The newsroom is your comprehensive source for what is happening at CHPR, including the latest policy and research news and stories.
A new UC Davis study published in the Journal of General Internal Medicine shows some people may be overlooked for tobacco cessation counseling, putting them at risk for lung cancer. The study attributes the finding to the way health care providers are asking some people about their current tobacco use.
The research was conducted by three population health scientists who were affiliated with CHPR. They found that if people are asked during lung cancer screenings "Do you now smoke cigarettes?" and they answer, "not at all," they might be classified as former smokers when, in actuality, they used tobacco recently.
“Unfortunately, this screening approach can lead to misclassifying 1 in 5 former smokers eligible for lung cancer screening who may be current tobacco users,” said CHPR faculty member and senior author of the study Elisa Tong. “That means nearly 1.5 million Americans may have a missed opportunity for tobacco cessation counseling during lung cancer screening.”
What prevents family medicine physicians from providing medical abortions for patients who need them?
This is a question that UC Davis and UC San Francisco researchers explored in a new study published in the Journal of the American Board of Family Medicine. The study identified multiple barriers – including lack of training and restrictions from federal and state government as well as their institutions – that family physicians must navigate to provide abortion services to their patients.
“Family physicians are the first contact for many patients within the health care system,” said CHPR faculty member Na’amah Razon, assistant professor of family and community medicine at UC Davis Health and lead author of the study. “As such, they play a critical role in promoting better access to safe abortion options.”
CHPR and the UC Davis Comprehensive Cancer Center are co-hosting a special event as part of the CHPR Seminar Series: “Unfinished Business: The Achievable Goal of Eliminating All Tobacco Product Use in the United States by 2030.” Michael Fiore, the nation’s leading expert on smoking cessation and evidence-based guidelines, is the session's featured speaker. Fiore is the director of the Center for Tobacco Research and Intervention and professor at the University of Wisconsin School of Medicine and Public Health.
A recent study found the odds of starting and continuing breastfeeding is significantly lower among individuals who used a combination of tobacco and illicit substances during pregnancy. Adverse health outcomes for pregnant individuals and their children have been associated with prenatal tobacco and substance use as well as with suboptimal breastfeeding.
The study examined Centers for Disease Control and Prevention data from 2016-2018 in eight U.S. states, finding 42% lower odds of breastfeeding initiation and 39% lower odds of breastfeeding continuation for at least six weeks among people with tobacco and illicit substance use during pregnancy compared to those without tobacco and illicit substance use.
CHPR faculty members Alicia Agnoli, assistant professor of family and community medicine, and Laura Kair, associate professor of clinical pediatrics, along with UC Davis’ Kathleen Groh and colleagues Nichole Nidey, Christine Wilder, Tanya E. Froehlich and Stephanie Weber from University of Cincinnati co-authored the study published in Breastfeeding Medicine.
CHPR advisory board member Diana Farmer, distinguished professor and chair of the UC Davis Health Department of Surgery, is one of 11 recipients of the 2022 Harrington Scholar-Innovator Awards. The awards are given by the Harrington Discovery Institute at University Hospitals (UH) of Cleveland, Ohio.
The scholar awards support a diverse set of drug discovery projects, including new treatments for pulmonary diseases, COVID-19, multiple cancers, corneal disease, hepatitis, and acquired spinal cord injuries. They include grants of at least $100,000, with the opportunity to qualify for up to $1.1 million.
CHPR faculty member Alicia Agnoli, assistant professor of family and community medicine at UC Davis Health, was honored with a 2022 Top Ten Clinical Research Achievement Award by the Clinical Research Forum.
This award is in recognition of her remarkable work, published in a paper in Jama, studying opioid dose tapering. Agnoli’s coauthors are CHPR interim director Anthony Jerant, CHPR faculty members Daniel Tancredi and Elizabeth Magnan, and CHPR statistician Guibo Xing.
“We are thrilled to receive this prestigious award for our work on understanding the risks of opioid dose tapering,” said Agnoli.
A newly launched website, Cal Long Term Care Compare (CLTCC), gives California consumers useful information to compare nursing home quality.
