Brown, Susan Archives - Kaiser Permanente Division of Research

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

Patients with gestational diabetes mellitus and from racial/ethnic minority groups face disproportionate risk for type 2 diabetes. Lifestyle interventions, if accessible and acceptable to diverse patients, could advance diabetes prevention and mitigate racial/ethnic disparities. Here we describe overall and race/ethnicity-specific…

A Web-Based mHealth Intervention With Telephone Support to Increase Physical Activity Among Pregnant Patients With Overweight or Obesity: Feasibility Randomized Controlled Trial

Pregnant patients with overweight or obesity are at high risk for perinatal complications. Excess gestational weight gain (GWG) further exacerbates this risk. Mobile health (mHealth) lifestyle interventions that leverage technology to facilitate self-monitoring and provide just-in-time feedback may motivate behavior…

Uptake of guideline-recommended postpartum diabetes screening among diverse women with gestational diabetes: associations with patient factors in an integrated health system in USA

Clinical guidelines urge timely postpartum screening for diabetes among women with gestational diabetes mellitus (GDM), yet patient factors associated with screening uptake remain unclear. We aimed to identify patient factors associated with completed postpartum diabetes screening (2-hour oral glucose tolerance…

Perspectives on Postpartum Diabetes Screening among Patients with Gestational Diabetes in an Integrated Healthcare System

Behavioural and psychosocial factors associated with 5-year weight trajectories within the PORTAL Overweight/Obesity Cohort

The purpose of this study was to model weight trajectories over a 5-year time period (2012-2016) and their association with behavioural and psychosocial characteristics and health care-related experiences using data from the Patient Outcomes Research to Advance Learning (PORTAL) overweight/obesity…

A Seat at the Table: Strategic Engagement in Service Activities for Early Career Faculty From Underrepresented Groups in the Academy

Many academic institutions strive to promote more diverse and inclusive campuses for faculty, staff, and students. As part of this effort, these institutions seek to include individuals from historically underrepresented groups (URGs)-such as women, people from racial/ethnic minority populations, persons…

A Randomized Study of Values Affirmation to Promote Interest in Diabetes Prevention Among Women With a History of Gestational Diabetes

The objective of this study was to test whether 2 interventions promote interest in diabetes prevention among women with a history of gestational diabetes mellitus, who face high lifetime risk for diabetes. We designed an email outreach message promoting an…

Opportunities to encourage mail order pharmacy delivery service use for diabetes prescriptions: a qualitative study

Medication non-adherence is a major contributor to poor outcomes in diabetes. Previous research has shown an association between use of mail order pharmacy delivery and better medication adherence, but little is known about the barriers and facilitators to mail order…

Gestational weight gain and optimal wellness (GLOW): rationale and methods for a randomized controlled trial of a lifestyle intervention among pregnant women with overweight or obesity

Excess gestational weight gain (GWG) is common among women with overweight or obesity, increasing their risks for pregnancy complications, delivering a large infant, and postpartum weight retention. To date, only intensive interventions have had success and few interventions have been…

Dietary Quality and Glycemic Control Among Women with Gestational Diabetes Mellitus

Poor dietary quality, measured by the Healthy Eating Index 2010 (HEI-2010), is associated with risk of gestational diabetes mellitus (GDM) and type 2 diabetes. The aim was to investigate the association between dietary quality and glycemic control in women with…

Motivational Determinants of Postpartum Lifestyle Behaviors, Weight Retention, and Metabolic Syndrome – DUPLICATED DO NOT ACTIVATE

January 14, 2019
Chris Myers
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The Pregnancy Environment and Lifestyle Study-2 (PETALS-2) aims to identify psychosocial influences on healthy lifestyle behaviors — such as healthy eating, self-weighing, and physical activity — and examine their relation to weight retention and cardiometabolic profile in the transition from…

Optimizing a Scalable Intervention to Maximize Guideline-recommended Diabetes Testing after Gestational Diabetes Mellitus

December 18, 2018
Chris Myers
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Guideline-recommended postpartum screening is a critical step toward diabetes prevention after a diagnosis of gestational diabetes mellitus (GDM). However, patient uptake of postpartum screening remains suboptimal and uneven across racial/ethnic groups. This creates a missed opportunity for diabetes prevention or…

A Tailored Letter Based on Electronic Health Record Data Improves Gestational Weight Gain Among Women With Gestational Diabetes: The Gestational Diabetes’ Effects on Moms (GEM) Cluster-Randomized Controlled Trial

