RESEARCH

The goal of this randomized intervention study is to evaluate the effectiveness of a quarterly mailing intervention on human papillomavirus vaccine three-dose regimen completion.

KPSC is one of nine sites throughout the country funded by an Innovation Award from the Centers of Medicare and Medicaid to implement a coordinated care model for depressed patients with cardiovascular disease. We have the following goals for this project: 1. To implement in three stages a multiple condition collaborative care management model in primary care clinics of care systems in states. 2. To demonstrate that this model improves care quality, patient experience and health, provider satisfaction, and total healthcare costs for the Medicare and Medicaid patients with the targeted conditions. 3. To develop role descriptions and training for the two new types of workers required for this model – care managers and care consultants. 4. To identify the costs and payment models needed by care systems to sustain and spread this care model.

The goals of this study are to assess in HIV-infected patients, the degree of association between successful general clinical care by HIV disease-treating providers (reflected in overall adherence to recommended general prevention and screening guidelines) and higher-quality HIV-specific care and related clinical outcome.

Mindfulness Based Cognitive Therapy (MBCT) an 8-session in-person intervention using mindfulness meditation and cognitive-behavioral strategies, has shown effectiveness in reducing residual depressive symptoms and risk for recurrence among pregnant women with histories of depression. A digital adaptation of MBCT for pregnant women, Mindful Mood Balance for Moms (MMBFM), was recently developed to overcome access barriers to in-person groups and increase potential for scale-up in OB care settings. We will address the following aims for this study: 1) Compare the clinical effectiveness (i.e. engagement and symptom reduction) of MMBFM supported by clinician vs. peer coaches among women with a history of prior depressive episodes; 2) examine specific mechanisms of action for MMBFM participants receiving clinician vs. peer coaching; 3) examine the effects of specific implementation strategies on reach of the MMBFM program; and 4) estimate the cost-effectiveness of MMBFM supported by clinician vs. peer coaches. We hypothesize that MMBFM will be more cost-effective when supported by peer vs. clinician coaches.

The Patient Centered Outcomes Research Institute created a new Health Systems Implementation Initiative (HSII) to accelerate the adoption of scientific evidence into health care practice. Kaiser Permanente Southerna California was selected as 1 of 6 health care systems throughout the U.S. to test the implementation and institutionalization of evidence-based programs for intensive lifestyle weight management in primary care settings. The proposal tests the following two aims: 1. To use a patient and clinician partner-driven process improvement method tested in community1 and healthcare settings2,3 to implement evidence-based strategies for a 12-month virtual intensive lifestyle treatment program in patients having class I obesity (Body Mass Index [BMI] 30 – 34.99 kg/m2) with a focus on those patients who also have uncontrolled type 2 diabetes (T2D; HbA1c> 8). 2. To use data and materials collected from this implementation to create a playbook for the organization to continue the program, institutionalize it for the care of patients with class I obesity, and expand its use in other populations of patients with obesity who are identified as high priorities for the organization (such as to prevent weight regain in patients who have undergone medication or surgical treatment for their obesity and those with multiple chronic conditions for which weight loss would be beneficial).

This study uses electronic health records to determine the effects of sugary beverage taxes initiated in 4 Northern California cities compared with control cities in Northern and Southern California. Outcomes include weight change trajectories and prevalence of overweight and obesity among children and adults, and incidence of diabetes among adults with prediabetes. Pre-specified sub-analyses include examining differences by race/ethnicity, age groups, and neighborhood socioeconomic status.

To determine the feasibility of a primary care based, telephone counseling physical activity behavioral intervention for diabetics and prediabetics.

EPPC is testing the effects of a 2-year motivational interview, telephone-based intervention on increasing moderate to vigorous physical activity among participants with diabetes and prediabetes.