Skip to main content

Cynthia Jan Coffman

Professor of Biostatistics & Bioinformatics
Biostatistics & Bioinformatics, Division of Biostatistics
Duke Box 3827, Med Ctr, Durham, NC 27710
Durham VAMC, 508 Fulton St (152), Durham, NC

Selected Publications


Understanding veterans' experiences with lung cancer and psychological distress: A multimethod approach.

Journal Article Psychol Serv · March 4, 2024 Psychological distress while coping with cancer is a highly prevalent and yet underrecognized and burdensome adverse effect of cancer diagnosis and treatment. Left unaddressed, psychological distress can further exacerbate poor mental health, negatively in ... Full text Link to item Cite

Diabetes distress in Veterans with type 2 diabetes mellitus: Qualitative descriptive study.

Journal Article J Health Psychol · February 21, 2024 Diabetes distress (DD) is a negative psychosocial response to living with type 2 diabetes mellitus (T2DM). We sought insight into Veterans' experiences with DD in the context of T2DM self-management. The four domains in the Diabetes Distress Scale (i.e. re ... Full text Open Access Link to item Cite

Evaluating Therapeutic Inertia in Two Telehealth Interventions for Type 2 Diabetes: Secondary Analyses of a Randomized Trial.

Journal Article Telemed J E Health · February 19, 2024 Introduction: Although therapeutic inertia is a known driver of suboptimal type 2 diabetes control, little is known about how to combat this phenomenon. We analyzed randomized trial data to determine whether a comprehensive telehealth intervention was more ... Full text Link to item Cite

If You Build It, Will They Come? Patient and Provider Use of a Novel Hybrid Telehealth Care Pathway for Low Back Pain.

Journal Article Phys Ther · February 1, 2024 OBJECTIVE: The purpose of this study was to describe the referrals and use of a hybrid care model for low back pain that includes on-site care by physical therapists, physical activity training, and psychologically informed practice (PiP) delivered by tele ... Full text Link to item Cite

Evaluation of strategies to support implementation of a hospital walking program: protocol for a type III effectiveness-implementation hybrid trial.

Journal Article Implement Sci Commun · January 12, 2024 BACKGROUND: STRIDE is a supervised walking program designed to address the negative consequences of immobility during hospitalization for older adults. In an 8-hospital stepped wedge randomized controlled trial, STRIDE was associated with reduced odds of h ... Full text Link to item Cite

Informing a home time measure reflective of quality of life: A data driven investigation of time frames and settings of health care utilization.

Journal Article Health Serv Res · December 2023 OBJECTIVE: To evaluate short- and long-term measures of health care utilization-days in the emergency department (ED), inpatient (IP) care, and rehabilitation in a post-acute care (PAC) facility-to understand how home time (i.e., days alive and not in an a ... Full text Link to item Cite

Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial.

Journal Article Implement Sci Commun · October 12, 2023 BACKGROUND: Knee osteoarthritis (OA) is a leading cause of chronic pain and disability and one of the most common conditions treated in outpatient physical therapy (PT). Because of the high and growing prevalence of knee OA, there is a need for efficient a ... Full text Open Access Link to item Cite

Implementation intensification to disseminate a skills-based caregiver training program: protocol for a type III effectiveness-implementation hybrid trial.

Journal Article Implement Sci Commun · August 16, 2023 BACKGROUND: Family caregiver training decreases caregiver psychological burden and improves caregiver depressive symptoms and health-related quality of life. Caregivers FIRST is an evidence-based group skills training curriculum for family caregivers and w ... Full text Link to item Cite

Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial.

Journal Article J Psychosom Res · July 2023 OBJECTIVE: Posttraumatic stress disorder (PTSD) is associated with elevated risk of coronary heart disease (CHD); however, the effects of PTSD treatment on CHD biomarkers is unknown. This study examined whether cognitive processing therapy (CPT) improves 2 ... Full text Link to item Cite

Ready, set, go! The role of organizational readiness to predict adoption of a family caregiver training program using the Rogers' diffusion of innovation theory.

Journal Article Implement Sci Commun · June 19, 2023 BACKGROUND: Caregivers FIRST is an evidence-based program addressing gaps in caregivers' skills. In 2020, the Veterans Health Administration Caregiver Support Program (CSP) nationally endorsed Caregivers FIRST, offering credit in leadership performance pla ... Full text Open Access Link to item Cite

Effects of Implementation of a Supervised Walking Program in Veterans Affairs Hospitals : A Stepped-Wedge, Cluster Randomized Trial.

Journal Article Ann Intern Med · June 2023 BACKGROUND: In trials, hospital walking programs have been shown to improve functional ability after discharge, but little evidence exists about their effectiveness under routine practice conditions. OBJECTIVE: To evaluate the effect of implementation of a ... Full text Link to item Cite

A Cluster Randomized Trial of a Family Health History Platform to Identify and Manage Patients at Increased Risk for Colorectal Cancer.

Journal Article J Gen Intern Med · May 2023 BACKGROUND: Obtaining comprehensive family health history (FHH) to inform colorectal cancer (CRC) risk management in primary care settings is challenging. OBJECTIVE: To examine the effectiveness of a patient-facing FHH platform to identify and manage patie ... Full text Link to item Cite

Factors Associated With Diabetes Distress Among Patients With Poorly Controlled Type 2 Diabetes.

Journal Article J Endocr Soc · March 6, 2023 OBJECTIVE: Examine factors associated with increased diabetes distress (DD) among patients with type 2 diabetes with DD assessed by Diabetes Distress Scale (DDS) total and subscale scores (emotional burden, physician-related distress, regimen-related distr ... Full text Link to item Cite

Have racial disparities in home dialysis utilization changed over time?

Journal Article Am J Manag Care · March 2023 OBJECTIVES: The Medicare end-stage kidney disease (ESKD) prospective payment system (PPS) for maintenance dialysis, implemented in 2011, resulted in modestly increased access to both home-based peritoneal dialysis (PD) and home hemodialysis (HHD) treatment ... Full text Link to item Cite

Implementation of an Intensive Telehealth Intervention for Rural Patients with Clinic-Refractory Diabetes.

Journal Article J Gen Intern Med · September 2022 BACKGROUND: Rural patients with type 2 diabetes (T2D) may experience poor glycemic control due to limited access to T2D specialty care and self-management support. Telehealth can facilitate delivery of comprehensive T2D care to rural patients, but implemen ... Full text Open Access Link to item Cite

Effect of a Comprehensive Telehealth Intervention vs Telemonitoring and Care Coordination in Patients With Persistently Poor Type 2 Diabetes Control: A Randomized Clinical Trial.

Journal Article JAMA Intern Med · September 1, 2022 IMPORTANCE: Persistently poorly controlled type 2 diabetes (PPDM) is common and causes poor outcomes. Comprehensive telehealth interventions could help address PPDM, but effectiveness is uncertain, and barriers impede use in clinical practice. OBJECTIVE: T ... Full text Open Access Link to item Cite

Application of Heterogeneity of Treatment-Effects Methods: Exploratory Analyses of a Trial of Exercise-Based Interventions for Knee Osteoarthritis.

Journal Article Arthritis Care Res (Hoboken) · August 2022 OBJECTIVE: To evaluate heterogeneity of treatment effects in a trial of exercise-based interventions for knee osteoarthritis (OA). METHODS: Participants (n = 350) were randomized to standard physical therapy (PT; n = 140), internet-based exercise training ... Full text Link to item Cite

Identifying Family and Unpaid Caregivers in Electronic Health Records: Descriptive Analysis.

Journal Article JMIR Form Res · July 18, 2022 BACKGROUND: Most efforts to identify caregivers for research use passive approaches such as self-nomination. We describe an approach in which electronic health records (EHRs) can help identify, recruit, and increase diverse representations of family and ot ... Full text Open Access Link to item Cite

Factors associated with non-adherence to insulin and non-insulin medications in patients with poorly controlled diabetes.

Journal Article Chronic Illn · June 2022 OBJECTIVES: To evaluate differences in factors associated with self-reported medication non-adherence to insulin and non-insulin medications in patients with uncontrolled type 2 diabetes. METHODS: In this secondary analysis of a randomized trial in patient ... Full text Link to item Cite

Understanding veterans' experiences with lung cancer and psychological distress: A multimethod approach.

Journal Article Psychol Serv · March 4, 2024 Psychological distress while coping with cancer is a highly prevalent and yet underrecognized and burdensome adverse effect of cancer diagnosis and treatment. Left unaddressed, psychological distress can further exacerbate poor mental health, negatively in ... Full text Link to item Cite

Diabetes distress in Veterans with type 2 diabetes mellitus: Qualitative descriptive study.