Evaluate whether a tailored letter improved gestational weight gain (GWG) and whether GWG mediated a multicomponent intervention's effect on postpartum weight retention among women with gestational diabetes mellitus (GDM). A cluster-randomized controlled trial of 44 medical facilities (n = 2,014…

Personalized Letter Aids Those With Gestational Diabetes

April 16, 2018
ncalresearch
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Leveraging EHRs for patient engagement: perspectives on tailored program outreach

Electronic health records (EHRs) present healthcare delivery systems with scalable, cost-effective opportunities to promote lifestyle programs among patients at high risk for type 2 diabetes, yet little consensus exists on strategies to enhance patient engagement. We explored patient perspectives on…

Understanding Patient Engagement in Lifestyle Programs for Diabetes Prevention among Women with a Recent History of GDM

May 10, 2017
Chris Myers
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While lifestyle programs to prevent type 2 diabetes are increasingly available, the drivers of patient engagement in them remain poorly understood. This study aims to identify characteristics of patient subgroups at risk for poor engagement, providing a basis for future…

Telephone-Based Coaching: A Comparison of Tobacco Cessation Programs in an Integrated Health Care System

Many Americans continue to smoke, increasing their risk of disease and premature death. Both telephone-based counseling and in-person tobacco cessation classes may improve access for smokers seeking convenient support to quit. Little research has assessed whether such programs are effective…

Moderate intensity sports and exercise is associated with glycaemic control in women with gestational diabetes

February 23, 2017
Ivan Rivera Caraballo
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To assess the association of regular, unsupervised sports and exercise during pregnancy, by intensity level, with glycaemic control in women with gestational diabetes (GDM). Prospective cohort study of 971 women who, shortly after being diagnosed with GDM, completed a Pregnancy Physical…

The Surprisingly Effective Way to Lose Weight

February 1, 2017
ncalresearch
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Engaging At-Risk Minority Women in Health System Diabetes Prevention Programs

January 29, 2017
Chris Myers
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The potential for efficacious lifestyle interventions to prevent type 2 diabetes hinges on patient engagement in real-world healthcare settings. Yet patient engagement strategies are suboptimal and attrition is often highparticularly concerning for ethnic minority women who bear disproportionate burdens of…

Engaging At-Risk Minority Women in Health System Diabetes Prevention Programs – DUPLICATED DO NOT ACTIVATE

January 16, 2017
Chris Myers
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The potential for efficacious lifestyle interventions to prevent type 2 diabetes hinges on patient engagement in real-world healthcare settings. Yet patient engagement strategies are suboptimal and attrition is often high, particularly for ethnic minority women who bear disproportionate burdens of…

Perceived psychosocial stress and gestational weight gain among women with gestational diabetes

Growing evidence links perceived stress-a potentially modifiable psychosocial risk factor-with health behaviors and obesity. Yet little is known about the relationship between stress during pregnancy and gestational weight gain, particularly among women with pregnancy complications. We conducted a cross-sectional analysis…

Lifestyle behaviors and ethnic identity among diverse women at high risk for type 2 diabetes

Diet and physical activity lifestyle behaviors are modifiable risk factors for type 2 diabetes and are shaped by culture, potentially influencing diabetes health disparities. We examined whether ethnic identity-the strength of attachment to one's ethnic group, and a long-standing focus…

Moderate and Vigorous Intensity Exercise During Pregnancy and Gestational Weight Gain in Women with Gestational Diabetes

Objectives To estimate the associations of moderate and vigorous intensity exercise during pregnancy with the rate of gestational weight gain (GWG) from gestational diabetes (GDM) diagnosis to delivery, overall and stratified by prepregnancy overweight/obesity. Methods Prospective cohort study with physical…

The Comparative Effectiveness of Diabetes Prevention Strategies to Reduce Postpartum Weight Retention in Women With Gestational Diabetes Mellitus: The Gestational Diabetes’ Effects on Moms (GEM) Cluster Randomized Controlled Trial

To compare the effectiveness of diabetes prevention strategies addressing postpartum weight retention for women with gestational diabetes mellitus (GDM) delivered at the health system level: mailed recommendations (usual care) versus usual care plus a Diabetes Prevention Program (DPP)-derived lifestyle intervention.…

Outreach to diversify clinical trial participation: A randomized recruitment study

