Behavior Change
“Our research is not just about empowering people to adopt healthy habits. It’s also about changing medical systems to best support these behavior changes."
Joseph Glass, PhD, MSW
Kaiser Permanente Washington Health Research Institute Senior Investigator
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 scientists with Kaiser Permanente Washington Health Research Institute (KPWHRI) are working to make the right choices the easy and sustainable ones.
Research suggests that approximately one-third of all deaths in the Unites States are related to 4 behavioral risk factors: physical inactivity, poor nutrition, tobacco use, and excessive alcohol use. 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.
Historically, KPWHRI's research has tested different forms of behavioral counseling or novel ways to deliver this counseling. 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.
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
- Creating personalized, convenient, effective behavioral interventions that can be delivered using various digital technologies
Recent Publications on Behavior Change
Hermes E, Lyon A, Schueller S, Glass JE. Measuring the implementation of behavioral intervention technologies: a recharacterization of established outcomes. J Med Internet Res. 2019 Jan 25;21(1):e11752. doi: 10.2196/11752. PubMed
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. 2020 Mar 16;22(3):354-362. doi: 10.1093/ntr/nty268. 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
Researchers in Behavior Change
 Katharine A. Bradley, MD, MPHSenior Investigator |
 Paula Lozano, MD, MPHSenior Investigator; Director, ACT Center |
 Dori E. Rosenberg, PhD, MPHSenior Investigator |
 James D. Ralston, MD, MPHSenior Investigator |
 Ben Balderson, PhDSenior Collaborative Scientist |
 Gwen Lapham, PhD, MPH, MSWAssistant Investigator |
 Melissa L. Anderson, MSPrincipal Collaborative Biostatistician |
 Paula R. Blasi, MPHSenior Collaborative Scientist |
 Joseph E. Glass, PhD, MSWSenior Investigator |
 Beverly B. Green, MD, MPHSenior Investigator |
 Julie E. Richards, PhD, MPHAssociate Investigator |
 Leah K. Hamilton, PhDSenior Collaborative Scientist |
 Chloe Krakauer, PhDCollaborative Biostatistician |
 Mikael Anne Greenwood-Hickman, MPHSenior Collaborative Scientist |
 Pamela A. Shaw, PhD, MSSenior Biostatistics Investigator |
 Kelsey Stefanik-Guizlo, MPHCollaborative Scientist |
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
Research
Digital tool could help people change smoking habits
A mobile application designed to engage smokers who are ambivalent about quitting shows promising results.
News
Toolkit offers guidance for people with persistent pain
The new comprehensive resource was written from the perspective of patients experiencing ongoing pain.
New findings
Relieving chronic pain with CBT
Cognitive behavioral therapy with yoga-based movement helps with pain for those on long-term opioids.
Healthy Findings Blog
We decreased people’s daily sedentary time by an hour
Changing behavior isn’t easy, but Dr. Dori Rosenberg helped older people to stand and walk more.
healthy findings blog
Should we consider vaping to be friend or foe?
Dr. Jennifer McClure discusses the rise in deaths and injuries associated with vaping and what you should know about this risk.
innovating care
Asking patients about cannabis may benefit overall health
Drs. Lapham and Bradley find frequency of cannabis use can be tied to other behavioral health patterns and needs.
What motivates Dr. Kathy Bradley to study prevention of alcohol use disorders?
With a passion for primary care and teaching, she aims to make high quality patient-centered care for substance use issues part of mainstream medical practice
research
Oral Health 4 Life: 10 years of research to improve smokers’ health and dental care
As Dr. Jennifer McClure completes the last of three innovative studies, she reflects on how the work began, the difference it may make, and what happens next.
opioids
Patient-doctor trust withstands opioid risk reduction
Risk-reduction initiative for chronic opioid therapy sustains patient-doctor trust, Dr. Karen Sherman finds.
behavior change
Patient-centered care for alcohol use disorders
Sharing CHOICE trial results, KPWHRI takes next steps to advance research on alcohol-related care at Kaiser Permanente Washington and beyond.
Healthy Aging
Stand up for your health!
Researcher Dori Rosenberg shares the importance of being less sedentary — and tips for sitting less.
Land Acknowledgment
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