Journal Article J Health Psychol · February 21, 2024 Diabetes distress (DD) is a negative psychosocial response to living with type 2 diabetes mellitus (T2DM). We sought insight into Veterans' experiences with DD in the context of T2DM self-management. The four domains in the Diabetes Distress Scale (i.e. re ... Full text Open Access Link to item Cite

Evaluating Therapeutic Inertia in Two Telehealth Interventions for Type 2 Diabetes: Secondary Analyses of a Randomized Trial.

Journal Article Telemed J E Health · February 19, 2024 Introduction: Although therapeutic inertia is a known driver of suboptimal type 2 diabetes control, little is known about how to combat this phenomenon. We analyzed randomized trial data to determine whether a comprehensive telehealth intervention was more ... Full text Link to item Cite

If You Build It, Will They Come? Patient and Provider Use of a Novel Hybrid Telehealth Care Pathway for Low Back Pain.

Journal Article Phys Ther · February 1, 2024 OBJECTIVE: The purpose of this study was to describe the referrals and use of a hybrid care model for low back pain that includes on-site care by physical therapists, physical activity training, and psychologically informed practice (PiP) delivered by tele ... Full text Link to item Cite

Evaluation of strategies to support implementation of a hospital walking program: protocol for a type III effectiveness-implementation hybrid trial.

Journal Article Implement Sci Commun · January 12, 2024 BACKGROUND: STRIDE is a supervised walking program designed to address the negative consequences of immobility during hospitalization for older adults. In an 8-hospital stepped wedge randomized controlled trial, STRIDE was associated with reduced odds of h ... Full text Link to item Cite

Informing a home time measure reflective of quality of life: A data driven investigation of time frames and settings of health care utilization.

Journal Article Health Serv Res · December 2023 OBJECTIVE: To evaluate short- and long-term measures of health care utilization-days in the emergency department (ED), inpatient (IP) care, and rehabilitation in a post-acute care (PAC) facility-to understand how home time (i.e., days alive and not in an a ... Full text Link to item Cite

Group physical therapy for knee osteoarthritis: protocol for a hybrid type III effectiveness-implementation trial.

Journal Article Implement Sci Commun · October 12, 2023 BACKGROUND: Knee osteoarthritis (OA) is a leading cause of chronic pain and disability and one of the most common conditions treated in outpatient physical therapy (PT). Because of the high and growing prevalence of knee OA, there is a need for efficient a ... Full text Open Access Link to item Cite

Implementation intensification to disseminate a skills-based caregiver training program: protocol for a type III effectiveness-implementation hybrid trial.

Journal Article Implement Sci Commun · August 16, 2023 BACKGROUND: Family caregiver training decreases caregiver psychological burden and improves caregiver depressive symptoms and health-related quality of life. Caregivers FIRST is an evidence-based group skills training curriculum for family caregivers and w ... Full text Link to item Cite

Effect of cognitive processing therapy on markers of cardiovascular risk in posttraumatic stress disorder patients: A randomized clinical trial.

Journal Article J Psychosom Res · July 2023 OBJECTIVE: Posttraumatic stress disorder (PTSD) is associated with elevated risk of coronary heart disease (CHD); however, the effects of PTSD treatment on CHD biomarkers is unknown. This study examined whether cognitive processing therapy (CPT) improves 2 ... Full text Link to item Cite

Ready, set, go! The role of organizational readiness to predict adoption of a family caregiver training program using the Rogers' diffusion of innovation theory.

Journal Article Implement Sci Commun · June 19, 2023 BACKGROUND: Caregivers FIRST is an evidence-based program addressing gaps in caregivers' skills. In 2020, the Veterans Health Administration Caregiver Support Program (CSP) nationally endorsed Caregivers FIRST, offering credit in leadership performance pla ... Full text Open Access Link to item Cite

Effects of Implementation of a Supervised Walking Program in Veterans Affairs Hospitals : A Stepped-Wedge, Cluster Randomized Trial.

Journal Article Ann Intern Med · June 2023 BACKGROUND: In trials, hospital walking programs have been shown to improve functional ability after discharge, but little evidence exists about their effectiveness under routine practice conditions. OBJECTIVE: To evaluate the effect of implementation of a ... Full text Link to item Cite

A Cluster Randomized Trial of a Family Health History Platform to Identify and Manage Patients at Increased Risk for Colorectal Cancer.

Journal Article J Gen Intern Med · May 2023 BACKGROUND: Obtaining comprehensive family health history (FHH) to inform colorectal cancer (CRC) risk management in primary care settings is challenging. OBJECTIVE: To examine the effectiveness of a patient-facing FHH platform to identify and manage patie ... Full text Link to item Cite

Factors Associated With Diabetes Distress Among Patients With Poorly Controlled Type 2 Diabetes.

Journal Article J Endocr Soc · March 6, 2023 OBJECTIVE: Examine factors associated with increased diabetes distress (DD) among patients with type 2 diabetes with DD assessed by Diabetes Distress Scale (DDS) total and subscale scores (emotional burden, physician-related distress, regimen-related distr ... Full text Link to item Cite

Have racial disparities in home dialysis utilization changed over time?

Journal Article Am J Manag Care · March 2023 OBJECTIVES: The Medicare end-stage kidney disease (ESKD) prospective payment system (PPS) for maintenance dialysis, implemented in 2011, resulted in modestly increased access to both home-based peritoneal dialysis (PD) and home hemodialysis (HHD) treatment ... Full text Link to item Cite

Implementation of an Intensive Telehealth Intervention for Rural Patients with Clinic-Refractory Diabetes.

Journal Article J Gen Intern Med · September 2022 BACKGROUND: Rural patients with type 2 diabetes (T2D) may experience poor glycemic control due to limited access to T2D specialty care and self-management support. Telehealth can facilitate delivery of comprehensive T2D care to rural patients, but implemen ... Full text Open Access Link to item Cite

Effect of a Comprehensive Telehealth Intervention vs Telemonitoring and Care Coordination in Patients With Persistently Poor Type 2 Diabetes Control: A Randomized Clinical Trial.

Journal Article JAMA Intern Med · September 1, 2022 IMPORTANCE: Persistently poorly controlled type 2 diabetes (PPDM) is common and causes poor outcomes. Comprehensive telehealth interventions could help address PPDM, but effectiveness is uncertain, and barriers impede use in clinical practice. OBJECTIVE: T ... Full text Open Access Link to item Cite

Application of Heterogeneity of Treatment-Effects Methods: Exploratory Analyses of a Trial of Exercise-Based Interventions for Knee Osteoarthritis.

Journal Article Arthritis Care Res (Hoboken) · August 2022 OBJECTIVE: To evaluate heterogeneity of treatment effects in a trial of exercise-based interventions for knee osteoarthritis (OA). METHODS: Participants (n = 350) were randomized to standard physical therapy (PT; n = 140), internet-based exercise training ... Full text Link to item Cite

Identifying Family and Unpaid Caregivers in Electronic Health Records: Descriptive Analysis.

Journal Article JMIR Form Res · July 18, 2022 BACKGROUND: Most efforts to identify caregivers for research use passive approaches such as self-nomination. We describe an approach in which electronic health records (EHRs) can help identify, recruit, and increase diverse representations of family and ot ... Full text Open Access Link to item Cite

Factors associated with non-adherence to insulin and non-insulin medications in patients with poorly controlled diabetes.

Journal Article Chronic Illn · June 2022 OBJECTIVES: To evaluate differences in factors associated with self-reported medication non-adherence to insulin and non-insulin medications in patients with uncontrolled type 2 diabetes. METHODS: In this secondary analysis of a randomized trial in patient ... Full text Link to item Cite

Psychological distress among medically complex veterans with a recent emergency department visit.

Journal Article Psychol Serv · May 2022 Medical complexity and psychological distress are associated with frequent emergency department (ED) use. Despite this known association, our understanding is limited about which patients are at risk for persistent psychological distress and what patterns ... Full text Link to item Cite

Cost and Quality of Life Outcomes of the STepped Exercise Program for Patients With Knee OsteoArthritis Trial.

Journal Article Value Health · April 2022 OBJECTIVES: This study aimed to evaluate the cost-effectiveness of the randomized clinical trial STEP-KOA (STepped Exercise Program for patients with Knee OsteoArthritis). METHODS: The trial included 230 intervention and 115 control participants from 2 Vet ... Full text Link to item Cite

Clinical associations of an updated medication effect score for measuring diabetes treatment intensity.

