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Social Risks and Health Care Use in Medically Complex Patients

JAMA network open, 2024-09, Vol.7 (9), p.e2435199

2024

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Predicting Self-Reported Social Risk in Medically Complex Adults Using Electronic Health Data

Medical care, 2024-09, Vol.62 (9), p.590-598

2024

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Telephone-based social health screening by pharmacists in the nonadherent Medicare population

Journal of managed care & specialty pharmacy, 2023-11, Vol.29 (11), p.1184-1192

2023

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Telehealth During COVID-19 for Adults with Multiple Chronic Conditions: Associations with Self-Reported Food Insecurity and with Physical Limitations

Telemedicine journal and e-health, 2023-10, Vol.29 (10), p.1446-1454

2023

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Associations Between Different Self-reported Social Risks and Neighborhood-level Resources in Medicaid Patients

Medical care, 2022-08, Vol.60 (8), p.563-569

2022

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Accounting for Social Risk Does not Eliminate Race/Ethnic Disparities in COVID-19 Infection Among Insured Adults: a Cohort Study

Journal of general internal medicine : JGIM, 2022-04, Vol.37 (5), p.1183-1190

2022

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Engaging patients in population-based chronic disease management: A qualitative study of barriers and intervention opportunities

Patient education and counseling, 2022-01, Vol.105 (1), p.182-189

2022

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Aligning care with the personal values of patients with complex care needs

Health services research, 2021-10, Vol.56 (5), p.1037-1044

2021

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Use of Latent Class Analysis and k-Means Clustering to Identify Complex Patient Profiles

JAMA network open, 2020-12, Vol.3 (12), p.e2029068-e2029068

2020

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Changing Results-Engage and Activate to Enhance Wellness: A Randomized Clinical Trial to Improve Cardiovascular Risk Management

Journal of the American Heart Association, 2019-12, Vol.8 (23), p.e014021-e014021

2019

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Patient-Defined Visit Priorities in Primary Care: Psychosocial Versus Medically-Related Concerns

Journal of the American Board of Family Medicine, 2019-07, Vol.32 (4), p.513-520

2019

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Prompting Patients with Poorly Controlled Diabetes to Identify Visit Priorities Before Primary Care Visits: a Pragmatic Cluster Randomized Trial

Journal of general internal medicine : JGIM, 2019-06, Vol.34 (6), p.831-838

2019

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Primary Care Physician Stress Driven by Social and Financial Needs of Complex Patients

Journal of general internal medicine : JGIM, 2019-06, Vol.34 (6), p.818-819

2019

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Translating/Creating a Culturally Responsive Spanish-Language Mobile App for Visit Preparation: Case Study of "Trans-Creation"

JMIR mHealth and uHealth, 2019-04, Vol.7 (4), p.e12457-e12457

2019

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Visit Planning Using a Waiting Room Health IT Tool: The Aligning Patients and Providers Randomized Controlled Trial

Annals of family medicine, 2019-03, Vol.17 (2), p.141-149

2019

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Knowing How to Ask Good Questions: Comparing Latinos and Non-Latino Whites Enrolled in a Cardiovascular Disease Prevention Study

Permanente journal, 2019, Vol.23 (2)

2019

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Which Complex Patients Should Be Referred for Intensive Care Management? A Mixed-Methods Analysis

Journal of general internal medicine : JGIM, 2018-09, Vol.33 (9), p.1454-1460

2018

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'The Hand on the Doorknob': Visit Agenda Setting by Complex Patients and Their Primary Care Physicians

Journal of the American Board of Family Medicine, 2018-01, Vol.31 (1), p.29-37

2018

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CREATE Wellness: A multi-component behavioral intervention for patients not responding to traditional Cardiovascular disease management

Contemporary clinical trials communications, 2017-12, Vol.8 (C), p.140-146

2017

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Primary care visit preparation and communication for patients with poorly controlled diabetes: A qualitative study of patients and physicians

Primary care diabetes, 2017-04, Vol.11 (2), p.148-153

2017

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Pre-Visit Prioritization for complex patients with diabetes: Randomized trial design and implementation within an integrated health care system

Contemporary clinical trials, 2016-03, Vol.47, p.196-201

2016

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Initial Persistence With Antihypertensive Therapies Is Associated With Depression Treatment Persistence, But Not Depression

The journal of clinical hypertension (Greenwich, Conn.), 2014-06, Vol.16 (6), p.412-417

2014

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Exercise as a Vital Sign: A Quasi-Experimental Analysis of a Health System Intervention to Collect Patient-Reported Exercise Levels

Journal of general internal medicine : JGIM, 2014-02, Vol.29 (2), p.341-348

2014

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A1-1: “Exercise as a Vital Sign”: Impact of Documenting Self-Reported Exercise in Primary Care

Clinical medicine & research, 2013-09, Vol.11 (3), p.142-142

2013

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Health system factors and antihypertensive adherence in a racially and ethnically diverse cohort of new users

JAMA internal medicine, 2013-01, Vol.173 (1), p.54

2013

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Social Risks and Health Care Use in Medically Complex Patients

Predicting Self-Reported Social Risk in Medically Complex Adults Using Electronic Health Data

Telephone-based social health screening by pharmacists in the nonadherent Medicare population

Telehealth During COVID-19 for Adults with Multiple Chronic Conditions: Associations with Self-Reported Food Insecurity and with Physical Limitations

Associations Between Different Self-reported Social Risks and Neighborhood-level Resources in Medicaid Patients

Accounting for Social Risk Does not Eliminate Race/Ethnic Disparities in COVID-19 Infection Among Insured Adults: a Cohort Study

Engaging patients in population-based chronic disease management: A qualitative study of barriers and intervention opportunities

Aligning care with the personal values of patients with complex care needs

Use of Latent Class Analysis and k-Means Clustering to Identify Complex Patient Profiles

Changing Results-Engage and Activate to Enhance Wellness: A Randomized Clinical Trial to Improve Cardiovascular Risk Management

Patient-Defined Visit Priorities in Primary Care: Psychosocial Versus Medically-Related Concerns

Prompting Patients with Poorly Controlled Diabetes to Identify Visit Priorities Before Primary Care Visits: a Pragmatic Cluster Randomized Trial

Primary Care Physician Stress Driven by Social and Financial Needs of Complex Patients

Translating/Creating a Culturally Responsive Spanish-Language Mobile App for Visit Preparation: Case Study of "Trans-Creation"

Visit Planning Using a Waiting Room Health IT Tool: The Aligning Patients and Providers Randomized Controlled Trial

Knowing How to Ask Good Questions: Comparing Latinos and Non-Latino Whites Enrolled in a Cardiovascular Disease Prevention Study

Which Complex Patients Should Be Referred for Intensive Care Management? A Mixed-Methods Analysis

'The Hand on the Doorknob': Visit Agenda Setting by Complex Patients and Their Primary Care Physicians

CREATE Wellness: A multi-component behavioral intervention for patients not responding to traditional Cardiovascular disease management

Primary care visit preparation and communication for patients with poorly controlled diabetes: A qualitative study of patients and physicians

Pre-Visit Prioritization for complex patients with diabetes: Randomized trial design and implementation within an integrated health care system

Initial Persistence With Antihypertensive Therapies Is Associated With Depression Treatment Persistence, But Not Depression

Exercise as a Vital Sign: A Quasi-Experimental Analysis of a Health System Intervention to Collect Patient-Reported Exercise Levels

A1-1: “Exercise as a Vital Sign”: Impact of Documenting Self-Reported Exercise in Primary Care

Health system factors and antihypertensive adherence in a racially and ethnically diverse cohort of new users

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