Jeffrey Fellows | Kaiser Permanente Center for Health Research (original) (raw)

Papers by Jeffrey Fellows

Research paper thumbnail of Concordance between practitioner questionnaire responses and observed clinical treatment recommendations for treatment of dentin hypersensitivity: findings from the National Dental Practice-Based Research Network

BMC Oral Health, 2019

Background: Few published reports have presented concordance between treatment choices selected b... more Background: Few published reports have presented concordance between treatment choices selected by dentists in hypothetical clinical scenarios and treatment choices made by the same dentists in actual clinical practice. The aim of the current cross-sectional study, conducted within the Management of Dental Hypersensitivity (MDH) study, was to assess the potential value of practitioners' questionnaire responses regarding their typical treatment provided for management of dentin hypersensitivity (DH), by evaluating agreement between these responses and subsequently-observed recommendations recorded during actual clinical examinations. Methods: A total of 171 practitioners enrolled in the National Dental Practice-Based Research Network completed both a questionnaire and a clinical study regarding methods they use to treat dental hypersensitivity. The questionnaire solicited first-, second-and third-choice products when prescribing or recommending management of dentin hypersensitivity. Agreement was calculated for first-choice products/recommendations and for inclusion in the top three choices, as identified by the practitioners, from 11 listed treatment options. Overall percent agreement and Cohen's kappa statistic were calculated, with associated 95% confidence intervals (CI). Associations between practitioner characteristics and agreement were also evaluated. Results: For individual treatment modalities, percentage agreement ranged from 63 to 99%, depending on the specific item. Percentage agreement between typical treatment and actual treatment for each practitioner's top three treatment modalities, as a combined grouping, ranged from 61 to 100%. When these same agreement pairings were quantified to account for agreement above that expected by chance, kappa values were poor to low.

Research paper thumbnail of Practitioner Participation in National Dental Practice-based Research Network (PBRN) Studies: 12-Year Results

The Journal of the American Board of Family Medicine, 2018

This study examines practitioner participation over 12 years in the National Dental Practice-Base... more This study examines practitioner participation over 12 years in the National Dental Practice-Based Research Network (PBRN) studies and practitioner meetings, average length of participation, and association of practitioner-and practice-level characteristics with participation. Little information exists about practitioners' long-term participation in PBRNs. Methods: The network conducted a retrospective analysis of practitioner participation in 3 main network activities during 2005 to 2017. Practitioners who completed an enrollment questionnaire, practiced in the United States, and either attended a network meeting or received an invitation to complete a questionnaire or clinical study were included in the analysis. Practitioners (n ‫؍‬ 3669) met inclusion criteria. The network implemented 38 studies (28 clinical and 10 questionnaire), 23 of which (15 clinical and 8 questionnaire) met the criteria for the current analysis. Results: Overall, 86% (N ‫؍‬ 3148) participated in at least 1 network activity during 2005 to 2017. Questionnaire studies had the highest rate with 81% (N ‫؍‬ 2963) completing at least 1, 21% (N ‫؍‬ 762) completed at least 1 clinical study and 19% (N ‫؍‬ 700) attended at least 1 network meeting. Among 1578 practitioners enrolled in the first 5 years of the Network launch, 20% (N ‫؍‬ 320) participated in multiple network activities over 5 to 9 years, and 14% (N ‫؍‬ 238) for 10 to 12 years. Practitioner characteristics associated with participation varied depending on the activity assessed. Conclusion: The network engaged practitioners in its research activities with relatively high participation rates over a 12-year period. Strategies employed by the network to engage practitioners may serve as a model for PBRN networks for other allied health professions.

