June 16, 2017: Arthur Stone delivers keynote at the Fifth Biennial Meeting of the Society for Ambulatory Assessment in Luxembourg.
Title: Challenges remaining for the field of real-time, self-reported data
Over the last 40 years, there has been a pronounced shift in techniques for measuring self-reports. It is now relatively common for ambulatory methods to query participants in real time about their thoughts, feelings, social and physical environments, and symptoms. There nevertheless remain several issues that diminish the impact and application of real-time self-reports, some of which have been mentioned in prior reviews. Among the issues to be discussed are: the low participation rate of people in such studies and the potential for many missing momentary reports, both of which are influenced by high burden associated with these studies; the inadequacy of our psychometric understanding of momentary reports and the lack of application of “modern” psychometric techniques; that we do not have a thorough understanding of the meaning of questions asked in the moment; the nagging issue of reactivity of monitoring; and, the difference between truly momentary reports v
June 15, 2017: Joan Broderick receives new funding to support dissemination of Pain Coping Skills Training, an evidence-based intervention for patients with chronic pain.
The California Health Care Foundation awarded a grant to Dr. Joan Broderick to train Los Angeles County health care providers in non-pharmaceutical approaches to the management of chronic pain. This work is being supported as part of a state-wide initiative to reduce prescriptions for opioid medications. Dr. Mindy Aisen, Co-Chair of the LAC Department of Health Services SPC Chronic Non-Cancer Pain Work Group and Chief of Innovation & Research at Rancho Los Amigos National Rehabilitation Center, and Dr. Patricia Bruckenthal, Associate Dean for Nursing Research and Innovation at Stony Brook University School of Nursing, are collaborators. This grant also provides support for development of a Train-the-Trainer workshop to encourage further dissemination of PCST within California healthcare systems. Systematic evaluation of the utility and rates of PCST implementation will be conducted following the workshops with an emphasis on patients currently prescribed opioid medications. One of the unique features of this training is a focus on strategies for implementation within multidisciplinary teams versus “momentary” assessments that cover a longer time period. I argue that these issues call out for timely study and suggest several paths for doing so.
December 16, 2016: Marcella May and Joan Broderick
"Can Real-Time Technologies Improve Cancer Patient Care?”
The advent of low-cost, real-time monitoring technologies is allowing researchers to collect more data than ever before. A USC trial investigates whether this data can be used to improve cancer patient care by bridging the information gap between doctor’s office visits.
October 17, 2016: Arthur Stone awarded John Ware and Alvin Tarlov Career Achievement Prize
Professor Arthur Stone, Director of the USC Dornsife Center for Self-Report Science (CSS) and Professor of Psychology, will receive the annual John Ware and Alvin Tarlov Career Achievement Prize for Patient Reported Outcomes Measures. The prize will be awarded at a ceremony during the annual meeting of the International Society for Quality Assurance in Health Care held in Tokyo, Japan, October 2016.
Patient Reported Outcomes (PROs) refer to patients’ self-reports about their health and well-being. PRO assessments are used by healthcare professionals in the care of patients and by behavioral and medical researchers to monitor health and to evaluate interventions to remedy diseases. The prize acknowledges Prof. Stone’s contributions to this field, including the development of real-time techniques for capturing patient experiences (Ecological Momentary Assessment and the Day Reconstruction Method) and, as a team effort, the Patient Reporting Outcome Monitoring and Information System (PROMIS). Over his career, he has also contributed to the fields of behavioral medicine and subjective well-being.
October 12, 2016: Op-ed in U.S. News & World Report, “Move beyond drugs to manage pain”
Dr. Joan Broderick of CSS and Dr. Jason Doctor, Associate Professor in the School of Pharmacy and the Director of Health Informatics at the Leonard D. Schaeffer Center for Health Policy and Economics at USC, have published an op-ed urging health policy changes to support access to non-opioid treatment for chronic pain. It was published today in U.S. News & World Report.
October 4, 2016: Opioid crisis policy paper published
Dr. Joan Broderick of CSS and Dr. Jason Doctor, Associate Professor in the School of Pharmacy and the Director of Health Informatics at the Leonard D. Schaeffer Center for Health Policy and Economics at USC, led a group of chronic pain experts in writing a policy paper on the opioid crisis. It was published today in Health Affairs Blog. The paper describes the treatment paradigms of the last several decades that inadvertently led to the opioid epidemic and policy initiatives that could effectively reshape treatment of chronic pain going forward.