Racial and ethnic minorities remain underrepresented in clinical research, yet few recruitment strategies have been rigorously evaluated. We experimentally tested whether targeted recruitment letters acknowledging diabetes health disparities and health risks specific to recipients' racial/ethnic group improved two metrics of…

Wellness Coaching for People With Prediabetes: A Randomized Encouragement Trial to Evaluate Outreach Methods at Kaiser Permanente, Northern California, 2013

Health coaching can improve lifestyle behaviors known to prevent or manage chronic conditions. Little is known about effective ways to encourage health and wellness coaching among people who might benefit. The purpose of this randomized encouragement trial was to assess…

Post-partum weight loss and glucose metabolism in women with gestational diabetes: the DEBI Study

Women with gestational diabetes are at high risk for developing diabetes; post-partum weight loss may reduce the risk of diabetes. We evaluated the association of post-partum weight change with changes in glucose, insulin and homeostasis model assessment of insulin resistance…

The Multigroup Ethnic Identity Measure-Revised: Measurement Invariance Across Racial and Ethnic Groups

The Multigroup Ethnic Identity Measure-Revised (MEIM-R), a brief instrument assessing affiliation with one's ethnic group, is a promising advance in the ethnic identity literature. However, equivalency of its measurement properties across specific racial and ethnic groups should be confirmed before…

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

Women with gestational diabetes (GDM) are at high risk of developing diabetes later in life. After a GDM diagnosis, women receive prenatal care to control their blood glucose levels via diet, physical activity and medications. Continuing such lifestyle skills into…

The Stanford Leisure-Time Activity Categorical Item (L-Cat): a single categorical item sensitive to physical activity changes in overweight/obese women

Physical activity is essential for chronic disease prevention, yet

Risk of Large-for-Gestational-Age Newborns in Women With Gestational Diabetes by Race and Ethnicity and Body Mass Index Categories

OBJECTIVE: To compare the prevalence of large-for-gestational-age (LGA) newborns across categories of body mass index (BMI) in five racial and ethnic groups. METHODS: This cohort study examined 7,468 women with gestational diabetes mellitus (GDM) who delivered a live newborn between…

Promoting healthy weight with ‘stability skills first’: A randomized trial

Although behavioral weight-loss interventions produce short-term weight loss, long-term maintenance remains elusive. This randomized trial examined whether learning a novel set of "stability skills" before losing weight improved long-term weight management. Stability skills were designed to optimize individuals' current satisfaction…

Health-Plan and Employer-Based Wellness Programs to Reduce Diabetes Risk: The Kaiser Permanente Northern California NEXT-D Study

Primary prevention of diabetes is increasingly recognized by both health plans and employers as an important strategy to improve the health of insured populations. As a part of the Natural Experiments in Translation for Diabetes (NEXT-D) network, the Kaiser Permanente…

Patient Satisfaction and Perceived Success with a Telephonic Health Coaching Program: The Natural Experiments for Translation in Diabetes (NEXT-D) Study, Northern California, 2011

Health coaching can improve lifestyle behaviors known to prevent or manage chronic conditions such as diabetes. However, little is known about the patient experience with telephonic coaching programs in real-world care settings. We examined patient satisfaction, patient's perceived success in…

Minority recruitment into clinical trials: experimental findings and practical implications

Racial and ethnic minorities in the US suffer disproportionately from obesity and related comorbidities, yet remain underrepresented in health research. To date, research on practical strategies to improve minority reach and recruitment into clinical trials is primarily descriptive rather than…

Social support for healthy behaviors: scale psychometrics and prediction of weight loss among women in a behavioral program

Social support could be a powerful weight-loss treatment moderator or mediator but is rarely assessed. We assessed the psychometric properties, initial levels, and predictive validity of a measure of perceived social support and sabotage from friends and family for healthy…

Outcome expectations and realizations as predictors of weight regain among dieters

This prospective study tested whether (a) baseline outcome expectations regarding the benefits of a weight-loss diet, (b) 6-month outcome realizations regarding perceived benefits actually experienced, and/or (c) the interaction between them predicted 6-12-month weight regain among overweight/obese women randomized to…

Mindfulness and experiential avoidance as predictors and outcomes of the narrative emotional disclosure task

September 1, 2009
Ivan Rivera Caraballo
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This randomized study examined whether narrative emotional disclosure improves mindfulness, experiential avoidance, and mental health, and how baseline levels of and changes in mindfulness and experiential avoidance relate to mental health. Participants (N=233) wrote repeated traumatic (experimental condition) or unemotional…