Andrea J Cook

Andrea J Cook
Kaiser Permanente Washington Health Research Institute · Biostatistics Unit

PhD

About

129
Publications
12,690
Reads
How we measure 'reads'
A 'read' is counted each time someone views a publication summary (such as the title, abstract, and list of authors), clicks on a figure, or views or downloads the full-text. Learn more
4,951
Citations
Citations since 2016
56 Research Items
3366 Citations
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
20162017201820192020202120220100200300400500600
Additional affiliations
July 2013 - present
University of Washington Seattle
Position
  • Affiliate Associate Professor
May 2012 - present
Kaiser Permanente Washington Health Research Institute
Position
  • Associate Investigator
January 2007 - June 2013
University of Washington Seattle
Position
  • Research Assistant
Education
September 2001 - June 2005
Harvard University
Field of study
  • Biostatistics
September 2001 - June 2003
Harvard School of Public Health, USA, Boston
Field of study
  • Biostatistics
September 1998 - June 2001
University of Washington Seattle
Field of study
  • Applied Computational Mathematical Sciences

Publications

Publications (129)
Article
Full-text available
Recombinant zoster vaccine (RZV) (Shingrix; GlaxoSmithKline, Brentford, United Kingdom) is an adjuvanted glycoprotein vaccine that was licensed in 2017 to prevent herpes zoster and its complications in older adults. In this prospective, post-licensure Vaccine Safety Datalink (VSD) study using electronic health records, we sequentially monitored a r...
Article
Both mindfulness-based stress reduction (MBSR) and cognitive-behavioral therapy (CBT) are effective for chronic low back pain (CLBP), but little is known regarding who might benefit more from one than the other. Using data from a randomized trial comparing MBSR, CBT, and usual care (UC) for adults aged 20-70 years with CLBP (N = 297), we examined b...
Preprint
Generalized linear mixed models (GLMM) are a popular tool to analyze clustered data, but when the number of clusters is small to moderate, standard statistical tests may produce elevated type I error rates. Small-sample corrections have been proposed to address this issue for continuous or binary outcomes without covariate adjustment. However, appr...
Article
Importance: Bariatric surgery is the most effective treatment for severe obesity; yet it is unclear whether the long-term safety and comparative effectiveness of these operations differ across racial and ethnic groups. Objective: To compare outcomes of Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) across racial and ethnic groups in...
Article
Full-text available
Objective To examine associations between neighborhood built environment (BE) variables, residential property values, and longitudinal 1- and 2-year changes in body mass index (BMI). Methods The Seattle Obesity Study III was a prospective cohort study of adults with geocoded residential addresses, conducted in King, Pierce, and Yakima Counties in...
Article
Background: Neighborhoods may play an important role in shaping long-term weight trajectory and obesity risk. Studying the impact of moving to another neighborhood may be the most efficient way to determine the impact of the built environment on health. We explored whether residential moves were associated with changes in body weight. Methods: K...
Article
Full-text available
Older adults have higher sedentary behavior (SB), lower physical activity, and are particularly susceptible to negative impacts from the COVID-19 pandemic and associated public health restrictions. Pandemic impacts to SB and health, particularly via objective assessment, are not well documented in the literature. Here we described differences in SB...
Article
In the presence of unmeasured spatial confounding, spatial models may actually increase (rather than decrease) bias, leading to uncertainty as to how they should be applied in practice. We evaluated spatial modelling approaches through simulation and application to a big data electronic health record study. Whereas the risk of bias was high for pur...
Article
Background: Automated office blood pressure (AOBP) using three to five measurements taken with an oscillometric device with or without an attendant in the room may decrease "white coat" effect. We evaluated the impact of the presence or absence of the attendant and rest on BP and diagnosis of hypertension. Methods: We randomly assigned 133 adult...
Article
In cluster randomized trials (CRTs), the hierarchical nesting of participants (level 1) within clusters (level 2) leads to two conceptual populations: clusters and participants. When cluster sizes vary and the goal is to generalize to a hypothetical population of clusters, the unit average treatment effect (UATE), which averages equally at the clus...
Article
Full-text available
Little is known about objective levels of sitting time (ST), patterns of ST, and physical activity (PA) among older adults before compared to during the COVID -19 pandemic. We used data from the Healthy Aging Resources to Thrive Trial to examine differences in activPAL-assessed ST, standing time, breaks from sitting, and steps in study enrollees pr...
