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Enid M. Hunkeler, MA


Kaiser Permanente Division of Research
2000 Broadway
Oakland, CA 94612

510-504-2035 (phone)
Kaiser Permanente Researcher Profiles

Enid Hunkeler, MA, is an emeritus research scientist at the Kaiser Permanente Northern California Division of Research. Her research interests include the development, implementation and dissemination of innovative models of care for depression, bipolar disorder, behavioral health, violence prevention (both community and domestic); and Internet-based programs for bipolar disorder, depression, diabetes and hypertension. She is also interested in issues related to suicide. Ms. Hunkeler has authored or co-authored more than fifty articles and book chapters.

Current Position(s):

  • Emeritus Research Scientist, Division of Research, Kaiser Permanente Northern California

    Primary Research Interests:

    • Internet-based treatment
    • Health services research in mental health
    • Depression
    • Domestic violence prevention
    • Alcohol, smoking and drug abuse programs
    • Behavioral health

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      Suicide Attempts Among a Cohort of Transgender and Gender Diverse People

      Author(s): Mak J; Hunkeler EM; Silverberg MJ; Goodman M; et al.

      Am J Prev Med. 2020 Aug 12.

      PubMed abstract

      Patterns of Health Care Utilization Before First Episode Psychosis in Racial and Ethnic Groups

      Author(s): Coleman KJ; Yarborough BJ; Beck A; Lynch FL; Stewart C; Penfold RS; Hunkeler EM; Operskalski BH; Simon GE

      Ethn Dis. 2019 Fall;29(4):609-616. Epub 2019-10-17.

      PubMed abstract

      Agreement between medical records and self-reports: Implications for transgender health research

      Author(s): Gerth J; Becerra-Culqui T; Bradlyn A; Getahun D; Hunkeler EM; Lash TL; Millman A; Nash R; Quinn VP; Robinson B; Roblin D; Silverberg MJ; Tangpricha V; Vupputuri S; Goodman M

      Rev Endocr Metab Disord. 2018 Sep 15.

      PubMed abstract

      Cross-sex Hormones and Acute Cardiovascular Events in Transgender Persons: A Cohort Study.

      Author(s): Getahun, Darios D; Nash, Rebecca R; Flanders, W Dana WD; Baird, Tisha C TC; Becerra-Culqui, Tracy A TA; Cromwell, Lee L; Hunkeler, Enid E; Lash, Timothy L TL; Millman, Andrea A; Quinn, Virginia P VP; Robinson, Brandi B; Roblin, Douglas D; Silverberg, Michael J MJ; Safer, Joshua J; Slovis, Jennifer J; Tangpricha, Vin V; Goodman, Michael M

      Annals of internal medicine. 2018 Aug 21;169(4):205-213. Epub 2018-07-10.

      PubMed abstract

      Near Real-time Surveillance for Consequences of Health Policies Using Sequential Analysis

      Author(s): Lu CY; Hunkeler EM; Kulldorff M; et al.

      Med Care. 2018 May;56(5):365-372.

      PubMed abstract

      Mental Health of Transgender and Gender Nonconforming Youth Compared With Their Peers

      Author(s): Becerra-Culqui TA; Cromwell L; Hunkeler EM; Millman A; Robinson B; Silverberg MJ; Goodman M; et al.

      Pediatrics. 2018 Apr 16.

      PubMed abstract

      Association Between Gender Confirmation Treatments and Perceived Gender Congruence, Body Image Satisfaction, and Mental Health in a Cohort of Transgender Individuals

      Author(s): Owen-Smith AA; Hunkeler E; Millman A; Silverberg MJ; Goodman M et al.

      J Sex Med. 2018 Feb 17.

      PubMed abstract

      Mortality Rates After the First Diagnosis of Psychotic Disorder in Adolescents and Young Adults

      Author(s): Simon GE; Stewart C; Yarborough BJ; Lynch F; Coleman KJ; Beck A; Operskalski BH; Penfold RB; Hunkeler EM

      JAMA Psychiatry. 2018 Jan 31.

      PubMed abstract

      Care Pathways Before First Diagnosis of a Psychotic Disorder in Adolescents and Young Adults

      Author(s): Simon GE; Stewart C; Hunkeler EM; Yarborough BJ; Lynch F; Coleman KJ; Beck A; Operskalski BH; Penfold RB; Carrell DS

      Am J Psychiatry. 2018 Jan 24:appiajp201717080844.

