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
Williams EC, Achtmeyer CE, Young JP, Berger D, Curran G, Bradley KA, Richards J, Siegel MB, Ludman EJ, Lapham GT, Forehand M, Harris AHS. Barriers to and facilitators of alcohol use disorder pharmacotherapy in primary care: a qualitative study in five VA clinics. J Gen Intern Med. 2017 Oct 30. doi: 10.1007/s11606-017-4202-z. [Epub ahead of print]. PubMed
Berger D, Lapham GT, Shortreed SM, Hawkins EJ, Rubinsky AD, Williams EC, Achtmeyer CE, Kivlahan DR, Bradley KA. Increased rates of documented alcohol counseling in primary care: more counseling or just more documentation? J Gen Intern Med. 2018 Mar;33(3):268-274. doi: 10.1007/s11606-017-4163-2. Epub 2017 Oct 18. PubMed
Tucker KL, Sheppard JP, Stevens R, Bosworth HB, Bove A, Bray EP, Earle K, George J, Godwin M, Green BB, Hebert P, Hobbs FDR, Kantola I, Kerry SM, Leiva A, Magid DJ, Mant J, Margolis KL, McKinstry B, McLaughlin MA, Omboni S, Ogedegbe O, Parati G, Qamar N, Tabaei BP, Varis J, Verberk WJ, Wakefield BJ, McManus RJ. Self-monitoring of blood pressure in hypertension: a systematic review and individual patient data meta-analysis. PLoS Med. 2017 Sep 19;14(9):e1002389. doi: 10.1371/journal.pmed.1002389. eCollection 2017 Sep. PubMed
Banerjee S, Garrison LP Jr, Flum DR, Arterburn DE. Cost and health care utilization implications of bariatric surgery versus intensive lifestyle and medical intervention for type 2 diabetes. Obesity (Silver Spring). 2017 Jul 19. doi: 10.1002/oby.21927. [Epub ahead of print]. PubMed
Lehavot K, Blosnich JR, Glass JE, Williams EC. Alcohol use and receipt of alcohol screening and brief intervention in a representative sample of sexual minority and heterosexual adults receiving health care. Drug Alcohol Depend. 2017 Oct 1;179:240-246. doi: 10.1016/j.drugalcdep.2017.07.003. Epub 2017 Aug 2. 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
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A mobile application designed to engage smokers who are ambivalent about quitting shows promising results.
News
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The new comprehensive resource was written from the perspective of patients experiencing ongoing pain.
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Healthy Findings Blog
We decreased people’s daily sedentary time by an hour
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healthy findings blog
Should we consider vaping to be friend or foe?
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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
Our Seattle offices sit on the occupied land of the Duwamish and by the shared waters of the Coast Salish people, who have been here thousands of years and remain. Learn about practicing land acknowledgment.