Author Archives: RWJF Blog Team

Cutting Calories: Good for Health, Good for Business

Sep 16, 2014, 12:58 PM, Posted by RWJF Blog Team

Four years ago, 16 companies, acting together as part of the Healthy Weight Commitment Foundation (HWCF), announced an ambitious pledge—to remove 1.5 trillion calories from the U.S. marketplace by 2015. They wanted to help reduce obesity in America, especially childhood obesity. Research published today in the American Journal of Preventive Medicine confirms that the companies far exceeded their pledge, and are making a difference that’s helping families buy fewer calories.

Collectively, these companies sold 6.4 trillion fewer calories in 2012 than they did in 2007, which we announced in early 2014. What’s new in these studies tells us that, during that same pledge period, families with children bought fewer calories from packaged foods and beverages—and the biggest cuts were from major sources of excess calories in kids’ diets, such as sweets, snacks, and soft drinks.

Why is this pledge so important, and what’s the next step for industry leaders who want to help reverse the childhood obesity epidemic? RWJF senior vice president Jim Marks and lead study author Barry Popkin, PhD, of the School of Public Health at the University of North Carolina at Chapel Hill, share their views.

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Another reason to get your flu shot - It can help reduce antibiotic resistance

Aug 17, 2011, 2:33 AM, Posted by RWJF Blog Team

Pioneer grantee Ramanan Laxminarayan, director of Extending the Cure, recently shared his perspective on The Health Care Blog about a new study published in the July issue of Infection Control and Hospital Epidemology. The study shows that antibiotic prescriptions tend to spike during the flu season, even though influenza is caused by a virus and cannot be treated with antibiotics.

According to Extending the Cure, between 500,000 to one million antibiotic prescriptions are filled each year during the flu season for patients who have the flu and no bacterial illness. This overuse is one of the many causes of the recent spike in antibiotic resistant bacteria.

Laxminarayan proposes a simple solution to this problem – get your flu vaccine this year. If you do not contract the flu, then there is no possible way your care provider will needlessly prescribe you antibiotics to treat it.

 What are some other  ways to curtail the epidemic of drug-resistant bacteria, both during this year’s flu season and beyond? We’re interested in hearing your thoughts – leave a comment here or on THCB.

This commentary originally appeared on the RWJF Pioneering Ideas blog.

mHealth Evidence Workshop and Webinar, August 16

Aug 15, 2011, 5:11 AM, Posted by RWJF Blog Team

On August 16 the Pioneer Portfolio, along with the National Institutes of Health, McKesson Foundation and the National Science Foundation will present the mHealth Evidence Workshop in Bethesda, Maryland. This workshop, which will be shared via a free webinar, brings together individuals with diverse expertise in data analysis and experimental design to identify methods that can accelerate the evaluation of the efficacy and safety of mHealth technologies. We at Pioneer, along with many others, believe mHealth has the potential to simultaneously reduce the cost of health care and improve our health. The tremendous interest we’ve received in the event is also a great sign that we’ll have a productive day exploring the potential around design and infrastructure innovations, reality mining and plotting a direction to build upon current innovations.

We plan to use this to generate a research agenda to further guide development of the space. To register for the free webinar please visit Eventbrite. Also, be sure to check back here for a recap of the discussion and next steps. 

This commentary originally appeared on the RWJF Pioneering Ideas blog.

Interview with Philip Polgreen

Aug 8, 2011, 11:17 AM, Posted by RWJF Blog Team

 Philip Polgreen, M.D., an associate professor in the Department of Medicine at the University of Iowa Carver College of Medicine, and his colleagues published a study in the May 4, 2011 issue of the scientific journal PLoS ONE showing that Twitter can be used to track influenza activity. Support for the research was provided in part by the Robert Wood Johnson Foundation’s Pioneer Portfolio. Previous work by Polgreen and Forrest Nelson, Ph.D., an economics professor also at the University of Iowa, includes the development of an electronic prediction market that could help public health officials forecast the timing, severity and spread of seasonal influenza and other infectious diseases. In this post, Polgreen answers some questions about the current study’s findings and implications for the future

Q: Why did you look at Twitter and influenza activity?