      PubMed abstract

      Cohort profile: Study of Transition, Outcomes and Gender (STRONG) to assess health status of transgender people.

      Author(s): Quinn VP; Nash R; Hunkeler E; Contreras R; Cromwell L; Becerra-Culqui TA; Getahun D; Giammattei S; Lash TL; Millman A; Robinson B; Roblin D; Silverberg MJ; Slovis J; Tangpricha V; Tolsma D; Valentine C; Ward K; Winter S; Goodman M

      BMJ open. 2017 12 27;7(12):e018121. Epub 2017-12-27.

      PubMed abstract

      Cohort study of cancer risk among insured transgender people

      Author(s): Silverberg MJ; Nash R; Becerra-Culqui TA; Cromwell L; Getahun D; Hunkeler E; Lash TL; Millman A; Quinn VP; Robinson B; Roblin D; Slovis J; Tangpricha V; Goodman M

      Ann Epidemiol. 2017 Jul 22.

      PubMed abstract

      A novel method for estimating transgender status using electronic medical records

      Author(s): Roblin D; Barzilay J; Tolsma D; Robinson B; Schild L; Cromwell L; Braun H; Nash R; Gerth J; Hunkeler E; Quinn VP; Tangpricha V; Goodman M

      Ann Epidemiol. 2016 Feb 4.

      PubMed abstract

      Factors Influencing Variation in Physician Adenoma Detection Rates; a Theory-Based Approach for Performance Improvement

      Author(s): Atkins L; Hunkeler EM; Jensen CD; Michie S; Lee JK; Doubeni CA; Zauber AG; Levin TR; Quinn VP; Corley DA

      Gastrointest Endosc. 2015 Sep 11.

      PubMed abstract

      Racial/Ethnic differences in health care visits made before suicide attempt across the United States

      Author(s): Ahmedani BK; Stewart C; Simon GE; Lynch F; Lu CY; Waitzfelder BE; Solberg LI; Owen-Smith AA; Beck A; Copeland LA; Hunkeler EM; Rossom RC; Williams K

      Med Care. 2015 May;53(5):430-5.

      PubMed abstract

      National Prevalence of Receipt of Antidepressant Prescriptions by Persons Without a Psychiatric Diagnosis

      Author(s): Simon GE; Stewart C; Beck A; Ahmedani BK; Coleman KJ; Whitebird RR; Lynch F; Owen-Smith AA; Waitzfelder BE; Soumerai SB; Hunkeler EM

      Psychiatr Serv. 2014 Jul;65(7):944-6.

      PubMed abstract

      Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study

      Author(s): Lu CY; Zhang F; Lakoma MD; Madden JM; Rusinak D; Penfold RB; Simon G; Ahmedani BK; Clarke G; Hunkeler EM; Waitzfelder B; Owen-Smith A; Raebel MA; Rossom R; Coleman KJ; Copeland LA; Soumerai SB

      BMJ. 2014;348:g3596. Epub 2014-06-18.

      PubMed abstract

      Health Care Contacts in the Year Before Suicide Death

      Author(s): Ahmedani BK; Simon GE; Stewart C; Beck A; Waitzfelder BE; Rossom R; Lynch F; Owen-Smith A; Hunkeler EM; Whiteside U; Operskalski BH; Coffey MJ; Solberg LI

      J Gen Intern Med. 2014 Jun;29(6):870-7. Epub 2014-02-25.

      PubMed abstract

      How complete are E-codes in commercial plan claims databases?

      Author(s): Lu CY; Stewart C; Ahmed AT; Ahmedani BK; Coleman K; Copeland LA; Hunkeler EM; Lakoma MD; Madden JM; Penfold RB; Rusinak D; Zhang F; Soumerai SB

      Pharmacoepidemiol Drug Saf. 2014 Feb;23(2):218-20.

      PubMed abstract

      Use of antipsychotic medications in pediatric populations: what do the data say?

      Author(s): Penfold RB; Stewart C; Hunkeler EM; Madden JM; Cummings JR; Owen-Smith AA; Rossom RC; Lu CY; Lynch FL; Waitzfelder BE; Coleman KJ; Coleman KA; Ahmedani BK; Beck AL; Zeber JE; Simon GE

      Curr Psychiatry Rep. 2013 Dec;15(12):426.

      PubMed abstract

      A Web-Delivered Care Management and Patient Self-Management Program for Recurrent Depression: A Randomized Trial

      Author(s): Hunkeler EM; Hargreaves WA; Fireman B; Terdiman J; Meresman JF; Porterfield Y; Lee J; Dea R; Simon GE; Bauer MS; Unutzer J; Taylor CB

      Psychiatr Serv. 2012 Nov;63(11):1063-71.