Journal Article Chronic Illn · December 2021 OBJECTIVES: The medication effect score reflects overall intensity of a diabetes regimen by consolidating dosage and potency of agents used. Little is understood regarding how medication intensity relates to clinical factors. We updated the medication effe ... Full text Link to item Cite

Exploring differential response to an emergency department-based care transition intervention.

Journal Article Am J Emerg Med · December 2021 OBJECTIVE: To identify multivariable subgroups of patients with differential responses to a nurse-delivered care transition intervention after an emergency department (ED) visit in a randomized controlled trial (RCT) using an emerging data-driven method. D ... Full text Link to item Cite

Underrecognition of Nonalcoholic Fatty Liver Disease in Poorly Controlled Diabetes: A Call to Action in Diabetes Care.

Journal Article J Endocr Soc · December 1, 2021 Individuals with type 2 diabetes (T2DM) are at high risk for nonalcoholic fatty liver disease (NAFLD), and evidence suggests that poor glycemic control is linked to heightened risk of progressive NAFLD. We conducted an observational study based on data fro ... Full text Link to item Cite

Heterogeneity of Treatment Effects Among Patients With Type 2 Diabetes and Elevated Body Mass Index in a Study Comparing Group Medical Visits Focused on Weight Management and Medication Intensification.

Journal Article Med Care · November 1, 2021 BACKGROUND: Illuminating heterogeneity of treatment effect (HTE) within trials is important for identifying target populations for implementation. OBJECTIVE: The aim of this study was to examine HTE in a trial of group medical visits (GMVs) for patients wi ... Full text Link to item Cite

Trends in Dialysis Industry Consolidation After Medicare Payment Reform, 2006-2016.

Journal Article JAMA Health Forum · November 2021 IMPORTANCE: The dialysis industry is highly concentrated, with large dialysis organizations now providing dialysis for more than 85% of patients with kidney failure in the United States. In 2011, Medicare introduced a new Prospective Payment System (PPS) f ... Full text Open Access Link to item Cite

Veterans' Interpretation of Diabetes Distress in Diabetes Self-Management: Findings From Cognitive Interviews.

Journal Article Sci Diabetes Self Manag Care · October 2021 PURPOSE: The purpose of this project was to identify additional facets of diabetes distress (DD) in veterans that may be present due to the veteran's military-related experience. METHODS: The study team completed cognitive interviews with veterans with typ ... Full text Open Access Link to item Cite

Trends in Regional Supply of Peritoneal Dialysis in an Era of Health Reform, 2006 to 2013.

Journal Article Med Care Res Rev · June 2021 Peritoneal dialysis (PD), a home-based treatment for kidney failure, is associated with similar mortality, higher quality of life, and lower costs compared with hemodialysis. Yet <10% of patients receive PD. Access to this alternative treatment, vis-à-vis ... Full text Link to item Cite

Stepped Exercise Program for Patients With Knee Osteoarthritis : A Randomized Controlled Trial.

Journal Article Ann Intern Med · March 2021 BACKGROUND: Evidence-based models are needed to deliver exercise-related services for knee osteoarthritis efficiently and according to patient needs. OBJECTIVE: To examine a stepped exercise program for patients with knee osteoarthritis (STEP-KOA). DESIGN: ... Full text Link to item Cite

The effect of reducing posttraumatic stress disorder symptoms on cardiovascular risk: Design and methodology of a randomized clinical trial.

Journal Article Contemp Clin Trials · March 2021 Posttraumatic stress disorder (PTSD) has been associated with accelerated progression of coronary heart disease (CHD). However, the underlying pathophysiological pathway has remained elusive and it is unclear whether there is a direct link between PTSD and ... Full text Link to item Cite

Comparing Mortality of Peritoneal and Hemodialysis Patients in an Era of Medicare Payment Reform.

Journal Article Med Care · February 1, 2021 BACKGROUND: Prior studies have shown peritoneal dialysis (PD) patients to have lower or equivalent mortality to patients who receive in-center hemodialysis (HD). Medicare's 2011 bundled dialysis prospective payment system encouraged expansion of home-based ... Full text Link to item Cite

Discrimination Experiences and Depressive Symptoms among African Americans with Osteoarthritis Enrolled in a Pain Coping Skills Training Randomized Controlled Trial.

Journal Article J Health Care Poor Underserved · 2021 African Americans are more likely than members of other racial groups to report perceived discrimination in health care settings, and discrimination is linked to depression. Using data from a randomized controlled trial of pain coping skills training (PCST ... Full text Link to item Cite

Improving Veteran Access to Integrated Management of Back Pain (AIM-Back): Protocol for an Embedded Pragmatic Cluster-Randomized Trial.

Journal Article Pain Med · December 12, 2020 BACKGROUND: Coordinated efforts between the National Institutes of Health, the Department of Defense, and the Department of Veterans Affairs have built the capacity for large-scale clinical research investigating the effectiveness of nonpharmacologic pain ... Full text Open Access Link to item Cite

Advancing the science of population-based measures of home-time.

Journal Article Healthc (Amst) · December 2020 The "home time" measure is gaining appeal in evaluating outcomes for multiple patient populations including post-surgery or intervention and the last 6 months of life. Advancing the science of home time measures will require obtaining the perspectives of p ... Full text Link to item Cite

Practical telehealth to improve control and engagement for patients with clinic-refractory diabetes mellitus (PRACTICE-DM): Protocol and baseline data for a randomized trial.

Journal Article Contemp Clin Trials · November 2020 BACKGROUND: Persistent poorly-controlled type 2 diabetes mellitus (PPDM), or maintenance of a hemoglobin A1c (HbA1c) ≥8.5% despite receiving clinic-based diabetes care, contributes disproportionately to the national diabetes burden. Comprehensive telehealt ... Full text Open Access Link to item Cite

Implementation of a stepped wedge cluster randomized trial to evaluate a hospital mobility program.

Journal Article Trials · October 16, 2020 BACKGROUND: Stepped wedge cluster randomized trials (SW-CRT) are increasingly used to evaluate new clinical programs, yet there is limited guidance on practical aspects of applying this design. We report our early experiences conducting a SW-CRT to examine ... Full text Open Access Link to item Cite

Implementation of a group physical therapy program for Veterans with knee osteoarthritis.

Journal Article BMC Musculoskelet Disord · February 3, 2020 BACKGROUND: A previous randomized clinical trial found that a Group Physical Therapy (PT) program for knee osteoarthritis yielded similar improvements in pain and function compared with traditional individual PT. Based on these findings the Group PT progra ... Full text Open Access Link to item Cite

Adaptation and Implementation of a Family Caregiver Skills Training Program: From Single Site RCT to Multisite Pragmatic Intervention.

Journal Article J Nurs Scholarsh · January 2020 PURPOSE: We describe an approach to rapidly adapt and implement an education and skills improvement intervention to address the needs of family caregivers of functionally impaired veterans-Helping Invested Families Improve Veterans' Experience Study (HI-FI ... Full text Link to item Cite

Discharge Information and Support for Patients Discharged from the Emergency Department: Results from a Randomized Controlled Trial.

Journal Article J Gen Intern Med · January 2020 BACKGROUND: Little research has been done on primary care-based models to improve health care use after an emergency department (ED) visit. OBJECTIVE: To examine the effectiveness of a primary care-based, nurse telephone support intervention for Veterans t ... Full text Link to item Cite

Comparison of Group Medical Visits Combined With Intensive Weight Management vs Group Medical Visits Alone for Glycemia in Patients With Type 2 Diabetes: A Noninferiority Randomized Clinical Trial.

Journal Article JAMA Intern Med · January 1, 2020 IMPORTANCE: Traditionally, group medical visits (GMVs) for persons with diabetes improved glycemia by intensifying medications, which infrequently led to weight loss. Incorporating GMVs with intensive dietary change could enable weight loss and improve gly ... Full text Link to item Cite

Trends in Peritoneal Dialysis Use in the United States after Medicare Payment Reform.

Journal Article Clin J Am Soc Nephrol · December 6, 2019 BACKGROUND AND OBJECTIVES: Peritoneal dialysis (PD) for ESKD is associated with similar mortality, higher quality of life, and lower costs compared with hemodialysis (HD), but has historically been underused. We assessed the effect of the 2011 Medicare pro ... Full text Link to item Cite

An electronic family health history tool to identify and manage patients at increased risk for colorectal cancer: protocol for a randomized controlled trial.

Journal Article Trials · October 7, 2019 BACKGROUND: Colorectal cancer is the fourth most commonly diagnosed cancer in the United States. Approximately 3-10% of the population has an increased risk for colorectal cancer due to family history and warrants more frequent or intensive screening. Yet, ... Full text Link to item Cite

Composite measures of physical activity and pain associate better with functional assessments than pain alone in knee osteoarthritis.

