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Esti M. Iturralde, PhD

Kaiser Permanente Researcher Profiles

Esti  Iturralde, PhD

Estibaliz (Esti) Iturralde, PhD, is a licensed clinical psychologist and research scientist at the Kaiser Permanente Northern California Division of Research, which she joined as a delivery science fellow in 2017. Her work examines how psychological and mental health factors affect individuals’ long-term physical health, including their management of obesity, diabetes, and cardiovascular disease risks. Her recent work has focused on health system-based approaches to addressing the intersection between behavioral and physical health. She received her BA in the History of Science from Harvard University and her MA and PhD in Clinical Psychology from the University of Southern California, where her dissertation work was supported by a National Research Service Award from the National Institute of Child Health and Human Development. She completed clinical training in evidence-based mental health treatment and behavioral medicine at the Veterans Affairs Northern California Health Care System and the Stanford University School of Medicine. Her research uses observational, clinical trial, and mixed quantitative and qualitative methods to inform the implementation of evidence-based behavioral health interventions in specialty and primary care clinical settings. She serves as the Associate Director of the Kaiser Permanente Delivery Science Fellowship Program.

Current Positions

Section Affiliations

Primary Research Interests

  • Mental health factors in chronic disease prevention and management
  • Integration of behavioral health interventions into medical settings
  • Dissemination of evidence-based mental health treatments
  • Longitudinal data analysis
  • Mixed quantitative and qualitative methods


Diabetes Management in Addiction Medicine

Substance use disorder is a major risk factor for type 2 diabetes, diabetes complications, early diabetes-related mortality, and high use of costly medical care for individuals with diabetes. This study examines the clinical needs and potential care gaps that distinguish patients with comorbid diabetes and substance use disorder from those with one of these conditions alone.

Investigator: Iturralde, Estibaliz

Funder: KP National Office of Community Health

Naturalistic longitudinal examination of electroconvulsive therapy, transcranial magnetic stimulation, and intravenous ketamine for treatment-resistant depression in a large integrated healthcare system

This prospective observational study including 1,500 KPNC adult members with treatment-resistant depression will characterize factors related to selection of electroconvulsive therapy, transcranial magnetic stimulation, or ketamine; examine success rates and predictors of each treatment type; and examine inter-facility differences in referral patterns, treatment parameters, and outcomes.

Investigator: Iturralde, Estibaliz

Funder: TPMG Delivery Science Projects Program

Optimizing Care to Prevent Diabetes and Promote Cardiovascular Health Among Younger Adults with Severe Mental Illness

This K23 career development project seeks to leverage electronic health record data from KPNC and 2 health system collaborators within the Mental Health Research Network to investigate population health management strategies to prevent diabetes and improve cardiovascular health among people with serious mental health conditions. Specific aims of this project are to: (1) develop a risk prediction tool using early-stage treatment data; (2) conduct a pre-implementation qualitative study with health system stakeholders; and (3) pilot-test a clinical decision tool based on findings from Aims 1 and 2. These specific aims are supported by a training plan focused on advanced predictive analytics and machine learning; qualitative methods in implementation science; and, pragmatic clinical trial design.

Investigator: Iturralde, Estibaliz

Funder: National Institute of Mental Health

Improve Quality and Overall Health Outcomes Through Population Management to Treat Schizophrenia, Schizoaffective Disorder and Bipolar Disorder

This study aims to use population management to improve the quality and overall health outcomes of people with schizophrenia, schizoaffective disorder, and bipolar disorder.

Investigator: Iturralde, Estibaliz

Funder: TPMG Delivery Science Projects Program


Exploring preferences for different modes of cannabis use during early pregnancy: A qualitative study

Authors: Mian, Maha N;Foti, Tara R;Green, Andrea;Iturralde, Esti;Altschuler, Andrea;Does, Monique B;Jackson-Morris, Melanie;Adams, Sara R;Satre, Derek D;Ansley, Deborah;Young-Wolff, Kelly C

Addict Behav. 2023 Nov;146:107812. Epub 2023-07-20.