October 3, 2016: Patient reported outcomes in cancer featured at White House event
CSS’s Dr. Joan Broderick and research assistant Marcella May have been collaborating with a multidisciplinary team at USC to improve patient care and clinical decision-making in the field of oncology. The ATOM-HP project, lead by USC Drs. Peter Kuhn and Jorge Nieva, is investigating the utility of intense, in vivo assessments of patient symptoms and health status in cancer patients undergoing chemotherapy. The CSS team leads the daily assessment of the patient-reported outcomes component. The ATOM-HP project has been recognized by Vice-President Joseph Biden’s Cancer Moonshot initiative and was invited to “South by South Lawn: A White House Festival of Ideas, Art and Action” (SXSL) to showcase this innovative work.
October 1, 2016: New study being launched to track physician work activities
Dr. Joan Broderick and Dr. Larry Casalino (Weill Cornell Medicine, Cornell University) have been awarded a 1-year grant from the Physicians Foundation to study physician work behavior. Rates of burnout among physicians are increasing, and with the increased use of EHRs and complexity of documentation, a systematic study of physician time spent in different work tasks will provide systematic data to frame the conversation.
Precise measurement of time usage is challenging, especially in busy medical settings. Obtaining data that are not subject to recall bias is important. One option is coding of direct observation by a researcher in the physican’s office; however, this is difficult to do in large, geographically diverse samples. To meet this challenge, we designed a pilot study using Ecological Momentary Assessment (EMA), an assessment procedure developed by Arthur Stone, director of CSS, with others. We will be tracking physicians (N=90) across three specialties on a typical workday in the office. Physicians will be “beeped” every 45 – 60 minutes and will indicate the activity that they were engaged in at the moment of the beep, thus avoiding recall. Work activities completed before and after office hours also will be captured. Depending upon the density of time sampling, the data generated for individual physicians are likely to be quite variable; however, across a large sample of physicians with reasonable compliance, the method does yield unbiases estimates of time-in-task. The goal of the project is to demonstrate feasibility of the approach to provide the basis for a study with a much larger sample.
SEPTEMBER 8, 2016: New research: Understanding HIV risk environment for Youth in Supportive Housing
Drs. Ania Filus and Stefan Schneider together with Dr. Benjamin Henwood (Principal Investigator) of the USC School of Social Work have received new NIH funding. They will investigate how Supportive Housing offered to homeless transition-age youth (TAY) in Los Angeles affects their HIV-risk behaviors. TAY are young people between the ages of 16 and 24 who are in transition from state custody or foster care, and are therefore aging out of the system. TAY experiencing homelessness are at highest risk for sexually transmitted diseases, including HIV, based on their patterns of substance use and sexual behaviors. Supportive Housing is a structural intervention that is being increasingly used with homeless TAY. Despite data indicating the positive effects of Supportive Housing on housing stability, there are elements of Supportive Housing that may instead promote HIV-risk behaviors. While Supportive Housing may create a safe space that exposes youth to more positive social influences as compared to being homeless, it may also be a space where an increase in substance use and abuse, selling of drugs engaging in unprotected sex, and therefore increased risk of HIV may occur.
This study will use qualitative methods and Ecological Momentary Assessment to investigate the mechanisms that can explain the association between Supportive Housing and HIV-risk behaviors among homeless TAY (unprotected sex and drug abuse). It is expected that the effects of Supportive Housing on homeless TAY’s risk behaviors can be explained by contextual factors such as where and with whom one spends their time and intra-individual factors such as mood and mental health. Since research has not yet addressed whether Supportive Housing yields the same outcomes for all youth, this study also investigates how individual factors such as age, gender, and sexual orientation may moderate the effects of Supportive Housing on TAY’s HIV-risk behaviors.
The results will provide the basis to guide future development of Supportive Housing for homeless TAY, and homeless populations in general. In addition, the findings from this study can capitalize on homeless TAY’s widespread use of mobile phone technology and be used to design Ecological Momentary Interventions for homeless populations.
: CSS researcher collaborates on pill-free protocol for treating chronic pain:
APRIL 18, 2016: What does it mean to have “frequent” health symptoms? It depends on whom you ask.