Research paper thumbnail of Barriers to sealant guideline implementation within a multi-site managed care dental practice

BMC oral health, Feb 2, 2018

The purpose of this study was to identify barriers frequently endorsed by dentists in a large, mu... more The purpose of this study was to identify barriers frequently endorsed by dentists in a large, multi-site dental practice to implementing the American Dental Association's recommendation for sealing noncavitated occlusal carious lesions as established in their 2016 pit-and-fissure sealant clinical practice guideline. Although previous research has identified barriers to using sealants perceived by dentists in private practice, barriers frequently endorsed by dentists in large, multi-site dental practices have yet to be identified. Identifying barriers for these dentists is important, because it is expected that in the future, the multi-site group practice configuration will comprise more dental practices. We anonymously surveyed the 110 general and pediatric dentists at a multi-site dental practice in the U.S. The survey assessed potential barriers in three domains: practice environment, prevailing opinion, and knowledge and attitudes. Results were summarized using descriptive s...

Research paper thumbnail of Use of caries-preventive agents in children: findings from the dental practice-based research network

Oral health & preventive dentistry, 2010

Scientific evidence supports the application of caries-preventive agents in children and adolesce... more Scientific evidence supports the application of caries-preventive agents in children and adolescents, and this knowledge must be applied to the practice of dentistry. There are few multi-region data that allow for comparisons of practice patterns between types of dental practices and geographical regions. The objective of the present study was to characterise the use of specific caries-preventive agents for paediatric patients in a large multi-region sample of practising clinicians. The present study surveyed clinicians from the Dental Practice-based Research Network who perform restorative dentistry in their practices. The survey consisted of a questionnaire that presented a range of questions about caries risk assessment and the use of preventive techniques in children aged 6 to 18 years. Dental sealants (69%) or in-office fluoride (82%) were the most commonly used caries-preventive agents of the caries preventive regimens. The recommendation of at-home caries-preventive agents ra...

Research paper thumbnail of Materials used to repair or replace restorations in DPBRN practices

Objective: The study aims were to determine which material is most commonly used to repair or rep... more Objective: The study aims were to determine which material is most commonly used to repair or replace defective restorations and to determine whether some materials are more commonly used to repair or replace existing restorations in Dental Practice-Based Research Network practices (DPBRN; www.DentalPBRN.org). Methods: This cross-sectional study used a consecutive patient/restoration recruitment design. Practitioner-investigators recorded data for 50 or more enrolled restoration that needed repair or replacement on permanent tooth surfaces. The DPBRN comprises outpatient dental practices mainly from five regions in the United States and Scandinavia that have affiliated to investigate research questions. Data collected included the tooth type and tooth surfaces being restored and the restorative material of the failed restoration, including amalgam (AM), direct resin-based composite (DRBC), indirect resin-based composite (IRBC), glass-ionomer (GI), ceramic or porcelain (PC), gold (GD...

Research paper thumbnail of Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from the National Dental PBRN

American journal of dentistry, 2014

Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. ... more Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. Actual clinical data were used to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists were combined. ANOVA and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Network den...

Research paper thumbnail of Restoration of noncarious tooth defects by dentists in The Dental Practice-Based Research Network

The Journal of the American Dental Association, 2011

Objective-To quantify the reasons for placing restorations on non-carious tooth defects (NCTD) by... more Objective-To quantify the reasons for placing restorations on non-carious tooth defects (NCTD) by Dental Practice-Based Research Network (DPBRN) dentists, and associated tooth, patient and dentist characteristics.

Research paper thumbnail of The Coordinated Evaluation of Statewide Tobacco Control Programs in the United States

Eastern Economic Association, Mar 1, 2002

Research paper thumbnail of The Health and Economic Benefits of California's Tobacco Control Program

the Annual Meeting of the American Public Health Association, Oct 1, 2001

Research paper thumbnail of Tobacco Control Policy and Heart Disease Mortality in California

National Conference on Tobacco or Health, Nov 1, 2002

Research paper thumbnail of Additional file 1: of Barriers to sealant guideline implementation within a multi-site managed care dental practice

Use of Dental Sealants by KP Dentists. This file contains the text, coding, and skip patterns of ... more Use of Dental Sealants by KP Dentists. This file contains the text, coding, and skip patterns of the survey we administered to the study participants. (DOCX 17 kb)

