Behavior Change

“The everyday choices we make—like what we eat, how active we are, or what substances we put in our bodies—are key to preventing, developing, and managing disease. That’s why behavior change is so important to our research."

Jennifer McClure, PhD, 
Kaiser Permanente Washington Health Research Institute Director of Research, Faculty, & Development

Research overview

If you’re like most people, your health depends more on what you do every day than on what your health care provider can do for you. Nonetheless, making healthy lifestyle choices can be difficult, especially when it means changing your daily routine and then maintaining these changes over time. That’s why Kaiser Permanente Washington Health Research Institute (KPWHRI) researchers want to make the right choices the easy and sustainable ones.

“The evidence is clear,” says Jennifer B. McClure, PhD, KPWHRI senior investigator and director of research, faculty, & development. “The most effective way to prevent the leading causes of death in the United States is to address their underlying behavioral risk factors: physical inactivity, poor nutrition, tobacco use, and excessive alcohol use. Collectively, these four behaviors account for over one third of all deaths.” But other behaviors are also critical to health and well-being, such as not misusing prescription opioids or marijuana, getting routine cancer screenings, and following your providers’ medical advice. That’s why KPWHRI scientists focus not only on individual behavior but also on ways to change health care systems.

“Our research is not just about empowering people to adopt healthy habits,” says Joe Glass, PhD, MSW, assistant investigator. “It’s also about changing medical systems to best support these behavior changes.”

KPWHRI’s behavioral medicine research includes:

  • reducing  unhealthy use or abuse of substances such as tobacco, alcohol, cannabis, and opioids;
  • promoting physical activity, healthy eating, and weight loss;
  • improving oral health care;
  • increasing treatment adherence and routine cancer screening;
  • improving chronic pain management; and
  • creating personalized, convenient, effective behavioral interventions that can be delivered using various digital technologies.

“Historically our work has tested different forms of behavioral counseling or novel ways to deliver this counseling,” Dr. McClure says. “Increasingly, we are now testing digital therapeutic interventions delivered via smartphone app or text—for example, to help people set and achieve their health goals. People like the convenience of digital interventions, but it remains to be seen how effective they are and for whom they work best. Our research is helping to answer these important questions.”

Recent Publications on Behavior Change

McClure JB, Bricker J, Mull K, Heffner JL. Comparative-effectiveness of group-delivered acceptance and commitment therapy vs. cognitive behavioral therapy for smoking cessation: a randomized controlled trial. Nicotine Tob Res. 2018 Dec 24. pii: 5258090. doi: 10.1093/ntr/nty268. [Epub ahead of print]. PubMed

Frost MC, Matson TE, Tsui JI, Williams EC. Influence of comorbid drug use disorder on receipt of evidence-based treatment for alcohol use disorder among VA patients with alcohol use disorder and hepatitis C and/or HIV. Drug Alcohol Depend. 2019 Jan 1;194:288-295. doi: 10.1016/j.drugalcdep.2018.10.008. Epub 2018 Oct 30. PubMed

Heffner JL, Mull KE, Watson NL, McClure JB, Bricker JB. Smokers with bipolar disorder, other affective disorders, and no mental health conditions: comparison of baseline characteristics and success at quitting in a large 12-month behavioral intervention randomized trial. Drug Alcohol Depend. 2018 Oct 10;193:35-41. doi: 10.1016/j.drugalcdep.2018.08.034. [Epub ahead of print]. PubMed

Watson NL, Mull KE, Heffner JL, McClure JB, Bricker JB. Participant Recruitment and Retention in Remote eHealth Intervention Trials: Methods and Lessons Learned From a Large Randomized Controlled Trial of Two Web-Based Smoking Interventions. J Med Internet Res. 2018;20(8):e10351. doi: 10.2196/10351. PubMed