PubMed abstract

Serious Mental Illness, Glycemic Control, and Neighborhood Factors within an Urban Diabetes Cohort

Authors: Iturralde, Esti;Rubinsky, Anna D;Nguyen, Kim H;Anderson, Chelsie;Lyles, Courtney R;Mangurian, Christina

Schizophr Bull. 2023 Aug 19.

PubMed abstract

Patient Perceptions of Prenatal Cannabis Use and Implications for Clinicians

Authors: Foti, Tara R;Green, Andrea;Altschuler, Andrea;Iturralde, Esti;Does, Monique B;Jackson-Morris, Melanie;Adams, Sara R;Goler, Nancy;Ansley, Deborah;Conway, Amy;Young-Wolff, Kelly C

Obstet Gynecol. 2023 Aug 10.

PubMed abstract

Cardiometabolic Monitoring and Sociodemographic and Clinical Characteristics of Youths Prescribed Antipsychotic Medications

Authors: Hsueh, Loretta;Iturralde, Esti;Slama, Natalie E;Spalding, Scott R;Sterling, Stacy A

Psychiatr Serv. 2023 Aug 01;74(8):801-808. Epub 2023-04-05.

PubMed abstract

Expanding the use of patient-reported outcomes (PROs): Screening youth with type 1 diabetes from underrepresented populations

Authors: Addala, Ananta;Barley, Regan C;Hood, Korey K;et al.

J Diabetes Complications. 2023 Jul;37(7):108514. Epub 2023-05-24.

PubMed abstract

Performance of a Prediction Model of Suicide Attempts Across Race and Ethnicity

Authors: Papini, Santiago; Hsin, Honor; Kipnis, Patricia; Liu, Vincent X; Lu, Yun; Sterling, Stacy A; Iturralde, Esti

JAMA Psychiatry. 2023 Apr 01;80(4):399-400.

PubMed abstract

Racial-Ethnic Differences in Treatment Initiation for New Diagnoses of Perinatal Depression

Authors: Avalos, Lyndsay A; Nance, Nerissa; Iturralde, Esti; Badon, Sylvia E; Quesenberry, Charles P; Sterling, Stacy; Li, De-Kun; Flanagan, Tracy

Psychiatr Serv. 2023 Apr 01;74(4):341-348. Epub 2022-10-13.

PubMed abstract

Pregnant individual’s lived experience of cannabis use during the COVID-19 pandemic: a qualitative study

Authors: Young-Wolff, Kelly C;Foti, Tara R;Green, Andrea;Iturralde, Esti;Jackson-Morris, Melanie;Does, Monique B;Adams, Sara R;Goler, Nancy;Conway, Amy;Ansley, Deborah;Altschuler, Andrea

Front Psychiatry. 2023;14:1161137. Epub 2023-04-21.

PubMed abstract

Evaluating Implementation and Outcomes of the Achieving Depression and Anxiety Patient-Centered Treatment Collaborative Care Program in a Large, Integrated Health Care System: A Mixed Methods Observational Study Protocol

Authors: Ridout, Kathryn K; Ridout, Samuel J; Alavi, Mubarika; Koshy, Maria T; Harris, Brooke; Awsare, Sameer; Fazzolari, Lisa; Weisner, Constance M; Iturralde, Esti

Perm J. 2022 Dec 19;26(4):39-48. Epub 2022-11-10.

PubMed abstract

Electroconvulsive Therapy Anesthetic Choice and Clinical Outcomes

Authors: Li, Kevin J; Slama, Natalie E; Hirschtritt, Matthew E; Anshu, Prachi; Iturralde, Esti

J ECT. 2022 Dec 09.

PubMed abstract

Perceptions About Cannabis Following Legalization Among Pregnant Individuals With Prenatal Cannabis Use in California

Authors: Young-Wolff, Kelly C; Mian, Maha N; Iturralde, Esti; et al.

