Jeroan J Allison

University of Massachusetts Amherst, Amherst Center, Massachusetts, United States

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Publications (222)809.65 Total impact

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    ABSTRACT: Issues:In 2005, India launched three reformative healthcare policies and programs to improve Maternal and Child Health (MCH) and expand health coverage in rural areas. However, they lack strong support of evidence based findings and have failed to significantly reduce health disparities. Description:RAHI, led by two medical students from U.S.A., is a joint effort between a charitable Indian tertiary-care hospital and an American academic institution aiming to strengthen the public healthcare system of rural western India through community-based participatory research and advocacy. Leveraging the commitment of founding institutions through funding and in-kind support, RAHI developed an international collaborative platform for faculty and students to work together and with the community to investigate the underlying causes of health disparities and develop innovative solutions. Solutions are likely to succeed when community is engaged in the research process. RAHI’s focus is guided by findings from community health needs assessment (CHNA) through a cross-sectional survey of female community members and discussions with local health ministry and key stakeholders. RAHI’s current research identifies predictors and underlying causes of poor MCH. A community-based trauma outcomes registry and surveillance program will begin in August 2014. Other key areas as identified by CHNA include type-2-diabetes-mellitus and tobacco utilization among adolescents. Conclusion:The ongoing participation of community, students, and faculty, paired with the engagement of public officials and community stakeholders provides an innovative platform for launching evidence-based, community interventions within existing public health infrastructure. RAHI serves as a model of international and inter-institutional partnership to promote health equity in underserved populations.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: Background: Efforts by the Indian government to improve maternal and child health (MCH) outcomes have failed to have significant impact, calling for a more evidence-based approach. This study stems from an Indo-US collaboration led by two U.S. medical students designed to address critical gaps in knowledge about the underlying causes of adverse MCH outcomes. Methods: The pilot longitudinal study will enroll 150 pregnant women between the ages of 18-45 and spans from first trimester of a pregnancy to six months post-partum and includes eight visits at a tertiary healthcare center in rural Western India. Participants receive clinical evaluations, ultrasound imaging studies, and serum biomarker measurements. Trained research coordinators manage their visits and conduct standardized interview surveys in the local language. Results: Currently, 86 participants are enrolled, with enrollment projected to conclude in May 2014. To date, 53 participants reported a previous pregnancy, with only half (51.6%) resulting in a live childbirth. Of the participants, 76.7% were anemic (Hgb < 12g/dL) and 41.1% were Vitamin B12 deficient (< 120 pmol/L). Only one of the 17 participants who have completed their third trimester visit was aware of the government MCH program. Conclusions: Preliminary evidence reveals important insight into the nutritional, psychosocial, and clinical problems affecting pregnancy in rural Western India. Additionally, our findings suggest lack of patient engagement in large government-operated MCH programs. Findings from the full data set will guide future interventions to be developed by ongoing cohorts of medical students in collaboration with academic partners and the existing local public health infrastructure.
    142nd APHA Annual Meeting and Exposition 2014; 11/2014
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    ABSTRACT: The aim of this study was to evaluate screening questions for estimating nonsteroidal anti-inflammatory drug (NSAID) risk knowledge.
    Journal of Patient Safety 10/2014;
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    ABSTRACT: Despite national guidelines recommending bone mineral density screening with dual-energy x-ray absorptiometry (DXA) in women aged 65 years and older, many women do not receive initial screening.
    Medical care. 06/2014;
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    ABSTRACT: As the number of primary total knee arthroplasties (TKAs) performed in the United States increases, policymakers have questioned whether the indications and timing of TKA have evolved so that surgery is offered earlier.
    Clinical Orthopaedics and Related Research 06/2014; · 2.79 Impact Factor
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    ABSTRACT: This study evaluated a culturally relevant, social cognitive theory-based, Internet-enhanced physical activity (PA) pilot intervention developed for overweight/obese African American (AA) female college students.
