Effectiveness of Gastric Sleeve vs. Gastric Bypass for Cardiovascular Disease (ENGAGE-CVD)
This study will include only bariatric surgery patients from Kaiser Permanente Southern California and is designed to achieve the following aims: 1) compare the effectiveness of vertical sleeve gastrectomy (VSG) and Roux-en-Y Gastric Bypass (RYGB) in remission of risk factors for cardiovascular disease (CVD) and reduction in overall CVD risk using advanced statistical and econometric techniques.; 2) compare VSG and RYGB surgical safety using similar methods; and 3) understand the treatment effect heterogeneity in remission of CVD risk factors, reduction in overall CVD risk, and safety outcomes for patients with different racial/ethnic backgrounds, sexes, and disease burdens at the time of surgery.
Impact of Bariatric Surgery on Cancer Incidence in Severely Obese Adults
The goal of this project is to estimate the impact of bariatric surgery versus routine non-surgical care on the incidence of cancer (all types) in all severely obese patients (men and women).
Impact of Sugary Beverage Taxes on Weight and Health Outcomes after 3-5 Years
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.
Kaiser Permanente & Strategic Partners Patient Outcomes Research To Advance Learning, (PCORI/PORTAL Network)
The PORTAL network propose to create a cohort of adults who are overweight or obese, including those who have pre-diabetes or diabetes. The cohort development activity will demonstrate that the PORTAL network is able to meet the 10 criteria for a clinical data research network specified by PCORI.
PCORnet Bariatric Study
This study is designed to address the following aims in over 30 clinical sites participating in the national Patient-Centered Outcomes Research Network (PCORnet) Bariatric Study: Aim 1: To what extent does weight loss and weight regain differ across bariatric surgical procedures (Roux-en-Y gastric bypass, sleeve gastrectomy, and adjustable gastric banding) at 1, 3, and 5 years? Aim 2: To what extent does bariatric surgery lead to improvements in diabetes risk at 1, 3, and 5 years? Aim 3: What is the frequency of adverse events following different bariatric surgical procedures at 1, 3, and 5 years? Aim 4: To elicit patient preferences around the risks and benefits regarding the choice of (a) whether to undergo bariatric surgery; (b) which bariatric procedure to utilize; and (c) follow-up care after bariatric surgery.
Predictors of Weight Loss Failure and Regain in Bariatric Patients (BELONG)
This study will include only bariatric surgery patients from Kaiser Permanente Southern California right before they have surgery and then for three years after having surgery. The aims of this study are to determine over a 3-year follow up period how demographic, behavioral, psychosocial, and perceived environmental pre-surgical factors, and post-surgical behavioral and psychosocial factors predict a) weight loss trajectory and b) weight loss success. To understand the variability in weight loss using qualitative methods in cross-sectional samples of post-operative survey respondents and use these findings to inform mediational models addressing aim 1; and over the follow-up period, study the development of adverse psychosocial consequences and determine how they relate to a) overall weight loss and b) weight loss success.
Prenatal Antibiotic Use and Body Weight in Children
The goal of this study is to examine the potential relationship between antibiotic use during pregnancy and pediatric weight problems. Particular focus is given to infants exposed to intrapartum Group B streptococcus prophylaxis and its impact on a child’s body weight.
Randomized Trial of Exercise Promotion In Primary Care (EPPC)
To determine the feasibility of a primary care based, telephone counseling physical activity behavioral intervention for diabetics and prediabetics.
The association between Cesarean Delivery, Labor and Body Weight in Children.
This project is part of a series of CDC studies to better understand the association between birth factors such as delivery mode labor or rupture of membrane, and exposure to intrapartum antibiotics and childhood weight gain.
The Bariatric Experience Long Term (BELONG) II for Racial and Ethnic Minority Patients
Effective treatments for severe obesity are particularly needed in racial/ethnic minority populations. Rates of severe obesity are as high as 36% for middle-aged non-Hispanic black women compared to 16% for their white counterparts in the U.S. Research on bariatric weight loss outcomes among racial/ethnic minorities is limited. What evidence does exist suggests that black patients consistently lose less weight than whites over 2–3 years of follow-up. The evidence for differences between Hispanic and white or black bariatric patients is equivocal. Hispanic patients have been shown to lose more, less, or the same amount of weight as non-Hispanic black and white patients. Across studies, the disparities in % total weight loss vary from less than 2% to 10%. This variability is twice as much as the amount of weight loss considered clinically meaningful. This study will extend the work done by our team during the Bariatric Experience Long-Term (BELONG) study which addressed how self-reported behavioral, psychosocial, and perceived environmental factors predicted weight loss over 3 years following gastric bypass and sleeve. Patients (n = 1,975) were 41% Hispanic, 17% non-Hispanic black, and 37% non-Hispanic white. The proposed study will expand the work of BELONG by incorporating: 1) A focus on weight regain during 3-5 years after surgery; 2) measures shown to contribute to health disparities in severe obesity (vigilant coping style and internalized racism); and 3) innovative qualitative methods (photo-elicitation and ethnography) to understand the patient experience.
The Role of Adipokines in Glucose Regulation and Metabolic Decline
This project measured a large panel of pro- and anti-inflammatory adipokines in existing blood samples collected from BetaGene I and II study participants, combine these data with genome-wide genetic variation, dietary and physical activity information, and elucidate the pathophysiological pathways that underlie metabolic decline leading to type 2 diabetes.
Using Computational Approaches to Optimize Asthma Care Management
This project aims to improve the accuracy of computationally identifying high-risk asthma patients, it’s assess potential impact on outcomes and to provide automated prediction result explanations for care management.