Journal Article Clin Rheumatol · August 2019 INTRODUCTION: Recent research showed that physical activity (PA)-adjusted pain measures were more strongly associated with radiographic osteoarthritis (OA) severity than an unadjusted pain measure. This exploratory study examined whether PA-adjusted pain m ... Full text Link to item Cite

Authors' Reply.

Journal Article J Am Soc Nephrol · July 2019 Full text Link to item Cite

Pain coping skills training for African Americans with osteoarthritis: results of a randomized controlled trial.

Journal Article Pain · June 2019 African Americans bear a disproportionate burden of osteoarthritis (OA), but they have been underrepresented in trials of behavioral interventions for pain. This trial examined a culturally tailored pain coping skills training (CST) program, compared to a ... Full text Link to item Cite

STepped exercise program for patients with knee OsteoArthritis (STEP-KOA): protocol for a randomized controlled trial.

Journal Article BMC Musculoskelet Disord · May 28, 2019 BACKGROUND: Physical therapy (PT) and other exercise-based interventions are core components of care for knee osteoarthritis (OA), but both are underutilized, and some patients have limited access to PT services. This clinical trial is examining a STepped ... Full text Open Access Link to item Cite

Survival among Veterans Obtaining Dialysis in VA and Non-VA Settings.

Journal Article J Am Soc Nephrol · January 2019 BACKGROUND: Outcomes of veterans with ESRD may differ depending on where they receive dialysis and who finances this care, but little is known about variation in outcomes across different dialysis settings and financial arrangements. METHODS: We examined s ... Full text Link to item Cite

Medicare's New Prospective Payment System on Facility Provision of Peritoneal Dialysis.

Journal Article Clin J Am Soc Nephrol · December 7, 2018 BACKGROUND AND OBJECTIVES: Peritoneal dialysis is a self-administered, home-based treatment for ESKD associated with equivalent mortality, higher quality of life, and lower costs compared with hemodialysis. In 2011, Medicare implemented a comprehensive pro ... Full text Link to item Cite

Comparative Assessment of Utilization and Hospital Outcomes of Veterans Receiving VA and Non-VA Outpatient Dialysis.

Journal Article Health Serv Res · December 2018 OBJECTIVE: Growing demand for VA dialysis exceeds its supply and travel distances prohibit many Veterans from receiving dialysis in a VA facility, leading to increased use of dialysis from non-VA providers. This study compared utilization and hospitalizati ... Full text Link to item Cite

Pain coping skills training for African Americans with osteoarthritis study: baseline participant characteristics and comparison to prior studies.

Journal Article BMC Musculoskelet Disord · September 19, 2018 BACKGROUND: The Pain Coping Skills Training for African Americans with OsteoaRTthritis (STAART) trial is examining the effectiveness of a culturally enhanced pain coping skills training (CST) program for African Americans with osteoarthritis (OA). This dis ... Full text Link to item Cite

How Views of the Organization of Primary Care Among Patients with Hypertension Vary by Race or Ethnicity.

Journal Article Mil Med · September 1, 2018 INTRODUCTION: We assessed potential racial or ethnic differences in the degree to which veterans with pharmaceutically treated hypertension report experiences with their primary care system that are consistent with optimal chronic illness care as suggested ... Full text Open Access Link to item Cite

Demographic and Clinical Factors Associated With Nonsurgical Osteoarthritis Treatment Among Patients in Outpatient Clinics.

Journal Article Arthritis Care Res (Hoboken) · August 2018 OBJECTIVE: To identify patient demographic and clinical characteristics associated with osteoarthritis (OA) treatment use. METHODS: This was a secondary data analysis of 3 clinical trials among patients with hip or knee OA conducted in Duke Primary Care pr ... Full text Link to item Cite

Physician Weight-Related Counseling Is Unrelated to Extreme Weight Loss Behaviors Among Overweight and Obese Adolescents.

Journal Article Clin Pediatr (Phila) · July 2018 Some physicians may be hesitant to counsel overweight and obese adolescents about weight because of concerns that such counseling may result in extreme weight loss behaviors and the subsequent development of eating disorders. We compared self-reported extr ... Full text Link to item Cite

Internet Use and Technology-Related Attitudes of Veterans and Informal Caregivers of Veterans.

Journal Article Telemed J E Health · July 2018 BACKGROUND: Healthcare systems are interested in technology-enhanced interventions to improve patient access and outcomes. However, there is uncertainty about feasibility and acceptability for groups who may benefit but are at risk for disparities in techn ... Full text Link to item Cite

The influence of oral statin medications on progression of glaucomatous visual field loss: A propensity score analysis.

Journal Article Ophthalmic Epidemiol · June 2018 PURPOSE: The purpose of this study was to examine the association between oral statin use and the progression of open angle glaucoma. METHODS: Medical records of 847 Veterans were reviewed to collect statin use history, record demographic and comorbid medi ... Full text Link to item Cite

Effects of a Home-Based Telephone-Supported Physical Activity Program for Older Adult Veterans With Chronic Low Back Pain.

Journal Article Phys Ther · May 1, 2018 BACKGROUND: Chronic low back pain (CLBP) is highly prevalent in older adults, leading to functional decline. OBJECTIVE: The objective of this study was to evaluate physical activity (PA) only and PA plus cognitive-behavioral therapy for pain (CBT-P) among ... Full text Link to item Cite

Supporting teams to optimize function and independence in Veterans: a multi-study program and mixed methods protocol.

Journal Article Implement Sci · April 20, 2018 BACKGROUND: Successful implementation of new clinical programs depends on effectively establishing, reorganizing, or enhancing team structures and processes to coordinate the work of individuals who are interdependent in their tasks, manage relationships, ... Full text Open Access Link to item Cite

Cognitive Mediators of Change in Physical Functioning in Response to a Multifaceted Intervention for Managing Osteoarthritis.

Journal Article Int J Behav Med · April 2018 PURPOSE: Although non-pharmacological interventions have been shown to improve physical functioning in individuals with osteoarthritis (OA), the mechanisms by which this occurs are often unclear. This study assessed whether changes in arthritis self-effica ... Full text Link to item Cite

Prevalence of and characteristics associated with insomnia and obstructive sleep apnea among veterans with knee and hip osteoarthritis.

Journal Article BMC Musculoskelet Disord · March 9, 2018 BACKGROUND: Few studies have examined patterns of specific sleep problems among individuals with osteoarthritis (OA). The primary objective of this study was to examine prevalence of symptoms of insomnia and obstructive sleep apnea (OSA) among Veterans wit ... Full text Open Access Link to item Cite

A feasibility study to develop and test a Spanish patient and provider intervention for managing osteoarthritis in Hispanic/Latino adults (PRIMO-Latino).

Journal Article Pilot Feasibility Stud · 2018 BACKGROUND: Arthritis affects approximately 50 million adults in the USA. Hispanics/Latinos have a higher prevalence of arthritis-attributed activity limitations primarily related to osteoarthritis (OA). Hispanic/Latinos are less likely to receive hip repl ... Full text Open Access Link to item Cite

A problem-solving intervention for cardiovascular disease risk reduction in veterans: Protocol for a randomized controlled trial.

Journal Article Contemp Clin Trials · September 2017 BACKGROUND: Health behaviors related to diet, tobacco usage, physical activity, medication adherence, and alcohol use are highly determinative of risk for developing cardiovascular disease. This paper describes a study protocol to evaluate a problem-solvin ... Full text Link to item Cite

Risk stratification for return emergency department visits among high-risk patients.

Journal Article Am J Manag Care · August 1, 2017 OBJECTIVES: To compare 2 methods of identifying patients at high-risk of repeat emergency department (ED) use: high Care Assessment Need (CAN) score (≥90), derived from a model using Veterans Health Administration (VHA) data, and "Super User" status, defin ... Link to item Cite

Jump starting shared medical appointments for diabetes with weight management: Rationale and design of a randomized controlled trial.

Journal Article Contemp Clin Trials · July 2017 BACKGROUND: Rates of glycemic control remain suboptimal nationwide. Medication intensification for diabetes can have undesirable side effects (weight gain, hypoglycemia), which offset the benefits of glycemic control. A Shared Medical Appointment (SMA) int ... Full text Link to item Cite

Patient, Provider, and Combined Interventions for Managing Osteoarthritis in Primary Care: A Cluster Randomized Trial.