    06/2014;
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    ABSTRACT: Frequent use and serious adverse effects related to non-steroidal anti-inflammatory drugs (NSAIDs) underscore the need to raise patient awareness about potential risks. Partial success of patient- or provider-based interventions has recently led to interest in combined approaches focusing on both patient and physician. This research tested a shared decision-making intervention for increasing patient-reported awareness of NSAID risk.
    Journal of Evaluation in Clinical Practice 06/2014; · 1.51 Impact Factor
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    ABSTRACT: Objective To assess the following among women hospitalized antenatally due to high-risk pregnancies: (1) rates of depression symptoms and anxiety symptoms; (2) changes in depression symptoms and anxiety symptoms; and, (3) rates of mental health treatment. Methods Sixty-two participants hospitalized for high-risk obstetrical complications completed the Edinburgh Postnatal Depression Scale (EPDS), Generalized Anxiety Disorder 7-item scale (GAD-7), and Short-Form 12 (SF-12) weekly until delivery or discharge, and once postpartum. Results Average length of total hospital stay was 8.3 ± 7.6 days for women who completed an initial admission survey (n = 62) and 16.3 ± 8.9 (n = 34), 25.4 ± 10.2 (n = 17) and 35 ± 10.9 days (n = 9) for those who completed 2, 3 and 4 surveys, respectively. EPDS was ≥ 10 in 27% (n = 17) and GAD-7 was ≥ 10 in 13% (n = 8) of participants at initial survey. Mean anxiety (4.2 ± 6.5 vs. 5.2 ± 5.1, p = 0.011) and depression (4.4 ± 5.6 vs. 6.9 ± 4.8, p = 0.011) scores were lower postpartum compared to initial survey. Past mental health diagnosis predicted depression symptoms (OR = 4.54; 95% CI 1.91-7.17) and anxiety symptoms (OR = 5.95; 95% CI 3.04-8.86) at initial survey; however, 21% (n = 10) with no diagnostic history had EPDS ≥ 10. Five percent (n = 3) received mental health treatment during pregnancy. Conclusion Hospitalized high-risk obstetrical patients may commonly experience depression symptoms and/or anxiety symptoms and not receive treatment. A history of mental health treatment or diagnosis was associated with depression symptoms or anxiety symptoms in pregnancy. Of women with an EPDS ≥ 10, > 50% did not report a past mental health diagnosis.
    General Hospital Psychiatry. 01/2014;
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    ABSTRACT: Innovative approaches are needed to promote physical activity among young adult overweight and obese African American women. We sought to describe key elements that African American women desire in a culturally relevant Internet-based tool to promote physical activity among overweight and obese young adult African American women. A mixed-method approach combining nominal group technique and traditional focus groups was used to elicit recommendations for the development of an Internet-based physical activity promotion tool. Participants, ages 19 to 30 years, were enrolled in a major university. Nominal group technique sessions were conducted to identify themes viewed as key features for inclusion in a culturally relevant Internet-based tool. Confirmatory focus groups were conducted to verify and elicit more in-depth information on the themes. Twenty-nine women participated in nominal group (n = 13) and traditional focus group sessions (n = 16). Features that emerged to be included in a culturally relevant Internet-based physical activity promotion tool were personalized website pages, diverse body images on websites and in videos, motivational stories about physical activity and women similar to themselves in size and body shape, tips on hair care maintenance during physical activity, and online social support through social media (eg, Facebook, Twitter). Incorporating existing social media tools and motivational stories from young adult African American women in Internet-based tools may increase the feasibility, acceptability, and success of Internet-based physical activity programs in this high-risk, understudied population.