JAMA Netw Open. 2022 Dec 01;5(12):e2246912. Epub 2022-12-01.

PubMed abstract

Patterns of Health Care Use 5 Years After an Intervention Linking Patients in Addiction Treatment With a Primary Care Practitioner

Authors: Iturralde, Esti; Weisner, Constance M; Adams, Sara R; Chi, Felicia W; Ross, Thekla B; Cunningham, Sarah F; Ghadiali, Murtuza; Asyyed, Asma H; Satre, Derek D; Campbell, Cynthia I; Sterling, Stacy A

JAMA Netw Open. 2022 Nov 01;5(11):e2241338. Epub 2022-11-01.

PubMed abstract

Closing the Care Gap for People with Severe and Persistent Mental Illness: Collaborative Care, Telehealth, and Clinical Pharmacy

Authors: Iturralde, Esti; Fazzolari, Lisa; Shia, Macy; Slama, Natalie; Leang, Jessica; Awsare, Sameer; Nguyen, Lily T

NEJM Catal Innov Care Deliv. 2022 May;3(5).

PubMed abstract

Engaging patients in population-based chronic disease management: A qualitative study of barriers and intervention opportunities

Authors: Fang, Anya; Abdelgadir, Dana; Gopalan, Anjali; Ross, Thekla; Uratsu, Connie S; Sterling, Stacy A; Grant, Richard W; Iturralde, Esti

Patient Educ Couns. 2022 01;105(1):182-189. Epub 2021-05-04.

PubMed abstract

Adult Suicide-Related emergency department encounters during the COVID-19 Pandemic: a Cross-Sectional study

Authors: Ridout, Kathryn K; Alavi, Mubarika; Ridout, Samuel J; Koshy, Maria T; Awsare, Sameer; Harris, Brooke; Vinson, David R; Weisner, Constance M; Sterling, Stacy; Iturralde, Esti

Lancet Reg Health Am. 2021 Dec;4:100078. Epub 2021-09-21.

PubMed abstract

Adult Suicide-Related emergency department encounters during the COVID-19 Pandemic a Cross-Sectional study

Authors: Ridout, Kathryn K; Alavi, Mubarika; Ridout, Samuel J; Koshy, Maria T; Awsare, Sameer; Harris, Brooke; Vinson, David R; Weisner, Constance M; Sterling, Stacy; Iturralde, Esti

Lancet Reg Health Am. 2021 Dec;4:100078. Epub 2021 Sep 21.

Emergency Department Encounters Among Youth With Suicidal Thoughts or Behaviors During the COVID-19 Pandemic

Authors: Ridout, Kathryn K; Alavi, Mubarika; Ridout, Samuel J; Koshy, Maria T; Awsare, Sameer; Harris, Brooke; Vinson, David R; Weisner, Constance M; Sterling, Stacy; Iturralde, Esti

JAMA Psychiatry. 2021 12 01;78(12):1319-1328.

PubMed abstract

Opportunities to Integrate Mobile App-Based Interventions Into Mental Health and Substance Use Disorder Treatment Services in the Wake of COVID-19

Authors: Satre, Derek D; Meacham, Meredith C; Asarnow, Lauren D; Fisher, Weston S; Fortuna, Lisa R; Iturralde, Esti

Am J Health Promot. 2021 11;35(8):1178-1183. Epub 2021-10-15.

PubMed abstract

Psychotropic medication prescribing during the COVID-19 pandemic

Authors: Hirschtritt, Matthew E; Slama, Natalie; Sterling, Stacy A; Olfson, Mark; Iturralde, Esti

Medicine (Baltimore). 2021 Oct 29;100(43):e27664.

