional Career Development Core

The Clinical and Translational Science Institute (CTSI) facilitates the rapid translation of research to improvements in patient and community health. It is a cross-school, campus-wide institute with scientist leaders at its helm. To achieve its goals, CTSI provides infrastructure, services and training to support clinical and translational research. To advance its mission, it develops broad coalitions and partnerships at the local and national levels to enable a transformation of the research environment.
Investigator: Grant, Richard
Funder: National Center for Advancing Translational Sciences

Mentored Research to Improve Care for Complex Patients With Diabetes

K24 Midcareer Investigator Awards in Patient-Oriented Research are designed to support established scientists with a track record of mentoring to devote time to research mentorship for junior investigators. The overarching goal of this K24 award is to develop innovative approaches to improving the care of complex patients with type 2 diabetes, including the growing number of Latinos with diabetes, by developing new care models and innovative tools to support patients and providers in achieving more effective diabetes primary care. Specific research aims are to: 1) Examine the relationship between patient visit priorities and PCP care plans; 2) Adapt pre-visit prioritization for Low-English-Proficiency and Spanish-speaking Latinos; and 3) Learn how to effectively implement alternative health IT platforms such as smart phones, interactive voice response, and other novel modalities for pre-visit prioritization. The project will provide ample mentored research opportunities for highly promising mentees with an interest and passion for patient-oriented research to improve the care of patients with type 2 diabetes.
Investigator: Grant, Richard
Funder: National Institute of Diabetes and Digestive and Kidney Diseases

Multi-Component Behavioral Intervention for Complex Patients with CVD Risk

Disease management programs have had success in CVD risk factor control among uncomplicated patients but often fall short in more complex patients. New approaches are needed to address the multiple barriers faced by CVD patients with complex medical and behavioral comorbidity. We propose to develop and implement a multi-component intervention that includes patient activation, patient engagement, broad brush screening for undiagnosed behavioral health conditions, and creation of personal care plans tailored to each individuals unique set of barriers, motivators, and clinical goals. By focusing on core health skills and cross-cutting barriers to care in high risk patients not meeting clinical treatment goals, we are designing this intervention to be widely generalizable to all patients with multiple complex chronic conditions. We will conduct a randomized clinical trial of the intervention vs. usual care to examine effectiveness on proximal outcomes and CVD risk factor control.
Investigator: Grant, Richard
Funder: National Heart, Lung, and Blood Institute

Aligning the Visit Priorities of Complex Patients and their Primary Care Providers

The primary care visit is a key opportunity for catalyzing changes in care for complex patients with multiple heath issues. With too many items to address in the time allotted, however, the decision of which items to focus on requires prioritization. Prior studies have shown that: 1) patients and providers often have discordant priorities, 2) this discordance is associated with less effective care (e.g., poor adherence, lack of medication intensification), and, conversely, 3) collaborative interactions with informed, activated patients and prepared providers lead to better clinical outcomes. We hypothesize that a systematic approach that enables patients and providers to align visit priorities will result in more effective, patient-centered care because explicitly negotiated management decisions that address both patient and provider priorities are more likely to be adopted. This project will include focus groups and a pilot clinical trial examining impact on patient-centered outcomes.
Investigator: Grant, Richard
Funder: Patient-Centered Outcomes Research Institute

​Defining patient complexity from the primary care physician's perspective: a cohort study.

Author(s): Grant RW; Ashburner JM; Hong CS; Chang Y; Barry MJ; Atlas SJ;

Ann Intern Med. 2011 Dec 20;155(12):797-804. doi: 10.7326/0003-4819-155-12-201112200-00001.

PubMed abstract

Practice-linked online personal health records for type 2 diabetes mellitus: a randomized controlled trial

Author(s): Grant RW; Wald JS; Schnipper JL; Gandhi TK; Poon EG; Orav EJ; Williams DH; Volk LA; Middleton B;

​Arch Intern Med. 2008 Sep 8;168(16):1776-82. doi: 10.1001/archinte.168.16.1776.