A: Right now, public health officials report suspected cases of the flu to the Centers for Disease Control and Prevention (CDC), but that process can take several weeks, a lag that gives the flu an opportunity to spread. When reports of the H1N1 virus that causes swine flu started increasing, we wondered if we could tap into the Twitter stream to find evidence of an upswing in cases of the flu in real time. Twitter is a micro-blogging service that allows millions of users to send and read “tweets” on all kinds of information, including, as it turns out, useful information about people suffering from fever and other flu symptoms.

Q: Your team also found that Twitter could be used to track the rapidly evolving public sentiment with respect to H1N1. How did the team come to that conclusion?

 A: We collected and stored tweets containing key words such as “H1N1”, “influenza”, or “swine flu” that were sent at the start of the outbreak. At the start of the outbreak in April 2009, we saw a flurry of tweets, including some expressing fear about the virus. But as time went on, public health messages indicating that the H1N1 virus was not as deadly as expected kicked in and we saw a gradual decline of tweets talking about such concerns.

Q: The study also found that public interest in hand-washing seemed tied to public health messages aimed at slowing the spread of the flu. Can you explain why that finding is important?

A: If this method proves accurate, public health officials may one day use it to find out whether people understand key messages aimed at flu control and prevention. If not, they can tailor the messages to increase the knowledge of, say, the importance of hand-washing, a habit that can protect people from the flu and can contain its spread.

 Q: You also did a second analysis that used Twitter to track disease activity. Can you explain what your team found?

A: We analyzed tweets that contained the words “fever”, “flu”, “muscle aches” and other symptoms, finding that Twitter data could be used to estimate incidence of the flu in real time. In addition, we found that Tweets from people experiencing flu symptoms tracked closely with the information collected by the CDC (data that comes out two to three weeks after people report feeling sick) in both time and location. If this method of tracking disease is confirmed by additional research, public health officials could use it as an early warning of a potential uptick in flu cases in a specific geographic area.

Q: Why is early warning a critical part of protecting the public?

A: Public health officials need as much information as they can gather in order to combat the flu and other infectious diseases. With early warning that a flu strain is particularly virulent in some part of the country or is spreading rapidly in others, public health officials can ramp up production of a vaccine or push out public health messages urging people to line up for a flu shot, which can turn down the dial on the outbreak.

Q: Does this have the potential to accelerate the progress we’ve made in protecting people from the flu or other infectious diseases?

A: Yes. This is one of the first large-scale efforts to investigate if data from Twitter can be used to predict the flu or to track public interest in a disease like H1N1 influenza. Additional research will need to confirm the accuracy of this method and extend it to other infectious diseases. But if all goes well, public health officials may one day be able to tap into the Twitter stream to get real-time information that could pinpoint an outbreak’s location and show when it is starting to spread to other areas of the country. This method will not replace current disease-tracking methods but could augment existing approaches to surveillance.

This commentary originally appeared on the RWJF Pioneering Ideas blog.

Accentuating the Positives: Positive Health

Aug 2, 2011, 12:44 PM, Posted by RWJF Blog Team

What comes to mind when you think of medicine? If you’re like most people, it is preventing disease and treating them when they are sick.

But health is more than the mere absence of disease. So what if there were options for medicine beyond the prevention, diagnosis, treatment and cure of disease?

Researchers who work in the emerging field of Positive Health are exploring the possibility that people have and can develop positive health assets that keep them healthier and help them recover more quickly when they are sick. The research, supported by the Pioneer Portfolio, is taking an empirical approach to developing the field. Positive Health research explores associations between health assets -- including subjective factors like optimism, functional factors like stable marriage, and biological factors like high heart rate variability – and people’s health.

The research is starting to gain traction in health and medical literature.