Williams EC, McGinnis KA, Bobb JF, Rubinsky AD, Lapham GT, Skanderson M, Catz SL, Bensley KM, Richards JE, Bryant KJ, Edelman EJ, Satre DD, Marshall BDL, Kraemer KL, Blosnich JR, Crystal S, Gordon AJ, Fiellin DA, Justice AC, Bradley KA. Changes in alcohol use associated with changes in HIV disease severity over time: a national longitudinal study in the Veterans Aging Cohort. Drug Alcohol Depend. 2018 May 24;189:21-29. doi: 10.1016/j.drugalcdep.2018.04.022.[Epub ahead of print]. PubMed

Researchers in Behavior Change

Katharine A. Bradley, MD, MPH

Senior Investigator
206-287-2151
Katharine.A.Bradley@kp.org

Curriculum vitae (CV)

Paula Lozano, MD, MPH

Senior Investigator, KPWHRI; Associate Medical Director for Research and Translation & Physician, Pediatrics, Washington Permanente Medical Group
206-287-2113
Paula.Lozano@kp.org

Curriculum vitae (CV)

Jennifer B. McClure, PhD

Director of Research, Faculty, & Development; Senior Investigator
206-287-2737
Jennifer.B.Mcclure@kp.org

Curriculum vitae (CV)

Dori E. Rosenberg, PhD, MPH

Associate Investigator
206-287-2532
Dori.E.Rosenberg@kp.org

Curriculum vitae (CV)

James D. Ralston, MD, MPH

Senior Investigator
206-287-2076
James.D.Ralston@kp.org

Curriculum vitae (CV)

Nora Henrikson, PhD, MPH

Assistant Investigator
206-287-4675
Nora.B.Henrikson@kp.org

Curriculum vitae (CV)

Ben Balderson, PhD

Research Associate
206-287-2803
Benjamin.H.Balderson@kp.org

Curriculum vitae (CV)

Gwen Lapham, PhD, MPH, MSW

Assistant Investigator
206-287-2021
Gwen.T.Lapham@kp.org

Curriculum vitae (CV)

Melissa L. Anderson, MS

Senior Biostatistician
206-287-2647
Melissa.L.Anderson@kp.org

Curriculum vitae (CV)

Paula R. Blasi, MPH

Research Associate
206-287-2094
Paula.R.Blasi@kp.org

Curriculum vitae (CV)

Leah Tuzzio, MPH

Research Associate
206-287-2109
Leah.Tuzzio@kp.org

Curriculum vitae (CV)

Cara C. Lewis, PhD, HSPP

Associate Investigator
206-442-4076
Cara.C.Lewis@kp.org

Curriculum vitae (CV)

Joseph E. Glass, PhD, MSW

Associate Investigator
206-287-4266
Joseph.E.Glass@kp.org

Curriculum vitae (CV)

Amy K. Lee, MPH

Research Associate
206-287-2827
Amy.K.Lee@kp.org

Curriculum vitae (CV)

Beverly B. Green, MD, MPH

Senior Investigator
206-287-2997
Bev.B.Green@kp.org

Curriculum vitae (CV)

Julie E. Richards, PhD, MPH

Research Associate II
206-287-2100
Julie.E.Richards@kp.org

Curriculum vitae (CV)

Lynn DeBar, PhD

Senior Investigator
(206) 287-2942
Lynn.Debar@kp.org

Curriculum vitae (CV)

Predrag Klasnja, PhD

Associate Investigator, KPWHRI; Assistant Professor of Information, University of Michigan School of Information
206-442-5207
Predrag.V.Klasnja@kp.org

Curriculum vitae (CV)

Affiliate researchers

Sheryl L. Catz, PhD
Professor, Health Care Innovation and Technology, Betty Irene Moore School of Nursing
University of California–Davis

Elizabeth Lin, MD, MPH
Kaiser Foundation Health Plan of Washington Family Practice;
Kaiser Permanente Washington Research Institute

Sue McCurry, PhD
University of Washington (UW) Department of Psychosocial and Community Health

Emily Williams, PhD, MPH
UW Department of Health Services; VA Health Services Research & Development Center of Excellence