PubMed abstract

Physical, Mental Health and Developmental Conditions, and Sociodemographic Characteristics Associated With Adverse Childhood Experiences Among Young Children in Pediatric Primary Care

Authors: Sterling, Stacy; Iturralde, Esti; Young-Wolff, Kelly; Metz, Verena E; Espinas, Paul; et al.

J Pediatr Health Care. 2021 Sep-Oct;35(5):491-499. Epub 2021-07-03.

PubMed abstract

Engagement in perinatal depression treatment: a qualitative study of barriers across and within racial/ethnic groups

Authors: Iturralde, Esti; Hsiao, Crystal A; Nkemere, Linda; Kubo, Ai; Sterling, Stacy A; Flanagan, Tracy; Avalos, Lyndsay A

BMC Pregnancy Childbirth. 2021 Jul 16;21(1):512. Epub 2021-07-16.

PubMed abstract

Perceived Barriers and Motivators for Physical Activity in Women With Perinatal Depression

Authors: Badon, Sylvia E; Iturralde, Esti; Nkemere, Linda; Nance, Nerissa; Avalos, Lyndsay A

J Phys Act Health. 2021 07 01;18(7):801-810. Epub 2021-05-12.

PubMed abstract

Do Youth Want Psychosocial Screenings in Diabetes Clinic? Profiles of Acceptability

Authors: Wong, Jessie J; Hanes, Sarah; Iturralde, Esti; Lanning, Monica S; Naranjo, Diana; Tanenbaum, Molly; Hood, Korey K

J Pediatr Psychol. 2021 03 18;46(3):332-340.

PubMed abstract

Changes in Diagnostic and Demographic Characteristics of Patients Seeking Mental Health Care During the Early COVID-19 Pandemic in a Large, Community-Based Health Care System

Authors: Ridout, Kathryn K; Alavi, Mubarika; Ridout, Samuel J; Koshy, Maria T; Harris, Brooke; Dhillon, Inderpreet; Awsare, Sameer; Weisner, Constance M; Campbell, Cynthia I; Iturralde, Esti

J Clin Psychiatry. 2021 03 03;82(2). Epub 2021-03-03.

PubMed abstract

Premature mortality associated with severe mental illness or substance use disorder in an integrated health care system

Authors: Iturralde, Esti; Slama, Natalie; Kline-Simon, Andrea H; Young-Wolff, Kelly C; Mordecai, Don; Sterling, Stacy A

Gen Hosp Psychiatry. 2021 Jan-Feb;68:1-6. Epub 2020-11-10.

PubMed abstract

Treatment for Anxiety and Substance Use Disorders During the COVID-19 Pandemic: Challenges and Strategies

Authors: Satre, Derek D; Iturralde, Esti; Ghadiali, Murtuza; Young-Wolff, Kelly C; Campbell, Cynthia I; Leibowitz, Amy S; Sterling, Stacy A

J Addict Med. 2020 12;14(6):e293-e296.

PubMed abstract

Changing Results-Engage and Activate to Enhance Wellness: A Randomized Clinical Trial to Improve Cardiovascular Risk Management

Authors: Iturralde E; Sterling SA; Uratsu CS; Mishra P; Ross TB; Grant RW

J Am Heart Assoc. 2019 12 03;8(23):e014021. Epub 2019-11-30.

PubMed abstract

Assessing strengths of children with type 1 diabetes: Validation of the Diabetes Strengths and Resilience (DSTAR) measure for ages 9 to 13

Authors: Iturralde E; Hood KK; Weissberg-Benchell J; Anderson BJ; Hilliard ME

Pediatr Diabetes. 2019 11;20(7):1007-1015. Epub 2019-07-29.

PubMed abstract

Association of Anxiety With High-Cost Health Care Use Among Individuals With Type 2 Diabetes

Authors: Iturralde E; Chi FW; Grant RW; Weisner C; Van Dyke L; Pruzansky A; Bui S; Madvig P; Pearl R; Sterling SA

Diabetes Care. 2019 09;42(9):1669-1674. Epub 2019-06-18.

