Category Archives: Behavior change

Jul 11 2014

How Stress Makes Us Sick

Keely Muscatell, PhD, is a social neuroscientist and psychoneuroimmunologist. She is a post-doctoral scholar in the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program at the University of California (UC), San Francisco and UC, Berkeley.

Results from the recent NPR/RWJF/Harvard School of Public Health poll suggesting that Americans are living under high levels of stress probably don’t surprise anyone. In a way, I’ve been taking an informal version of this poll for the last six years, since when I tell people I meet on airplanes or at local bars that I study stress and health, I am unfailingly met with knowing glances and stories about stressors people are facing in their lives. Given that stress is pervasive (and problematic) in modern life, lots of current research in psychology and neuroscience is focused on understanding exactly how stress can get “into our brains” and “under our skin” to make us sick.

When we think of illness, one of the first things that comes to mind is the immune system, with its lymph nodes, white blood cells, and antibodies hanging around to help us fight off infections and heal our injuries. An especially important component of the immune system involves inflammation. If you’ve ever gotten a paper cut, you’ve probably noticed that the area of skin around the cut tends to turn red and warm up shortly after the injury. This happens because proteins called “pro-inflammatory cytokines” swim through your blood stream to the site of the wound, where they call out to other immune cells to come to the area and help heal the cut. In the short term, this is a good thing; those little cytokines are a key part of healing. But if inflammation becomes widespread throughout the body, cytokines can lead to depression and even physical diseases, like arthritis and heart disease.

Read more

Apr 8 2014

Preventing Youth Violence May Cost Less Than You Think…

Adam L. Sharp, MD, MS is an emergency physician and recent University of Michigan Robert Wood Johnson Foundation Clinical Scholar (2011-2013). He works for Kaiser Permanente Southern California in the Research and Evaluation Department performing acute care health services and implementation research.

Violence is a leading cause of death and injury in adolescents. Recent studies show effective interventions can prevent violent behavior in youth seen in the Emergency Department (ED). Adoption of this type of preventive care has not been broadly implemented in EDs, however, and cost concerns frequently create barriers to utilization of these types of best practices. Understanding the costs associated with preventive services will allow for wise stewardship over limited health care resources. In a recent publication in Pediatrics, "Cost Analysis of Youth Violence Prevention," colleagues and I predict that it costs just $17.06 to prevent an incident of youth violence.

The violence prevention intervention is a computer-assisted program using motivational interviewing techniques delivered by a trained social worker. The intervention takes about 30 minutes to perform and was evaluated within an urban ED for youth who screened positive for past year violence and alcohol abuse. The outcomes assessed were violence consequences (i.e., trouble at school because of fighting, family/friends suggested you stop fighting, arguments with family/friends because of fighting, felt cannot control fighting, trouble getting along with family/friends because of your fighting), peer victimization (i.e., hit or punched by someone, had a knife/gun used against them), and severe peer aggression (i.e., hit or punched someone, used a knife/gun against someone).

Read more

Feb 13 2014

Human Capital News Roundup: Obesity, suicide prevention, syphilis, co-sleeping with infants, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

The deluge of articles, research, and books on obesity and diabetes are “the noise generated by a dysfunctional research establishment” and are not solving either epidemic, Gary Taubes, MSE, MS, writes in an opinion piece for the New York Times. “Making meaningful inroads ... requires that we know how to treat and prevent it on an individual level. We’re going to have to stop believing we know the answer, and challenge ourselves to come up with trials that do a better job of testing our beliefs.” Taubes received an RWJF Investigator Award in Health Policy Research. Read an interview with him about obesity and diabetes on the RWJF Human Capital Blog.

Finding healthy food, including fresh fruits and vegetables, lean meats, and low-fat dairy products, is more challenging for minorities living in urban areas than for others, according to research by RWJF Health & Society Scholars alumna Carolyn Cannuscio, ScD, ScM. Huffington Post’s Latino Voices features her study, which finds that most residents in urban settings have to bypass nearby corner stores offering little healthy food to find better options elsewhere.

In an opinion piece for the Seattle Times, RWJF Health & Society Scholars alumna Jennifer Stuber, PhD, writes that many health care professionals in the state do not feel prepared to handle suicide prevention and say training should be a requirement for licensure. Her piece was reprinted in Medical Xpress. Stuber’s work also was covered recently by Medical Daily and the New Republic. Read her RWJF Human Capital blog post on the subject.

In the Scientist, RWJF Health & Society Scholars alumna Kristin Harper, PhD, MPH, and colleagues analyze the origins of syphilis and discuss how understanding the history of the disease could help in developing a modern-day strategy to slow its spread.