CLTCC centralizes publicly available information from federal and state agencies about nursing homes in California, offering metrics covering staffing, quality of facilities, fines and other quality information. The website's data and ratings will be updated on a bi-annual basis. While consumers are the target audience, CLTCC will be useful to other stakeholders including nursing home providers, hospitals referring patients, policymakers, regulators, health plans and nonprofit organizations.
Data analysis for CLTCC is led by CHPR members and staff. The project’s Co-PIs are Deb Bakerjian, clinical professor at the Betty Irene Moore School of Nursing at UC Davis Health, and Patrick Romano, professor of internal medicine and pediatrics at UC Davis Health who also serves on CHPR’s leadership team.
About 5.8 million Americans miss or delay medical care annually because of transportation barriers. This has a major impact on their ability to take care of their health. CHPR faculty member Na’amah Razon, assistant professor in the Department of Family and Community Medicine at UC Davis Health, researches how medical providers screen patients about their transportation needs and how that affects patients’ access to health care.
In this Q&A, Razon shares her findings from a recent study which analyzed transportation screening and assessment questions used in adult clinics to understand how these tools assess patients’ mobility and transportation needs.
A new study found the rates of frontline physician burnout increased through the first year of the COVID-19 pandemic, raising concerns about the well-being of physicians and impacts of physician burnout on the healthcare system. The study surveyed a national sample of five types of U.S. physicians, (emergency medicine, critical care, primary care, hospitalist and infectious disease physicians), during May–June 2020 and again during December 2020–January 2021. Emergency medicine and critical care physicians had the highest rates of burnout early in the pandemic, but hospitalist and primary care physician respondents showed the most substantial increases in burnout rates over time. CHPR faculty member Joy Melnikow, emeritus professor in UC Davis Health's Department of Family and Community Medicine, and statistician Andrew Padovani and health policy analyst Marykate Miller co-authored the study in BMC Health Services Research.
“Physicians experiencing burnout have decreased well-being from stress and exhaustion, which can have adverse effects on quality of care,” said Melnikow. “Physician burnout was an ongoing concern before COVID-19 but the pandemic appears to have further accelerated burnout rates. Healthcare organizations can attenuate the effects of burnout by investing resources and improving physician support.”
Half of all women will experience at least one false positive mammogram over a decade of annual breast cancer screening with digital breast tomosynthesis (3D mammography), according to a new UC Davis Health-led study. A false positive is when a test incorrectly produces abnormal results, even though the patient does not have breast cancer. Diana Miglioretti, CHPR faculty member and professor and division chief of biostatistics at the UC Davis Health’s Department of Public Health Sciences, was a senior author of the study published in Jama Network Open.
“Despite the important benefit of screening mammography in reducing breast cancer mortality, it can lead to extra imaging and biopsy procedures, financial and opportunity costs, and patient anxiety,” said Miglioretti. “Women shouldn’t be overly worried if recalled for additional imaging or biopsy. Most of these results are benign.”
A recent study provided confirmation that women can use abortion pills safely without first having an in-person medical appointment or getting an ultrasound scan. In Jama Internal Medicine, Jennifer Karlin, CHPR faculty member and assistant professor in UC Davis Health’s Department of Family and Community Medicine, co-authored a commentary on the study which builds on a body of research showing the safety of medication abortion and that restrictions, such as ultrasound requirements, in certain U.S. states are unnecessary.
"This makes the evidence even more robust," said Karlin in an interview with HealthDay about the study. She thinks the growing body of evidence that certain restrictions are unnecessary could change policy. "Eventually," she said, "there's so much evidence, there's a tipping point where people can't keep fighting it."
Read Karlin’s commentary: “Is It Time to Change the Standard of Medication Abortion.”
Multiple CHPR members have been involved in mentoring Sonia Singh as she completes her doctoral research. One paper from her research was recently published in Archives of Disease in Childhood. After assembling an analytic cohort of 18,471 children presenting to the Emergency Department (ED) with blunt head trauma, Singh and her team stratified them by the Pediatric Emergency Care Applied Research Network (PECARN) traumatic brain injury (TBI) risk categories. The research found that planned ED observation in selected children with minor head trauma was cost-effective for reducing CT use for the PECARN intermediate-risk and high-risk categories.