    Preventing chronic disease 01/2014; 11:E09. · 1.82 Impact Factor
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    ABSTRACT: Much of the excessive morbidity and mortality from cardiovascular disease among African Americans results from low adherence to anti-hypertensive medications. Therefore, we examined the association between weight-based discrimination and medication adherence. We used cross-sectional data from low-income African Americans with hypertension. Ordinal logistic regression estimated the odds of medication non-adherence in relation to weight-based discrimination adjusted for age, sex, education, income, and weight. Of all participants (n = 780), the mean (SD) age was 53.7 (9.9) years and the mean (SD) weight was 210.1 (52.8) lbs. Reports of weight-based discrimination were frequent (28.2%). Weight-based discrimination (but not weight itself) was associated with medication non-adherence (OR: 1.94; 95% CI: 1.41-2.67). A substantial portion 38.9% (95% CI: 19.0%-79.0%) of the association between weight-based discrimination and medication non-adherence was mediated by medication self-efficacy. Self-efficacy is a potential explanatory factor for the association between reported weight-based discrimination and medication non-adherence. Future research should develop and test interventions to prevent weight-based discrimination at the societal, provider, and institutional levels.
    Ethnicity & disease 01/2014; 24(2):162-8. · 1.12 Impact Factor
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    ABSTRACT: We examined pregnant women's interest in using a website or mobile application to help them gain a healthy amount of weight during pregnancy. Pregnant women (N=64) completed a short questionnaire during routine prenatal care at hospital-based obstetric clinics in [STATE] during April-August 2012. Eighty-six percent reported interest in using a website or mobile application to help them gain a healthy amount of weight; interest ranged from 67-100% across demographics, clinical characteristics, and technology use. The Internet is a promising modality for delivering interventions to prevent excessive gestational weight gain and associated maternal and child health consequences.
    Sexual & Reproductive Healthcare. 01/2014;
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    ABSTRACT: The quality of transitional care is associated with important health outcomes such as rehospitalization and costs. The widely used Care Transitions Measure (CTM-15) was developed with a classic test theory approach; its short version (CTM-3) was included in the CAHPS Hospital Survey. We conducted a psychometric evaluation of both measures and explored whether item response theory (IRT) could produce a more precise measure.
    Journal of the American Heart Association. 01/2014; 3(3).
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    ABSTRACT: Current US colorectal cancer screening guidelines that call for shared decision making regarding the choice among several recommended screening options are difficult to implement. Multicriteria decision analysis (MCDA) is an established method well suited for supporting shared decision making. Our study goal was to determine whether a streamlined form of MCDA using rank-order-based judgments can accurately assess patients' colorectal cancer screening priorities. We converted priorities for 4 decision criteria and 3 subcriteria regarding colorectal cancer screening obtained from 484 average-risk patients using the analytic hierarchy process (AHP) in a prior study into rank-order-based priorities using rank order centroids. We compared the 2 sets of priorities using Spearman rank correlation and nonparametric Bland-Altman limits of agreement analysis. We assessed the differential impact of using the rank-order-based versus the AHP-based priorities on the results of a full MCDA comparing 3 currently recommended colorectal cancer screening strategies. Generalizability of the results was assessed using Monte Carlo simulation. Correlations between the 2 sets of priorities for the 7 criteria ranged from 0.55 to 0.92. The proportions of differences between rank-order-based and AHP-based priorities that were more than ±0.15 ranged from 1% to 16%. Differences in the full MCDA results were minimal, and the relative rankings of the 3 screening options were identical more than 88% of the time. The Monte Carlo simulation results were similar. Rank-order-based MCDA could be a simple, practical way to guide individual decisions and assess population decision priorities regarding colorectal cancer screening strategies. Additional research is warranted to further explore the use of these methods for promoting shared decision making.
