Scholars@Duke
James Lloyd Michener

James Lloyd Michener

Professor Emeritus in Family Medicine and Community Health
Family Medicine and Community Health
lloyd.michener@duke.edu
Duke Box 2914, Durham, NC 27710
319 Hanes House, Durham, NC 27710

Scholarly Works - Journal articles

Institutional transformations for authentic community engaged and participatory research.

Journal article J Clin Transl Sci · 2026 This special issue of the Journal of Clinical Translational Science on Institutional Transformation provides strategies to strengthen community and patient engagement in research in which collaborative knowledge creation is valued and centered in the histo ... Full text Link to item Cite

A Foundation for Health Equity and Resilience

Journal article AMERICAN JOURNAL OF PUBLIC HEALTH · July 2025 Link to item Cite

Parent-Child Vaccination Concordance and Its Relationship to Child Age, Parent Age and Education, and Perceived Social Norms.

Journal article Vaccines (Basel) · July 6, 2023 Researchers established that parental vaccination status often predicts that of their children, but a limited number of studies have examined factors influencing dyadic concordance or discordance (i.e., same or different vaccination status or intent for bo ... Full text Link to item Cite

Academic Medicine's Fourth Mission: Building on Community-Oriented Primary Care to Achieve Community-Engaged Health Care.

Journal article Acad Med · February 1, 2023 A 2021 article, "Now is our time to act: Why academic medicine must embrace community collaboration as its fourth mission," by Association of American Medical Colleges (AAMC) authors, including AAMC president and CEO Dr. David J. Skorton, offers 2 aims tha ... Full text Link to item Cite

Attitudes towards diversity, equity, and inclusion across the CTSA Programs: Strong but not uniform support and commitment.

Journal article J Clin Transl Sci · 2023 BACKGROUND: This study describes attitudes towards diversity, equity, and inclusion (DEI) among members of the Clinical and Translational Science Awards (CTSA) Program. It also explores associations between program members' roles and their perceived import ... Full text Link to item Cite

It should not require a pandemic to make community engagement in research leadership essential, not optional.

Journal article J Clin Transl Sci · February 5, 2021 Efforts to move community engagement in research from marginalized to mainstream include the NIH requiring community engagement programs in all Clinical and Translational Science Awards (CTSAs). However, the COVID-19 pandemic has exposed how little these e ... Full text Link to item Cite

Partnerships to Care for Our Patients and Communities During COVID-19.

Journal article J Am Board Fam Med · 2021 The Coronavirus disease 2019 (COVID-19) pandemic forced not only rapid changes in how clinical care and educational programs are delivered but also challenged academic medical centers (AMCs) like never before. The pandemic made clear the need to have coord ... Full text Open Access Link to item Cite

Engagement science: The core of dissemination, implementation, and translational research science.

Journal article J Clin Transl Sci · January 20, 2020 Stakeholder engagement is acknowledged as central to dissemination and implementation (D&I) of research that generates and answers new clinical and health service research questions. There is both benefit and risk in conducting stakeholder engagement. Done ... Full text Link to item Cite

A Framework for Resident Participation in Population Health.

Journal article Acad Med · January 2019 Population health experiences have become more common in medical education. Yet, most resident population health experiences are in patient panel management and fail to connect with the rapidly growing movement of cross-sector, data-driven, and community-l ... Full text Open Access Link to item Cite

Dr. Carek's Commentary on Training PAs and NPs

Journal article Family medicine · October 1, 2016 Link to item Cite

Geographic clustering of elevated blood heavy metal levels in pregnant women.

Journal article BMC Public Health · October 9, 2015 BACKGROUND: Cadmium (Cd), lead (Pb), mercury (Hg), and arsenic (As) exposure is ubiquitous and has been associated with higher risk of growth restriction and cardiometabolic and neurodevelopmental disorders. However, cost-efficient strategies to identify a ... Full text Link to item Cite

A national strategy to develop pragmatic clinical trials infrastructure.

Journal article Clin Transl Sci · April 2014 An important challenge in comparative effectiveness research is the lack of infrastructure to support pragmatic clinical trials, which compare interventions in usual practice settings and subjects. These trials present challenges that differ from those of ... Full text Link to item Cite

Population health initiatives for primary care at Duke University School of Medicine.

Journal article N C Med J · 2014 To help shape the future of health care in North Carolina, Duke University School of Medicine has implemented several new initiatives aimed at providing primary care providers with the knowledge, skills, and attitudes required to improve population health ... Full text Link to item Cite

Developing physicians as catalysts for change.

Journal article Acad Med · November 2013 Failures in care coordination are a reflection of larger systemic shortcomings in communication and in physician engagement in shared team leadership. Traditional medical care and medical education neither focus on nor inspire responses to the challenges o ... Full text Link to item Cite

Teaching population health: a competency map approach to education.

Journal article Acad Med · May 2013 A 2012 Institute of Medicine report is the latest in the growing number of calls to incorporate a population health approach in health professionals' training. Over the last decade, Duke University, particularly its Department of Community and Family Medic ... Full text Open Access Link to item Cite

Scutchfield et al. respond

Journal article American Journal of Public Health · October 1, 2012 Full text Cite

Are we there yet? Seizing the moment to integrate medicine and public health.