PubMed abstract

A systematic review of care management interventions targeting multimorbidity and high care utilization

Author(s): Baker JM; Grant RW; Gopalan A

BMC Health Serv Res. 2018 01 30;18(1):65. Epub 2018-01-30.

PubMed abstract

Six-Year Diabetes Incidence After Genetic Risk Testing and Counseling: A Randomized Clinical Trial

Author(s): Vassy JL; He W; Florez JC; Meigs JB; Grant RW

Diabetes Care. 2018 Jan 05.

PubMed abstract

Influence of Language and Culture in the Primary Care of Spanish-Speaking Latino Adults with Poorly Controlled Diabetes: A Qualitative Study

Author(s): Zamudio CD; Sanchez G; Altschuler A; Grant RW

Ethn Dis. 2017 Fall;27(4):379-386. Epub 2017-12-07.

PubMed abstract

Communicating Through a Patient Portal to Engage Family Care Partners

Author(s): Reed ME; Huang J; Brand R; Ballard D; Yamin C; Hsu J; Grant R

JAMA Intern Med. 2017 Nov 20.

PubMed abstract

CREATE Wellness: A multi-component behavioral intervention for patients not responding to traditional Cardiovascular disease management

Author(s): Miller-Rosales C; Sterling SA; Wood SB; Ross T; Richardson MC; Samayoa C; Charvat-Aguilar N; Vo M; Whelan K; Uratsu CS; Grant RW; et al.

Contemp Clin Trials Commun. 2017 Dec;8:140-146. Epub 2017-10-04.

PubMed abstract

Crossing the Research to Quality Chasm: A Checklist for Researchers and Clinical Leadership Partners

Author(s): Schmittdiel JA; Grant RW

J Gen Intern Med. 2017 Oct 02.

PubMed abstract

Association of Patient-Physician Language Concordance and Glycemic Control for Limited-English Proficiency Latinos With Type 2 Diabetes

Author(s): Parker MM; Fernández A; Moffet HH; Grant RW; Torreblanca A; Karter AJ

JAMA Intern Med. 2017 Mar 01;177(3):380-387.

PubMed abstract

Identification of the joint effect of a dynamic treatment intervention and a stochastic monitoring intervention under the no direct effect assumption

Author(s): Neugebauer R; Schmittdiel JA; Adams AS; Grant RW; van der Laan MJ

J Causal Inference. 2017 03;5(1). Epub 2017-01-18.

PubMed abstract

Overcoming barriers to diabetic polyneuropathy management in primary care

Author(s): Adams AS; Callaghan B; Grant RW

Healthc (Amst). 2016 Dec 06.

PubMed abstract

Transforming Care for Complex Patients: Addressing Interconnected Medical, Social, and Behavioral Challenges

Author(s): Zulman DM; Grant RW

J Gen Intern Med. 2015 Dec 2.

PubMed abstract

User-Centered Design of a Tablet Waiting Room Tool for Complex Patients to Prioritize Discussion Topics for Primary Care Visits

Author(s): Lyles CR; Altschuler A; Chawla N; Kowalski C; McQuillan D; Bayliss E; Heisler M; Grant RW

JMIR Mhealth Uhealth. 2016;4(3):e108. Epub 2016-09-14.

PubMed abstract

Community Health Workers: A Missing Piece of the Puzzle for Complex Patients With Diabetes?

Author(s): Garcia ME; Grant RW

J Gen Intern Med. 2015 Apr 11.

PubMed abstract

The Diabetes Telephone Study; Design and challenges of a pragmatic cluster randomized trial to improve diabetic peripheral neuropathy treatment

Author(s): Adams AS; Bayliss EA; Schmittdiel JA; Altschuler A; Dyer W; Neugebauer R; Jaffe M; Young JD; Kim E; Grant RW; Diabetes Telephone Study Team

Clin Trials. 2016 Mar 31.

PubMed abstract

Association of Acculturation and Health Literacy with Prevalent Dysglycemia and Diabetes Control Among Latinos in the Boston Area Community Health (BACH) Survey

Author(s): L?? L; Grant RW; Marceau L; Piccolo R; McKinlay JB; Meigs JB

J Immigr Minor Health. 2016 Feb 22.

