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3. Most people share genetic test results with relatives even if the findings are normal: Family communication in a diverse population

Author

Allen, Jake, Angelo, Frank, Arnold, Briana L., Bellcross, Cecelia, Bendelow, Tiffany, B, Barbara, Biesecker, Breslin, Kristin D., Booker, Kristina F., Caruncho, Mikaella, Davis, James V., Deutsch, Sonia, Devine, Beth, Dorschner, Michael O., Duenas, Devan, Eubanks, Donna J., Feigelson, Heather Spencer, Freed, Amanda S., Greaney, Clay, Gruß, Inga, Guerra, Claudia, Guo, Boya, Holup, Joan, Ingphakorn, Chalinya L., Jackson, Paige, Jarvik, Gail P., Jenkins, Charisma L., Karliner, Leah S., Kaufmann, Tia, Keast, Erin, Knerr, Sarah, Koomas, Alyssa H., Kraft, Stephanie A., Lee, Mi H., Lee, Robin, Soo-Jin Lee, Sandra, Lewis, Hannah S., Liles, Elizabeth G., Lindberg, Nangel M., Lynch, Frances, McMullen, Carmit K., Medina, Elizabeth, Mittendorf, Kathleen F., Muessig, Kristin R., Okuyama, Sonia, Peterson, C. Samuel, Paolucci, Angela R., Perez, Rosse Rodriguez, Porter, Kathryn M., Ransom, Chelese L., Reyes, Ana, Robinson, Sperry, Rolf, Bradley A., Rope, Alan F., Schield, Emily, Schneider, Jennifer L., Shipman, Kelly J., Shirts, Brian H., Shuster, Elizabeth, Syngal, Sapna, Torgrimson-Ojerio, Britta N., Ukaegbu, Chinedu, Vandermeer, Meredith L., Varga, Alexandra M., Veenstra, David L., Whitebirch, W. Chris, Lee White, Larissa, Hunter, Jessica Ezzell, Riddle, Leslie, Joseph, Galen, Amendola, Laura M., Gilmore, Marian J., Zepp, Jamilyn M., Bulkley, Joanna E., Anderson, Katherine P., Goddard, Katrina A.B., Wilfond, Benjamin S., and Leo, Michael C.

Published
2023
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4. Study protocol: a pragmatic, stepped-wedge trial of tailored support for implementing social determinants of health documentation/action in community health centers, with realist evaluation

Author

Gold, Rachel, Bunce, Arwen, Cottrell, Erika, Marino, Miguel, Middendorf, Mary, Cowburn, Stuart, Wright, Dagan, Mossman, Ned, Dambrun, Katie, Powell, Byron J, Gruß, Inga, Gottlieb, Laura, Dearing, Marla, Scott, Jason, Yosuf, Nadia, and Krancari, Molly

Subjects
Clinical Research, Health Services, Generic health relevance, Good Health and Well Being, Adolescent, Adult, Aged, Child, Child, Preschool, Cluster Analysis, Community Health Centers, Data Collection, Diabetes Mellitus, Electronic Health Records, Female, Humans, Implementation Science, Infant, Infant, Newborn, Interprofessional Relations, Male, Middle Aged, Multicenter Studies as Topic, Patient Care Team, Pragmatic Clinical Trials as Topic, Randomized Controlled Trials as Topic, Referral and Consultation, Social Determinants of Health, Social Support, Young Adult, Social determinants of health, Electronic health records, Community health centers, Implementation, Implementation strategies, Information and Computing Sciences, Medical and Health Sciences, Health Policy & Services
Abstract