Journal article Am J Public Health · June 2012 Multiple promising but unsustainable attempts have been made to maintain programs integrating primary care and public health since the middle of the last century. During the 1960s, social justice movements expanded access to primary care and began to integ ... Full text Link to item Cite

Aligning the goals of community-engaged research: why and how academic health centers can successfully engage with communities to improve health.

Journal article Acad Med · March 2012 Community engagement (CE) and community-engaged research (CEnR) are increasingly viewed as the keystone to translational medicine and improving the health of the nation. In this article, the authors seek to assist academic health centers (AHCs) in learning ... Full text Link to item Cite

Perceived discrimination and use of health care services in a North Carolina population of Latino immigrants

Journal article Hispanic Health Care International · March 19, 2010 Relationships were investigated between perceived discrimination at the usual health care source and health care services use among Latinos. Three perceived discrimination variables were explored-based on race/ethnicity, based on insurance status, or based ... Full text Cite

Clinical and translational science awards and community engagement: now is the time to mainstream prevention into the nation's health research agenda.

Journal article Am J Prev Med · November 2009 Although much attention is devoted to the slow process of cutting-edge "bench science" finding its way to clinical translation, less attention is paid to the fact that basic prevention messages, tests, and interventions never find their way into communitie ... Full text Link to item Cite

Family physicians as team leaders: "time" to share the care.

Journal article Prev Chronic Dis · April 2009 Featured Publication A major contributor to shortfalls in delivery of recommended health care services is lack of physician time. On the basis of recommendations from national clinical care guidelines for preventive services and chronic disease management, and including the ti ... Link to item Cite

Estimated time spent on preventive services by primary care physicians.

Journal article BMC Health Serv Res · December 1, 2008 Featured Publication BACKGROUND: Delivery of preventive health services in primary care is lacking. One of the main barriers is lack of time. We estimated the amount of time primary care physicians spend on important preventive health services. METHODS: We analyzed a large dat ... Full text Link to item Cite

Improving the health of the community: Duke's experience with community engagement.

Journal article Acad Med · April 2008 Featured Publication Evidence is accumulating that the United States is falling behind in its potential to translate biomedical advances into practical applications for the population. Societal forces, increased awareness of health disparities, and the direction of clinical an ... Full text Link to item Cite

Defining high-performance teams and physician leadership.

Journal article Physician Exec · 2008 Beset with complex reimbursement and regulatory structures, rapidly advancing technology and a population that is growing increasingly older, sicker, and more obese, the U.S. medical environment needs coordinated interdisciplinary teamwork now more than ev ... Link to item Cite

New models of care: building medical homes in empowered communities.

Journal article N C Med J · 2007 Featured Publication Link to item Cite

Just for Us: an academic medical center-community partnership to maintain the health of a frail low-income senior population.

Journal article Gerontologist · April 2006 Featured Publication PURPOSE: To promote health and maintain independence, Just for Us provides financially sustainable, in-home, integrated care to medically fragile, low-income seniors and disabled adults living in subsidized housing. DESIGN AND METHODS: The program provides ... Full text Link to item Cite

Alternative models for academic family practices.

Journal article BMC Health Serv Res · March 20, 2006 Featured Publication BACKGROUND: The Future of Family Medicine Report calls for a fundamental redesign of the American family physician workplace. At the same time, academic family practices are under economic pressure. Most family medicine departments do not have self-support ... Full text Link to item Cite

Dynamics of patient targeting for care management in Medicaid: a case study of the Durham Community Health Network.

Journal article Care Manag J · 2006 Featured Publication Targeting appropriate patients for care management is crucial to maximizing quality of care and cost-effectiveness in Medicaid care management programs. This study examined patient characteristics predicting selection for care management pre- and postmanag ... Full text Link to item Cite

Risk classification of adult primary care patients by self-reported quality of life.

Journal article Med Care · February 2005 Featured Publication BACKGROUND: : Although patient-reported health-related quality of life (HRQOL) is known to predict health services utilization, most risk assessment systems use provider-reported diagnoses as predictors rather than HRQOL. OBJECTIVE: : We sought to classify ... Full text Link to item Cite

Is there time for management of patients with chronic diseases in primary care?

Journal article Ann Fam Med · 2005 Featured Publication PURPOSE: Despite the availability of national practice guidelines, many patients fail to receive recommended chronic disease care. Physician time constraints in primary care are likely one cause. METHODS: We applied guideline recommendations for 10 common ... Full text Link to item Cite

Making a home in the community for the academic medical center.

Journal article Acad Med · January 2005 Featured Publication Academic medical centers (AMCs) have traditionally provided primary care for low-income and other underserved populations. However, they have had difficulty developing lasting partnerships with other organizations serving the same populations. This article ... Full text Link to item Cite

Academic family medicine chairs.

Journal article Ann Fam Med · 2005 Full text Link to item Cite

Assessing departments of family medicine.