PubMed abstract

Pre-visit prioritization for complex patients with Diabetes; Randomized Trial Design and Implementation within an Integrated Health Care system

Author(s): Grant RW; Uratsu CS; Hansen KR; Altschuler A; Kim E; Fireman B; Adams AS; Schmittdiel JA; Heisler M

Contemp Clin Trials. 2016 Jan 25.

PubMed abstract

Health IT-assisted population-based preventive cancer screening: a cost analysis

Author(s): Levy DE; Munshi VN; Ashburner JM; Zai AH; Grant RW; Atlas SJ

Am J Manag Care. 2015 Dec;21(12):885-91.

PubMed abstract

Evaluating a Model to Predict Primary Care Physician-Defined Complexity in a Large Academic Primary Care Practice-Based Research Network

Author(s): Hong CS; Atlas SJ; Ashburner JM; Chang Y; He W; Ferris TG; Grant RW

J Gen Intern Med. 2015 Jun 6.

PubMed abstract

Randomized Trial of a Health IT Tool to Support Between-Visit-Based Laboratory Monitoring for Chronic Disease Medication Prescriptions

Author(s): Grant RW; Ashburner JM; Jernigan MC; Chang J; Borowsky LH; Chang Y; Atlas SJ

J Gen Intern Med. 2015 May;30(5):619-25. Epub 2015-01-06.

PubMed abstract

The Study to Understand the Genetics of the Acute Response to Metformin and Glipizide in Humans (SUGAR-MGH): Design of a pharmacogenetic Resource for Type 2 Diabetes

Author(s): Walford GA; Colomo N; Todd JN; Billings LK; Fernandez M; Chamarthi B; Warner AS; Davis J; Littleton KR; Hernandez AM; Fanelli RR; Lanier A; Barbato C; Ackerman RJ; Khan SQ; Bui R; Garber L; Stolerman ES; Moore AF; Huang C; Kaur V; Harden M; Taylor A; Chen L; Manning AK; Huang P; Wexler D; McCarthy RM; Lo J; Thomas MK; Grant RW; Goldfine A; Hudson MS; Florez JC

PLoS ONE. 2015;10(3):e0121553. Epub 2015-3-26.

PubMed abstract

Changes in physical activity among adults with diabetes: a longitudinal cohort study of inactive patients with Type 2 diabetes who become physically active

Author(s): Palakodeti S; Uratsu CS; Schmittdiel JA; Grant RW

Diabet Med. 2015 Mar 12.

PubMed abstract

Electronic Health Records and the Evolution of Diabetes Care: A Narrative Review

Author(s): Patel V; Reed ME; Grant RW

J Diabetes Sci Technol. 2015 Feb 23.

PubMed abstract

Building Equity Improvement into Quality Improvement: Reducing Socioeconomic Disparities in Colorectal Cancer Screening as Part of Population Health Management

Author(s): Berkowitz SA; Percac-Lima S; Ashburner JM; Chang Y; Zai AH; He W; Grant RW; Atlas SJ

J Gen Intern Med. 2015 Feb 13.

PubMed abstract

Patients who self-monitor blood glucose and their unused testing results

Author(s): Grant RW; Huang ES; Wexler DJ; Laiteerapong N; Warton ME; Moffet HH; Karter AJ

Am J Manag Care. 2015;21(2):e119-29. Epub 2015-02-01.

PubMed abstract

Building a Career as a Delivery Science Researcher in a Changing Health Care Landscape

Author(s): Grant RW; Schmittdiel JA

J Gen Intern Med. 2015 Jan 16.

PubMed abstract

Trends in the Evidence Level for the American Diabetes Association's "Standards of Medical Care in Diabetes" From 2005 to 2014

Author(s): Grant RW; Kirkman MS

Diabetes Care. 2015 Jan;38(1):6-8.