Read more

Jan 30 2014

Human Capital News Roundup: HIV treatment for ex-offenders, ‘healthy’ fast food myths, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

Making new medical device technology quickly available is important, but research suggests there is a risk associated with swift Food and Drug Administration approval of implantable heart devices. Aaron Kesselheim, MD, JD, MPH, recipient of an RWJF Investigator Award in Health Policy Research, told USA Today that the medical community should be wary of the expedited review process because it can compromise product safety and effectiveness. The Boston Globe also covered Kesselheim’s research.

Health Canal featured a study co-authored by RWJF Health & Society Scholars alumna Chyvette Williams, PhD, MPH, that examines gender differences in HIV treatment outcomes among recently released prisoners. Williams and colleagues found that women were considerably less likely than men to attain any of the three optimal HIV treatment outcomes six months after release from jail, and thus had significantly more negative health outcomes.

Despite media campaigns promoting healthy eating, customers at fast food restaurants such as Subway do not necessarily make better food choices, according to a Medical Daily article. Citing research from Lenard Lesser, MD, MSHS, an RWJF Clinical Scholar alumnus, the article states that people consume nearly as many calories, and as much sugar, carbohydrates, and sodium from Subway as they would at another fast food restaurant. Lesser’s research was also covered by WNCN. Read more about Lesser’s research.

Read more

Jan 29 2014

Serious Illnesses Changed Our Perspectives for 2014 and Beyond

Taura Barr, PhD, RN, is an assistant professor at the West Virginia University School of Nursing. Timothy Landers, PhD, RN, CNP, is an assistant professor at The Ohio State University College of Nursing. Both are Robert Wood Johnson Foundation Nurse Faculty Scholars. This post is part of the “Health Care in 2014” series.

Taura Barr and her family.
Timothy Landers and his family.

This is the time of year when people consider how they are doing with their new year’s resolutions. The three most common resolutions are lose weight, improve finances, and exercise more. Two out of three of those resolutions involve health.

Sadly, most of these resolutions will fail.

While we rate our physical, emotional, and spiritual health as a top priority, in practice we often fall short. This seems to be especially true for us as health care providers and our health care system.

Read more

Jan 14 2014

Healthy Caregivers Are Important to Your Health Care

Karen A. Daley, PhD, RN, FAAN, is president of the American Nurses Association. This post kicks off the “Health Care in 2014” series, in which health leaders, as well as Robert Wood Johnson Foundation scholars, grantees, and alumni share their New Year’s resolutions for our health care system and their priorities for action this year.

Karen Daley

With so much attention focused these days on our health care system, it may not have occurred to you that the health of your own caregivers could also help determine the quality and safety of the care you receive.

Paying attention to things like getting enough rest, managing fatigue and work/life stress, living tobacco-free, taking advantage of preventive immunizations and exams, eating nutritionally and maintaining an active lifestyle and healthy weight are important for everyone. Unfortunately, nurses are often so busy caring for others that they fail to care for themselves. It is for this reason the American Nurses Association, which represents the interests of the nation's 3.1 million registered nurses (RNs), recently launched a Healthy Nurse™ program to promote healthier lifestyles and behaviors among nurses.

Read more

Dec 16 2013

Explaining the Link between Income, Race, and Susceptibility to Kidney Disease

Deidra Crews, MD, ScM, an alumna of the Harold Amos Medical Faculty Development Program (2009-2013), was named the 2013-2015 Gilbert S. Omenn Anniversary Fellow at the prestigious Institute of Medicine. Among her current research is a study examining the association between unhealthy diet and kidney disease among low-income individuals.

Human Capital Blog: Congratulations on your fellowship! What are your priorities for the coming year?

Deidra Crews: Over the next two years, I'll be participating in different activities of the Institute of Medicine (IOM). I'll be working with IOM committees and participating in roundtables and workshops. That's the main function of the fellowship. The great thing about it is I'll get to experience firsthand the activities of IOM and hopefully contribute to one or more of the reports that will come out of the IOM over the next couple of years. Because of my interest in disparities in chronic kidney disease, I will be working with the committee on social and behavioral domains for electronic health records, which falls under the IOM board of population health and public health practice. We will be making recommendations on which social and behavioral factors should be tracked in patients' electronic health records.

Read more

Dec 12 2013

Human Capital News Roundup: TV coverage of terrorism, alcohol laws, electronic health records, and more.

