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 Investigative Science

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 investigative science. “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, associate 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

Cummings DE, Arterburn DE, Westbrook EO, Kuzma JN, Stewart SD, Chan CP, Bock SN, Landers JT, Kratz M, Foster-Schubert KE, Flum DR. Gastric bypass surgery vs intensive lifestyle and medical intervention for type 2 diabetes: the CROSSROADS randomised controlled trial. Diabetologia. 2016 May;59(5):945-53. doi: 10.1007/s00125-016-3903-x. Epub 2016 Mar 17. PubMed

Bradley KA, Lapham GT. Is it time for a more ambitious research agenda for decreasing alcohol-related harm among young adults? Addiction. 2016 Sep;111(9):1531-2. doi: 10.1111/add.13235. Epub 2016 Mar 6. PubMed

Lehavot K, Williams EC, Millard SP, Bradley KA, Simpson TL. Association of alcohol misuse with sexual identity and sexual behavior in women veterans. Subst Use Misuse. 2016 Jan 28;51(2):216-29. doi: 10.3109/10826084.2015.1092988. Epub 2016 Jan 22. PubMed

Williams EC, Achtmeyer CE, Young JP, Rittmueller SE, Ludman EJ, Lapham GT, Lee AK, Chavez LJ, Berger D, Bradley KA. Local implementation of alcohol screening and brief intervention at five Veterans Health Administration primary care clinics: perspectives of clinical and administrative staff. J Subst Abuse Treat. 2015 Jul 26. J Subst Abuse Treat. 2016 Jan;60:27-35. doi: 10.1016/j.jsat.2015.07.011. Epub 2015 Jul 26. PubMed

Chavez LJ, Liu CF, Tefft N, Herbert PL, Clark BJ, Rubinsky AD, Lapham GT, Bradley KA. Unhealthy alcohol use in older adults: association with readmissions and emergency department use in the 30 days after hospital discharge. Drug Alcohol Depend. 2016 Jan 1;158:94-101. doi: 10.1016/j.drugalcdep.2015.11.008. Epub 2015 Nov 19.

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
206-287-2113
Paula.Lozano@kp.org

Curriculum vitae (CV)

Jennifer B. McClure, PhD

Director, Investigative Science
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

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

Curriculum vitae (CV)

Ben Balderson, PhD

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

Curriculum vitae (CV)

Paula R. Blasi, MPH

Collaborative Scientist
206-287-2094
Paula.R.Blasi@kp.org

Curriculum vitae (CV)

Cara C. Lewis, PhD

Senior 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)

Beverly B. Green, MD, MPH

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

Curriculum vitae (CV)

Julie E. Richards, PhD, MPH

Senior Collaborative Scientist
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)

Leah K. Hamilton, PhD

Collaborative Scientist
206-287-2515
Leah.K.Hamilton@kp.org

Curriculum vitae (CV)

Chloe Krakauer, PhD

Collaborative Biostatistician II
chloe.a.krakauer@kp.org

Curriculum vitae (CV)

Mikael Anne Greenwood-Hickman, MPH

Collaborative Scientist
(206) 287-2908
Mikael.Anne.Greenwood-Hickman@kp.org

Pamela A. Shaw, PhD, MS

Senior Biostatistics Investigator
Pamela.A.Shaw@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

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