      PubMed abstract

      Does gender moderate the relationship between childhood maltreatment and adult depression?

      Author(s): Arnow BA; Blasey CM; Hunkeler EM; Lee J; Hayward C

      Child Maltreat. 2011 Aug;16(3):175-83. Epub 2011 Jul 4.

      PubMed abstract

      Catastrophizing, depression and pain-related disability

      Author(s): Arnow BA; Blasey CM; Constantino MJ; Robinson R; Hunkeler E; Lee J; Fireman B; Khaylis A; Feiner L; Hayward C

      Gen Hosp Psychiatry. 2011 Mar-Apr;33(2):150-6. Epub 2011 Feb 21.

      PubMed abstract

      Relationships among depression, chronic pain, chronic disabling pain, and medical costs

      Author(s): Arnow BA; Blasey CM; Lee J; Fireman B; Hunkeler EM; Dea R; Robinson R; Hayward C

      Psychiatr Serv. 2009 Mar;60(3):344-50.

      PubMed abstract

      Collaborative depression care, screening, diagnosis and specificity of depression treatments in the primary care setting

      Author(s): Alexander JL; Richardson G; Grypma L; Hunkeler EM

      Expert Rev Neurother. 2007 Nov;7(11 Suppl):S59-80.

      PubMed abstract

      Risk of suicide attempt and suicide death in patients treated for bipolar disorder

      Author(s): Simon GE; Hunkeler E; Fireman B; Lee JY; Savarino J

      Bipolar Disord. 2007 Aug;9(5):526-30.

      PubMed abstract

      Tamoxifen treatment and new-onset depression in breast cancer patients

      Author(s): Lee KC; Ray GT; Hunkeler EM; Finley PR

      Psychosomatics. 2007 May-Jun;48(3):205-10.

      PubMed abstract

      Reducing suicidal ideation in depressed older primary care patients

      Author(s): Unutzer J; Tang L; Oishi S; Katon W; Williams JW Jr; Hunkeler E; Hendrie H; Lin EH; Levine S; Grypma L; Steffens DC; Fields J; Langston C; for the IMPACT Investigators

      J Am Geriatr Soc. 2006 Oct;54(10):1550-6.

      PubMed abstract

      Comorbid depression, chronic pain, and disability in primary care

      Author(s): Arnow BA; Hunkeler EM; Blasey CM; Lee J; Constantino MJ; Fireman B; Kraemer HC; Dea R; Robinson R; Hayward C

      Psychosom Med. 2006 Mar-Apr;68(2):262-8.

      PubMed abstract

      Depression treatment preferences in older primary care patients

      Author(s): Gum AM; Arean PA; Hunkeler E; Tang L; Katon W; Hitchcock P; Steffens DC; Dickens J; Unutzer J

      Gerontologist. 2006 Feb;46(1):14-22.

      PubMed abstract

      Cost-effectiveness and net benefit of enhanced treatment of depression for older adults with diabetes and depression

      Author(s): Katon W; Unutzer J; Fan MY; Williams JW Jr; Schoenbaum M; Lin EH; Hunkeler EM

      Diabetes Care. 2006 Feb;29(2):265-70.

      PubMed abstract

      Long term outcomes from the IMPACT randomised trial for depressed elderly patients in primary care

      Author(s): Hunkeler EM; Katon W; Tang L; Williams JW Jr; Kroenke K; Lin EH; Harpole LH; Arean P; Levine S; Grypma LM; Hargreaves WA; Unutzer J

      BMJ. 2006 Feb 4;332(7536):259-63. Epub 2006 Jan 20.

      PubMed abstract

      Improving depression care for older, minority patients in primary care

      Author(s): Arean PA; Ayalon L; Hunkeler E; Lin EH; Tang L; Harpole L; Hendrie H; Williams JW Jr; Unutzer J; IMPACT Investigators

      Med Care. 2005 Apr;43(4):381-90.

      PubMed abstract

      Treatment of depression improves physical functioning in older adults

      Author(s): Callahan CM; Kroenke K; Counsell SR; Hendrie HC; Perkins AJ; Katon W; Noel PH; Harpole L; Hunkeler EM; Unutzer J; IMPACT Investigators

      J Am Geriatr Soc. 2005 Mar;53(3):367-73.