Journal Article Ann Intern Med · March 21, 2017 BACKGROUND: A single-site study showed that a combined patient and provider intervention improved outcomes for patients with knee osteoarthritis, but it did not assess separate effects of the interventions. OBJECTIVE: To examine whether patient-based, prov ... Full text Open Access Link to item Cite

Impacts of Geographic Distance on Peritoneal Dialysis Utilization: Refining Models of Treatment Selection.

Journal Article Health Serv Res · February 2017 OBJECTIVE: To examine the relationship between distance to dialysis provider and patient selection of dialysis modality, informed by the absolute distance from a patient's home and relative distance of alternative modalities. DATA SOURCES: U.S. Renal Data ... Full text Link to item Cite

To condition or not condition? Analysing 'change' in longitudinal randomised controlled trials.

Journal Article BMJ Open · December 30, 2016 OBJECTIVE: The statistical analysis for a 2-arm randomised controlled trial (RCT) with a baseline outcome followed by a few assessments at fixed follow-up times typically invokes traditional analytic methods (eg, analysis of covariance (ANCOVA), longitudin ... Full text Link to item Cite

Teaching primary care physicians the 5 A's for discussing weight with overweight and obese adolescents.

Journal Article Patient Educ Couns · October 2016 OBJECTIVE: We developed an online intervention to teach physicians both MI (addressed in outcomes paper) and the 5 A's (Ask, Advise, Assess, Assist, and Arrange) when discussing weight with overweight/obese adolescents. METHODS: We audio recorded 527 encou ... Full text Link to item Cite

Open-label randomized trial of titrated disease management for patients with hypertension: Study design and baseline sample characteristics.

Journal Article Contemp Clin Trials · September 2016 Despite the availability of efficacious treatments, only half of patients with hypertension achieve adequate blood pressure (BP) control. This paper describes the protocol and baseline subject characteristics of a 2-arm, 18-month randomized clinical trial ... Full text Open Access Link to item Cite

Pain coping skills training for African Americans with osteoarthritis (STAART): study protocol of a randomized controlled trial.

Journal Article BMC Musculoskelet Disord · August 23, 2016 BACKGROUND: African Americans bear a disproportionate burden of osteoarthritis (OA), with higher prevalence rates, more severe pain, and more functional limitations. One key barrier to addressing these disparities has been limited engagement of African Ame ... Full text Link to item Cite

Food preferences and weight change during low-fat and low-carbohydrate diets.

Journal Article Appetite · August 1, 2016 UNLABELLED: Understanding associations between food preferences and weight loss during various effective diets could inform efforts to personalize dietary recommendations and provide insight into weight loss mechanisms. We conducted a secondary analysis of ... Full text Open Access Link to item Cite

Teaching Physicians Motivational Interviewing for Discussing Weight With Overweight Adolescents.

Journal Article J Adolesc Health · July 2016 PURPOSE: We tested whether an online intervention combined with a patient feedback report improved physicians' use of motivational interviewing (MI) techniques when discussing weight with overweight and obese adolescents. METHODS: We randomized 46 pediatri ... Full text Link to item Cite

Practical Telemedicine for Veterans with Persistently Poor Diabetes Control: A Randomized Pilot Trial.

Journal Article Telemed J E Health · May 2016 BACKGROUND: Telemedicine-based diabetes management improves outcomes versus clinic care but is seldom implemented by healthcare systems. In order to advance telemedicine-based management as a practical option for veterans with persistent poorly controlled ... Full text Link to item Cite

Group Versus Individual Physical Therapy for Veterans With Knee Osteoarthritis: Randomized Clinical Trial.

Journal Article Phys Ther · May 2016 BACKGROUND: Efficient approaches are needed for delivering nonpharmacological interventions for management of knee osteoarthritis (OA). OBJECTIVE: This trial compared group-based versus individual physical therapy interventions for management of knee OA. D ... Full text Open Access Link to item Cite

Unrecognized Cognitive Impairment in Medically Complex Older Veterans

Conference JOURNAL OF THE AMERICAN GERIATRICS SOCIETY · May 1, 2016 Link to item Cite

A Combined Patient and Provider Intervention for Management of Osteoarthritis in Veterans: A Randomized Clinical Trial.

Journal Article Ann Intern Med · January 19, 2016 BACKGROUND: Management of osteoarthritis requires both medical and behavioral strategies, but some recommended therapies are underused. OBJECTIVE: To examine the effectiveness of a combined patient and provider intervention for improving osteoarthritis out ... Full text Open Access Link to item Cite

Does Type 2 Diabetes Genetic Testing and Counseling Reduce Modifiable Risk Factors? A Randomized Controlled Trial of Veterans.

Journal Article J Gen Intern Med · November 2015 OBJECTIVE: We examined the clinical utility of supplementing type 2 diabetes mellitus (DM) risk counseling with DM genetic test results and counseling. RESEARCH DESIGN AND METHODS: In this randomized controlled trial, non-diabetic overweight/obese veteran ... Full text Link to item Cite

The association of comorbid conditions with patient-reported outcomes in Veterans with hip and knee osteoarthritis.

Conference Clin Rheumatol · August 2015 There is limited understanding of how comorbid health conditions affect osteoarthritis (OA)-related outcomes. This study examined associations of different comorbidity measures with baseline OA-related patient-reported outcomes (PROs) among patients with h ... Full text Link to item Cite

Effects of provision of type 2 diabetes genetic risk feedback on patient perceptions of diabetes control and diet and physical activity self-efficacy.

Journal Article Patient Educ Couns · June 30, 2015 OBJECTIVE: We examined effects of providing type 2 diabetes genetic risk feedback on controllability perceptions. METHODS: This is a secondary analysis of a randomized controlled trial in which overweight/obese Veterans Affairs patients without diabetes re ... Full text Link to item Cite

Effect of Allowing Choice of Diet on Weight Loss: A Randomized Trial.

Journal Article Ann Intern Med · June 16, 2015 BACKGROUND: Choosing a diet rather than being prescribed one could improve weight loss. OBJECTIVE: To examine whether offering choice of diet improves weight loss. DESIGN: Double-randomized preference trial of choice between 2 diets (choice) versus random ... Full text Link to item Cite

Stability of Diagnoses of Cognitive Impairment, Not Dementia in a Veterans Affairs Primary Care Population.

Journal Article J Am Geriatr Soc · June 2015 OBJECTIVES: To describe the stability of cognitive impairment, not dementia (CIND) in a longitudinal cohort of primary care veterans. To examine the association between baseline brief cognitive screening tests, demographic and clinical characteristics, and ... Full text Link to item Cite

Nurse-led behavioral management of diabetes and hypertension in community practices: a randomized trial.

Journal Article J Gen Intern Med · May 2015 BACKGROUND: Several trials have demonstrated the efficacy of nurse telephone case management for diabetes (DM) and hypertension (HTN) in academic or vertically integrated systems. Little is known about the real-world potency of these interventions. OBJECTI ... Full text Open Access Link to item Cite

Associations of coping strategies with diary based pain variables among Caucasian and African American patients with osteoarthritis.

Journal Article Int J Behav Med · February 2015 PURPOSE: The purposes of this study are to examine the associations between pain coping strategies and daily diary-based pain measures and to determine whether these associations differed by race (African American and Caucasian). METHODS: Primary care pati ... Full text Link to item Cite

Mechanisms of patient health behavior change in a randomized controlled trial of a spouse-assisted intervention.

Journal Article Psychol Health Med · 2015 Spouse-assisted interventions can improve health behaviors, but mechanisms of action are unknown. This study evaluated mediators of dietary and physical activity outcomes during a spouse-assisted intervention to improve low-density lipoprotein cholesterol. ... Full text Link to item Cite

Clinic variation in recruitment metrics, patient characteristics and treatment use in a randomized clinical trial of osteoarthritis management.

Journal Article BMC Musculoskelet Disord · December 6, 2014 BACKGROUND: The Patient and PRovider Interventions for Managing Osteoarthritis (OA) in Primary Care (PRIMO) study is one of the first health services trials targeting OA in a multi-site, primary care network. This multi-site approach is important for asses ... Full text Open Access Link to item Cite

Spouse health behavior outcomes from a randomized controlled trial of a spouse-assisted lifestyle change intervention to improve patient low-density lipoprotein cholesterol.

Journal Article J Behav Med · December 2014 This study evaluated spouse health behavior outcomes from a randomized controlled trial of a spouse-assisted lifestyle intervention to reduce patient low-density lipoprotein cholesterol and improve patient health behaviors. Participants were 251 spouses of ... Full text Link to item Cite

Factors associated with choice of a low-fat or low-carbohydrate diet during a behavioral weight loss intervention.