    Medical Decision Making 12/2013; · 2.89 Impact Factor
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    ABSTRACT: Integrating electronic referral systems into clinical practices may increase use of web-accessible tobacco interventions. We report on our feasibility evaluation of using theory-driven implementation science techniques to translate an e-referral system (ReferASmoker.org) into the workflow of 137 community-based medical and dental practices, including system use, patient registration, implementation costs, and lessons learned. After 6 months, 2,376 smokers were e-referred (medical, 1,625; dental, 751). Eighty-six percent of the medical practices [75/87, mean referral = 18.7 (SD = 17.9), range 0-105] and dental practices [43/50, mean referral = 15.0 (SD = 10.5), range 0-38] had e-referred. Of those smokers e-referred, 25.3 registered [mean smoker registration rate-medical 4.9 (SD = 7.6, range 0-59), dental 3.6 (SD = 3.0, range 0-10)]. Estimated mean implementation costs are medical practices, US$429.00 (SD = 85.3); and dental practices, US$238.75 (SD = 13.6). High performing practices reported specific strategies to integrate ReferASmoker.org; low performers reported lack of smokers and patient disinterest in the study. Thus, a majority of practices e-referred and 25.3 % of referred smokers registered demonstrating e-referral feasibility. However, further examination of the identified implementation barriers is important as of the estimated 90,000 to 140,000 smokers seen in the 87 medical practices in 6 months, only 1,625 were e-referred.
    Translational behavioral medicine. 12/2013; 3(4):370-378.
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    ABSTRACT: Background: Increasing evidence supports web-assisted tobacco interventions, but few smokers take advantage of these tools. Objective: We evaluated an integrated clinical-public health informatics system where primary care providers e-referred patients to Decide2Quit.org, a web-assisted tobacco intervention. Methods: Practices (Internal Medicine and Family Practice) were randomized to one of two referral methods: 1) a paper brochure or 2) a point-of-care e-referral completed by entering smoker's email into the ReferASmoker.org web-based e-referral system. Smokers from e-referral practices received automated email links to Decide2Quit.org. All smokers who registered with Decide2Quit.org received access to interactive quit smoking calculators and decision tools. Using a within-practice fractional factorial design, smokers were further randomized to three conditions: (A), receiving only the calculators and tools above, or (B) A plus motivational emails tailored to their readiness to quit, or (C) B plus asynchronous communication with tobacco treatment specialist. At the practice-level, we evaluated number of referrals and subsequent smoker registrations. At the smoker-level, we compared self-reported smoking cessation at six months. Results: The 174 practices referred 4380 smokers to Decide2Quit.org, with a per-practice mean of 26.7(95% CI=21.0-32.3) among brochure practices, compared with 21.9 (range: 17.1-26.6) per e-referral practice (p = 0.3). The e-referral practices had a higher mean number of smokers registrations 6.7 (4.8-8.5) compared with 2.7 (2.0-3.4) in brochure practices, yielding a statistically significant Incident Rate Ratio (IRR) of 2.5 (95% CI 1.8-3.5). At the smoker-level, the tools only (A) condition had a self-reported cessation rate of 17%, and the (B) condition was higher at 26%, as was the (C) condition 25%. Six-month cessation in the two groups that received motivational email messages (B and C) combined was significantly higher than the tools only (A) condition (Odds Ratio 1.6 (95% CI 1.02-2.8) p = 0.38). Conclusion: Clinical practices that used e-referrals had higher rates (more than double) of smokers using Decide2Quit.org, and augmented Decide2Quit.org tools increased patient quit rates.
    141st APHA Annual Meeting and Exposition 2013; 11/2013
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    ABSTRACT: Introduction: Existing evidence indicates nontraditional factors such as spirituality may influence medication adherence. Spirituality has been linked with lower blood pressure and stress related medical symptoms. We examined factors associated with spirituality and the association between spiritual health locus of control (SLC) and medication adherence (MA) among individuals of African descent with hypertension. Methods: Baseline data were obtained from the ongoing group randomized control trial Faith-based Approaches in the Treatment of Hypertension (FAITH). MA was measured using the Morisky 8-item scale, with a lower score indicating greater adherence. SLC was measured using the Spiritual Health Locus of Control Scale; a higher SLC score indicated a more active approach to his/her healthcare (e.g. God works through doctors to heal us). Ordinal logistic regression was used for bivariate analysis and multivariate analysis which was adjusted for age, gender, employment, education, and income. Results: The study sample consisted of 249 participants with an average age of 62.5 years 12.3. The sample was 73% female with 54% reporting an income of less than $39,999, 21% reported perfect adherence to medication. Active SLC was associated with attending college (p=0.010), employment (p=0.048) and age (p=0.022). The mean SLC scores were 27.8 for high adherence 27.8 moderate and 28.6 for low adherence (p=0.532). Discussion: We did not find a statistically significant relationship between SLC and MA at baseline; however participants that were younger, employed, and more educated reported higher SLC. Future work will assess the association between spirituality and medication adherence at six months.