      PubMed abstract

      Trends in use of antidepressants, lithium, and anticonvulsants in Kaiser Permanente-insured youths, 1994-2003

      Author(s): Hunkeler EM; Fireman B; Lee J; Diamond R; Hamilton J; He CX; Dea R; Nowell WB; Hargreaves WA

      J Child Adolesc Psychopharmacol. 2005 Feb;15(1):26-37.

      PubMed abstract

      Depression and comorbid illness in elderly primary care patients: impact on multiple domains of health status and well-being

      Author(s): Noel PH; Williams JW Jr; Unutzer J; Worchel J; Lee S; Cornell J; Katon W; Harpole LH; Hunkeler E

      Ann Fam Med. 2004 Nov-Dec;2(6):555-62.

      PubMed abstract

      Incidence and duration of side effects and those rated as bothersome with selective serotonin reuptake inhibitor treatment for depression: patient report versus physician estimate

      Author(s): Hu XH; Bull SA; Hunkeler EM; Ming E; Lee JY; Fireman B; Markson LE

      J Clin Psychiatry. 2004 Jul;65(7):959-65.

      PubMed abstract

      The effectiveness of depression care management on diabetes-related outcomes in older patients

      Author(s): Williams JW Jr; Katon W; Lin EH; Noel PH; Worchel J; Cornell J; Harpole L; Fultz BA; Hunkeler E; Mika VS; Unutzer J; IMPACT Investigators

      Ann Intern Med. 2004 Jun 15;140(12):1015-24.

      PubMed abstract

      Effect of improving depression care on pain and functional outcomes among older adults with arthritis: a randomized controlled trial

      Author(s): Lin EH; Katon W; Von Korff M; Tang L; Williams JW Jr; Kroenke K; Hunkeler E; Harpole L; Hegel M; Arean P; Hoffing M; Della Penna R; Langston C; Unutzer J; IMPACT Investigators

      JAMA. 2003 Nov 12;290(18):2428-9.

      PubMed abstract

      Suicide risk in bipolar disorder during treatment with lithium and divalproex

      Author(s): Goodwin FK; Fireman B; Simon GE; Hunkeler EM; Lee J; Revicki D

      JAMA. 2003 Sep 17;290(11):1467-73.

      PubMed abstract

      Psychiatric symptoms, impaired function, and medical care costs in an HMO setting

      Author(s): Hunkeler EM; Spector WD; Fireman B; Rice DP; Weisner C

      Gen Hosp Psychiatry. 2003 May-Jun;25(3):178-84.

      PubMed abstract

      Depression treatment in a sample of 1,801 depressed older adults in primary care

      Author(s): Unutzer J; Katon W; Callahan CM; Williams JW Jr; Hunkeler E; Harpole L; Hoffing M; Della Penna RD; Noel PH; Lin EH; Tang L; Oishi S

      J Am Geriatr Soc. 2003 Apr;51(4):505-14.

      PubMed abstract

      A case report: implementing a nurse telecare program for treating depression in primary care

      Author(s): Meresman JF; Hunkeler EM; Hargreaves WA; Kirsch AJ; Robinson P; Green A; Mann EZ; Getzell M; Feigenbaum P

      Psychiatr Q. 2003 Spring;74(1):61-73.

      PubMed abstract

      Evidence-based care for depression in Maine: dissemination of the Kaiser Permanente Nurse Telecare Program

      Author(s): Pearson B; Katz SE; Soucie V; Hunkeler E; Meresman J; Rooney T; Amick BC 3rd

      Psychiatr Q. 2003 Spring;74(1):91-102.

      PubMed abstract

      Reaching out and linking up

      Author(s): Leutz W; Hillier M; Hunkeler E; Nguyen H

      In: Leutz W, Greenlick MR, Nonnenkamp L, editors. Linking medical care and community services: Practical models for bridging the gap. New York, NY: Springer Publishing Co; 2003.

      PubMed abstract

      Collaborative care management of late-life depression in the primary care setting: a randomized controlled trial

      Author(s): Unutzer J; Katon W; Callahan CM; Williams JW Jr; Hunkeler E; Harpole L; Hoffing M; Della Penna RD; Noel PH; Lin EH; Arean PA; Hegel MT; Tang L; Belin TR; Oishi S; Langston C; IMPACT Investigators.Improving Mood-Promoting Access to Collaborative Treatment

      JAMA. 2002 Dec 11;288(22):2836-45.