Journal Article Appetite · December 2014 Individuals undertaking a weight loss effort have a choice among proven dietary approaches. Factors contributing to choice of either a low-fat/low-calorie diet or a low-carbohydrate diet, two of the most studied and popular dietary approaches, are unknown. ... Full text Link to item Cite

Weight-related SMS texts promoting appropriate pregnancy weight gain: a pilot study.

Journal Article Patient Educ Couns · November 2014 OBJECTIVES: Excessive gestational weight gain (GWG) puts women and children at risk of obesity. We piloted an SMS-texting intervention to promote healthy GWG among overweight and obese women. METHODS: We recruited 35 women and randomized them in a 2:1 fash ... Full text Link to item Cite

Discharge information and support for veterans Receiving Outpatient Care in the Emergency Department: study design and methods.

Journal Article Contemp Clin Trials · November 2014 BACKGROUND: An explicit goal of Patient Aligned Care Teams (PACTs) within the Veterans Health Administration is to promote continuity of care in primary care clinics and thereby reduce Emergency Department (ED) utilization; however, there has been little r ... Full text Link to item Cite

Weight's up? Predictors of weight-related communication during primary care visits with overweight adolescents.

Journal Article Patient Educ Couns · September 2014 OBJECTIVE: Physicians' use of Motivational Interviewing (MI) techniques when discussing weight with adolescent patients is unknown. METHODS: We coded audio-recorded encounters between 49 primary care physicians and 180 overweight adolescent patients. Durin ... Full text Link to item Cite

Can group medical clinics improve lipid management in diabetes?

Journal Article Am J Med · February 2014 BACKGROUND: Group medical clinics may improve diabetes and hypertension control, but data about dyslipidemia are limited. We examined the impact of group medical clinics on lipids among patients with uncontrolled diabetes and hypertension. METHODS: Prespec ... Full text Link to item Cite

Teen CHAT: Development and utilization of a web-based intervention to improve physician communication with adolescents about healthy weight.

Journal Article Patient Educ Couns · December 2013 OBJECTIVE: To describe the theoretical basis, use, and satisfaction with Teen CHAT, an online educational intervention designed to improve physician-adolescent communication about healthy weight. METHODS: Routine health maintenance encounters between pedia ... Full text Link to item Cite

Tailored Case Management for Diabetes and Hypertension (TEACH-DM) in a community population: study design and baseline sample characteristics.

Journal Article Contemp Clin Trials · September 2013 BACKGROUND: Despite recognition of the benefits associated with well-controlled diabetes and hypertension, control remains suboptimal. Effective interventions for these conditions have been studied within academic settings, but interventions targeting both ... Full text Open Access Link to item Cite

Impact of baseline insulin regimen on glycemic response to a group medical clinic intervention.

Journal Article Diabetes Care · July 2013 OBJECTIVE: Group medical clinics (GMC) combine medication management and self-management training, and may improve diabetes outcomes. It remains unclear which patients benefit most from GMC. This secondary analysis examined the impact of baseline insulin r ... Full text Link to item Cite

Differences in osteoarthritis self-management support intervention outcomes according to race and health literacy.

Journal Article Health Educ Res · June 2013 We explored whether the effects of a telephone-based osteoarthritis (OA) self-management support intervention differed by race and health literacy. Participants included 515 veterans with hip and/or knee OA. Linear mixed models assessed differential effect ... Full text Open Access Link to item Cite

Considering patient diet preference to optimize weight loss: design considerations of a randomized trial investigating the impact of choice.

Journal Article Contemp Clin Trials · May 2013 A variety of diet approaches achieve moderate weight loss in many individuals. Yet, most diet interventions fail to achieve meaningful weight loss in more than a few individuals, likely due to inadequate adherence to the diet. It is widely conjectured that ... Full text Link to item Cite

Predictors of fatigue in patients with hip and knee osteoarthritis

Conference Osteoarthritis and Cartilage · April 2013 Full text Cite

Group physical therapy for veterans with knee osteoarthritis: study design and methodology.

Journal Article Contemp Clin Trials · March 2013 Physical therapy (PT) is a key component of treatment for knee osteoarthritis (OA) and can decrease pain and improve function. Given the expected rise in prevalence of knee OA and the associated demand for treatment, there is a need for models of care that ... Full text Open Access Link to item Cite

A randomized controlled trial to evaluate the effectiveness of CouPLES: a spouse-assisted lifestyle change intervention to improve low-density lipoprotein cholesterol.

Journal Article Prev Med · January 2013 OBJECTIVE: This randomized controlled trial evaluated the effectiveness of a telephone-delivered, spouse-assisted lifestyle intervention to reduce patient LDL-C. METHOD: From 2007 to 2010, 255 outpatients with LDL-C>76 mg/dL and their spouses from the Durh ... Full text Open Access Link to item Cite

Patient self-efficacy and spouse perception of spousal support are associated with lower patient weight: baseline results from a spousal support behavioral intervention.

Journal Article Psychol Health Med · 2013 Obesity and related chronic illnesses are leading causes of death and excessive health care costs, necessitating identification of factors that can help patients achieve and maintain healthy weight. Greater self-efficacy and perceived spousal support in pa ... Full text Link to item Cite

Can physicians accurately predict which patients will lose weight, improve nutrition and increase physical activity?

Journal Article Fam Pract · October 2012 BACKGROUND: Physician counselling may help patients increase physical activity, improve nutrition and lose weight. However, physicians have low outcome expectations that patients will change. The aims are to describe the accuracy of physicians' outcome exp ... Full text Link to item Cite

Examining the impact of genetic testing for type 2 diabetes on health behaviors: study protocol for a randomized controlled trial.

Journal Article Trials · August 1, 2012 BACKGROUND: We describe the study design, procedures, and development of the risk counseling protocol used in a randomized controlled trial to evaluate the impact of genetic testing for diabetes mellitus (DM) on psychological, health behavior, and clinical ... Full text Link to item Cite

Screening for cognitive impairment: comparing the performance of four instruments in primary care.

Journal Article J Am Geriatr Soc · June 2012 OBJECTIVES: To determine whether brief cognitive screening tests perform as well as a longer screening test in diagnosis of cognitive impairment, no dementia (CIND) or dementia. DESIGN: A cross-sectional comparison of cognitive screening tests to an indepe ... Full text Link to item Cite

Mixed-effects regression modeling of real-time momentary pain assessments in osteoarthritis (OA) patients

Journal Article Health Services and Outcomes Research Methodology · June 1, 2012 Mixed-effects regression models have extraordinary capacity to capture the essence of complex longitudinal data. In this paper we present analyses from a longitudinal study on 157 patients with osteoarthritis (OA) where real-time momentary self-reported pa ... Full text Cite

Patient and provider interventions for managing osteoarthritis in primary care: protocols for two randomized controlled trials.

Journal Article BMC Musculoskelet Disord · April 24, 2012 BACKGROUND: Osteoarthritis (OA) of the hip and knee are among the most common chronic conditions, resulting in substantial pain and functional limitations. Adequate management of OA requires a combination of medical and behavioral strategies. However, some ... Full text Open Access Link to item Cite

Participant evaluation of a telephone-based osteoarthritis self-management program, 2006-2009.

Journal Article Prev Chronic Dis · 2012 INTRODUCTION: Self-management support interventions can help improve osteoarthritis outcomes but are underused. Little is known about how participants evaluate the helpfulness of these programs. We describe participants' evaluations of a telephone-based, o ... Open Access Link to item Cite

Factors associated with survival of veterans with gastrointestinal neuroendocrine tumors.

Journal Article J Cancer Epidemiol · 2012 Background. Gastrointestinal (GI) neuroendocrine tumor (NET) incidence has been increasing; however, GI NET within the national Veterans Affairs (VA) health system has not been described. Methods. We used the VA Central Cancer Registry to identify the coho ... Full text Link to item Cite

Effects of counseling techniques on patients' weight-related attitudes and behaviors in a primary care clinic.

Journal Article Patient Educ Couns · December 2011 OBJECTIVE: Examine primary care physicians' use of counseling techniques when treating overweight and obese patients and the association with mediators of behavior change as well as change in nutrition, exercise, and weight loss attempts. METHODS: We audio ... Full text Link to item Cite

Predictors of weight loss communication in primary care encounters.

Journal Article Patient Educ Couns · December 2011 OBJECTIVE: Evidence suggests that physicians' use of motivational interviewing (MI) techniques helps patients lose weight. We assessed patient, physician, relationship, and systems predictors of length of weight-loss discussions and whether physicians' use ... Full text Link to item Cite

The trials and tribulations of enrolling couples in a randomized, controlled trial: a self-management program for hyperlipidemia as a model.