UC Davis has renewed CHPR's designation as a campus Organized Research Unit (ORU), a special entity under the UC Davis Office of Research, for another five years. ORUs are established to run collaborative and multidisciplinary research programs that complement the campus’ academic goals. This remarkable recognition is currently awarded to only seven centers at UC Davis.
“This renewal was a collective accomplishment, reflecting countless hours of hard and high-quality work contributed by so many of our faculty and staff over time. I am so grateful for their efforts and deeply proud of the Center for reaching this milestone,” said Anthony Jerant, professor and chair of family medicine and interim director of the CHPR.
CHPR faculty members and staff contribute to new federally funded programs to support future pandemic preparedness and digital health equity
A new federal spending law allocates $2.7 million for two UC Davis projects: $1 million for future pandemic preparedness and $1.7 million for digital health equity.
The UC Davis Office of Grand Challenges will launch the Future Pandemic Prevention and Rapid Response Institute, which seeks to anticipate, prevent, identify and respond to emerging diseases and pandemic threats. Foundational steps to establishing the institute include a multiday Pandemic Preparedness Workshop. CHPR staff, led by Dominique Ritley, CHPR senior health policy analyst, will support workshop sessions and a draft policy brief for local, state and national governments, illustrating the benefits of incorporating universities into disaster preparedness planning.
CHPR faculty member and medical director of Express Care at UC Davis Health, Joshua Elder, received $1.7 million in funding for UC Davis Health’s Digital Health Equity Program to help establish a regional digital public health platform in the Sacramento area and northern California region.
Nathan Kuppermann, faculty member of the UC Davis Center for Healthcare Policy and Research and chair of the Department of Emergency Medicine, was recognized as the 2022 Maureen Andrew Mentor Award recipient by the Society for Pediatric Research. Established in 2003, the annual award honors an academic pediatrician for exceptional mentorship and leadership.
“I am honored to receive this award for mentoring many physicians who have gone on to be leaders in pediatric emergency care,” said Kuppermann. “Throughout my own career, I have been incredibly fortunate to have received outstanding mentorship. I have strived to ‘pay it forward’ and encourage, teach and guide those whom I have served as mentor.”
Sergio Aguilar-Gaxiola was appointed by Gov. Gavin Newsom to join other California leaders to promote health and wellness across the state. Aguilar-Gaxiola is a faculty member of the UC Davis Center for Healthcare Policy and Research, founder and director of the UC Davis Center for Reducing Health Disparities, and professor in the Department of Internal Medicine at UC Davis Health.
The Governor’s Advisory Council on Physical Fitness and Mental Well-Being is led by First Partner Jennifer Siebel Newsom and Pro Football Hall of Fame inductee Ronnie Lott, and comprises leaders from health and wellness organizations, youth sports programs, education, the entertainment and fitness industry, and other experts on physical and mental health.
The council aims to provide guidance on the development of physical activity and wellness goals for Californians; increase awareness of the benefits of physical activity, sports, nutrition and mental wellness; encourage physical fitness activities; promote equitable access to outdoor and physical activities for underserved communities; and facilitate collaboration among public, private and nonprofit stakeholders.
For more information, read the news release from the governor’s office.
A recent study examined the effectiveness of Tobacco Tracker, a tool to crowdsource reporting of tobacco use and related litter to shape behaviors linked to smoke- and tobacco-free policies and create healthier college campuses. UC Davis Center for Healthcare Policy and Research faculty member Elisa Tong, professor in the Department of Internal Medicine at UC Davis Health, co-authored the study in the Nicotine & Tobacco Research journal published by Oxford University Press.
The study surveyed students, faculty, and staff at two California public universities with 100% smoke- and tobacco-free policies, finding that awareness and use of Tobacco Tracker could mobilize campus communities to help reduce tobacco use. “What we found is that the Tobacco Tracker is effective in helping ingrain smoke-free policies into campus life,” said Tong. “The Tobacco Tracker is an easy way for individuals to make a difference for the environment and well-being of the campus community.”
For more information, read the Tobacco-Related Disease Research Program article: “New Online Tool Helps Keep College Campuses Smoke and Tobacco Free.”
