The research mission of the Division of Primary Care and Population Health is to develop innovative research that increases the quality and equity of primary care to improve health for all. We strive to learn how to best deliver care and optimize the health of the populations we serve.
Learn more about our research faculty:
Safe Reduction of Opioid and Benzodiazepine Co-Perscibing in the Primary Care Setting: More
Despite the slight decline in non-medical use of prescription opioids from 2003-2013, opioid-related adverse health consequences, including dependence and mortality, continue at disturbingly high rates. This study aims to assess primary care physician prescribing behaviors.
Integrating Predictive Informatics to Improve Palliative Care Access: More
The specific aims of Dr. Stephanie Harman's proposal include to:
1. Collaborate with Clinical Informatics (Stanford Hospital) and Bioinformatics (School of Medicine) to refine a new morality predictor model to identify patients with appropriate palliative care needs.
2. Incorporate the predictive model info into informatics tools to facilitate the integration of primary palliative care interventions into the electronic health record and frontline clinical practice at Stanford.
3. Evaluate patient and family centered perspectives on implementation of the model and priorities for outcomes (e.g. healthcare free days).
4. Pilot and implement routine access to palliative care on a Stanford medicine ward including implementation of the predictive model, primary palliative care for ward clinicians, and appropriate use of specialty palliative consultation.
Dr. Karl Lorenz's research encompasses implementing and interpreting routine pain and symptoms measures in general practice and specialty settings; literature synthesis and the development standards, More including guidelines and process quality indicators for symptom management and information and care planning; and methods for the development, implementation, and use of clinical informatics tools to improve the quality of palliative care practice.
Dr. Periyakoil is a mixed-methods researcher. Her work is focused on the study of biological, psychosocial and cultural aspects of care of persons with chronic and serious illnesses by conducting mixed-methods observational studies and randomized clinical trials. More She is an expert on e-learning and in using multi-media and Web 2.0 techniques, the science of Social Media (blogs, micro-blogs, Apps etc) and videos to foster learning behaviors and change to improve care of patients from diverse backgrounds. She founded and directs the Stanford Letter Project which has earned international acclaim.
Her current clinical trials include
· Stanford Letter or Traditional Advance Directive in Advance Care Planning in Patients Undergoing Bone Marrow Transplant (RCT funded through the PCRC from NINR/NIH)
· Comparing the Stanford Letter Project Form to Traditional Advance Directives (RCT)
· Trial of Strategies to Communicate Genetic Information to Different Ethnic Subpopulations (Observational study funded by NIMHD/NIH)
· Inreach for Successful Aging for Multi-cultural Populations (Observational study funded by NIMHD/NIH)
Dr. Shaw's work and evaluation efforts during fellowship included homeless veterans outreach, and leading an interdisciplinary team (ImPACt) working to improve care coordination for the VA Palo Alto's most medically complex veterans. More His research interests include psycho-social determinants of health, women's health, the impact of health policies on vulnerable and underserved populations, and research to improve primary care delivery to these groups. Dr. Shaw has contributed to partnered research and implementation science, both at the VA Palo Alto (as clinical lead and coinvestigator of an intensive outpatient care program targeting 'super-users' of VA care) and at Stanford within the Evaluation Sciences Unit - where he leads ongoing evaluation of primary care design, Stanford's University Health Alliance, and as contributor to the evaluation of Stanford's new model of primary care, PC 2.0.
My research encompasses a collaborative, transdisciplinary initiative to translate molecular insights to genomically-tailored and patient-centered precision medicine. Investigations are focused on the integration of three translational streams of investigation. The first stream triangulates genome-wide association studies with preclinical research using functional neuroimaging and other modalities aimed at elucidating biobehavioural mechanisms nicotine dependence and smoking cessation. More The second stream investigates moderating effects of genotype on health-related behavior and drug response (particularly in smoking cessation treatment) in multiple ancestral populations. The third stream investigates the efficacy of genomically-tailored drug and behavioural therapies in prospective first-in-human clinical trials and evidenced-based medicine and policy research (e.g., systematic review/meta-analyses, cost-effectiveness analyses, healthcare delivery systems & educating the primary care workforce). I am presently a co-investigator in the NIH-funded Stanford Precision Health for Ethnic and Racial Equity (SPHERE) study and am an affiliated faculty member with the Meta-Research Innovation Center at Stanford (METRICS), Stanford Neurochoice, co-Chair of the Society for Research on Nicotine and Tobacco Genetics Network, and member of the National Comprehensive Cancer Network (NCCN) Smoking Cessation Guideline Panel.