Journal Article Patient Educ Couns · July 2011 OBJECTIVE: Capitalizing on spousal support may enhance the effectiveness of interventions for chronic disease management. However, couples-based interventions present logistical challenges. We describe our experience and lessons learned while recruiting co ... Full text Open Access Link to item Cite

Physician empathy and listening: associations with patient satisfaction and autonomy.

Journal Article J Am Board Fam Med · 2011 PURPOSE: Motivational Interviewing (MI) is used to help patients change their behaviors. We sought to determine if physician use of specific MI techniques increases patient satisfaction with the physician and perceived autonomy. METHODS: We audio-recorded ... Full text Link to item Cite

Telephone-based self-management of osteoarthritis: A randomized trial.

Journal Article Ann Intern Med · November 2, 2010 BACKGROUND: Osteoarthritis is a leading cause of pain and disability, and self-management behaviors for osteoarthritis are underutilized. OBJECTIVE: To examine the effectiveness of a telephone-based self-management intervention for hip or knee osteoarthrit ... Full text Open Access Link to item Cite

Physician communication techniques and weight loss in adults: Project CHAT.

Journal Article Am J Prev Med · October 2010 BACKGROUND: Physicians are encouraged to counsel overweight and obese patients to lose weight. PURPOSE: It was examined whether discussing weight and use of motivational interviewing techniques (e.g., collaborating, reflective listening) while discussing w ... Full text Link to item Cite

Medical clinics versus usual care for patients with both diabetes and hypertension: a randomized trial.

Journal Article Ann Intern Med · June 1, 2010 BACKGROUND: Group medical clinics (GMCs) are widely used in the management of diabetes and hypertension, but data on their effectiveness are limited. OBJECTIVE: To test the effectiveness of GMCs in the management of comorbid diabetes and hypertension. DESI ... Full text Link to item Cite

Ascertainment of colonoscopy indication using administrative data.

Journal Article Dig Dis Sci · June 2010 BACKGROUND: Administrative procedure code data can estimate colonoscopy utilization; however, determining colonoscopy indication is more difficult as procedure codes do not inherently reflect the purpose (screening, surveillance, diagnosis) of the colonosc ... Full text Link to item Cite

Comparison of pain measures among patients with osteoarthritis.

Journal Article J Pain · June 2010 UNLABELLED: This study compared recalled average pain, assessed at the end of the day, with the average of real-time pain ratings recorded throughout the day among patients with osteoarthritis (OA). Participants (N = 157) with hand, hip, or knee OA complet ... Full text Link to item Cite

Racial differences in osteoarthritis pain and function: potential explanatory factors.

Journal Article Osteoarthritis Cartilage · February 2010 OBJECTIVE: This study examined factors underlying racial differences in pain and function among patients with hip and/or knee osteoarthritis (OA). METHODS: Participants were n=491 African Americans and Caucasians enrolled in a clinical trial of telephone-b ... Full text Link to item Cite

Time to diagnosis in the National Registry of Veterans with Amyotrophic Lateral Sclerosis.

Journal Article Amyotroph Lateral Scler · 2010 Featured Publication Our objective was to determine the interval from symptom onset to diagnosis, and to evaluate associated factors in a cohort of U.S. Veterans with motor neuron diseases. We retrospectively evaluated 1359 patients enrolled in the National Registry of Veteran ... Full text Link to item Cite

Daily pain variations among patients with hand, hip, and knee osteoarthritis.

Journal Article Osteoarthritis Cartilage · October 2009 Featured Publication OBJECTIVE: This study examined within-day osteoarthritis (OA)-related pain patterns and associated patient characteristics. METHODS: Participants with physician diagnoses and self-reported symptoms of hand (N=40), hip (N=32), and knee (N=85) OA recorded pa ... Full text Link to item Cite

GnRH: Authors' response

Journal Article Journal of Women's Health · September 1, 2009 Full text Cite

Primary care physicians' discussions of weight-related topics with overweight and obese adolescents: results from the Teen CHAT Pilot study.

Journal Article J Adolesc Health · August 2009 Physicians should counsel overweight adolescents about nutrition and exercise. We audio recorded 30 physician-adolescent encounters. Female, older, normal-weight physicians and pediatricians were more Motivational Interviewing (MI) adherent. When physician ... Full text Link to item Cite

Validation of a questionnaire to assess self-reported colorectal cancer screening status using face-to-face administration.

Journal Article Dig Dis Sci · June 2009 Featured Publication PURPOSE: The aim of this study was to assess the accuracy of a National Cancer Institute (NCI)-developed colorectal cancer screening questionnaire. METHODS: We conducted 36 cognitive interviews and made iterative changes to the questionnaire to improve com ... Full text Link to item Cite

Ovarian preservation by GnRH agonists during chemotherapy: a meta-analysis.

Journal Article J Womens Health (Larchmt) · March 2009 Featured Publication PURPOSE: Treatment with cyclophosphamide (CYC) confers up to a 40% risk of ovarian failure in women of reproductive age. The use of GnRH agonists (GnRHa) to preserve ovarian function has been investigated in several small studies. We performed a systematic ... Full text Link to item Cite

Study protocol: Couples Partnering for Lipid Enhancing Strategies (CouPLES) - a randomized, controlled trial.

Journal Article Trials · February 6, 2009 Featured Publication BACKGROUND: Almost 50% of Americans have elevated low-density lipoprotein cholesterol (LDL-C). The behaviors required to lower LDL-C levels may be difficult to adhere to if they are inconsistent with spouses' health practices, and, alternatively, may be en ... Full text Link to item Cite

Clinical aspects of ALS in Gulf War veterans.

Journal Article Amyotroph Lateral Scler · February 2009 Featured Publication The increased incidence of ALS in military veterans of the first Persian Gulf War raised speculation that they may have a 'Persian Gulf' variant of ALS with atypical clinical features. Medical records of military veterans with ALS, previously identified in ... Full text Link to item Cite

Time to diagnosis in the National Registry of Veterans with Amyotrophic Lateral Sclerosis.

Journal Article Amyotrophic lateral sclerosis : official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases · January 2009 Our objective was to determine the interval from symptom onset to diagnosis, and to evaluate associated factors in a cohort of U.S. Veterans with motor neuron diseases. We retrospectively evaluated 1359 patients enrolled in the National Registry of Veteran ... Cite

Factors associated with survival in the National Registry of Veterans with ALS.

Journal Article Amyotroph Lateral Scler · 2009 The clinical course of patients with ALS is highly variable. While the median survival time from symptom onset is 2-4 years, there are reports of survival ranging from less than a year to more than 40 years. Such variability makes planning difficult for pa ... Full text Link to item Cite

Home health care and patterns of subsequent VA and medicare health care utilization for veterans.

Journal Article Gerontologist · October 2008 Featured Publication PURPOSE: The Veterans Affairs or VA health care system is in the process of significantly expanding home health care (HHC) nationwide. We describe VA HHC use in 2003 for all VA HHC users from 2002; we examine whether VA utilization across a broad spectrum ... Full text Link to item Cite

Clinical aspects of ALS in Gulf War Veterans.

Journal Article Amyotrophic lateral sclerosis : official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases · September 2008 The increased incidence of ALS in military veterans of the first Persian Gulf War raised speculation that they may have a 'Persian Gulf' variant of ALS with atypical clinical features. Medical records of military veterans with ALS, previously identified in ... Cite

Within-day pain variations among patients with osteoarthritis

Conference ARTHRITIS AND RHEUMATISM · September 1, 2008 Link to item Cite

Factors associated with survival in the National Registry of Veterans with ALS.

Journal Article Amyotrophic lateral sclerosis : official publication of the World Federation of Neurology Research Group on Motor Neuron Diseases · August 2008 The clinical course of patients with ALS is highly variable. While the median survival time from symptom onset is 2-4 years, there are reports of survival ranging from less than a year to more than 40 years. Such variability makes planning difficult for pa ... Cite

The Self-Management of OsteoArthritis in Veterans (SeMOA) Study: design and methodology.

Journal Article Contemp Clin Trials · July 2008 Featured Publication BACKGROUND: Osteoarthritis (OA) is a leading cause of disability among adults. Although self-management behaviors such as exercise and weight management can improve pain and function, these behaviors are vastly underutilized. There is a need to implement e ... Full text Link to item Cite

Do patients know why they had a colonoscopy?