Research paper thumbnail of Additional file 3: of Concordance between practitioner questionnaire responses and observed clinical treatment recommendations for treatment of dentin hypersensitivity: findings from the National Dental Practice-Based Research Network

STROBE Checklist. Completed STROBE Checklist (DOC 79 kb)

Research paper thumbnail of Additional file 2: of Concordance between practitioner questionnaire responses and observed clinical treatment recommendations for treatment of dentin hypersensitivity: findings from the National Dental Practice-Based Research Network

Sensitive Teeth Study Baseline Exam. Patient Baseline Examination Form: Information on number and... more Sensitive Teeth Study Baseline Exam. Patient Baseline Examination Form: Information on number and location of sensitive teeth and recommended treatments. (PDF 221 kb)

Research paper thumbnail of Additional file 1: of Concordance between practitioner questionnaire responses and observed clinical treatment recommendations for treatment of dentin hypersensitivity: findings from the National Dental Practice-Based Research Network

Sensitive Teeth Study Online Practitioner Questionnaire. Pre-Study Questionnaire: Information on ... more Sensitive Teeth Study Online Practitioner Questionnaire. Pre-Study Questionnaire: Information on practitionersâ diagnosis and treatment modalities used when seeing patients presenting with a dentin hypersensitivity complaint. (PDF 226 kb)

Research paper thumbnail of Counseling and

Using radon risk to motivate smoking reduction II: randomized evaluation of brief telephone

Research paper thumbnail of Counseling and

Using radon risk to motivate smoking reduction II: randomized evaluation of brief telephone

Research paper thumbnail of Applying a Scoping Review Approach for Identifying Effective Implementation Strategies in Oral Health Settings

Journal of Clinical and Translational Science, 2021

Dental service providers have limited capacity to identify strategies to implement evidence-based... more Dental service providers have limited capacity to identify strategies to implement evidence-based practices (EBPs). We developed a rigorous yet parsimonious scoping review approach to identify, select, and rate implementation strategies based on an oral health system context. From 153 strategies identified, we selected the top 11 strategies, which had a moderate level of support of evidence and where managers were the main actors. The main actions were to educate, remind, structure, and influence. Targets included dentists, dental hygienists, and assistants and managers from a large prepaid dental care delivery system. This approach responds to calls for rapid and innovative methods to implement EBPs in oral health.

Research paper thumbnail of Referring Hospitalized Smokers to Outpatient Quit Services: A Randomized Trial

American journal of preventive medicine, Oct 1, 2016

Linking outpatient cessation services to bedside counseling for hospitalized smokers can improve ... more Linking outpatient cessation services to bedside counseling for hospitalized smokers can improve long-run quit rates. Adding an assisted referral (AR) offer to a tobacco treatment specialist consult service fits the team approach to care in U.S. hospitals. A two-arm patient-randomized trial tested the effectiveness of adding an AR offer to outpatient smoking-cessation services and interactive voice recognition (AR+IVR) follow-up to a usual care (UC) tobacco-cessation consult for hospitalized smokers. Over 24 months (November 2011-November 2013), 898 hospitalized adult smokers interested in quitting smoking were recruited from three large hospitals in the Portland, Oregon, area: an integrated group model HMO (n=622), a community hospital (n=195), and an academic health center (n=81). Tobacco treatment specialists identified smokers and provided an intensive bedside tobacco use assessment and cessation consultation (UC). AR+IVR recipients also received proactive ARs to available outpa...

Research paper thumbnail of CHARTing a Path to Pragmatic Tobacco Treatment Research

American Journal of Preventive Medicine, 2016

Introduction-It is important to consider the degree to which studies are explanatory versus pragm... more Introduction-It is important to consider the degree to which studies are explanatory versus pragmatic to understand the implications of their findings for patients, healthcare professionals, and policymakers. Pragmatic trials test the effectiveness of interventions in real-world conditions; explanatory trials test for efficacy under ideal conditions. The Consortium of Hospitals Advancing Research on Tobacco (CHART) is a network of seven NIH-funded trials designed to identify effective programs that can be widely implemented in routine clinical practice.