A call to redefine the boundaries of medical intervention for vulnerable persons was issued in Annals of Family Medicine by UC Davis Center for Healthcare Policy and Research faculty member Jennifer Karlin. In her essay, Karlin, assistant professor in the Department of Family and Community Medicine at UC Davis Health, shares her experiences treating hepatitis C for Sam, a former patient who also needed social support for narcotics addiction and insecure housing, and uses Sam’s story to bolster her call for medicine to include structures that support patients’ social needs.
Karlin describes how a flaw in the social safety net meant Sam was denied housing due to his treatment for addiction and contributed to his death. Medical providers are given the authority to intervene in cases of life or death by providing direct medical services, but can do little about the majority of preventable deaths attributable to social determinants of health, Karlin said. In her article, she calls on primary care doctors to redefine the medical paradigm to remedy the disjointed logics of care that result in unnecessarily high financial and human costs.
Read Karlin’s paper: "Sam’s Story: The Financial and Human Costs of Disjointed Logics of Care."
The outcomes experienced by more than 3,000 children with COVID-19 who sought care at emergency departments (EDs) across 10 different countries were documented in a study published recently in JAMA Network Open. Two faculty affiliates of the UC Davis Center for Healthcare Policy and Research are among the study’s authors: Daniel Tancredi, a professor in the Pediatrics Department at UC Davis Health, and Nathan Kuppermann, chair of the Department of Emergency Medicine at UC Davis Health. Kuppermann co-led the study.
Almost 23% of the children were hospitalized within two weeks of their visit to the ED and 3.3% suffered severe outcomes, including four who died. Seeking ED care 4-7 days after the start of symptoms (versus 0-3 days after their start), previously having had pneumonia, and having an underlying chronic condition were among the characteristics of children who experienced severe outcomes. The authors suggest that it may be useful to consider these risk factors when making clinical care decisions for children suffering with COVID-19.
Several experts at UC Davis Health recently answered pressing questions many people have about the Omicron variant of the virus that causes COVID-19, the variant currently sweeping across our region. Lorena Garcia, Ph.D., M.P.H., and a faculty affiliate of the Center for Healthcare Policy and Research, was among them.
Garcia noted that the symptoms of Omicron are similar to those associated with other variants—although some evidence suggests that fewer people experience loss of taste and smell—but are, in most cases, more severe in unvaccinated individuals than in those that have been both vaccinated and boosted.
A big difference with Omicron, however, is how very infectious it is. As Garcia pointed out, the “viral load is much higher in Omicron, which means that someone infected with the Omicron variant is more infectious than someone infected with the Delta variant. Older adults and those with compromised immune systems should take special care.”
That means that wearing masks is more critical than ever. “But remember,” Garcia reminds us, “it’s important to cover both the mouth and nose, as COVID-19 can be found in the nose, mouth and throat.”
The UC Davis Center for Healthcare Policy and Research (CHPR) is pleased to announce that 11 of its affiliated medical doctors are among our region's best in their respective medical fields, as determined through surveys of their peers. And, as she did in 2019, CHPR-affiliated faculty member Alicia Agnoli made this year's “Top Docs” list twice, once for Family Medicine and the other for Addiction Medicine.
The list was generated for Sacramento Magazine by a third-party firm, Professional Research Services, which compiled survey results from thousands of doctors associated with multiple health systems and medical groups in the area. Those doctors nominated the colleagues they consider best in their specialty.
In addition to Agnoli, the following CHPR-affiliated doctors with UC Davis Health were named 2021 Top Docs: CHPR Interim Director Anthony Jerant (Family Medicine), Calvin Hirsch (Geriatric Medicine), Craig McDonald (Physical Medicine and Rehabilitation), Lisa Brown (Surgery), and Misty Humphries (Vascular Surgery). Diana Farmer (Surgery), James Marcin (Critical Care Medicine), Nathan Kuppermann (Emergency Medicine), Erik Fernandez y Garcia (General Pediatrics) and Robert Byrd (General Pediatrics) were all named Top Docs in their pediatric specialties.
Congratulations to all our Top Docs!