Dr. Lianne Kurina's research program is focused on the physical and mental health of active-duty U.S. Army soldiers. More She has developed the Stanford Military Data Repository (SMDR) in collaboration with colleagues at the Army's Office of the Surgeon General to enable large-scale cohort studies addressing disability, heat injury, musculoskeletal injuries, pregnancy outcomes, and behavioral health outcomes among soldiers.
Stanford Family Medicine Adolescent Transition Program:
Family medicine practices offer solutions to many of the gaps in care identified for successful transition from a pediatric to an adult facility for young adult patients with chronic health care needs. More These include family-and patient-centered care, the use of the Wagner Chronic Care model, and a multidisciplinary care team. However, few family medicine transition programs exist nationally. We aim to evaluate the feasibility and acceptability of Stanford Family Medicine Adolescent Transition Program. In this program, we will recruit young adults with chronic health care needs to transition primary care to Stanford Family Medicine within our community, facilitate bridge visits with their former pediatrician, coordinate transition of specialty care, and establish a virtual patient advisory board and online discussion board to enhance self-efficacy with the use of agenda setting instruments.
Dr. Kavitha Ramachandran's research focuses on the innovative models of care delivery to understand how to integrate primary and specialist palliative care. More We also do work in palliative care education and how to scale our education to be impactful and sustainable. We are evaluation online models. In cancer care, she does research on novel therapeutics in thoracic malignancies including immunotherapy, new targeted agents, and new sequencing of approved drugs.
Dr. Kavitha Ramachandran's research focuses on the innovative models of care delivery to understand how to integrate primary and specialist palliative care. We also do work in palliative care education and how to scale our education to be impactful and sustainable. We are evaluation online models. In cancer care, she does research on novel therapeutics in thoracic malignancies including immunotherapy, new targeted agents, and new sequencing of approved drugs.
Stanford study finds that most American seniors would be interested in takins a test that would inform them if they were at risk for Alzheimer's disease. More Lead author Meera Sheffrin, MD, MAS, Clinical Assistant Professor of Medicine, is quoted in a HealthDay News article that appears on USNews.com.
Diet and Physical Activity Intervention Pilot Study in Philippines More
The overarching goals of this pilot study are to:
1. Identify and describe the study communities with populations at risk for hypertension using the WHO STEPS questionnaire.
2. Determine the effectiveness of lifestyle modification like nutritional changes and activity enhancement programs to decrease blood pressure in subjects with pre hypertension and Stage 1 hypertension (HTN).
Fesibility of Offering an Option for Patients to select Physical Therapy via Telemedicine versus at in-person clinics: More
The primary goal of this project is to assess the feasibility of a quality improvement initiative in improving access and adherence to physical therapy in order to improve patient outcomes. We hope to understand if offering this option will help patients to better access and adhere to the standard of care to help them recover faster. We will look at the number of patients who select to use telemedicine versus go to an inpatient clinic. We will also look at the number of physical therapy sessions that patients attend versus the number that the physical therapist prescribes.
Minimizing Stress, Maximizing Success of Physicians' Use of Health Information and Communication Technologies (HICT): More
The goal of this study is to understand and promote the stress management strategies and design features of Health Information and Communication Technologies (HICT) that best promote the highest quality health care, at the lowest possible cost, all while assuring the general wellness of its users. Our first step toward our long term goal is to learn more about the stresses brought on by the use of advancing HCIT in the practice of modern medicine. We will also identify individual clinician strategies for successfully coping with the stresses of using HCIT. For the benefits of the long term and widespread adoption of HCIT to be ultimately realized, managing user stress and burn-out are going to be essential as HCIT becomes more and more ubiquitous in the practice of medicine.
Socioeconomic Gradients in Cancer: More
Disparities in cancer incidence by race/ethnicity and socioeconomic position exist, but it is unclear whether socioeconomic incidence disparities exist in a graded manner across socioeconomic categories and whether such gradients are primarily due to differences in screening practices and tobacco or other factors. Our study will answer these questions by analyzing a database of cancer cases in California from 1999-2011 will include approximately 1,911,438 cases.
Dr. Zulman's research focuses on improving health care delivery for patients with multiple chronic conditions and complex medical and social needs, and optimizing health-related technology to personalize care and improve outcomes for high-risk patients.