Lynn E. Kunkel
Oregon Health & Science University
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Featured researches published by Lynn E. Kunkel.
Medical Care | 2001
Todd H. Wagner; Judith H. Hibbard; Merwyn R. Greenlick; Lynn E. Kunkel
Objective.To determine whether providing health information to residents of Boise ID had an effect on their self-reported medical utilization. Research Design.The Healthwise Communities Project (HCP) evaluation followed a quasi-experimental design. Subjects.Random households in metropolitan zip codes were mailed questionnaires before and after the HCP. A total of 5,909 surveys were returned. Measures.The dependent variable was self-reported number of visits to the doctor in the past year. A difference-in-differences estimator was used to assess the intervention’s community-level effect. We also assessed the intervention’s effect on the variance of self-report utilization. Results.Boise residents had a higher adjusted odds of entering care (OR = 1.27, 95% CI 0.88, 1.85) and 0.1 more doctor visits compared with residents in the control cities; however, for both outcomes, the effects were small and not significant. Although the means changed little, the data suggest that the variance of utilization in Boise decreased. Conclusions.The HCP had a small effect on overall self-reported utilization. Although the findings were not statistically significant, a posthoc power analysis revealed that the study was underpowered to detect effects of this magnitude. It may be possible to achieve larger effects by enrolling motivated people into a clinical trial. However, these data suggest that population-based efforts to provide health information have a small effect on self-reported utilization.
Evaluation & the Health Professions | 1999
Judith H. Hibbard; Merwyn R. Greenlick; Holly Jimison; Lynn E. Kunkel; Martin Tusler
Health care reform goals are to reduce costs and increase access while maintaining quality of care. A potentially effective avenue for achieving these difficult goals is to activate the untapped potential of consumers in managing their own health care. This study focuses on three Northwest communities and examines the prevalence of the use of self-care resources and the correlates of use. A random sample of households was surveyed using a mail-out questionnaire. The findings indicated that the use of self-care resources was high in the three community populations. Consulting a self-care book was the most commonly used resource, followed by telephone advice nurses. Communities do vary in their level of self-care resource use. Understanding this variability may help communities to expand the use of such resources and lessen the demand for formal health care services. Suggestions for future studies are discussed.
Evaluation & the Health Professions | 2001
Judith H. Hibbard; Merwyn R. Greenlick; Holly Jimison; Jeffrey Capizzi; Lynn E. Kunkel
This study assesses the effects of the Healthwise Communities Project (HCP) on use of self-care resources and health care utilization. The intervention included the distribution of the Healthwise Handbook, the provision of a telephone advice line, and a Web site. All of these products use a symptom-based approach and are aimed at a general population. A quasi-experimental design was used with two comparison communities. Measurements over time assessed the effects of the HCP while controlling for secular trends. Survey and utilization data are used to assess the effect of the intervention. Findings indicate that the community intervention increased the use of self-care resources. Users believe that these products help them make better decisions regarding when to seek care and how to self-treat problems. Most believe that using the self-care resources saved them from seeking unnecessary care. The findings from the utilization data provide some evidence to support this conclusion.
Journal of Substance Abuse Treatment | 2013
Allison L. Buti; Danielle Eakins; Holly E. Fussell; Lynn E. Kunkel; Aisha Kudura; Dennis McCarty
The National Drug Abuse Treatment Clinical Trials Network (CTN) works to bridge the gap between research and practice and tested a Web-delivered psychosocial intervention (the Therapeutic Education System, TES) in 10 community treatment centers. Computer-assisted therapies, such as Web-delivered interventions, may improve the consistency and efficiency of treatment for alcohol and drug use disorders. Prior to the start of the study, we surveyed counselors (N=96) in participating treatment centers and assessed counselor attitudes, perceived social norms and intentions to use a Web-delivered intervention. Analysis of the intention to adopt a Web-delivered intervention assessed the influence of attitudes and perceived social norms. Perceived social norms were a significant contributor to clinician intention to adopt Web-based interventions while attitude was not. To promote successful implementation, it may be helpful to create social norms supportive of computer-assisted therapies.
American Journal of Drug and Alcohol Abuse | 2011
Holly E. Fussell; Lynn E. Kunkel; Dennis McCarty; Colleen S. Lewy
Background: Training research staff to implement clinical trials occurring in community-based addiction treatment programs presents unique challenges. Standardized patient walkthroughs of study procedures may enhance training and protocol implementation. Objectives: Examine and discuss cross-site and cross-study challenges of participant screening and data collection procedures identified during standardized patient walkthroughs of multi-site clinical trials. Method: Actors portrayed clients and “walked through” study procedures with protocol research staff. The study completed 57 walkthroughs during implementation of 4 clinical trials. Results: Observers and walkthrough participants identified three areas of concern (consent procedures, screening and assessment processes, and protocol implementation) and made suggestions for resolving the concerns. Conclusions and Scientific Significance: Standardized patient walkthroughs capture issues with study procedures previously unidentified with didactic training or unscripted rehearsals. Clinical trials within the National Drug Abuse Treatment Clinical Trials Network are conducted in addiction treatment centers that vary on multiple dimensions. Based on walkthrough observations, the national protocol team and local site leadership modify standardized operating procedures and resolve cross-site problems prior to recruiting study participants. The standardized patient walkthrough improves consistency across study sites and reduces potential site variation in study outcomes.
Drug and Alcohol Dependence | 2006
Kathleen M. Carroll; Samuel A. Ball; Charla Nich; Steve Martino; Tami L. Frankforter; Christiane Farentinos; Lynn E. Kunkel; Susan K. Mikulich-Gilbertson; Jon Morgenstern; Jeanne L. Obert; Doug Polcin; Ned Snead; George E. Woody
Journal of Substance Abuse Treatment | 2008
Holly E. Fussell; Lynn E. Kunkel; Colleen S. Lewy; Bentson H. McFarland; Dennis McCarty
Addiction | 2017
Philip T. Korthuis; Paula J. Lum; Pamela Vergara-Rodriguez; Keith Ahamad; Evan Wood; Lynn E. Kunkel; Neal L. Oden; Robert Lindblad; James L. Sorensen; Virgilio Arenas; Doan Ha; Raul N. Mandler; Dennis McCarty
Substance Abuse | 2015
Shannon Gwin Mitchell; Robert P. Schwartz; Anika A. H. Alvanzo; Monique S. Weisman; Tiffany Kyle; Eva Turrigiano; Martha L. Gibson; Livangelie Perez; Erin A. McClure; Sara Clingerman; Autumn Froias; Danielle R. Shandera; Robrina Walker; Dean Babcock; Genie L. Bailey; Gloria M. Miele; Lynn E. Kunkel; Michael Norton; Maxine L. Stitzer
American Journal of Preventive Medicine | 2001
Judith H. Hibbard; Merwyn R. Greenlick; Lynn E. Kunkel; Jeffrey Capizzi