Research paper thumbnail of Use of caries preventive agents on adult patients compared to pediatric patients by general practitioners: findings from The Dental Practice-Based Research Network

Journal of the American Dental Association, Jun 1, 2010

BackgroundEvidence suggests that caries prevention reduces caries in adults. This study tested th... more BackgroundEvidence suggests that caries prevention reduces caries in adults. This study tested the frequency of recommended caries prevention agents for children compared to adult patients.MethodsThis study surveyed 467 Dental Practice-Based Research Network general dentists who practice within the United States and treat both pediatric and adult patients. Dentists were asked the percentage of their patients who are administered or recommended dental sealants, in-office and at-home fluoride, chlorhexidine rinse, and xylitol gum.ResultsAdults were less likely to receive in-office caries preventive agents compared to pediatric patients. However, the rate of recommendation for at-home preventive regimens was very similar. Dentists with a conservative approach to caries treatment were the most likely to use caries prevention at similar rates in adults as in children. In addition, practices with a greater number of patients with dental insurance were significantly less likely to provide in-office fluoride or sealants to adult patients than to their pediatric patients.ConclusionIn-office caries prevention agents are more commonly used by general dentists for their pediatric patients compared to their adult patients.Practice ImplicationsSome general dentists should consider providing additional in-office prevention agents for their adult patients who are at increased risk for dental caries.

Research paper thumbnail of Concordance between practitioner questionnaire responses and observed clinical treatment recommendations for treatment of dentin hypersensitivity: findings from the National Dental Practice-Based Research Network

BMC Oral Health, 2019

Background: Few published reports have presented concordance between treatment choices selected b... more Background: Few published reports have presented concordance between treatment choices selected by dentists in hypothetical clinical scenarios and treatment choices made by the same dentists in actual clinical practice. The aim of the current cross-sectional study, conducted within the Management of Dental Hypersensitivity (MDH) study, was to assess the potential value of practitioners' questionnaire responses regarding their typical treatment provided for management of dentin hypersensitivity (DH), by evaluating agreement between these responses and subsequently-observed recommendations recorded during actual clinical examinations. Methods: A total of 171 practitioners enrolled in the National Dental Practice-Based Research Network completed both a questionnaire and a clinical study regarding methods they use to treat dental hypersensitivity. The questionnaire solicited first-, second-and third-choice products when prescribing or recommending management of dentin hypersensitivity. Agreement was calculated for first-choice products/recommendations and for inclusion in the top three choices, as identified by the practitioners, from 11 listed treatment options. Overall percent agreement and Cohen's kappa statistic were calculated, with associated 95% confidence intervals (CI). Associations between practitioner characteristics and agreement were also evaluated. Results: For individual treatment modalities, percentage agreement ranged from 63 to 99%, depending on the specific item. Percentage agreement between typical treatment and actual treatment for each practitioner's top three treatment modalities, as a combined grouping, ranged from 61 to 100%. When these same agreement pairings were quantified to account for agreement above that expected by chance, kappa values were poor to low.

Research paper thumbnail of Practitioner Participation in National Dental Practice-based Research Network (PBRN) Studies: 12-Year Results