Social scientists commonly use labeled rating scales to assess health problems. For example, a question may ask “Do you have trouble sleeping: ‘never’, ‘rarely’, ‘sometimes’, or ‘often’”? Responses to these types of questions are used to compare health problems across groups and to make policy decisions. However, these comparisons assume that labels such as ‘rarely’ or ‘often’ have the same meaning to different people. A recent article by Drs. Schneider and Stone questions the validity of this assumption. In the study, people rated their health symptoms using the traditional labeled scales, and – to clarify the meaning of the ratings – they were asked to count how many times the symptoms occurred. The results indicate that having health symptoms ‘often’ denotes a higher frequency for respondents with a medical history than for those without. Younger and older respondents also differ in how they interpret the response labels. The study suggests that the “measuring sticks” that people apply when they rate their health problems are not always comparable. Read the full article: http://link.springer.com/article/10.1007/s11136-016-1293-7
NOVEMBER 17, 2015: Understanding Social Security Administration nomenclature: Implications for retirement decisions
Drs. Filus and Stone with Lila Rabinovich of the USC Center for Social and Economic Research are conducting a qualitative study to examine people’s understanding of the language used by the Social Security Administration (SSA) around retirement benefits and claiming decisions. The SSA informs the American public about social security programs and benefits in many different ways. For the SSA to be effective it must understand what its target audience knows about social security and whether the nomenclature used to explain retirement benefits is understandable. A recent study by Suzanne Shu (School of Management, UCLA, 2015) indicates that SSA nomenclature itself may be confusing to beneficiaries, potentially affecting their retirement decisions and claims behavior. Furthermore, the study indicated that age and gender of respondents may be related to understanding of social security benefits.
This study will build on Shu’s findings and will further explore why people are confused about SSA nomenclature and their social security retirement benefits. Using qualitative interviews, we want to learn how people interpret specific SSA nomenclature as well as whether beneficiaries’ demographic characteristics can be associated with how they understand their retirement benefits. For example it is important to know whether there are substantial differences in knowledge and understanding of social security retirement between younger and older beneficiaries, men and women or people of different socio-economic status. Finally, we will investigate whether new, easier to understand terms could be generated that could replace standard terms used by SSA. We anticipate that the outcomes of this study may form the basis for improving future communication strategies used by the Social Security Administration.
NOVEMBER 2, 2015: Broderick joins USC Human Optimization Project
Drs. Broderick has joined the USC Kuhn Lab, Department of Biological Sciences, in a one-year pilot project. This program is a joint effort of the National Cancer Institute’s Center for Strategic Initiatives and the Department of Defense’s Rapid Response Technology Office. It is aimed at improving the lives of cancer patients undergoing treatment and the successful mission completion/survival of warfighters. Both the patient and the warfighter suffer from treatment/duty-induced fatigue that impairs their ability to survive/perform. While the sources of the fatigue might be different, the measurement approaches might be similar. This project brings together intellectual competencies from around USC and other collaborating institutions to frame the problem and look at paths for solutions that can affect outcomes for patients undergoing treatment and warfighter readiness. The CSS team will be contributing expertise in the measurement of self-reported fatigue.
JANUARY 15, 2015: Moment of Truth
Creators of the Day Reconstruction Method, an assessment tool that evaluates people’s experiences and well-being moment-to-moment, recently convened at USC on the 10th anniversary of its inception. Read the full article: https://dornsife.usc.edu/news/stories/1953/moment-of-truth/
NOVEMBER 20, 2014: As Young as You Feel
How you feel as you age may depend on where you live, says a new study by psychology’s Arthur Stone who examined self-reports from around the world. Read the full article: http://dornsife.usc.edu/news/stories/1911/as-young-as-you-feel/">http://dornsife.usc.edu/news/stories/1911/as-young-as-you-feel/
NOVEMBER 12, 2014: Pfizer awards Broderick $350,000 grant for training nurse practitioners in pain management
Millions of Americans suffer with chronic pain despite receiving medical care. Pain Coping Skills Training (PCST), a cognitive-behavioral treatment for chronic pain, has been developed and shown to be effective by clinical health psychologists over the last two decades. However, few psychologists are trained in this treatment and they are not widely available in community medical clinics. Thus, patients have not had access to this treatment. PCST guides patients in the acquisition of a set of self-management skills that help to reduce pain, regulate activity to reduce pain flares, and re-engage in life roles and interests to improve wellbeing.
Dr. Joan Broderick of USC’s Dornsife Center for Self-Report Science and colleagues recently completed a multi-site clinical trial1 to test the effectiveness of nurse practitioners (NPs) delivering PCST to patients with chronic osteoarthritis pain in community settings. Results confirmed that NPs could achieve patient improvements equivalent to those reported in the original clinical trials.
Based on the success of the nurse practitioner trial, Pfizer awarded Dr. Broderick and her colleague, Dr. Bruckenthal at the School of Nursing, Stony Brook University, a grant to test a national training program in PCST for nurse practitioners. This project will first train NPs in PCST and then will evaluate the utility of this training for improving pain and quality of life outcomes among a sample of patients of the trained nurses. If effective, it will demonstrate a new way of disseminating PCST treatment via NPs, and in the end will make this treatment available to many more chronic pain patients.
MARCH 10, 2014: New USC center seeks accuracy in health self-reports
Center for Self-Report Science focuses on facts. Read the full article: https://news.usc.edu/59901/new-usc-center-seeks-accuracy-in-health-self-...