Scholars@Duke
Karen Scherr

Karen Scherr

Assistant Professor in Family Medicine and Community Health
Family Medicine and Community Health, Family Medicine
2100 Erwin Rd, Marshall L. Pickens Building, Durham, NC 27705

Selected Publications

Parent Perspectives on the 2023 Clinical Practice Guideline for Pediatric Obesity: A Mixed-Methods Study of Acceptance and Concerns.

Journal Article Pediatr Obes · January 2026 BACKGROUND: The 2023 Clinical Practice Guideline for pediatric obesity recommends immediate, intensive treatment, including behavioral therapy, medications, and surgery when indicated. Understanding parental agreement with the guideline is critical for suc ... Full text Link to item Cite

Use of an Electronic Health Record Order to Directly Refer Patients With Prediabetes to Community-Based Diabetes Prevention Programs.

Journal Article Ann Fam Med · September 22, 2025 PURPOSE: Rates of participation in community-based diabetes prevention programs (DPPs) are low among patients with prediabetes. This may be due, in part, to low rates of referrals to these programs from health systems. One key opportunity to augment clinic ... Full text Link to item Cite

Randomized Controlled Trial of a Text-Based Smokeless Tobacco Cessation Intervention for Rural and Medically Underserved Communities.

Journal Article Nicotine Tob Res · December 23, 2024 INTRODUCTION: Smokeless tobacco use remains prevalent in rural and medically underserved populations, leading to increased rates of tobacco-related cancers and chronic disease. While access to effective cessation programs is limited, text-based interventio ... Full text Link to item Cite

Willingness to trade-off years of life for an HIV cure - an experimental exploration of affective forecasting.

Journal Article AIDS Res Ther · August 6, 2024 BACKGROUND: In the US, 1.2 million people live with HIV (PWH). Despite having near-normal life expectancies due to antiretroviral therapy (ART), many PWH seek an HIV cure, even if it means risking their lives. This willingness to take risks for a cure rais ... Full text Link to item Cite

Communication, bias, and stigma

Chapter · October 25, 2023 Communicating with children, teens, and families about obesity can feel like walking a tightrope between the responsibility to promote health while also preventing harm. Providers use weight and BMI to guide screening, diagnosis, and treatment decisions. A ... Full text Cite

Community-based organizations' perspectives on piloting health and social care integration in North Carolina.

Journal Article BMC Public Health · October 4, 2023 BACKGROUND: Community-based organizations (CBOs) are key players in health and social care integration initiatives, yet little is known about CBO perspectives and experiences in these pilot programs. Understanding CBO perspectives is vital to identifying b ... Full text Open Access Link to item Cite

Two Specialists, Two Recommendations: Discordance Between Urologists' & Radiation Oncologists' Prostate Cancer Treatment Recommendations.

Journal Article Urology · November 2022 OBJECTIVE: To examine the treatment recommendation patterns among urologists and radiation oncologists, the level of concordance or discordance between physician recommendations, and the association between physician recommendations and the treatment that ... Full text Link to item Cite

Practice Patterns of Fundoscopic Examination for Diabetic Retinopathy Screening in Primary Care.

Journal Article JAMA Netw Open · June 1, 2022 IMPORTANCE: Primary care professionals (PCPs) have a central role in screening for diabetic retinopathy (DR), especially in settings where access to specialty eye care is limited. Data on current DR screening practice patterns in primary care are needed to ... Full text Link to item Cite

Preparing Patients with Early Stage Prostate Cancer to Participate in Clinical Appointments Using a Shared Decision Making Training Video.

Journal Article Med Decis Making · April 2022 BACKGROUND: Rates of shared decision making (SDM) are relatively low in early stage prostate cancer decisions, as patients' values are not well integrated into a preference-sensitive treatment decision. The study objectives were to develop a SDM training v ... Full text Link to item Cite

Gain-loss framing and patients' decisions: a linguistic examination of information framing in physician-patient conversations.

Journal Article J Behav Med · February 2021 When discussing risks and benefits with cancer patients, physicians could focus on losses such as mortality rates and cancer recurrence or, alternatively, gains such as survival rates and curing cancer. Previous research has shown that the way health infor ... Full text Link to item Cite

"Cure" Versus "Clinical Remission": The Impact of a Medication Description on the Willingness of People Living with HIV to Take a Medication.