The Journal of the American Board of Family Medicine, 2018

This study examines practitioner participation over 12 years in the National Dental Practice-Base... more This study examines practitioner participation over 12 years in the National Dental Practice-Based Research Network (PBRN) studies and practitioner meetings, average length of participation, and association of practitioner-and practice-level characteristics with participation. Little information exists about practitioners' long-term participation in PBRNs. Methods: The network conducted a retrospective analysis of practitioner participation in 3 main network activities during 2005 to 2017. Practitioners who completed an enrollment questionnaire, practiced in the United States, and either attended a network meeting or received an invitation to complete a questionnaire or clinical study were included in the analysis. Practitioners (n ‫؍‬ 3669) met inclusion criteria. The network implemented 38 studies (28 clinical and 10 questionnaire), 23 of which (15 clinical and 8 questionnaire) met the criteria for the current analysis. Results: Overall, 86% (N ‫؍‬ 3148) participated in at least 1 network activity during 2005 to 2017. Questionnaire studies had the highest rate with 81% (N ‫؍‬ 2963) completing at least 1, 21% (N ‫؍‬ 762) completed at least 1 clinical study and 19% (N ‫؍‬ 700) attended at least 1 network meeting. Among 1578 practitioners enrolled in the first 5 years of the Network launch, 20% (N ‫؍‬ 320) participated in multiple network activities over 5 to 9 years, and 14% (N ‫؍‬ 238) for 10 to 12 years. Practitioner characteristics associated with participation varied depending on the activity assessed. Conclusion: The network engaged practitioners in its research activities with relatively high participation rates over a 12-year period. Strategies employed by the network to engage practitioners may serve as a model for PBRN networks for other allied health professions.

Research paper thumbnail of Barriers to sealant guideline implementation within a multi-site managed care dental practice

BMC oral health, Feb 2, 2018

The purpose of this study was to identify barriers frequently endorsed by dentists in a large, mu... more The purpose of this study was to identify barriers frequently endorsed by dentists in a large, multi-site dental practice to implementing the American Dental Association's recommendation for sealing noncavitated occlusal carious lesions as established in their 2016 pit-and-fissure sealant clinical practice guideline. Although previous research has identified barriers to using sealants perceived by dentists in private practice, barriers frequently endorsed by dentists in large, multi-site dental practices have yet to be identified. Identifying barriers for these dentists is important, because it is expected that in the future, the multi-site group practice configuration will comprise more dental practices. We anonymously surveyed the 110 general and pediatric dentists at a multi-site dental practice in the U.S. The survey assessed potential barriers in three domains: practice environment, prevailing opinion, and knowledge and attitudes. Results were summarized using descriptive s...

Research paper thumbnail of Use of caries-preventive agents in children: findings from the dental practice-based research network

Oral health & preventive dentistry, 2010

Scientific evidence supports the application of caries-preventive agents in children and adolesce... more Scientific evidence supports the application of caries-preventive agents in children and adolescents, and this knowledge must be applied to the practice of dentistry. There are few multi-region data that allow for comparisons of practice patterns between types of dental practices and geographical regions. The objective of the present study was to characterise the use of specific caries-preventive agents for paediatric patients in a large multi-region sample of practising clinicians. The present study surveyed clinicians from the Dental Practice-based Research Network who perform restorative dentistry in their practices. The survey consisted of a questionnaire that presented a range of questions about caries risk assessment and the use of preventive techniques in children aged 6 to 18 years. Dental sealants (69%) or in-office fluoride (82%) were the most commonly used caries-preventive agents of the caries preventive regimens. The recommendation of at-home caries-preventive agents ra...

Research paper thumbnail of Materials used to repair or replace restorations in DPBRN practices

Objective: The study aims were to determine which material is most commonly used to repair or rep... more Objective: The study aims were to determine which material is most commonly used to repair or replace defective restorations and to determine whether some materials are more commonly used to repair or replace existing restorations in Dental Practice-Based Research Network practices (DPBRN; www.DentalPBRN.org). Methods: This cross-sectional study used a consecutive patient/restoration recruitment design. Practitioner-investigators recorded data for 50 or more enrolled restoration that needed repair or replacement on permanent tooth surfaces. The DPBRN comprises outpatient dental practices mainly from five regions in the United States and Scandinavia that have affiliated to investigate research questions. Data collected included the tooth type and tooth surfaces being restored and the restorative material of the failed restoration, including amalgam (AM), direct resin-based composite (DRBC), indirect resin-based composite (IRBC), glass-ionomer (GI), ceramic or porcelain (PC), gold (GD...