The Center for Health Decisions (CHD), a program affiliated with the Center for Healthcare Policy and Research (CHPR), recently held public deliberations about police reforms with members of three California communities. A brief describing key findings from this deliberative process, authored by Patricia E. Powers, Principal Consultant with CHD, and Shani Buggs, a CHPR faculty affiliate, can be found here.
In addition to general agreement on the need for significant changes in local policing that will improve public safety and health outcomes, the diverse community members who took part in the deliberations also expressed appreciation for the opportunity to discuss the topic and learn from other community members in a respectful and open setting. Most (82%) agreed that the discussion expanded their views and 11% of participants changed their vote after hearing others’ opinions suggesting that public deliberation sessions are helpful in exploring potential benefits and drawbacks to various police reform approaches and in encouraging civic engagement around public safety issues.
Details about specific reforms discussed during deliberation sessions and conclusions community members reached about them can be found in the brief.
CHPR faculty member collaborates with UC Davis Department of Linguistics to bring knowledge in opioid-related policies
CHPR faculty member and associate professor of Internal Medicine, Stephen Henry, M.D., collaborates with doctoral candidate, Peter Torres of UC Davis Department of Linguistics to bring knowledge in opioid-related policies.
CHPR informed UC Davis Health partnership to develop a “Community for Health and Independence”
UC Davis Health announced this month that it is partnering with AKT Development Corporation (AKT) to develop a future “Community for Health and Independence” near its planned Folsom Ranch medical campus. The UC Davis Center for Healthcare Policy and Research (CHPR) informed this public-private partnership by preparing a white paper that explored how the two partners might leverage their respective experience and expertise to create a planned community focused on healthy aging in place for all its residents, including vulnerable and developmentally disabled adults.
The CHPR report includes a description of regional demographics, existing resources for older and vulnerable adults, examples of model communities, and an overview of research on use of technology, the built environment, and community-based interventions to facilitate aging in place. It also describes opportunities and challenges associated with the University maintaining a relationship with the future “Community for Health and Independence” that include conducting community-based research and education to eliminate current gaps in knowledge about the interplay between social, physical, and environmental factors that influence healthy aging.
More details about the “Community for Health and Independence” project and the partnership between UC Davis Health and AKT can be found in the UC Davis Health online Newsroom and in articles in the Sacramento Business Journal and The Sacramento Bee.
Sergio Aguilar-Gaxiola receives national awards for reducing Latino health disparities
Sergio Aguilar-Gaxiola, M.D., Ph.D., has recently been recognized by two national organizations for his work on reducing health disparities among Latino populations and Hispanics. Dr. Aguilar-Gaxiola is director of the UC Davis Center for Reducing Health Disparities, a professor of internal medicine at UC Davis Health, and a faculty member affiliate of the UC Davis Center for Healthcare Policy and Research (CHPR).
He received the 2021 National Award of Excellence in Research by a Senior Investigator from the National Hispanic Science Network for his outstanding track record of “consistent contributions to the field of drug abuse that are culturally innovative, demonstrate some of the unique aspects of drug abuse among Hispanics, and/or having impacted the larger field of drug abuse research.” And, at its annual conference, the National Latino Behavioral Health Association (NLBHA) bestowed upon Dr. Aguilar-Gaxiola its 2021 Lifetime Award for the Advancement of Latino Behavioral Health. Dr. Aguilar-Gaxiola was also a keynote speaker at this year’s virtual NLBHA conference.
Congratulations, Dr. Aguilar-Gaxiola, for these well-deserved honors!
The California Department of Public Health has awarded a 5-year $7.5 million grant to the UC Davis Center for Healthcare Policy and Research (CHPR) to provide intensive training and technical assistance on smoking cessation to some 40 community clinics serving at-risk populations. This smoking cessation program has been named the Healthy Living Clinic Initiative (HLCI).
HLCI’s leaders at CHPR include the Center’s Associate Director, Jeffrey Hoch, who is also professor and Chief of the Division of Health Policy and Management in the UC Davis Department of Public Health Sciences; Desiree Backman, Chief of the Prevention Policy and Practice Group (PPPG) at CHPR; and Neal Kohatsu, Chief Health Strategist of PPPG.