BACKGROUND:National leaders recommend documenting social determinants of health and actions taken to address social determinants of health in electronic health records, and a growing body of evidence suggests the health benefits of doing so. However, little evidence exists to guide implementation of social determinants of health documentation/action. METHODS:This paper describes a 5-year, mixed-methods, stepped-wedge trial with realist evaluation, designed to test the impact of providing 30 community health centers with step-by-step guidance on implementing electronic health record-based social determinants of health documentation. This guidance will entail 6 months of tailored support from an interdisciplinary team, including training and technical assistance. We will report on tailored support provided at each of five implementation steps; impact of tailored implementation support; a method for tracking such tailoring; and context-specific pathways through which these tailored strategies effect change. We will track the competencies and resources needed to support the study clinics' implementation efforts. DISCUSSION:Results will inform how to tailor implementation strategies to meet local needs in real-world practice settings. Secondary analyses will assess impacts of social determinants of health documentation and referral-making on diabetes outcomes. By learning whether and how scalable, tailored implementation strategies help community health centers adopt social determinants of health documentation and action, this study will yield timely guidance to primary care providers. We are not aware of previous studies exploring implementation strategies that support adoption of social determinants of action using electronic health and interventions, despite the pressing need for such guidance. TRIAL REGISTRATION:clinicaltrials.gov, NCT03607617 , registration date: 7/31/2018-retrospectively registered.

Published
2019

17. The emergence of the temporary migrant: bureaucracies, legality and Myanmar migrants in Thailand

Author

Gruss, Inga

Subjects
Migrant labor -- Laws, regulations and rules, Rule of law -- Analysis, Bureaucracy -- Analysis, Government regulation, Anthropology/archeology/folklore, Regional focus/area studies, Sociology and social work
Abstract

The national verification process that has provided formalized guidelines to regulate the migration of Myanmar workers to Thailand permanently places migrants in a zone of temporary legality. This zone is a bureaucratic space in which legality surfaces as a flexible concept serving the interests of the Thai and Myanmar states while placing an economic burden on migrants. Legality also emerges as a commodity that does not relate to migrants' compliance with the law, but rather to their ability to mobilize resources. Brokers not only guide migrants in navigating the transnational bureaucracies, but also mediate the emotional ties between migrants and those bureaucracies. The emotional undercurrents of the process ultimately serve as a reminder that any bureaucratic space is inherently affective. Keywords: migration, affective bureaucracy, legality, temporality, Myanmar, Thailand., Approximately three million Myanmar migrant workers currently reside in Thailand. An estimated 1.7 million migrant workers possess legal documents that authorize them to live and work in the country temporarily; [...]

Published
2017
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18. Costs and Cost-Effectiveness of Implementing a Digital Diabetes Prevention Program in a Large, Integrated Health System

Author

Smith, David H, primary, O’Keeffe-Rosetti, Maureen, additional, Fitzpatrick, Stephanie L, additional, Mayhew, Meghan, additional, Firemark, Alison J, additional, Gruß, Inga, additional, Nyongesa, Denis B, additional, Smith, Ning, additional, Dickerson, John F, additional, Stevens, Victor J, additional, Vollmer, William M, additional, and Fortmann, Stephen P, additional

Published
2022
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19. ORCA, a values-based decision aid for selecting additional findings from genomic sequencing in adults: Efficacy results from a randomized trial

Author

Liles, Elizabeth G., primary, Leo, Michael C., additional, Freed, Amanda S., additional, Porter, Kathryn M., additional, Zepp, Jamilyn M., additional, Kauffman, Tia L., additional, Keast, Erin, additional, McMullen, Carmit K., additional, Gruß, Inga, additional, Biesecker, Barbara B., additional, Muessig, Kristin R., additional, Eubanks, Donna J., additional, Amendola, Laura M., additional, Dorschner, Michael O., additional, Rolf, Bradley A., additional, Jarvik, Gail P., additional, Goddard, Katrina A.B., additional, and Wilfond, Benjamin S., additional

Published
2022
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20. Laboratory-related outcomes from integrating an accessible delivery model for hereditary cancer risk assessment and genetic testing in populations with barriers to access