    141st APHA Annual Meeting and Exposition 2013; 11/2013
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    ABSTRACT: We engaged dental practices enrolled in The National Dental Practice-Based Research Network to quantify tobacco screening (ASK) and advising (ADVISE); and to identify patient and practice ­characteristics associated with tobacco control. Dental practices (N = 190) distributed patient surveys that measured ASK and ADVISE. Twenty-nine percent of patients were ASKED about tobacco use during visit, 20% were identified as tobacco users, and 41% reported being ADVISED. Accounting for clustering of patients within practices, younger age and male gender were positively associated with ASK and ADVISE. Adjusting for patient age and gender, a higher proportion of non-whites in the practice, preventive services and proportion on public assistance were positively associated with ASK. Proportion of tobacco users in the practice and offering other preventive services were more strongly associated with ASK and ADVISE than other practice characteristics. Understanding variations in performance is an important step toward designing strategies for improving tobacco control in dentistry.
    Special Care in Dentistry 11/2013; 33(6).
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    ABSTRACT: PurposeThis study examined the relationship between coping style and understanding of diabetes self-care among African American and white elders in a southern Medicare-managed care plan.Methods Participants were identified through a diabetes-related pharmacy claim or ICD-9 code and completed a computer-assisted telephone survey in 2006-2007. Understanding of diabetes self-care was assessed using the Diabetes Care Profile Understanding (DCP-U) scale. Coping styles were classified as active (talk about it/take action) or passive (keep it to yourself). Linear regression was used to estimate the associations between coping style with the DCP-U, adjusting for age, sex, education, and comorbidities. Based on the conceptual model, 4 separate categories were established for African American and white participants who displayed active and passive coping styles.ResultsOf 1420 participants, the mean age was 73 years, 46% were African American, and 63% were female. Most respondents (77%) exhibited active coping in response to unfair treatment. For African American participants in the study, active coping was associated with higher adjusted mean DCP-U scores when compared to participants with a passive coping style. No difference in DCP-U score was noted among white participants on the basis of coping style.Conclusions Active coping was more strongly associated with understanding of diabetes self-care among older African Americans than whites. Future research on coping styles may give new insights into reducing diabetes disparities among racial/ethnic minorities.
    The Diabetes Educator 10/2013; · 1.94 Impact Factor
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    ABSTRACT: Objectives. We sought to determine if reported racial discrimination was associated with medication nonadherence among African Americans with hypertension and if distrust of physicians was a contributing factor. Methods. Data were obtained from the TRUST project conducted in Birmingham, Alabama, 2006 to 2008. All participants were African Americans diagnosed with hypertension and receiving care at an inner city, safety net setting. Three categories of increasing adherence were defined based on the Morisky Medication Adherence Scale. Trust in physicians was measured with the Hall General Trust Scale, and discrimination was measured with the Experiences of Discrimination Scale. Associations were quantified by ordinal logistic regression, adjusting for gender, age, education, and income. Results. The analytic sample consisted of 227 African American men and 553 African American women, with a mean age of 53.7 ±9.9 years. Mean discrimination scores decreased monotonically across increasing category of medication adherence (4.1, 3.6, 2.9; P = .025), though the opposite was found for trust scores (36.5, 38.5, 40.8; P < .001). Trust mediated 39% (95% confidence interval = 17%, 100%) of the association between discrimination and medication adherence. Conclusions. Within our sample of inner city African Americans with hypertension, racial discrimination was associated with lower medication adherence, and this association was partially mediated by trust in physicians. Patient, physician and system approaches to increase "earned" trust may enhance existing interventions for promoting medication adherence. (Am J Public Health. Published online ahead of print September 12, 2013: e1-e8. doi:10.2105/AJPH.2013.301554).
