Robert Penfold, PhD, is a health services research and health policy expert whose work focuses on developing and testing strategies to optimize behavioral health care delivery and patient outcomes—particularly in children and adolescents. His research addresses practical issues, such as how to reduce unnecessary use of antipsychotic medications in youth. He also studies the effects of cost-control policies on how clinicians deliver care, how people use care, and how those changes can promote or worsen their health.
Dr. Penfold is a co-investigator in the Mental Health Research Network (MHRN), a resource for studies on mental health conditions ranging from autism to postnatal depression. He leads the MHRN’s child and adolescent scientific interest group. He is also investigating reasons why similar patients receive different mental health treatment, such as different medications, depending on where they live or receive care.
His other recent and ongoing projects include:
Dr. Penfold has extensive experience gathering and analyzing information from large health databases, including those of Medicare, Medicaid, and the Health Care Systems Research Network’s Virtual Data Warehouse. These data and analyses allow rapid information sharing among Kaiser Permanente Washington and participating sites, which improves patient safety and timely access to effective, cutting-edge therapies.
He has also conducted several novel pragmatic clinical trials using the Epic electronic health record system.
Before joining KPWHRI in 2010, Dr. Penfold held research and teaching positions at Nationwide Children's Hospital in Columbus, Ohio; the Winnipeg Regional Health Authority; the Manitoba Centre for Health Policy; and most recently, at Harvard Medical School in the Department of Population Medicine and Harvard Pilgrim Health Care Institute.
Children and adolescents; anti-psychotics and anti-depressants; bipolar disorder, and depression
Comparative effectiveness; consumer-directed health plans; patient outcomes; costs of chronic illnesses; Medicare and Medicaid
Space-time surveillance; interrupted time series analysis
Harris M, Penfold RB, Hawkins A, Maccombs J, Wallace B, Reynolds B. Dimensions of impulsive behavior and treatment outcomes for adolescent smokers. Exp Clin Psychopharmacol. 2014 Feb;22(1):57-64. doi: 10.1037/a0034403. Epub 2014 Jan 13. PubMed
Wagner EH, Ludman EJ, Aiello Bowles EJ, Penfold R, Reid RJ, Rutter CM, Chubak J, McCorkle R. Nurse navigators in early cancer care: a randomized, controlled trial. J Clin Oncol. 2014 Jan 1;32(1):12-8. doi: 10.1200/JCO.2013.51.7359. Epub 2013 Nov 25. PubMed
Bauer MS, Lee A, Li M, Bajor L, Rasmusson A, Kazis Lem, and the ASTANA Group [Penfold]. Off-label use of second generation antipsychotics for post-traumatic stress disorder in the Department of Veterans Affairs: time trends and sociodemographic, comorbidity, and regional correlates. Pharmacoepidemiol Drug Saf. 2014;23(1):77-86.
Hacker KA, Penfold R, Arsenault L, Zhang F, Murphy M, Wissow L. Screening for behavioral health issues in children enrolled in Massachusetts Medicaid. Pediatrics. 2014 Jan;133(1):46-54. doi: 10.1542/peds.2013-1180. Epub 2013 Dec 2. PubMed
Lu CY, Zhang F, Lakoma MD, Madden JM, Rusinak D, Penfold RB, Simon G, Ahmedani BK, Clarke G, Hunkeler EM, Waitzfelder B, Owen-Smith A, Raebel MA, Rossom R, Coleman KJ, Copeland LA, Soumerai SB. Changes in antidepressant use by young people and suicidal behavior after FDA warnings and media coverage: quasi-experimental study. BMJ. 2014 Jun 18;348:g3596. doi: 10.1136/bmj.g3596. PubMed
Rob Penfold, PhD, writes about suicide trends in children and adolescents and what researchers are doing about them.
Dr. Sascha Dublin explains why sometimes not taking medications may be a safer and healthier choice.
A new study shows how a little supplemental support can result in big gains, especially in managing patients’ blood pressure.
Bloomberg Businessweek, Feb. 5, 2019