  • Health Psychology published a study finding that positive psychological well-being – defined as emotional vitality and optimism – was associated with lower levels of risk for heart disease. The study re-analyzed existing data from a survey of 7,942 middle-aged men and women over five years who were measured through their responses to statements about purpose in life, mental energy and the expectation of more good things than bad to occur in the near future. Positive psychological well-being was associated with a modest, but consistent reduced risk of fatal heart disease, first heart attack or first definite angina. 
  • The European Heart Journal published a study stating that higher levels of life satisfaction were associated with lower risk of heart disease. The study re-analyzed existing data from a survey of 7,956 British civil servants who rated their satisfaction with eight domains of life: love relationships, leisure activities, standard of living, job, health, family, sex life and self. Four of these life domains—job, family life, sex life and self satisfaction—were independently associated with a 12 percent reduced risk of heart disease, as was higher overall life satisfaction.
  • The journal Stroke published a study linking higher levels of optimism to lower risk for stroke. The study assessed 6,044 American adults for optimism and tracked their incidence of stroke. Participants rated items such as “In uncertain times, I usually expect the best” on a six-point scale, resulting in an overall score between 3 and 18. Each unit increase in optimism correlated to a 9 percent decrease in stroke risk during a two-year follow-up period.

Positive Health changes the way we think about health and health care—it reframes the goal of our health care system from treating and preventing disease to building more robust health. This  innovative approach to health and well-being  promotes people’s positive health assets—their strengths that can help protect against disease and lead to a healthier, longer life. The focus is not on prevention or treatment of disease, but instead on building an individual’s “good” assets that are desirable in their own right.

With the support of the Pioneer Portfolio, Martin Seligman, Ph.D., project director and director of the Positive Psychology Center at the University of Pennsylvania, and a team of researchers are working to identify these assets. If identified and validated, the next step would be to design potent, low-cost approaches to enhance well-being and help protect against physical and mental illness.

Support for this research is provided by the Robert Wood Johnson Foundation’s Pioneer Portfolio through a grant, “Exploring Concepts of Positive Health."

Follow the growing research this team is building on Positive Health.

This commentary originally appeared on the RWJF Pioneering Ideas blog.

New Journal Represents Leap Forward for Health Video Games

Jul 28, 2011, 3:55 AM, Posted by RWJF Blog Team

Recently, we were thrilled to learn about the launch of a new peer-reviewed publication focused on health video games in the fall. Exploring how video games can be used to drive positive health outcomes for millions of people is something we’ve invested in for quite some time, through both our Health Games Research national program and the annual Games for Health Conference, which just wrapped-up its seventh conference last May.

According to Pioneer Senior Program Officer Paul Tarini, the launch of this journal represents a big step forward for the field: "There's an increasing number of people who are interested in the question of whether games work, how well they work, and what makes them work," Tarini said in a post on NewsWorks. "If we weren't beginning to see a critical mass of people who are interested in those questions, we wouldn't see somebody saying. 'I think it's time for a journal.' "

As the first-ever peer-reviewed publication that focuses on this emerging field, Games for Health: Research, Development, and Clinical Applications (G4H), published my Mary Ann Liebert, Inc,  will help build an evidence base of effective interventions,  which  developers can use to build the next generation of health video games. As stated on the blog Gamification  by Health Games Research National Program Director Debra Lieberman: “The Journal will be a starting point for anyone interested in the research and design of health games that integrate well-tested, evidence-based behavioral health strategies to help improve health behaviors and to support the delivery of care.”

Lieberman and several other Health Games Research grantees will serve on the journal’s editorial board and will help shape its direction. Their years of experience studying the impacts of video games on health and deep knowledge of the subject matter will greatly benefit this groundbreaking publication’s body of research.

How do you think video games can impact health? Are there any specific topics you would like to see the journal provide more insight into? Leave a comment and let us know your thoughts. 

This commentary originally appeared on the RWJF Pioneering Ideas blog.

Noodles of ODLs

Jun 17, 2011, 1:19 AM, Posted by RWJF Blog Team

By Steve Downs and Patricia Flatley Brennan 

On the heels of a recent meeting with our Project HealthDesign teams, we’ve been thinking a lot about how this Pioneer-funded national program has the potential to affect the way providers and patients share information that has personal and clinical relevance – and what that information may include. It’s interesting stuff.