Author

Amendola, Laura M., primary, Shuster, Elizabeth, additional, Leo, Michael C., additional, Dorschner, Michael O., additional, Rolf, Bradley A., additional, Shirts, Brian H., additional, Gilmore, Marian J., additional, Okuyama, Sonia, additional, Zepp, Jamilyn M., additional, Kauffman, Tia L., additional, Mittendorf, Kathleen F., additional, Bellcross, Cecilia, additional, Jenkins, Charisma L., additional, Joseph, Galen, additional, Riddle, Leslie, additional, Syngal, Sapna, additional, Ukaegbu, Chinedu, additional, Goddard, Katrina A.B., additional, Wilfond, Benjamin S., additional, Jarvik, Gail P., additional, Allen, Jake, additional, Amendola, Laura M., additional, Anderson, Katherine P., additional, Angelo, Frank, additional, Arnold, Briana L., additional, Bellcross, Cecelia, additional, Bendelow, Tiffany, additional, Biesecker, Barbara B., additional, Breslin, Kristin D., additional, Bulkley, Joanna E., additional, Booker, Kristina F., additional, Caruncho, Mikaella, additional, Davis, James V., additional, Deutsch, Sonia, additional, Devine, Beth, additional, Duenas, Devan M., additional, Eubanks, Donna J., additional, Feigelson, Heather Spencer, additional, Freed, Amanda S., additional, Greaney, Clay, additional, Gruß, Inga, additional, Guerra, Claudia, additional, Guo, Boya, additional, Holup, Joan, additional, Hunter, Jessica Ezzell, additional, Ingphakorn, Chalinya L., additional, Jackson, Paige, additional, Karliner, Leah S., additional, Keast, Erin, additional, Knerr, Sarah, additional, Koomas, Alyssa H., additional, Kraft, Stephanie A., additional, Lee, Mi H., additional, Lee, Robin, additional, Soo-Jin Lee, Sandra, additional, Lewis, Hannah S., additional, Liles, Elizabeth G., additional, Lindberg, Nangel M., additional, Lynch, Frances, additional, McMullen, Carmit K., additional, Medina, Elizabeth, additional, Muessig, Kristin R., additional, Peterson, C. Samuel, additional, Paolucci, Angela R., additional, Perez, Rosse Rodriguez, additional, Porter, Kathryn M., additional, Ransom, Chelese L., additional, Reyes, Ana, additional, Riddle, Leslie S., additional, Robinson, Sperry, additional, Rope, Alan F., additional, Schield, Emily, additional, Schneider, Jennifer L., additional, Shipman, Kelly J., additional, Torgrimson-Ojerio, Britta N., additional, Vandermeer, Meredith L., additional, Varga, Alexandra M., additional, Veenstra, David L., additional, Whitebirch, W. Chris, additional, and Lee White, Larissa, additional

Published
2022
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22. Evaluating the Implementation of Digital and In-Person Diabetes Prevention Program in a Large, Integrated Health System: Natural Experiment Study Design

Author

Fitzpatrick, Stephanie L, primary, Mayhew, Meghan, additional, Catlin, Chris L, additional, Firemark, Alison, additional, Gruß, Inga, additional, Nyongesa, Denis B, additional, O’Keeffe-Rosetti, Maureen, additional, Rawlings, Andreea M, additional, Smith, David H, additional, Smith, Ning, additional, Stevens, Victor J, additional, Vollmer, William M, additional, and Fortmann, Stephen P, additional

Published
2022
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28. Participants' perspectives on perceived usefulness of digital and in‐person diabetes prevention programs: A qualitative study to inform decisions related to program participation.

Author

Gruß, Inga, Mayhew, Meghan, Firemark, Alison, and Fitzpatrick, Stephanie L.

Subjects
WEIGHT loss, DIABETES, QUALITATIVE research, SOCIAL interaction, PARTICIPATION
Abstract

Objective: Given the effectiveness of both in‐person and digital diabetes prevention programs (DPPs), participants have an opportunity to select a delivery mode based on their needs and preferences. The objective of this study was to understand and compare participants' experiences with digital and in‐person DPPs to identify factors that affected how useful participants perceived these two program delivery modes. Methods: Semi‐structured interviews with participants who were enrolled in DPPs as either a digital (n = 23) or in‐person (n = 20) program within one health care system were conducted. Data were analyzed following the template method using the qualitative software NVivo 12. Results: Findings from the interviews indicated that creating accountability for weight loss was crucial for all program participants. In the digital program, weight and food tracking played a central role in creating accountability, while in the in‐person program, group interactions fostered accountability. The digital program was perceived to encourage self‐monitoring, oftentimes resulting in participants' reflection on their habits. The in‐person program provided a platform for group support and mutual encouragement. Conclusions: Participants perceived both programs as similarly useful. Yet program characteristics such as the ability to engage with other participants in‐person or to seamlessly track weight on a daily basis appealed to different participants. It may be beneficial to align participants' preferences with programs' characteristics and strengths. [ABSTRACT FROM AUTHOR]