Previously conducted research indicated that, for women younger than 65 years old, the higher the density of the tissue in their breasts, the higher their risk for developing breast cancer. A new study published recently in JAMA Network now extends those findings to include women older than 65.
Diana Miglioretti, Ph.D., who co-authored the study along with colleagues in the US Breast Cancer Surveillance Consortium, noted that their results provide “evidence that breast density remains an important risk factor in older women.” As reported by UPI Miglioretti, a professor and Division Chief of Biostatistics in the UC Davis Department of Public Health Sciences and a faculty member with the UC Davis Center for Healthcare Policy and Research (CHPR), said that this new evidence could be used, in conjunction with other factors, “to help identify women who may benefit most from continued screening” into their golden years.
CHPR Interim Direct Anthony Jerant is lead author of an investigation into how taking postbaccalaureate (post-bacc) coursework, or other strategies, might affect the diversity of the students in five UC medical schools, as well as overall student performance or choice of specialty once in medical school. CHPR faculty members Tonya Fancher, M.D., M.P.H., and Peter Franks, M.D., are among the co-authors of the study, which was published in the Journal of Health Care for the Poor and Underserved.
Jeffrey Hoch, Associate Director of the UC Davis Center for Healthcare Policy and Research (CHPR) and Chief of the Division of Health Policy and Management in the Department of Public Health Sciences (PHS), is the lead author of “How Economic Decision Modeling Can Facilitate Health Equity,” published this month in the AMA Journal of Ethics.
CHPR researchers identify risks associated with tapering opioid dose for patients prescribed long-term opioids
A team of researchers affiliated with the UC Davis Center for Healthcare Policy and Research (CHPR) has completed an assessment of whether opioid dose tapering among patients prescribed stable, long-term, high-dose opioids is associated with risks of subsequent overdose or mental health crisis. The team, led by Alicia Agnoli, M.D., M.P.H., M.H.S., published their results in the August 3 issue of JAMA.
Dr. Agnoli and co-authors of the JAMA paper Elizabeth Magnan, Anthony Jerant, and Joshua Fenton are all faculty members in the UC Davis Department of Family and Community Medicine, while co-author Daniel Tancredi is a faculty member in the Department of Pediatrics. Co-author Guibo Xing, Ph.D., is a staff statistician at CHPR.
CHPR has moved!
The Center for Healthcare Policy and Research (CHPR) is pleased to announce that the Center has moved to a new location.
Our new address is 4900 Broadway, Suite 1430, Sacramento, CA 95820.
Our new home is in the Broadway Building on the Sacramento campus of UC Davis, which houses the UC Davis Health System. We thereby remain in close proximity to downtown Sacramento and look forward to continuing to serve the University and wider community through our work facilitating research, promoting education, and informing policy to improve healthcare access, delivery, costs, quality, and outcomes.
Please update your records with our new address. (All other contact information remains the same.)
- Visitor parking (1 hour) is available at the Broadway Building
- Daily parking is available in lot 25 for $6
- Printable parking map (PDF) »
The 2020 Deans’ Excellence Awards, which recognize outstanding work by faculty, staff and teams at the UC Davis School of Medicine and Betty Irene Moore School of Nursing (BIMSON), have been announced. The UC Davis Center for Healthcare Policy and Research (CHPR) is pleased to note that five of this year’s awardees are UC Davis Health faculty members affiliated with our Center.
CHPR is proud of these excellent clinicians and researchers and agrees with Allison Brashear, Dean of the UC Davis School of Medicine, who said their “work is improving health and changing lives.” Congratulations!
After serving for 12 years as the director of the UC Davis Center for Healthcare Policy and Research (CHPR), and 29 years as a faculty member in the UC Davis Department of Community and Family Medicine, Dr. Joy Melnikow has retired from the University of California. Anthony Jerant, M.D. and Professor and Chair of Community and Family Medicine, has stepped in as Interim Director of CHPR in her stead.
CHPR is grateful for Dr. Melnikow’s leadership over the last 12 years and welcomes Dr. Jerant in his new role with the Center. Congratulations to both Drs. Melnikow and Jerant!