Five questions for … Dr. Kristen Choi

Kristen Choi, PHD, MS, RN, is a child/adolescent psychiatric nurse and health services researcher who is also an adjunct investigator with the Department of Research & Evaluation. She is an assistant professor at the UCLA School of Nursing and associate director of nursing for the UCLA National Clinician Scholars Program. Dr. Choi studies health services and policy approaches to behavioral health, trauma, and violence among children. Her research portfolio includes studies on autism spectrum disorder, post-traumatic stress disorder, adverse childhood experiences, community violence, and health system factors associated with firearm violence.

How did you initially come to Kaiser Permanente’s Department of Research & Evaluation?

I started working with the Department of Research & Evaluation as a post-doctoral fellow at UCLA. At the time, I was taking a course on health system and community partnerships in research. I connected with the department through one of my mentors at UCLA to learn about partnered research and soon after started a project on autism spectrum disorder. I was excited to find that Research & Evaluation has very strong operational and clinical partnerships that guide the research process and research implementation.

Your work on the COVID-19 vaccine has been very prominent. Can you talk about your public role in the vaccine rollout?

Originally, I wrote a short story about what it was like to participate in the Pfizer-BioNTech COVID-19 vaccine phase 3 clinical trial. I wrote about what it felt like to be a researcher on the other side of research as a participant, and also about my concern that clinicians were potentially unprepared to talk with patients about vaccine side effects. Because I intended the article to be for a medical and research audience, I shared openly about my own experience of strong side effects, that I initially felt scared, and that it felt disconcerting to be blinded and randomized in such a consequential study. I didn’t anticipate that anyone besides a few journal subscribers and medical providers would read this. However, instead, it was immediately picked up by national and international media.

Given that my story had an important public health message about preparing for vaccine side effects, I felt that it was important to use media engagement opportunities to provide public education. I did a total of 21 television interviews on networks like CNN, MSNBC, NBC, Fox News, and ABC, as well international television interviews in France, Greece, Japan, and Canada. My story was picked up 83 times by 58 different news outlets like the New York Times and Wall Street Journal, and I even did a public town hall on COVID-19 vaccines with U.S. Congressman Adam Schiff. Studies show that nurses are the #1 most trusted profession in the United States, but that they are almost never interviewed for health news media (about 2% of health news media articles interview nurses). I feel honored to have had the opportunity to explain to such a large audience from the perspective of nursing how the new COVID-19 vaccines work, what side effects to expect and why, and how health care providers should prepare to have conversations about vaccines with patients. I am now helping to give vaccines at the drive-in sites in Los Angeles County, so I get to have these same conversations with patients myself.

Your primary affiliation is with UCLA. What do you see as unique with our program and what made you want to work with R&E as an adjunct investigator?

I am an assistant professor of Nursing and Public Health at UCLA. While I very much enjoy teaching students and being involved in academic life at a university, I also feel strongly that my research should lead to action and real-world change in health care. One of the best ways to ensure that research results are used in practice is to partner with health system leaders and clinicians from the very beginning of study—and to decide on research priorities together. Kaiser Permanente Southern California Research & Evaluation already has a wonderful model for this type of partnered research with their Care Improvement Research Team (CIRT). I was eager to learn about Kaiser Permanente Southern California’s approach to partnered research and also to conduct the kind of research CIRT is known for that leads to real-world health system change. This kind of research is especially needed in mental health services for children, which are often understudied and under-resourced.

Tell us about your clinical practice as a registered nurse at a downtown Los Angeles community psychiatric hospital, and how it informs your research.

I am a psychiatric registered nurse. I practice in adult and adolescent inpatient psychiatry at a safety net hospital that primarily serves patients in Los Angeles County who do not have health insurance. Among our adult patients, more than half are experiencing homelessness and frequently have complex medical conditions, substance use disorder, immigration challenges, and carceral system involvement. They are most often hospitalized for psychotic disorders, schizophrenia, and other serious mental illnesses. Our adolescent patients tend to be most often hospitalized for suicidality and mood disorders. They, too, often have complex health and social needs including abuse and neglect, bullying, school difficulties, grief and loss, and substance use disorders. I enjoy practicing as a nurse and seeing first-hand what kinds of challenges patients and families with mental illness are experiencing. My practice informs my research, and vice versa.

When you are not at work, how do you spend your free time?

I really enjoy all things outdoors—running, hiking, biking, climbing, and backpacking. During the pandemic I’ve tried picking up surfing, too. I also enjoy cooking, playing the piano, reading, and hanging out with my 180-pound Great Dane (who is super goofy and cuddly!).

Photo: Dr. Choi hiking in Malibu, Calif.