Conference GASTROENTEROLOGY · April 1, 2008 Link to item Cite

The survival of US military veterans with ALS

Conference NEUROLOGY · March 11, 2008 Link to item Cite

Frequency and predictors of de novo hepatocellular carcinoma in patients awaiting orthotopic liver transplantation during the model for end-stage liver disease era.

Journal Article Liver Transpl · February 2008 Featured Publication In the current system of allocation, patients awaiting orthotopic liver transplantation (OLT) remain at risk of developing de novo hepatocellular carcinoma (HCC) and removal from the waiting list. Using the United Network for Organ Sharing database, we cal ... Full text Link to item Cite

Amyotrophic lateral sclerosis among 1991 Gulf War veterans: evidence for a time-limited outbreak.

Journal Article Neuroepidemiology · 2008 Featured Publication BACKGROUND: In follow-up to recent reports of an elevated risk of amyotrophic lateral sclerosis (ALS) among 1991 Gulf War veterans, we analyzed the distribution of disease onset times to determine whether the excess risk was time limited. METHODS: This sec ... Full text Link to item Cite

The National Registry of Veterans with amyotrophic lateral sclerosis.

Journal Article Neuroepidemiology · 2008 Featured Publication BACKGROUND: The Department of Veterans Affairs (VA) Cooperative Studies Program has established a National Registry of Veterans with Amyotrophic Lateral Sclerosis (ALS). This article describes the objectives, methods, and sample involved in the registry. M ... Full text Link to item Cite

Characteristics associated with participation in DNA banking: The National Registry of Veterans with ALS.

Journal Article Contemp Clin Trials · September 2007 Featured Publication OBJECTIVE: Characteristics that may influence participation in DNA banks are not well defined. The purpose of this study was to examine characteristics associated with participation in a DNA bank among veterans diagnosed with Amyotrophic Lateral Sclerosis ... Full text Link to item Cite

Dose-response effects of cognitive-behavioral insomnia therapy: a randomized clinical trial.

Journal Article Sleep · February 2007 Featured Publication SUBJECT OBJECTIVE: To determine the optimal number of therapist-guided Cognitive-Behavioral Insomnia Therapy (CBT) sessions required for treating primary sleep-maintenance insomnia. DESIGN AND SETTING: Randomized, parallel-group, clinical trial at a single ... Full text Link to item Cite

Gender differences in health care utilization among veterans with chronic pain.

Journal Article J Gen Intern Med · February 2007 Featured Publication BACKGROUND: Previous research reports that 48% of veterans regularly experience and express concern over pain. Outpatient service use is higher for veterans with pain than for veterans without pain. Our study objective was to identify differences in outpat ... Full text Link to item Cite

Compliance with referral for hepatitis C evaluation among veterans.

Journal Article J Clin Gastroenterol · 2007 Featured Publication GOALS: The goals of this study were to quantify the rate and to identify predictors of compliance with outpatient hepatitis C evaluation. BACKGROUND: Challenges in hepatitis C management include patient compliance with multiple clinic visits, laboratory te ... Full text Link to item Cite

Colorectal cancer screening, comorbidity, and follow-up in elderly patients.

Journal Article Am J Med Sci · October 2006 OBJECTIVE: We examined the relationship between comorbid disease and performance of complete colon examination by colonoscopy or double contrast barium enema (DCBE) after positive screening fecal occult blood test (FOBT) in patients 70 years of age or olde ... Full text Link to item Cite

Barriers to full colon evaluation for a positive fecal occult blood test.

Journal Article Cancer Epidemiol Biomarkers Prev · June 2006 Featured Publication BACKGROUND: Failure to appropriately evaluate a positive cancer screening test may negate the value of doing that test. The primary aim of this study was to explore the factors associated with undergoing a full colon evaluation for a positive fecal occult ... Full text Link to item Cite

Gender differences in opioid prescription among veterans with chronic pain.

Journal Article JOURNAL OF GENERAL INTERNAL MEDICINE · April 1, 2006 Link to item Cite

Comparison of three comorbidity measures for predicting health service use in patients with osteoarthritis.

Journal Article Arthritis Rheum · October 15, 2005 Featured Publication OBJECTIVE: To compare the ability of 3 database-derived comorbidity scores, the Charlson Score, Elixhauser method, and RxRisk-V, in predicting health service use among individuals with osteoarthritis (OA). METHODS: The study population comprised 306 patien ... Full text Link to item Cite

Model selection in binary trait locus mapping.

Journal Article Genetics · July 2005 Featured Publication Quantitative trait locus (QTL) mapping methodology for continuous normally distributed traits is the subject of much attention in the literature. Binary trait locus (BTL) mapping in experimental populations has received much less attention. A binary trait ... Full text Link to item Cite

Hormone therapy does not affect depression severity in older women.

Journal Article Am J Geriatr Psychiatry · July 2005 Featured Publication OBJECTIVE: Although estrogens are thought to have a beneficial effect on menopausal symptoms, the role of estrogen in the etiology and treatment of depression in older women remains unclear. The authors examined the relationship between hormone therapy (HT ... Full text Link to item Cite

Gender differences in healthcare utilization for chronic pain

Conference JOURNAL OF GENERAL INTERNAL MEDICINE · April 1, 2005 Link to item Cite

Identification of co-regulated transcripts affecting male body size in Drosophila.

Journal Article Genome Biol · 2005 Featured Publication Factor analysis is an analytic approach that describes the covariation among a set of genes through the estimation of 'factors', which may be, for example, transcription factors, microRNAs (miRNAs), and so on, by which the genes are co-regulated. Factor an ... Full text Link to item Cite

Estimating the occurrence of amyotrophic lateral sclerosis among Gulf War (1990-1991) veterans using capture-recapture methods.

Journal Article Neuroepidemiology · 2005 Featured Publication OBJECTIVE: Using data from a recent report that indicated a 2-fold higher risk of amyotrophic lateral sclerosis (ALS) among veterans of the 1991 Gulf War, we applied capture-recapture methodology to estimate possible under-ascertainment of ALS cases among ... Full text Link to item Cite

One-year follow-up study of blood pressure and dietary patterns in dietary approaches to stop hypertension (DASH)-sodium participants.

Journal Article Am J Hypertens · December 2004 Featured Publication BACKGROUND: We conducted a 12-month follow-up study on participants in the Dietary Approaches to Stop Hypertension (DASH)-Sodium trial to determine the impact of the DASH diet and 150, 100, or 50 mmol/day of sodium after discontinuation of the feeding inte ... Full text Link to item Cite

The impact of environmental tobacco smoke on women's risk of dying from heart disease: a meta-analysis.

Journal Article J Womens Health (Larchmt) · October 2004 Featured Publication OBJECTIVE: To review systematically and analyze the association between environmental tobacco smoke (ETS) exposure and the risk of dying from heart disease in women. METHODS: We searched the English-language literature using MEDLINE (1966-April 2004), CINA ... Full text Link to item Cite

Occurrence of amyotrophic lateral sclerosis among Gulf War veterans.

Journal Article Neurology · September 23, 2003 Featured Publication BACKGROUND: In response to Gulf War veterans' concerns of high rates of ALS, this investigation sought to determine if Gulf War veterans have an elevated rate of ALS. METHODS: A nationwide epidemiologic case ascertainment study design was used to ascertain ... Full text Link to item Cite

Intersection tests for single marker QTL analysis can be more powerful than two marker QTL analysis.

Journal Article BMC Genet · June 19, 2003 Featured Publication BACKGROUND: It has been reported in the quantitative trait locus (QTL) literature that when testing for QTL location and effect, the statistical power supporting methodologies based on two markers and their estimated genetic map is higher than for the gene ... Full text Link to item Cite

Is specialty care associated with improved survival of patients with congestive heart failure?

Journal Article Am Heart J · February 2003 Featured Publication BACKGROUND: Implementation of the complex treatment strategies that have been shown to improve survival of patients with congestive heart failure (CHF) may require certain expertise. We wanted to examine the association between pattern of outpatient care a ... Full text Link to item Cite

Detection and localization of a single binary trait locus in experimental populations.

Journal Article Genet Res · August 2001 Featured Publication The advancements made in molecular technology coupled with statistical methodology have led to the successful detection and location of genomic regions (quantitative trait loci; QTL) associated with quantitative traits. Binary traits (e.g. susceptibility/r ... Full text Link to item Cite

Population dynamics of Microtus pennsylvanicus in corridor-linked patches

Journal Article Oikos · January 1, 2001 Corridors have become a key issue in the discussion of conservation planning; however, few empirical data exist on the use of corridors and their effects on population dynamics. The objective of this replicated, population level, capture-recapture experime ... Full text Cite