Research paper thumbnail of Dentist and practice characteristics associated with restorative treatment of enamel caries in permanent teeth: multiple-regression modeling of observational clinical data from the National Dental PBRN

American journal of dentistry, 2014

Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. ... more Current evidence in dentistry recommends non-surgical treatment to manage enamel caries lesions. However, surveyed practitioners report they would restore enamel lesions that are confined to the enamel. Actual clinical data were used to evaluate patient, dentist, and practice characteristics associated with restoration of enamel caries, while accounting for other factors. Data from a National Dental Practice-Based Research Network observational study of consecutive restorations placed in previously unrestored permanent tooth surfaces and practice/demographic data from 229 participating network dentists were combined. ANOVA and logistic regression, using generalized estimating equations (GEE) and variable selection within blocks, were used to test the hypothesis that patient, dentist, and practice characteristics were associated with variations in enamel restorations of occlusal and proximal caries compared to dentin lesions, accounting for dentist and patient clustering. Network den...

Research paper thumbnail of Restoration of noncarious tooth defects by dentists in The Dental Practice-Based Research Network

The Journal of the American Dental Association, 2011

Objective-To quantify the reasons for placing restorations on non-carious tooth defects (NCTD) by... more Objective-To quantify the reasons for placing restorations on non-carious tooth defects (NCTD) by Dental Practice-Based Research Network (DPBRN) dentists, and associated tooth, patient and dentist characteristics.

Research paper thumbnail of The Coordinated Evaluation of Statewide Tobacco Control Programs in the United States

Eastern Economic Association, Mar 1, 2002

Research paper thumbnail of The Health and Economic Benefits of California's Tobacco Control Program

the Annual Meeting of the American Public Health Association, Oct 1, 2001

Research paper thumbnail of Tobacco Control Policy and Heart Disease Mortality in California

National Conference on Tobacco or Health, Nov 1, 2002

Research paper thumbnail of Additional file 1: of Barriers to sealant guideline implementation within a multi-site managed care dental practice

Use of Dental Sealants by KP Dentists. This file contains the text, coding, and skip patterns of ... more Use of Dental Sealants by KP Dentists. This file contains the text, coding, and skip patterns of the survey we administered to the study participants. (DOCX 17 kb)

Research paper thumbnail of Additional file 3: of Concordance between practitioner questionnaire responses and observed clinical treatment recommendations for treatment of dentin hypersensitivity: findings from the National Dental Practice-Based Research Network

STROBE Checklist. Completed STROBE Checklist (DOC 79 kb)

Research paper thumbnail of Additional file 2: of Concordance between practitioner questionnaire responses and observed clinical treatment recommendations for treatment of dentin hypersensitivity: findings from the National Dental Practice-Based Research Network

Sensitive Teeth Study Baseline Exam. Patient Baseline Examination Form: Information on number and... more Sensitive Teeth Study Baseline Exam. Patient Baseline Examination Form: Information on number and location of sensitive teeth and recommended treatments. (PDF 221 kb)

Research paper thumbnail of Additional file 1: of Concordance between practitioner questionnaire responses and observed clinical treatment recommendations for treatment of dentin hypersensitivity: findings from the National Dental Practice-Based Research Network

Sensitive Teeth Study Online Practitioner Questionnaire. Pre-Study Questionnaire: Information on ... more Sensitive Teeth Study Online Practitioner Questionnaire. Pre-Study Questionnaire: Information on practitionersâ diagnosis and treatment modalities used when seeing patients presenting with a dentin hypersensitivity complaint. (PDF 226 kb)

Research paper thumbnail of Counseling and

Using radon risk to motivate smoking reduction II: randomized evaluation of brief telephone

Research paper thumbnail of Counseling and

Using radon risk to motivate smoking reduction II: randomized evaluation of brief telephone