Published
2022
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30. Optional Results Choice Aid

Author

Freed, Amanda S., primary, Gruß, Inga, additional, McMullen, Carmit K., additional, Leo, Michael C., additional, Kauffman, Tia L., additional, Porter, Kathryn M., additional, Muessig, Kristin R., additional, Eubanks, Donna, additional, Goddard, Katrina A. B., additional, Wilfond, Benjamin S., additional, and Liles, Elizabeth G., additional

Published
2021
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35. Challenges With Implementing the Diabetes Prevention Program for Medicare Beneficiaries in an Integrated Health System.

Author

Gruß, Inga, Firemark, Alison, Papajorgji-Taylor, Dea, and Fitzpatrick, Stephanie L.

Subjects
*DIABETES prevention, *LIFESTYLES, *RESEARCH methodology, *STAKEHOLDER analysis, *INTERVIEWING, *HUMAN services programs, *QUALITATIVE research, *INTEGRATED health care delivery, *THEMATIC analysis, *MEDICARE
Abstract

OBJECTIVES: In April 2018, CMS began reimbursing both clinical and community settings for providing the CDC-recognized Diabetes Prevention Program (DPP) to eligible Medicare beneficiaries. To better understand the process of offering the program to Medicare beneficiaries, we interviewed relevant stakeholders in a large, integrated health care delivery system. STUDY DESIGN: Qualitative interview study. METHODS: We conducted semistructured interviews with 12 delivery system stakeholders. Data were analyzed following a thematic analysis approach. RESULTS: Stakeholders described systemic challenges to the implementation of Medicare DPP (MDPP), including inadequate reimbursement for the health care system, low awareness of MDPP among patients and providers, and challenges with utilizing third-party vendors to connect patients to CDC-recognized MDPPs. CONCLUSIONS: Although the reimbursement of DPP for Medicare beneficiaries was a landmark decision, the current structure and requirements make it difficult for health systems and community-based providers to implement and promote this benefit. This study highlights the challenges that even integrated health systems are facing to implement MDPP, as well as potential strategies to overcome these barriers and expand the reach of the program. Medicare should seek ways to increase the financial incentives and decrease the barriers associated with implementing MDPP. [ABSTRACT FROM AUTHOR]

Published
2021
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40. Most people share genetic test results with relatives even if the findings are normal: Family communication in a diverse population

Author

Hunter, Jessica Ezzell, Riddle, Leslie, Joseph, Galen, Amendola, Laura M., Gilmore, Marian J., Zepp, Jamilyn M., Shuster, Elizabeth, Bulkley, Joanna E., Muessig, Kristin R., Anderson, Katherine P., Goddard, Katrina A.B., Wilfond, Benjamin S., Leo, Michael C., Allen, Jake, Angelo, Frank, Arnold, Briana L., Bellcross, Cecelia, Bendelow, Tiffany, B, Barbara, Biesecker, Breslin, Kristin D., Booker, Kristina F., Caruncho, Mikaella, Davis, James V., Deutsch, Sonia, Devine, Beth, Dorschner, Michael O., Duenas, Devan, Eubanks, Donna J., Feigelson, Heather Spencer, Freed, Amanda S., Greaney, Clay, Gruß, Inga, Guerra, Claudia, Guo, Boya, Holup, Joan, Ingphakorn, Chalinya L., Jackson, Paige, Jarvik, Gail P., Jenkins, Charisma L., Karliner, Leah S., Kaufmann, Tia, Keast, Erin, Knerr, Sarah, Koomas, Alyssa H., Kraft, Stephanie A., Lee, Mi H., Lee, Robin, Soo-Jin Lee, Sandra, Lewis, Hannah S., Liles, Elizabeth G., Lindberg, Nangel M., Lynch, Frances, McMullen, Carmit K., Medina, Elizabeth, Mittendorf, Kathleen F., Muessig, Kristin R., Okuyama, Sonia, Peterson, C. Samuel, Paolucci, Angela R., Perez, Rosse Rodriguez, Porter, Kathryn M., Ransom, Chelese L., Reyes, Ana, Robinson, Sperry, Rolf, Bradley A., Rope, Alan F., Schield, Emily, Schneider, Jennifer L., Shipman, Kelly J., Shirts, Brian H., Shuster, Elizabeth, Syngal, Sapna, Torgrimson-Ojerio, Britta N., Ukaegbu, Chinedu, Vandermeer, Meredith L., Varga, Alexandra M., Veenstra, David L., Whitebirch, W. Chris, and Lee White, Larissa

Abstract

With increasing utilization of genetic testing, sharing genetic information can become part of general family health communication while providing biological relatives with important information about their own genetic risk. Importantly, little is known about motivations for and barriers to family communication of genetic information in historically underserved populations.