Patients participating in Project HealthDesign studies are using technology to track personally meaningful information about their daily feelings, thoughts, moods and behaviors – or observations of daily living (ODLs) – and sharing this information with providers. Currently, nearly all of our project teams are beginning the testing phase, recruiting patients and providers to participate in the studies. Part of their task is to figure out which ODLs are relevant to share; another job is to share them in ways that are meaningful to all involved. We think the work of the teams may spark innovations in the patient-provider relationship and improve the management of chronic disease.

We’ve already learned that ODLs have the potential to provide clinicians with a richer picture of a patient’s overall health—addressing the entire continuum of care, not just acute episodes of illness.

We’ve also noted the complexities of tracking patient behavior and engaging clinicians to look at and act upon ODL data.

As we continue to track each team’s progress, we anticipate results that will help patients, technology leaders, policymakers and health care experts plan and implement new initiatives that put individuals and their needs at the center of the nation’s health information technology infrastructure.

Follow the work of our research teams as we report on their major breakthroughs and challenges, and learn more about the exciting work our Project HealthDesign teams are undertaking here

This commentary originally appeared on the RWJF Pioneering Ideas blog.

Project ECHO: A Game-Changer for Patient Care?

Jun 16, 2011, 4:32 AM, Posted by RWJF Blog Team

Note: This post originally appeared on The Health Care Blog June 14, 2011

By Brian Quinn, RWJF assistant vice president, Research and Evaluation:

I met Sanjeev Arora as part of the RWJ crowd at TEDMED last year and was pretty impressed with his approach–especially given the lack of access to care in poor and minority regions. Now there’s proof his approach works –Matthew Holt

On June 1 the New England Journal of Medicinepublished a study about how primary care providers can treat very sick patients who previously did not have access to specialty care.  The piece described Project ECHO, a disruptive model of health care delivery based on collaborative practice that has the potential to transform health care.  Supported by Robert Wood Johnson’s Pioneer Portfolio and based at the University of New Mexico Health Sciences Center (UNMHSC), Project ECHO was developed by Sanjeev Arora, M.D., a hepatologist at UNMHSC and leading social innovator.

The ECHO model organizes community-based primary care clinicians into disease-specific knowledge networks that meet through weekly videoconferencing to present patient cases.  These “virtual grand rounds” are led by specialists at academic medical centers who train providers to provide specialized care, share best practices and co-manage complex chronic illness care for patients with the local care team. Under this model, primary care providers treat patients in their own communities – burdens on academic center capacity are reduced, poor access to care is eliminated  (patients are no longer limited by geography when seeking quality care), and the health care systems’ capacity to provide high quality care to more patients, sooner, is dramatically expanded.

In the NEJM study, patients with hepatitis C treated by primary care clinicians working through Project ECHO achieved results that were identical to patients treated by UNMHSC specialists.  The evaluation also showed that the ECHO model can reduce racial and ethnic disparities in treatment outcomes.

Project ECHO offers promise as a game-changer for how patients with complex illnesses are treated.  Dr. Arora describes the power of ECHO’s knowledge networks as a “force multiplier,” which “transforms the dynamics and the capacity of health care delivery and the spread of best practices.”

In an accompanying editorial, Thomas D. Sequist, M.D., associate professor of medicine and of health care policy at Harvard Medical School and Brigham and Women’s Hospital, said Project ECHO “represents an important step forward” in addressing barriers to accessing specialty care.  He notes that the NEJM study raises several issues, including the need for  adequate health information technology to implement the ECHO model successfully, the critical role of academic medical centers in supporting the model and the potential for meeting local community health care needs by extending the model to additional chronic diseases.

Sequist makes excellent points, and Project ECHO is already addressing them head-on.

The ECHO model harnesses communications technology to form truly collaborative provider partnerships that permit care in home communities.  It connects the wealth of knowledge and expertise housed at academic medical centers and the desire of primary care providers to do more for their patients.  And although the findings from theNEJM evaluation focus on hepatitis C, the Project ECHO model has spread to include asthma, mental illness, chronic pain, diabetes and cardiovascular risk reduction, high-risk pregnancy, HIV/AIDS, pediatric obesity, rheumatology and substance abuse.