Research paper thumbnail of Applying a Scoping Review Approach for Identifying Effective Implementation Strategies in Oral Health Settings

Journal of Clinical and Translational Science, 2021

Dental service providers have limited capacity to identify strategies to implement evidence-based... more Dental service providers have limited capacity to identify strategies to implement evidence-based practices (EBPs). We developed a rigorous yet parsimonious scoping review approach to identify, select, and rate implementation strategies based on an oral health system context. From 153 strategies identified, we selected the top 11 strategies, which had a moderate level of support of evidence and where managers were the main actors. The main actions were to educate, remind, structure, and influence. Targets included dentists, dental hygienists, and assistants and managers from a large prepaid dental care delivery system. This approach responds to calls for rapid and innovative methods to implement EBPs in oral health.

Research paper thumbnail of Referring Hospitalized Smokers to Outpatient Quit Services: A Randomized Trial

American journal of preventive medicine, Oct 1, 2016

Linking outpatient cessation services to bedside counseling for hospitalized smokers can improve ... more Linking outpatient cessation services to bedside counseling for hospitalized smokers can improve long-run quit rates. Adding an assisted referral (AR) offer to a tobacco treatment specialist consult service fits the team approach to care in U.S. hospitals. A two-arm patient-randomized trial tested the effectiveness of adding an AR offer to outpatient smoking-cessation services and interactive voice recognition (AR+IVR) follow-up to a usual care (UC) tobacco-cessation consult for hospitalized smokers. Over 24 months (November 2011-November 2013), 898 hospitalized adult smokers interested in quitting smoking were recruited from three large hospitals in the Portland, Oregon, area: an integrated group model HMO (n=622), a community hospital (n=195), and an academic health center (n=81). Tobacco treatment specialists identified smokers and provided an intensive bedside tobacco use assessment and cessation consultation (UC). AR+IVR recipients also received proactive ARs to available outpa...

Research paper thumbnail of CHARTing a Path to Pragmatic Tobacco Treatment Research

American Journal of Preventive Medicine, 2016

Introduction-It is important to consider the degree to which studies are explanatory versus pragm... more Introduction-It is important to consider the degree to which studies are explanatory versus pragmatic to understand the implications of their findings for patients, healthcare professionals, and policymakers. Pragmatic trials test the effectiveness of interventions in real-world conditions; explanatory trials test for efficacy under ideal conditions. The Consortium of Hospitals Advancing Research on Tobacco (CHART) is a network of seven NIH-funded trials designed to identify effective programs that can be widely implemented in routine clinical practice.

Research paper thumbnail of Use of caries preventive agents on adult patients compared to pediatric patients by general practitioners: findings from The Dental Practice-Based Research Network

Journal of the American Dental Association, Jun 1, 2010

BackgroundEvidence suggests that caries prevention reduces caries in adults. This study tested th... more BackgroundEvidence suggests that caries prevention reduces caries in adults. This study tested the frequency of recommended caries prevention agents for children compared to adult patients.MethodsThis study surveyed 467 Dental Practice-Based Research Network general dentists who practice within the United States and treat both pediatric and adult patients. Dentists were asked the percentage of their patients who are administered or recommended dental sealants, in-office and at-home fluoride, chlorhexidine rinse, and xylitol gum.ResultsAdults were less likely to receive in-office caries preventive agents compared to pediatric patients. However, the rate of recommendation for at-home preventive regimens was very similar. Dentists with a conservative approach to caries treatment were the most likely to use caries prevention at similar rates in adults as in children. In addition, practices with a greater number of patients with dental insurance were significantly less likely to provide in-office fluoride or sealants to adult patients than to their pediatric patients.ConclusionIn-office caries prevention agents are more commonly used by general dentists for their pediatric patients compared to their adult patients.Practice ImplicationsSome general dentists should consider providing additional in-office prevention agents for their adult patients who are at increased risk for dental caries.