Around the country, print, broadcast, and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows, alumni, and grantees. Some recent examples:

MedPage Today reports that Medicare could save up to $560 million per year if the program reimbursed ambulances for transporting patients to places other than hospital emergency departments. Roughly 35 percent of Medicare patients taken to a hospital could be treated at other places, according to an analysis by Gregg Margolis, PhD, director of health care systems and health policy at the U.S. Department of Health and Human Services. Margolis is an alumnus of the RWJF Health Policy Fellows program.

Six or more daily hours of exposure to media coverage of the Boston Marathon bombings in the week following the tragedy was linked to more acute stress than having been at, or near, the marathon, reports KMBZ, an ABC affiliate in Boston. “We were very surprised at the degree to which repeated media exposure was so strongly associated with acute stress symptoms,” said E. Alison Holman, PhD, FNP, the study’s lead author and an RWJF Nurse Faculty Scholar. The study was also covered in Medical Xpress.

The herpes virus that produces cold sores has been linked to cognitive impairment throughout life, BioScience Tech reports. A study led by RWJF Health & Society Scholars alumna Allison Aiello, PhD, MS, documents that the virus’ effects on children ages 12 to 16 include lower reading and spatial reasoning test scores. The study is also covered in Medical Xpress.

Read more

Dec 6 2013

RWJF Scholar Explores Weight Disparities in Teenage Girls

Janet Tomiyama, PhD, an alumna of the Robert Wood Johnson Foundation (RWJF) Health & Society Scholars program (2009-2011), is director of the Dieting, Stress, and Health (DiSH) Lab at the University of California-Los Angeles. She was recently named the 2013 recipient of the Early Career Investigator Award from the Society of Behavioral Medicine.

Human Capital Blog: First, congratulations on receiving the Society of Behavioral Medicine’s 2013 Early Career Investigator Award! What does this award mean for your current research and for your career?

Janet Tomiyama: Thank you! Of course, as I’m fighting my way toward tenure, this kind of recognition is really key to my career. I am trained as a social psychologist, but this award was from the field of behavioral medicine. It shows that my work has interdisciplinary appeal, that people in the medical field find it important. It shows me that I was on the right path in trying to broaden my training through the RWJF Health and Society Scholars program and trying to incorporate aspects of medicine and population health. Getting recognition from a field that’s not my own means a lot to me.

HCB: What specific work did the award recognize?

Tomiyama: I was recognized for a paper about racial disparities in chronic psychological stress and body mass index (BMI) among girls between the ages of 10 and 19. Of all the many, many health disparities out there, the disparity in obesity between Black and White girls in adolescence is one of the biggest. I wanted to tackle a big disparity, and I thought stress had something to do with it. I completed the research during my time as an RWJF Health & Society Scholars fellow.

Read more

Mar 14 2013

Human Capital News Roundup: Television ads for statins, advanced nursing education, treatment for gunshot wounds, and more.

Around the country, print, broadcast and online media outlets are covering the groundbreaking work of Robert Wood Johnson Foundation (RWJF) leaders, scholars, fellows and grantees. Some recent examples:

In a piece about the growing need for advanced nursing education, interviewed a group of nurse leaders working to fulfill a recommendation from the Institute of Medicine report, The Future of Nursing: Leading Change, Advancing Health, which calls for doubling the number of doctorate-level nurses by 2020. Among those quoted: Christine Kovner, RN, PhD, FAAN, co-principal of RWJF’s RN Work Project; RWJF Executive Nurse Fellows alumna Jane Kirschling, RN, DNS, FAAN; and Susan Bakewell-Sachs, RN, PhD, PNP-BC, program director for the New Jersey Nursing Initiative, a program of RWJF and the New Jersey Chamber of Commerce Foundation. and Infection Control Today report on an RWJF-supported study that finds hospitals that have higher percentages of nurses with baccalaureate degrees have lower rates of postsurgical mortality. The study, published in the March issue of Health Affairs, stems from the Future of Nursing: Campaign for ActionRead more about the study.

“I recently traveled to Singapore, where I met with other doctors and told about being the emergency department (ED) doctor at the University of Colorado Hospital the morning of the Aurora theater shootings on July 20, 2012,” RWJF Clinical Scholars alumna Comilla Sasson, MD, MS, FACEP, writes in an op-ed for the Denver Post. “One thing dawned on me as I spoke: I had seen more gunshot wound victims in that one night than these doctors will see in their entire careers.” Read a post Sasson wrote for the RWJF Human Capital Blog about the Aurora theater shootings, and learn more about her experience talking to the national news media afterward.

Read more