    American Journal of Public Health 09/2013; · 3.93 Impact Factor
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    ABSTRACT: There are limited data informing the optimal treatment strategy for acute myocardial infarction in the oldest old (aged ≥85 years). The study aim was to examine whether decade-long increases in guideline-based cardiac medication use mediate declines in post-discharge mortality among oldest old patients hospitalized with acute myocardial infarction. The study sample included 1137 patients aged ≥85 years hospitalized in 6 biennial periods between 1997 and 2007 for acute myocardial infarction at all 11 greater Worcester, Massachusetts, medical centers. We examined trends in 90-day survival after hospital discharge and guideline-based medication use (aspirin, angiotensin-converting enzyme inhibitors/angiotensin receptor blockers, beta-blockers, lipid-lowering agents) for acute myocardial infarction during hospitalization and at discharge. Sequential multivariable Cox regression models examined the relationship among guideline-based medication use, study year, and 90-day post-discharge survival rates. Patients hospitalized between 2003 and 2007 experienced higher 90-day survival rates than those hospitalized between 1997 and 2001 (69.1% vs 59.8%, P < .05). Between 1997 and 2007, the average number of guideline-based medications prescribed at discharge increased significantly (1.8 to 2.9, P < .001). The unadjusted hazard ratio for 90-day post-discharge mortality in 2003-2007 compared with 1997-2001 was 0.73 (95% confidence interval, 0.60-0.89); after adjustment for patient characteristics and guideline-based cardiac medication use, this relationship was no longer significant (hazard ratio, 1.26; 95% confidence interval, 1.00-1.58). Between 1997 and 2007, 90-day survival improved among a population-based sample of patients aged ≥85 years hospitalized for acute myocardial infarction. This encouraging trend was explained by increased use of guideline-based medications.
    The American journal of medicine 07/2013; · 5.30 Impact Factor

Publication Stats

4k Citations
809.65 Total Impact Points

Institutions

  • 2011–2014
    • University of Massachusetts Amherst
      Amherst Center, Massachusetts, United States
    • Vanderbilt University
      Nashville, Michigan, United States
    • University of Michigan
      • Medical School
      Ann Arbor, MI, United States
  • 2009–2014
    • University of Massachusetts Medical School
      • • Department of Quantitative Health Sciences
      • • Department of Medicine
      Worcester, Massachusetts, United States
    • University of Alberta
      Edmonton, Alberta, Canada
    • Florida A&M University
      • Institute of Public Health
      Tallahassee, FL, United States
  • 2013
    • Massachusetts General Hospital
      Boston, Massachusetts, United States
    • University of Massachusetts Boston
      Boston, Massachusetts, United States
  • 1996–2011
    • University of Alabama at Birmingham
      • • Division of Preventive Medicine
      • • Division of Infectious Diseases
      • • Division of General Internal Medicine
      • • Department of Pediatrics
      • • Department of Medicine
      Birmingham, AL, United States
  • 2010
    • University of Oklahoma Health Sciences Center
      • College of Pharmacy
      Oklahoma City, OK, United States
    • The Ohio State University
      • Department of Internal Medicine
      Columbus, OH, United States
    • University of Oklahoma
      • College of Pharmacy
      Oklahoma City, OK, United States
  • 1997–2010
    • University of Alabama
      • Department of Internal Medicine
      Tuscaloosa, Alabama, United States
  • 2008
    • VHA National Center for Organization Development (NCOD)
      Cincinnati, Ohio, United States
    • American Society of Health-System Pharmacists
      Maryland, United States
    • University of Colorado
      Denver, Colorado, United States
  • 2007–2008
    • Duke University
      Durham, North Carolina, United States
  • 2006
    • Duke University Medical Center
      • Division of General Internal Medicine
      Durham, NC, United States
  • 2004–2006
    • University of Nebraska Medical Center
      Omaha, Nebraska, United States