ECHO represents a fundamental rethinking of how we use our limited supply of physicians, how we engage a full care team in chronic disease management, how we teach best practices and how we provide access to quality care for all.  We know we have physician shortages, an aging population and 32 million more Americans who are going to become insured in the coming years.  Dr. Arora has developed a disruptive innovation that addresses these challenges.

Through ECHO, providers – not just doctors, but nurses, nurse practitioners, physician assistants and community health workers – are teamed to work together to the benefit of patients who receive accessible, high quality care.

Isn’t that what we all are striving to deliver?

This commentary originally appeared on the RWJF Pioneering Ideas blog.

Self-Trackers Collaborate at 2011 Quantified Self Conference 2011

Jun 10, 2011, 12:46 PM, Posted by RWJF Blog Team

In a recent blog post, we told you about a group of pioneers who are making and using tools to track quantifiable qualities about their own bodies, habits, emotions and symptoms. They use this data to better understand how their decisions impact their health and other aspects of their lives.  

We had the pleasure of spending Memorial Day weekend with just about 400 of these self-trackers at the inaugural  Quantified Self Conference 2011. We also brought along a few invited guests to help us explore, collect and share ideas with those on the cutting edge of the self-tracking movement, and to provide us with some additional perspective as we seek to understand the potential self-tracking may have to transform health and health care.

You can read more about the conference and the potential from the perspective of one of our guests, Ethan Zuckerman with the Berkman Center for Internet & Society, who blogged prolifically throughout the weekend. Also, the San Jose Mercury News penned a great overview of the event. And the conversation is still going on at #QS2011.

We'll share more about our thoughts from the conference soon, but in the meantime, check out the first product to come out of our grant to Quantified Self and the Institute for the Future: The Complete Quantified Self Guide to Self-Tracking. This online resource guide, which is still currently in beta, aggregates all available tools for self-tracking. Each tool, app, and project is tagged, rated and reviewed by users, making it easy for beginners and self-tracking experts alike to harness the power of their own personal data to improve their lives.

We invite you to try out this new resource, or just take a closer look into how the Quantified Self community is tapping into the power of data to drive positive health outcomes. Then let us know your thoughts by leaving a comment or connecting with us on Twitter (@PioneerRWJF). Happy tracking.

This commentary originally appeared on the RWJF Pioneering Ideas blog.

Project ECHO: Transforming Health Care Education and Delivery

Jun 2, 2011, 6:05 AM, Posted by RWJF Blog Team

Findings from an evaluation of Project ECHO published June 1 online by the New England Journal of Medicine demonstrate that primary care providers can be trained via videoconferencing technology to manage complex chronic conditions formerly outside their expertise – in this case, hepatitis C – thus expanding their ability to treat very sick patients.

Project ECHO (Extension for Community Healthcare Outcomes) is a disruptive model for health care training and delivery that shows how health care providers everywhere can work collaboratively to provide better care. 

In the NEJM study, primary care providers across a variety of settings in New Mexico were able to treat – and even cure – patients with hepatitis C who previously couldn’t get treatment.  In fact, cure rates for patients treated through ECHO were the same as those for patients treated at a university medical center.  Project ECHO’s videoconferencing clinics also address asthma, mental illness, chronic pain, diabetes and cardiovascular risk reduction, high-risk pregnancy, HIV/AIDS, pediatric obesity, rheumatology and substance.

Risa Lavizzo-Mourey, M.D., M.B.A., president and CEO of the Robert Wood Johnson Foundation (RWJF), calls the model “the future of health care for those who aspire to excellence.” Project ECHO, she says, “demonstrates how health care providers everywhere can—and should—work collaboratively to provide better care.”

With the support of a three-year grant from RWJF’s Pioneer Portfolio, the ECHO model is spreading across the United States.  Replications of ECHO are already underway in Washington state and Chicago, and other potential sites are actively exploring the model.  Several government agencies have expressed strong interest in ECHO, as well.

To learn more about the study and Project ECHO, we encourage you to read some  of the excellent coverage on nextgov and HealthcareITNews.

This commentary originally appeared on the RWJF Pioneering Ideas blog.