PubMed abstract

Association of African genetic ancestry with fasting glucose and HbA1c levels in non-diabetic individuals: the Boston Area Community Health (BACH) Prediabetes Study

Author(s): Meigs JB; Grant RW; Piccolo R; López L; Florez JC; Porneala B; Marceau L; McKinlay JB

Diabetologia. 2014 Sep;57(9):1850-8. Epub 2014-06-19.

PubMed abstract

Non-visit-based cancer screening using a novel population management system

Author(s): Atlas SJ; Zai AH; Ashburner JM; Chang Y; Percac-Lima S; Levy DE; Chueh HC; Grant RW

J Am Board Fam Med. 2014 Jul-Aug;27(4):474-85.

PubMed abstract

Individualizing HbA1c targets for patients with diabetes; impact of an automated algorithm within a primary care network

Author(s): Berkowitz SA; Atlas SJ; Grant RW; Wexler DJ

Diabet Med. 2014 Jul;31(7):839-46. Epub 2014-04-11.

PubMed abstract

Exercise as a Vital Sign: A Quasi-Experimental Analysis of a Health System Intervention to Collect Patient-Reported Exercise Levels

Author(s): Grant RW; Schmittdiel JA; Neugebauer RS; Uratsu CS; Sternfeld B

J Gen Intern Med. 2014 Feb;29(2):341-8. Epub 2013-12-06.

PubMed abstract

Novel Use and Utility of Integrated Electronic Health Records to Assess Rates of Prediabetes Recognition and Treatment: Brief Report From an Integrated Electronic Health Records Pilot Study

Author(s): Schmittdiel JA; Adams SR; Segal J; Griffin MR; Roumie CL; Ohnsorg K; Grant RW; O'Connor PJ

Diabetes Care. 2014 Feb;37(2):565-8. Epub 2013-11-22.

PubMed abstract

Branched chain and aromatic amino acids change acutely following two medical therapies for type 2 diabetes mellitus

Author(s): Walford GA; Davis J; Warner AS; Ackerman RJ; Billings LK; Chamarthi B; Fanelli RR; Hernandez AM; Huang C; Khan SQ; Littleton KR; Lo J; McCarthy RM; Rhee EP; Deik A; Stolerman E; Taylor A; Hudson MS; Wang TJ; Altshuler D; Grant RW; Clish CB; Gerszten RE; Florez JC

Metab Clin Exp. 2013 Dec;62(12):1772-8. Epub 2013-08-15.

PubMed abstract

Establishing visit priorities for complex patients; A summary of the literature and conceptual model to guide innovative interventions

Author(s): Grant RW; Adams AS; Bayliss EA; Heisler M

Healthcare (Amst). 2013 Dec;1(3-4):117-122.

PubMed abstract

Lower blood pressure associated with higher mortality in retrospective study of patients with newly diagnosed type 2 diabetes

Author(s): Grant RW; Wexler DJ

Evid Based Med. 2013 Aug;18(4):e35. Epub 2012-11-20.

PubMed abstract

Genetic susceptibility testing for chronic disease and intention for behavior change in healthy young adults

Author(s): Vassy JL; Donelan K; Hivert MF; Green RC; Grant RW

J Community Genet. 2013 Apr;4(2):263-71. Epub 2013 Feb 24.

PubMed abstract

Characteristics of Primary Care Safety-Net Providers and Their Quality Improvement Attitudes and Activities: Results of a National Survey of Physician Professionalism

Author(s): López L; DesRoches CM; Vogeli C; Grant RW; Iezzoni LI; Campbell EG

Am J Med Qual. 2013 Mar-Apr;28(2):151-9. Epub 2012-10-12.

PubMed abstract

Intensification of diabetes medication and risk for 30-day readmission

Author(s): Wei NJ; Wexler DJ; Nathan DM; Grant RW

Diabet Med. 2013 Feb;30(2):e56-62.

PubMed abstract

Adults with diabetes who perceive family members' behaviour as unsupportive are less adherent to their medication regimen

Author(s): Grant RW; Schmittdiel JA

Evid Based Nurs. 2013 Jan;16(1):15-6. Epub 2012 Sep 5.