      PubMed abstract

      Discontinuation of use and switching of antidepressants: influence of patient-physician communication

      Author(s): Bull SA; Hu XH; Hunkeler EM; Lee JY; Ming EE; Markson LE; Fireman B

      JAMA. 2002 Sep 18;288(11):1403-9.

      PubMed abstract

      Discontinuing or switching selective serotonin-reuptake inhibitors

      Author(s): Bull SA; Hunkeler EM; Lee JY; Rowland CR; Williamson TE; Schwab JR; Hurt SW

      Ann Pharmacother. 2002 Apr;36(4):578-84.

      PubMed abstract

      Women referred for on-site domestic violence services in a managed care organization

      Author(s): McCaw B; Bauer HM; Berman WH; Mooney L; Holmberg M; Hunkeler E

      Women Health. 2002;35(2-3):23-40.

      PubMed abstract

      Alcohol consumption patterns and health care costs in an HMO

      Author(s): Hunkeler EM; Hung YY; Rice DP; Weisner C; Hu T

      Drug Alcohol Depend. 2001 Oct 1;64(2):181-90.

      PubMed abstract

      Beyond screening for domestic violence: a systems model approach in a managed care setting

      Author(s): McCaw B; Berman WH; Syme SL; Hunkeler EF

      Am J Prev Med. 2001 Oct;21(3):170-6.

      PubMed abstract

      Improving primary care for depression in late life: the design of a multicenter randomized trial

      Author(s): Unutzer J; Katon W; Williams JW Jr; Callahan CM; Harpole L; Hunkeler EM; Hoffing M; Arean P; Hegel MT; Schoenbaum M; Oishi SM; Langston CA

      Med Care. 2001 Aug;39(8):785-99.

      PubMed abstract

      Improving alcoholism treatment across the spectrum of services

      Author(s): Hilton ME; Maisto SA; Conigliaro J; McNiel M; Kraemer K; Kelley ME; Conigliaro R; Samet JH; Larson MJ; Savetsky J; Winter M; Sullivan LM; Saitz R; Weisner C; Mertens J; Parthasarathy S; Moore C; Hunkeler E; Hu TW; Selby J; Stout RL; Zywiak W; Rubin A; Zwick W; Shepard D

      Alcohol Clin Exp Res. 2001 Jan;25(1):128-35.

      PubMed abstract

      The outcome and cost of alcohol and drug treatment in an HMO: day hospital versus traditional outpatient regimens

      Author(s): Weisner C; Mertens J; Parthasarathy S; Moore C; Hunkeler EM; Hu T; Selby JV

      Health Serv Res. 2000 Oct;35(4):791-812.

      PubMed abstract

      Addiction severity index data from general membership and treatment samples of HMO members. One case of norming the ASI

      Author(s): Weisner C; McLellan AT; Hunkeler EM

      J Subst Abuse Treat. 2000 Sep;19(2):103-9.

      PubMed abstract

      Alcohol drinking patterns and medical care use in an HMO setting

      Author(s): Rice DP; Conell C; Weisner C; Hunkeler EM; Fireman B; Hu TW

      J Behav Health Serv Res. 2000 Feb;27(1):3-16.

      PubMed abstract

      Drinking patterns and problems of the 'stably insured': a study of the membership of a health maintenance organization

      Author(s): Weisner C; Conell C; Hunkeler EM; Rice D; McLellan AT; Hu TW; Fireman B; Moore C

      J Stud Alcohol. 2000 Jan;61(1):121-9.

      PubMed abstract

      Evaluating hypertension control in a managed care setting

      Author(s): Alexander M; Tekawa I; Hunkeler E; Fireman B; Rowell R; Selby JV; Massie BM; Cooper W

      Arch Intern Med. 1999 Dec 13-27;159(22):2673-7.

      PubMed abstract

      Role of a psychiatric outcome study in a large scale quality improvement project

      Author(s): Walter LJ; Schaefer C; Albright L; Parthasarathy S; Hunkeler EM; Westphal J; Williams M

      Eval Program Plann. 1999 May;22(2):233-43.

      PubMed abstract

      Recruitment in the Coronary Artery Disease Risk Development in Young Adults (Cardia) Study

      Author(s): Hughes GH; Cutter G; Donahue R; Friedman GD; Hulley S; Hunkeler E; Jacobs DR Jr; Liu K; Orden S; Pirie P; et al.

      Control Clin Trials. 1987 Dec;8(4 Suppl):68S-73S.

      PubMed abstract