Telehealth primary care outcomes remained steady well into 2021
New research finds patients treated during the COVID-19 pandemic had similar medical outcomes whether they saw their doctor in-person or virtually.
Racial and Ethnic Differences in Medication Initiation Among Adults Newly Diagnosed with Type 2 Diabetes
Given persistent racial/ethnic differences in type 2 diabetes outcomes and the lasting benefits conferred by early glycemic control, we examined racial/ethnic differences in diabetes medication initiation during the year following diagnosis. Among adults newly diagnosed with type 2 diabetes (2005-2016),…
Cross-Sectional Association of Patient Language and Patient-Provider Language Concordance with Video Telemedicine Use Among Patients with Limited English Proficiency
Telemedicine's dramatic increase during the COVID-19 pandemic elevates the importance of addressing patient-care gaps in telemedicine, especially for patients with limited English proficiency. To examine the associations of patient language and patient-provider language concordance with telemedicine visit type (video versus…
Primary care video and telephone telemedicine during the COVID-19 pandemic: treatment and follow-up health care utilization
Telemedicine use expanded greatly during the COVID-19 pandemic, and broad use of telemedicine is expected to persist beyond the pandemic. More evidence on the efficiency and safety of different telemedicine modalities is needed to inform clinical and policy decisions around…
The association between video or telephone telemedicine visit type and orders in primary care
Telemedicine is increasingly relied upon for care delivery in primary care, but the impact of visit type on clinical ordering behavior is uncertain. Within Kaiser Permanente Northern California, we identified patients who self-scheduled and completed telemedicine encounters with their personal…
Identifying modifiable obesogenic behaviors among Latino adolescents in primary pediatric care.
Latino adolescents engage in more obesogenic behaviors, including sedentary behaviors and sugary drink consumption, than White adolescents. However, it is unclear whether engagement in obesogenic behaviors differs within the Latino population. Cross-sectional data were examined from Latino adolescents ages 13-17…
Primary Care Visits Are Timelier When Patients Choose Telemedicine: A Cross-Sectional Observational Study
Introduction: Telemedicine could increase timely access to primary care-a key dimension of care quality. Methods: Among patient-scheduled appointments with their own primary care providers using the online portal in a large integrated health care delivery system, we measured the association…
Not all adults newly diagnosed with diabetes equally likely to start treatment
Kaiser Permanente study found adults of certain racial and ethnic groups are less likely to start medication within the first year of diagnosis.
Video Telehealth Access and Changes in HbA1c Among People With Diabetes
Video telehealth can offer people convenient, real-time access to clinicians without arranging transportation or time off work. Among people with diabetes, this study examines the association between video telehealth access and changes in HbA1c. This longitudinal cohort study (2016-2019) used…
Primary care telemedicine during the COVID-19 pandemic: patient’s choice of video versus telephone visit
The aim of this study is to examine the association between patient characteristics and primary care telemedicine choice among integrated delivery system patients self-scheduling visits during the COVID-19 pandemic. We used multivariate logistic regression to examine the association between the…
All in the Family: A Qualitative Study of the Early Experiences of Adults with Younger Onset Type 2 Diabetes
Adults with type 2 diabetes diagnosed at a younger age are at increased risk for poor outcomes. We examined life stage-related facilitators and barriers to early self-management among younger adults with newly diagnosed type 2 diabetes. We conducted 6 focus…
Tailoring initial type 2 diabetes care to meet the needs of younger Latinx adults: A randomized pilot study
Our goal is to evaluate the effectiveness of a proactive, tailored care intervention in improving early outcomes for Latinx individuals with younger-onset type 2 diabetes. We will also conduct post-intervention interviews with study participants to identify components of the intervention…
Engaging patients in population-based chronic disease management: A qualitative study of barriers and intervention opportunities
Cardiovascular disease (CVD) continues to be a leading cause of morbidity in the U.S. Managing CVD risk factors, such as diabetes or hypertension, can be challenging for many individuals. We investigated the barriers experienced by patients who persistently struggled to…
Pandemic mental health, diabetes, early puberty highlighted in 2021 research podcasts
Investigators at the Kaiser Permanente Division of Research (DOR) study a wide variety of research topics, and that’s reflected in the range of subjects highlighted by KP Research Radio podcasts in 2021, offering a chance to hear researchers discuss the what – and why – of their work in their own words.
Shining a light on early-onset type 2 diabetes
To mark National Diabetes Month, KP Research Radio spoke with research scientist Anjali Gopalan, MD, MS, about the unique needs of young people with diabetes or prediabetes.
Tailoring care to meet the needs of younger Latinx adults with newly diagnosed type 2 diabetes
We will evaluate a culturally responsive community health worker (CHW) intervention targeting younger-onset Latinx individuals with a new type 2 diabetes (T2D) diagnosis (AURORA [Active Outreach to Younger Latinx]). The AURORA strategy centers on a CHW who will proactively conduct…
Using predictive analytics to tailor care for patients with newly diagnosed type 2 diabetes
In a population of adults newly diagnosed with type 2 diabetes (T2D) from 2010-2015 and followed for 5 years this study will use machine learning-based predictive analytic methods to develop and validate predictive models using EHR-derived patient data available at…
The Role of Community-Based Organizations in Improving Chronic Care for Safety-Net Populations
Social determinants of health (SDoH) influence health outcomes and contribute to disparities in chronic disease in vulnerable populations. To inform health system strategies to address SDoH, we conducted a multi-stakeholder qualitative study to capture the multi-level influences on health for…
Disclosure of New Type 2 Diabetes Diagnoses to Younger Adults: a Qualitative Study
Adults diagnosed with type 2 diabetes at a younger age are at increased risk for poor outcomes. Yet, little is known about the early experiences of these individuals, starting with communication of the diagnosis. Addressing this knowledge gap is important…
Visit Content Analysis: Doctor-Patient Communication in Patients with Type 2 Diabetes
The primary care visit is an important opportunity to discuss and modify diabetes management. To gain insight into doctor-patient communication during primary care visits among English and Spanish speaking patients with type 2 diabetes and suboptimal glycemic control (HbA1c >…
5 Questions for…Anjali Gopalan
Research scientist uses her experiences as a physician to design studies that focus on and can improve care for people with early-onset type 2 diabetes.