PubMed abstract

Personalized Genetic Risk Counseling to Motivate Diabetes Prevention: A randomized trial

Author(s): Grant RW; O'Brien KE; Waxler JL; Vassy JL; Delahanty LM; Bissett LG; Green RC; Stember KG; Guiducci C; Park ER; Florez JC; Meigs JB

Diabetes Care. 2013 Jan;36(1):13-9. Epub 2012 Aug 28.

PubMed abstract

Genetic Counseling as a Tool for Type 2 Diabetes Prevention: A Genetic Counseling Framework for Common Polygenetic Disorders

Author(s): Waxler JL; O'Brien KE; Delahanty LM; Meigs JB; Florez JC; Park ER; Pober BR; Grant RW

J Genet Couns. 2012 Oct;21(5):684-91.

PubMed abstract

Effects of an online personal health record on medication accuracy and safety: a cluster-randomized trial

Author(s): Schnipper JL; Gandhi TK; Wald JS; Grant RW; Poon EG; Volk LA; Businger A; Williams DH; Siteman E; Buckel L; Middleton B

J Am Med Inform Assoc. 2012 Sep-Oct;19(5):728-34. Epub 2012 May 3.

PubMed abstract

Diabetes differentially affects depression and self-rated health by age in the U.S

Author(s): Wexler DJ; Porneala B; Chang Y; Huang ES; Huffman JC; Grant RW

Diabetes Care. 2012 Jul;35(7):1575-7. Epub 2012 May 18.

PubMed abstract

Characteristics of 'complex' patients with type 2 diabetes mellitus according to their primary care physicians

Author(s): Grant RW; Wexler DJ; Ashburner JM; Hong CS; Atlas SJ

Arch Intern Med. 2012 May 28;172(10):821-3.

PubMed abstract

Personalized medicine in Type 2 diabetes: what does the future hold?

Author(s): Grant RW; Wexler DJ

Diabetes Manag (Lond). 2012 May;2(3):199-204.

PubMed abstract

Implementation of a web-based tool for patient medication self-management: the Medication Self-titration Evaluation Programme (Med-STEP) for blood pressure control

Author(s): Grant RW; Pandiscio JC; Pajolek H; Woulfe A; Pelletier A; Kvedar J; Park ER

Inform Prim Care. 2012;20(1):57-67.

PubMed abstract

Closing the gap: eliminating health care disparities among Latinos with diabetes using health information technology tools and patient navigators

Author(s): Lopez L; Grant RW

J Diabetes Sci Technol. 2012 Jan 1;6(1):169-76.

PubMed abstract

​Defining patient complexity from the primary care physician's perspective: a cohort study.

Author(s): Grant RW; Ashburner JM; Hong CS; Chang Y; Barry MJ; Atlas SJ;

Ann Intern Med. 2011 Dec 20;155(12):797-804. doi: 10.7326/0003-4819-155-12-201112200-00001.

PubMed abstract

Relationship between patient panel characteristics and primary care physician clinical performance rankings.

Author(s): Hong CS; Atlas SJ; Chang Y; Subramanian SV; Ashburner JM; Barry MJ; Grant RW;

​JAMA. 2010 Sep 8;304(10):1107-13. doi: 10.1001/jama.2010.1287.

PubMed abstract

Practice-linked online personal health records for type 2 diabetes mellitus: a randomized controlled trial

Author(s): Grant RW; Wald JS; Schnipper JL; Gandhi TK; Poon EG; Orav EJ; Williams DH; Volk LA; Middleton B;

​Arch Intern Med. 2008 Sep 8;168(16):1776-82. doi: 10.1001/archinte.168.16.1776.

PubMed abstract

Medication adherence and racial differences in A1C control

Author(s): Adams AS; Trinacty CM; Zhang F; Kleinman K; Grant RW; Meigs JB; Soumerai SB; Ross-Degnan D

​​Diabetes Care. 2008 May;31(5):916-21. doi: 10.2337/dc07-1924. Epub 2008 Jan 30.

PubMed abstract