Journal article Fam Med · October 2004 Featured Publication Link to item Cite

Primary care: is there enough time for prevention?

Journal article Am J Public Health · April 2003 Featured Publication OBJECTIVES: We sought to determine the amount of time required for a primary care physician to provide recommended preventive services to an average patient panel. METHODS: We used published and estimated times per service to determine the physician time r ... Full text Link to item Cite

Duke Case-Mix System (DUMIX) for ambulatory health care.

Journal article J Clin Epidemiol · December 1997 Featured Publication The Duke Case-Mix System (DUMIX), which combines age, gender, patient-reported perceived and physical health status, and provider-reported or auditor-reported severity of illness to classify patients by their risk of high future utilization, explained 17.1 ... Full text Link to item Cite

Nutrition, education, and family physicians.

Journal article Arch Fam Med · 1997 Featured Publication Full text Link to item Cite

Nutrition, family physicians, and health.

Journal article Arch Fam Med · July 1995 Featured Publication Full text Link to item Cite

An integrated nutrition curriculum for medical students.

Journal article Acad Med · May 1995 Featured Publication Full text Link to item Cite

Computer-prompted diagnostic codes.

Journal article J Fam Pract · March 1995 Featured Publication BACKGROUND: The purpose of this study was to develop and evaluate a computer system that would translate patient diagnoses noted by a physician into appropriate International Classification of Diseases, 9th Revision, Clinical Modification (ICD-9-CM) codes ... Link to item Cite

Attitudes, experience, and influence of family medicine predoctoral education directors.

Journal article Fam Med · May 1994 Featured Publication BACKGROUND AND OBJECTIVES: While debate surrounds the determinants of medical students' specialty choices, the presence of favorable role models is generally agreed upon as beneficial to students' selection of a specialty. This study assessed the influence ... Link to item Cite

Tracking medical students' clinical experiences with a computerized medical records system.

Journal article Fam Med · 1994 Featured Publication A fully computerized system for recording and reporting of medical students' patient contacts has been developed and successfully used in a high-volume outpatient practice. In contrast to previously described systems, the need for manual recording and/or e ... Link to item Cite

The medical record: a comprehensive computer system for the family physician.

Journal article J Am Board Fam Pract · 1994 Featured Publication BACKGROUND: Despite the early excitement regarding the possible uses of computers in medical care in the 1980s, the computer has not had much effect on routine outpatient medicine except for billing and accounting. METHODS: An emerging comprehensive ambula ... Link to item Cite

Increasing compliance with mammography recommendations: health assessment forms.

Journal article J Fam Pract · January 1993 Featured Publication BACKGROUND: Inexpensive reminder systems are needed to ensure that primary care physicians consistently provide health maintenance services to their patients. The purpose of this study was to determine the effectiveness of a simple, inexpensive health asse ... Link to item Cite

Nutrition education

Journal article Academic Medicine · January 1, 1991 Cite

The effect of a telephone family assessment intervention on the functional health of patients with elevated family stress.

Journal article Med Care · July 1989 Featured Publication A randomized trial of a telephone family assessment intervention was conducted during a 2.5 month period on 224 ambulatory primary care patients, aged 18-49 years, who were selected according to self-report of elevated family stress levels. Family physicia ... Full text Link to item Cite

Associations among family support, family stress, and personal functional health status.

Journal article J Clin Epidemiol · 1989 Featured Publication The self-reported family support and stress of 249 ambulatory adult patients, aged 18-49 years, were studied relative to their self-reported functional health. Support from family members was found to be related positively with emotional function. Stress f ... Full text Link to item Cite

A health promotion program for medical students.

Journal article J Med Educ · September 1988 Featured Publication Full text Link to item Cite

A health promotion program for medical students

Journal article Academic Medicine · January 1, 1988 Cite

Clinical skills acquired during a clerkship in family medicine.

Journal article J Med Educ · October 1986 Featured Publication The authors report on their study of the perceived acquisition of clinical skills by 151 second-year students in six required clerkships: surgery, internal medicine, pediatrics, obstetrics-gynecology, psychiatry, and family medicine. The students completed ... Full text Link to item Cite

Clinical experience of medical students in model family practices and private family practices.

Journal article J Fam Pract · October 1986 Featured Publication The clinical experience of 21 Duke medical students during their family medicine clerkship is analyzed to compare experience in model family practices with that in private family practices. In model practices where 50 percent of the time involved patient c ... Link to item Cite

Development and modification of a required family medicine clerkship.

Journal article J Med Educ · October 1985 Featured Publication A new required clinical clerkship in family medicine at Duke University School of Medicine is described in terms of planning, implementation, and modification in response to students' evaluations. Seventy-five percent of the eight-week course involves dire ... Full text Link to item Cite

Development and modification of a required family medicine clerkship

Journal article Academic Medicine · January 1, 1985 A new required clinical clerkship in family medicine at Duke University School of Medicine is described in terms of planning, implementation, and modification in response to students' evaluations. Seventy-five percent of the eight-week course involves dire ... Cite