Published
2023
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42. BOOK REVIEWS

Author

MONAGIN, Corina, primary, NAGY, Stephen Robert, additional, NAKANO, Lynne, additional, NG, Benjamin W.M., additional, CREASER, Fiona, additional, COLLINS, Samuel Gerald, additional, MARTIN, Jeff, additional, Ching Angela, WONG Wai, additional, Gang, CHEN, additional, MATHEWS, Gordon, additional, Jing, SHAO, additional, HANSEN, Mette Halskov, additional, Keping, WU, additional, Danning, Wang, additional, BAER, A., additional, Ying, DUAN, additional, GRUß, Inga, additional, MATSUKAWA, Kyoko, additional, and VICENTE, Victor A., additional

Published
2011
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44. Study protocol: a pragmatic, stepped-wedge trial of tailored support for implementing social determinants of health documentation/action in community health centers, with realist evaluation

Author

Scott, Jason, Krancari, Molly, Powell, Byron J., Marino, Miguel, Wright, Dagan, Bunce, Arwen, Dearing, Marla, Cottrell, Erika, Cowburn, Stuart, Middendorf, Mary, Gottlieb, Laura, Dambrun, Katie, Gruß, Inga, Gold, Rachel, Mossman, Ned, and Yosuf, Nadia

Subjects
3. Good health
Abstract

Background National leaders recommend documenting social determinants of health and actions taken to address social determinants of health in electronic health records, and a growing body of evidence suggests the health benefits of doing so. However, little evidence exists to guide implementation of social determinants of health documentation/action. Methods This paper describes a 5-year, mixed-methods, stepped-wedge trial with realist evaluation, designed to test the impact of providing 30 community health centers with step-by-step guidance on implementing electronic health record-based social determinants of health documentation. This guidance will entail 6 months of tailored support from an interdisciplinary team, including training and technical assistance. We will report on tailored support provided at each of five implementation steps; impact of tailored implementation support; a method for tracking such tailoring; and context-specific pathways through which these tailored strategies effect change. We will track the competencies and resources needed to support the study clinics’ implementation efforts. Discussion Results will inform how to tailor implementation strategies to meet local needs in real-world practice settings. Secondary analyses will assess impacts of social determinants of health documentation and referral-making on diabetes outcomes. By learning whether and how scalable, tailored implementation strategies help community health centers adopt social determinants of health documentation and action, this study will yield timely guidance to primary care providers. We are not aware of previous studies exploring implementation strategies that support adoption of social determinants of action using electronic health and interventions, despite the pressing need for such guidance. Trial registration clinicaltrials.gov, NCT03607617 , registration date: 7/31/2018—retrospectively registered

45. Waiting For Elsewhere: Place, Temporality And Myanmar Migrants In Thailand

Author

Gruss, Inga

Subjects
Place-making, migration, temporality, Myanmar, Southeast Asia
Abstract

The central argument of this dissertation upholds that the experience of time cannot be understood independently of the experience of place, in other words, that the experience of time is inextricable from the experience of place. I argue that migrants experience Thailand foremost as a non-place. The difficulty they have in molding place according to their own wishes, results in an increased desire to formulate flexible orientations in and towards time. Migrants increasingly live oriented towards the future and the present becomes a tool for envisioning and working towards the life-to-be. The future, however, is not only a temporal condition. Embedded in the waiting process is the realization that the future will only fulfill its promise if it is going to be lived elsewhere. The return to a place with room for personal histories, meaningful identity-formation processes and lasting relations is necessarily a move through time and space.