Age- and race/ethnic-based disparities in diabetes outcomes among younger adults with newly diagnosed Type 2 Diabetes
This study will conduct focus groups with KPNC members (age 45) with newly diagnosed Type 2 diabetes to learn about members’ experiences with this new diagnosis and to identify early facilitators of and barriers to effective diabetes management in this…
Initial Glycemic Control and Care Among Younger Adults Diagnosed With Type 2 Diabetes
The prevalence of type 2 diabetes is increasing among adults under age 45. Onset of type 2 diabetes at a younger age increases an individual's risk for diabetes-related complications. Given the lasting benefits conferred by early glycemic control, we compared…
Testing patient-informed approaches for visually depicting the hemoglobin A1c value to patients with poorly controlled diabetes: a randomized, controlled trial
Patients' understanding of the hemoglobin A1c (HbA1c) has been linked to better diabetes care outcomes (glycemic control, self-care). This is concerning given low documented rates of HbA1c understanding. In this non-blinded, randomized trial, we compared two formats for communicating the…
Use and Discontinuation of Insulin Treatment Among Adults Aged 75 to 79 Years With Type 2 Diabetes
Among older individuals with type 2 diabetes, those with poor health have greater risk and derive less benefit from tight glycemic control with insulin. To examine whether insulin treatment is used less frequently and discontinued more often among older individuals…
Metformin Initiation and Early Adherence among Kaiser Permanente Northern California Members with Newly Diagnosed Type 2 Diabetes
Aim 1: Identify patient-level predictors of metformin treatment during the year following type 2 diabetes diagnosis. Examined factors will include: demographics, such as age, race/ethnicity, gender, and rural versus urban; clinical characteristics, such as A1c at diagnosis, diabetes-related comorbidities (hypertension,…
Use of financial incentives and text message feedback to increase healthy food purchases in a grocery store cash back program: a randomized controlled trial
The HealthyFood (HF) program offers members up to 25% cash back monthly on healthy food purchases. In this randomized controlled trial, we tested the efficacy of financial incentives combined with text messages in increasing healthy food purchases among HF members.…
Prevalence and predictors of delayed clinical diagnosis of Type 2 diabetes: a longitudinal cohort study
To examine the prevalence and person-level predictors of undiagnosed Type 2 diabetes among adults with elevated HbA1c values. We identified adults without diabetes who had a first elevated HbA1c (index HbA1c ≥ 48 mmol/mol; ≥ 6.5%) between January 2014 and…
Exploring how patients understand and assess their diabetes control
Poor understanding of diabetes management targets is associated with worse disease outcomes. Patients may use different information than providers to assess their diabetes control. In this study, we identify the information patients use to gauge their current level of diabetes…
The Initial Care of Younger Adults with Newly Diagnosed Type 2 Diabetes
In a population of adults with newly diagnosed, early onset type 2 diabetes, this study will identify patient-, provider-, and system-level predictors of inadequate glycemic control within one year following diagnosis. A longitudinal, retrospective cohort analysis of electronic health record…
Identifying Geographic Disparities in Diabetes Prevalence Among Adults and Children Using Emergency Claims Data
Geographic surveillance can identify hotspots of disease and reveal associations between health and the environment. Our study used emergency department surveillance to investigate geographic disparities in type 1 and type 2 diabetes prevalence among adults and children. Using all-payer emergency…
A systematic review of care management interventions targeting multimorbidity and high care utilization
Evidence supporting the effectiveness of care management programs for complex patients has been inconclusive. However, past reviews have not focused on complexity primarily defined by multimorbidity and healthcare utilization. We conducted a systematic review of care management interventions targeting the…
Population Health Management for Diabetes: Health Care System-Level Approaches for Improving Quality and Addressing Disparities
Population care approaches for diabetes have the potential to improve the quality of care and decrease diabetes-related mortality and morbidity. Population care strategies are particularly relevant as accountable care organizations (ACOs), patient-centered medical homes (PCMH), and integrated delivery systems are…
Improving early-stage diabetes management: An examination of the variation in early diabetes care and its relationship to clinical outcomes
Aim 1: Describe the type, frequency, and amount of diabetes-related health care KPNC members receive within 1 week, 3 months, and 1 year of a new diabetes diagnosis. Aim 2: Examine the relationships between the type, timing, and amount of…
Randomised controlled trial of alternative messages to increase enrolment in a healthy food programme among individuals with diabetes
We compared the effectiveness of diabetes-focused messaging strategies at increasing enrolment in a healthy food programme among adults with diabetes. Vitality is a multifaceted wellness benefit available to members of Discovery Health, a South Africa-based health insurer. One of the…
Health-Specific Information and Communication Technology Use and Its Relationship to Obesity in High-Poverty, Urban Communities: Analysis of a Population-Based Biosocial Survey
More than 35% of American adults are obese. For African American and Hispanic adults, as well as individuals residing in poorer or more racially segregated urban neighborhoods, the likelihood of obesity is even higher. Information and communication technologies (ICTs) may…