Journal Article AIDS Behav · July 2020 Many people living with HIV (PLWHIV) state that they would be willing to take significant risks to be "cured" of the virus. However, how they interpret the word "cure" in this context is not clear. We used a randomized survey to examine whether PLWHIV had ... Full text Link to item Cite

Racial differences in veterans' response to a standard vs. patient-centered decision aid for prostate cancer: Implications for decision making in African American and White men.

Journal Article Patient Educ Couns · June 3, 2020 OBJECTIVE: To determine whether racial differences exist in patient preferences for prostate cancer treatment after being informed about options using a patient-centered vs. a standard decision aid (DA). METHODS: This article reports secondary analyses of ... Full text Link to item Cite

HIV Cure Research: Risks Patients Expressed Willingness to Accept.

Journal Article Ethics Hum Res · November 2019 Despite doing well on antiretroviral therapy, many people living with HIV have expressed a willingness to accept substantial risks for an HIV cure. To date, few studies have assessed the specific quantitative maximal risk that future participants might tak ... Full text Link to item Cite

The primacy of “what” over “how much”: How type and quantity shape healthiness perceptions of food portions

Journal Article Management Science · July 1, 2019 Healthy eating goals influence many consumer choices, such that evaluating the healthiness of food portions is important. Given that both the type and quantity of food jointly contribute to weight and overall health, evaluations of a food portion's healthi ... Full text Cite

What risk of death would people take to be cured of HIV and why? A survey of people living with HIV.

Journal Article J Virus Erad · April 1, 2019 People living with HIV (PLWHIV) can reasonably expect near-normal longevity, yet many express a willingness to assume significant risks to be cured. We surveyed 200 PLWHIV who were stable on antiretroviral therapy (ART) to quantify associations between the ... Full text Link to item Cite

The Impact of Cost Conversations on the Patient-Physician Relationship.

Journal Article Health Commun · January 2019 Previous research has suggested that fear of harm to the patient-physician relationship is an important barrier to conversations about cost of care. However, few experimental studies have investigated the effects of cost of care conversations on the patien ... Full text Link to item Cite

Empowerment Failure: How Shortcomings in Physician Communication Unwittingly Undermine Patient Autonomy.

Journal Article Am J Bioeth · November 2017 Many health care decisions depend not only upon medical facts, but also on value judgments-patient goals and preferences. Until recent decades, patients relied on doctors to tell them what to do. Then ethicists and others convinced clinicians to adopt a pa ... Full text Link to item Cite

Treatment Availability Influences Physicians' Portrayal of Robotic Surgery During Clinical Appointments.

Journal Article Health Commun · January 2017 In order to empower patients as decision makers, physicians must educate them about their treatment options in a factual, nonbiased manner. We propose that site-specific availability of treatment options may be a novel source of bias, whereby physicians de ... Full text Link to item Cite

The Physician Recommendation Coding System (PhyReCS): A Reliable and Valid Method to Quantify the Strength of Physician Recommendations During Clinical Encounters.

Journal Article Med Decis Making · January 2017 BACKGROUND: Physicians' recommendations affect patients' treatment choices. However, most research relies on physicians' or patients' retrospective reports of recommendations, which offer a limited perspective and have limitations such as recall bias. OBJE ... Full text Link to item Cite

Physician Recommendations Trump Patient Preferences in Prostate Cancer Treatment Decisions.

Journal Article Med Decis Making · January 2017 OBJECTIVE: To assess the influence of patient preferences and urologist recommendations in treatment decisions for clinically localized prostate cancer. METHODS: We enrolled 257 men with clinically localized prostate cancer (prostate-specific antigen <20; ... Full text Link to item Cite

Poor Consumer Comprehension and Plan Selection Inconsistencies Under the 2016 HealthCare.gov Choice Architecture.

Journal Article MDM Policy Pract · 2017 BACKGROUND: Many health policy experts have endorsed insurance competition as a way to reduce the cost and improve the quality of medical care. In line with this approach, health insurance exchanges, such as HealthCare.gov, allow consumers to compare insur ... Full text Open Access Link to item Cite

Using a Non-Fit Message Helps to De-Intensify Negative Reactions to Tough Advice.

Journal Article Pers Soc Psychol Bull · August 2016 Sometimes physicians need to provide patients with potentially upsetting advice. For example, physicians may recommend hospice for a terminally ill patient because it best meets their needs, but the patient and their family dislike this advised option. We ... Full text Link to item Cite