Published
2015

46. Testing a Deliberative Democracy Engagement Intervention to Increase Guideline-Concordance Among Oral Health Providers: Results from the DISGO Cluster-Randomized, Stepped-Wedge Trial.

Author

Polk D, Shah NH, Dawson T, Gruß I, Pihlstrom DJ, Kaplan CD, Guerrero EG, and Fellows JL

Abstract

Background: Dental caries affects billions worldwide and in the U.S. is among the most prevalent noncommunicable diseases in both children and adults. Early in the caries process, it can be arrested by dental sealants, which are non-invasive and thus tooth sparing, however, few dentists have adopted this approach. Deliberative engagement processes enable participants to engage with diverse perspectives on a policy issue and develop and share with policy makers informed opinions about the policy issue. We examined the effects of a deliberative engagement process on the ability of oral health providers to endorse implementation interventions and to apply dental sealants., Methods: Using a stepped wedge design, 16 dental clinics were cluster randomized, and 680 providers and staff were exposed to a deliberative engagement process that included an introductory session, workbook, facilitated small group deliberative forum, and post-forum survey. Forum participants were assigned to forums to ensure diverse role representation. Mechanisms of action examined included sharing voice and diversity of opinion. Three months after each clinic's forum, the clinic manager was interviewed about implementation interventions deployed. There were 98 clinic-months in the non-intervention period and 101 clinic-months in the intervention period., Results: Compared with providers and staff in small clinics, providers and staff in medium and large clinics more strongly agreed that their clinic should adopt two of the three proposed implementation interventions targeting the first barrier and one of the two proposed implementation interventions targeting the second barrier. Compared with the non-intervention period, in the intervention period providers did not place more sealants on occlusal non-cavitated carious lesions. Survey respondents reported sharing both promotive and prohibitive voice. From the beginning to the end of the forums, most forum participants did not change their opinions about the possible implementation interventions. At the end of the forums, there was no significant within-group variability in implementation interventions endorsed., Conclusions: Deliberative engagement intervention may help clinic leadership identify implementation interventions when there is a challenging problem, a network of semi-autonomous clinics, and autonomous providers within those clinics. It remains to be determined whether there is a range of perspectives within clinics., Trial Registration: This project is registered at ClinicalTrials.gov with ID NCT04682730. The trial was first registered on 12/18/2020. https://clinicaltrials.gov/ct2/show/NCT04682730.

Published
2023
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47. Evaluating the Implementation of Digital and In-Person Diabetes Prevention Program in a Large, Integrated Health System: Natural Experiment Study Design.

Author

Fitzpatrick SL, Mayhew M, Catlin CL, Firemark A, Gruß I, Nyongesa DB, O'Keeffe-Rosetti M, Rawlings AM, Smith DH, Smith N, Stevens VJ, Vollmer WM, and Fortmann SP

Subjects
Glycated Hemoglobin analysis, Humans, Research Design, Delivery of Health Care, Integrated, Diabetes Mellitus, Type 2 prevention & control, Prediabetic State
Abstract

Introduction: Implementation of a Diabetes Prevention Program (DPP) in both in-person and digital health-care settings has been increasing. The purpose of this article is to describe the protocol of a mixed-methods, natural experiment study designed to evaluate the implementation of DPP in a large, integrated health system., Methods: Kaiser Permanente Northwest patients who were 19 to 75 years with prediabetes (hemoglobin A1c or glycated hemoglobin, 5.7-6.4) and obesity (body mass index ≥ 30 kg/m 2 ) were invited, via the Kaiser Permanente Northwest patient portal, to participate in the digital (n = 4124) and in-person (n = 2669) DPP during 2016 through 2018. Primary (weight) and secondary (hemoglobin A1c or glycated hemoglobin level) outcome data will be obtained from electronic health records. A cost-effectiveness analysis as well as qualitative interviews with patients (enrolled and not enrolled in the DPP) and stakeholders will be conducted to examine further implementation, acceptability, and sustainability., Conclusion: The mixed-methods, natural experiment design we will use to evaluate Kaiser Permanente Northwest's implementation of the digital and in-person DPP builds on existing evidence related to the effectiveness of these two DPP delivery modes and will contribute new knowledge related to best practices for implementing and sustaining the DPP within large health systems over the long term.

Published
2021
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