Health Services Research studies

Our health services research focuses on the delivery and outcomes of medical care. Our research crosses a range of areas, with a focus on primary and secondary prevention services for chronic diseases, such as diabetes and cardiovascular disease. Our studies have assessed health care initiatives targeting the care and behavior of patients at high risk for these conditions.

An Evaluation of the National Zero Suicide Model across Learning Healthcare Systems

Our project seeks to develop metrics to measure fidelity and outcomes for the National Zero Suicide Model components implemented in each system using electronic health records and insurance claims data sources that are easily extractable and generalizable to other systems. Then, we propose to use these metrics to conduct fidelity and outcome evaluation of the various Zero Suicide Initiative approaches in each system using Interrupted Time Series Designs, which are among the strongest, pragmatic designs appropriate for evaluating care system intervention and policy changes in ‘Learning Healthcare Systems.’ We hypothesize that the implementation of various National Zero Suicide Model components will significantly reduce suicidal behavior within and across the participating systems. We seek to accomplish the following aims: 1) Collaborate with health system leaders to develop EHR metrics to measure specific quality improvement targets and care processes tailored to local Zero Suicide Initiative implementation; 2) examine the fidelity of the specific Zero Suicide Initiative care processes implemented in each system; and 3) investigate suicide attempt and mortality outcomes within and across Zero Suicide Initiative healthcare system models.

Site Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

National Institute of Mental Health (NIMH)

Funding Years:

2017 - 2022

Building Capacity for Stakeholder Engagement in the Mental Health Research Network

This Eugene Washington engagement award will be used primarily to support the development of the involvement of our patients with mental health conditions, their caregivers and/or families, and national mental health community and advocacy groups who represent them in all phases of mental health research. The goals of this project are to: 1) Add the patient, caregiver, and family stakeholder voice and the community and advocacy groups who represent them to the national Mental Health Research Network (MHRN) executive leadership team to develop a shared direction for the network and a shared national voice for mental health comparative effectiveness research (CER); 2) Develop and pilot a strategy for stakeholder engagement within one MHRN-affiliated health system and the communities it serves to identify priorities for mental health CER; and 3) Develop and submit at least one new research proposal using the processes used in #1 and #2 at the end of the engagement award.

Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

Patient-Centered Outcomes Research Institute (PCORI)

Funding Years:

2018 - 2020

Care of Mental, Physical, and Substance Use Syndromes (COMPASS)

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.

Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

Institute for Clinical Systems Improvement (ICSI)

Funding Years:

2012 - 2015

Developing an HIV Specific-Specific Prevention Index Using Electronic Medical Record (HIV PI)

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.

Principal Investigator:

Chun Chao, PhD, MS

Funding Source:

Agency for Healthcare Research and Quality (AHRQ)

Funding Years:

2010 - 2013

Effects of Medical Products on Suicidal Ideation and Behavior in Serious Mental Illness

Reducing risk of suicidal behavior is an urgent public health priority. Suicide accounted for approximately 45,000 deaths in the United States in 2016. While most major causes of death have steadily declined, suicide mortality in the US has increased by over 25% in the past 15 years, with greater increases in young people. Increasing rates of suicidal behavior are intertwined with prescription opioid use and opioid overdose. Traditional clinical trials will not be able to enroll large enough nor generalizable enough samples of patients to adequately inform regulation regarding these issues. We propose a comprehensive program of infrastructure development and methods development to support future generation of real-world evidence addressing these critical gaps. The project team will include health systems and embedded research organizations with deep expertise in stakeholder engagement, medical informatics, data science, clinical epidemiology, biostatistics, pragmatic clinical trial methods, implementation science, and innovations in care delivery. This program will be embedded in 4 integrated health systems serving a combined population of approximately 10 million members. This work will be conducted in collaboration with health system and patient/family stakeholders, to assure that methods and evidence developed will actually address real-world questions.

Site Principal Investigator:

Karen J. Coleman, PhD, MS

Funding Source:

Food and Drug Administration (FDA)

Funding Years:

09/30/2018 - 09/30/2021

PAP Therapy and Acute Care Utilization in a Large Integrated Health System

This study will determine if clinically diagnosed sleep apnea for which a PAP machine has been prescribed is associated with a reduction in expensive acute care utilization and if significant variation in utilization exists to suggest treatment disparities.

Principal Investigator:

Stephen F. Derose, MD, MSHS

Funding Source:

ResMed Foundation

Funding Years:

2013 - 2016

Risk of Cancer in Childhood and Adolescence Associated with Medical Imaging

The goal of this study it to evaluate patterns of medical imaging associated with cumulative exposure to radiation (CT, nuclear medicine, fluoroscopy, angiography, and radiography), and subsequent risk of childhood cancers.

Principal Investigator:

Reina Haque, PhD, MPH

Funding Source:

National Cancer Institute (NCI)

Funding Years:

2015 - 2020

Risk Selection, Premium Stabilization, and Coverage Expansion (RISC) Assessing Adverse Selection in California's Individual Health Insurance Market, Phase I

This study examines the impact on health care utilization among California residents who began receiving health care under the Affordable Care Act.

Site Principal Investigator:

Stephen F. Derose, MD, MSHS

Funding Source:

Commonwealth Fund

Funding Years:

2015

The Virtual Visit for Women with Gestational Diabetes Mellitus (GDM)

This pilot study will address two specific aims: (1) to assess the acceptability of telemedicine technology to conduct virtual office visits alternating with regular office- based prenatal visits for women with GDM from the viewpoint of women with GDM and their health care providers using qualitative research methods, and (2) to assess the feasibility of this telemedicine-based intervention (Virtual Office Visit) for women with GDM. This information was be used to support a larger proposal to obtain funding to conduct a clinical trial to test the proposed intervention after it is refined based on input from patients and health care providers.

Principal Investigator:

David A. Sacks, MD

Funding Source:

Kaiser Permanente, Southern California

Funding Years:

2014

Trajectories of Physical Activity and Sedentary Time in Adolescent/Young Women (TAAG 3)

The major goals of this trial are to determine the effectiveness of a school and community-linked physical activity intervention to reduce the decline in physical activity in young women, a cohort who have been followed since middle school.

Principal Investigator:

Deborah Rohm Young, PhD, MBA

Funding Source:

Kaiser Permanente and Johns Hopkins Medicine Research Collaboration Committee

Funding Years:

2017 - 2018

Translation of a Lung Cancer Palliative Care Intervention for Clinical Practice

The purpose of this study is to test the dissemination of a Palliative Care Intervention (PCI) for patients with non-small cell lung cancer (NSCLC) and their primary family caregivers (FCG)

Principal Investigator:

Huong Q. Nguyen, PhD, RN

Funding Source:

National Institutes of Health (NIH)

Funding Years:

2014 - 2018