PubMed abstract

Optimizing the use of continuous glucose monitoring in young children with type 1 diabetes with an adaptive study design and multiple randomizations

Authors: Berget, Cari; Iturralde, Esti; Toddler Diabetes Technology Study Group,; et al.

Contemp Clin Trials. 2019 07;82:60-65. Epub 2019-05-23.

PubMed abstract

Barriers and facilitators to healthy eating among low-income Latino adolescents

Authors: Beck AL; Iturralde E; Haya-Fisher J; Kim S; Keeton V; Fernandez A

Appetite. 2019 07 01;138:215-222. Epub 2019-04-04.

PubMed abstract

Diabetes-Related Emotional Distress Over Time

Authors: Iturralde E; Rausch JR; Weissberg-Benchell J; Hood KK

Pediatrics. 2019 06;143(6). Epub 2019-05-01.

PubMed abstract

From Wary Wearers to d-Embracers: Personas of Readiness to Use Diabetes Devices

Authors: Tanenbaum ML; Adams RN; Iturralde E; Hanes SJ; Barley RC; Naranjo D; Hood KK

J Diabetes Sci Technol. 2018 11;12(6):1101-1107. Epub 2018-08-22.

PubMed abstract

The Diabetes Strengths and Resilience Measure for Adolescents With Type 1 Diabetes (DSTAR-Teen): Validation of a New, Brief Self-Report Measure.

Authors: Hilliard ME; Iturralde E; Weissberg-Benchell J; Hood KK;

J Pediatr Psychol. 2017 May 26. doi: 10.1093/jpepsy/jsx086. [Epub ahead of print]

PubMed abstract

Expectations and Attitudes of Individuals With Type 1 Diabetes After Using a Hybrid Closed Loop System.

Authors: Iturralde E; Tanenbaum ML; Hanes SJ; Suttiratana SC; Ambrosino JM; Ly TT; Maahs DM; Naranjo D; Walders-Abramson N; Weinzimer SA; Buckingham BA; Hood KK;

​Diabetes Educ. 2017 Apr;43(2):223-232. doi: 10.1177/0145721717697244.

PubMed abstract

Avoidant coping and diabetes-related distress: Pathways to adolescents’ Type 1 diabetes outcomes.

Authors: Iturralde E; Weissberg-Benchell J; Hood KK;

​Health Psychol. 2017 Mar;36(3):236-244. doi: 10.1037/hea0000445. Epub 2016 Nov 3.

PubMed abstract

​Diabetes Technology: Uptake, Outcomes, Barriers, and the Intersection With Distress.

Authors: Naranjo D; Tanenbaum ML; Iturralde E; Hood KK;

​J Diabetes Sci Technol. 2016 Jun 28;10(4):852-8. doi: 10.1177/1932296816650900. Print 2016 Jul.

PubMed abstract

​A randomized clinical trial aimed at preventing poor psychosocial and glycemic outcomes in teens with type 1 diabetes (T1D).

Authors: Weissberg-Benchell J; Rausch J; Iturralde E; Jedraszko A; Hood K;

​Contemp Clin Trials. 2016 Jul;49:78-84. doi: 10.1016/j.cct.2016.05.006. Epub 2016 Jun 4.

PubMed abstract

Positive and Negative Interactions Observed Between Siblings: Moderating Effects for Children Exposed to Parents’ Conflict.

Authors: Iturralde E; Margolin G; Spies Shapiro LA

​J Res Adolesc. 2013 Dec 1;23(4). doi: 10.1111/jora.12020.

PubMed abstract

​Youth exposed to violence: stability, co-occurrence, and context.

Authors: Margolin G; Vickerman KA; Ramos MC; Serrano SD; Gordis EB; Iturralde E; Oliver PH; Spies LA

​Clin Child Fam Psychol Rev. 2009 Mar;12(1):39-54. doi: 10.1007/s10567-009-0040-9.

PubMed abstract

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