Article
Full-text available
To explore the built environment (BE) and weight change relationship by age, sex, and racial/ethnic subgroups in adults. Weight trajectories were estimated using electronic health records for 115,260 insured Kaiser Permanente Washington members age 18–64 years. Member home addresses were geocoded using ArcGIS. Population, residential, and road inte...
Article
Older adults with obesity spend the majority of their waking hours sedentary. Given substantial barriers to regular physical activity in this population, approaches to reduce sedentary time could be an effective health promotion strategy. We present the protocol of a randomized controlled trial to reduce sitting time in older adults with a body mas...
Article
Full-text available
To determine whether selected features of the built environment can predict weight gain in a large longitudinal cohort of adults. Weight trajectories over a 5-year period were obtained from electronic health records for 115,260 insured patients aged 18–64 years in the Kaiser Permanente Washington health care system. Home addresses were geocoded usi...
Preprint
In the presence of unmeasured spatial confounding, spatial models may actually increase (rather than decrease) bias, leading to uncertainty as to how they should be applied in practice. We evaluated spatial modeling approaches through simulation and application to a big data electronic health record study. Whereas the risk of bias was high for pure...
Article
High-dose, long-term opioid therapy (LtOT) is associated with risk for serious harms. Rapid opioid discontinuation may lead to increased pain, psychological distress, and illicit opioid use, but gradual, supported opioid taper may reduce these risks. We previously demonstrated that an opioid taper support and pain coping skills training interventio...
Article
Background Screening over many years is required to optimize colorectal cancer (CRC) outcomes.Objective To evaluate the effect of a CRC screening intervention on adherence to CRC screening over 9 years.DesignRandomized trial.SettingIntegrated health care system in Washington state.ParticipantsBetween August 2008 and November 2009, 4653 adults in a...
Article
Full-text available
Higher consumption of “ultra-processed”(UP) foods has been linked to adverse health outcomes. The present paper aims to characterize percent energy from UP foods by participant socio-economic status (SES), diet quality measures, self-reported food expenditure, and energy-adjusted diet cost. Participants in the population-based Seattle Obesity Study...
Article
Adherence to the Dietary Guidelines for Americans (DGA) may involve higher diet costs. This study assessed the relation between two measures of food spending and diet quality among adult participants (N = 768) in the Seattle Obesity Study (SOS III). All participants completed socio-demographic and food expenditure surveys and the Fred Hutch food fr...
Article
Context: Automated office blood pressure (AOBP) where three to five blood pressures (BP) are taken using an oscillometric device without an attendant in the room may decrease white coat effect. Objective: We evaluated the presence/absence of the attendant and varying amounts of rest time on BP; and the diagnostic performance of AOBP in making a new...
Article
Context: The US Preventive Services Task Force recommends out-of-office blood pressure (BP) measurement before making a new diagnosis of hypertension, using 24-hour ambulatory (ABPM) or home BP monitoring. However, this approach is not common in routine practice. Objective: To evaluate provider knowledge, beliefs, and practices about BP diagnostic...
Article
Full-text available
Background In‐person assessments of physical activity (PA) and body weight can be burdensome for participants and cost prohibitive for researchers. This study examined self‐reported PA and weight accuracy and identified patterns of misreporting in a diverse sample. Methods King, Pierce, and Yakima county residents, aged 21‐59 years,,(n = 728) self...
Article
Background: Proportion of time covered (PTC, or "covered time") is a longitudinal measure of adherence to preventive health services, the use of which has increased in recent years. This measure is helpful for evaluating the success of delivering screening interventions over time. However, there are challenges and nuances in computing and interpre...
Article
Importance Bariatric surgery can lead to substantial improvements in type 2 diabetes (T2DM), but outcomes vary across procedures and populations. It is unclear which bariatric procedure has the most benefits for patients with T2DM. Objective To evaluate associations of bariatric surgery with T2DM outcomes. Design, Setting, and Participants This c...
Article
Importance Additional data comparing longer-term problems associated with various bariatric surgical procedures are needed for shared decision-making. Objective To compare the risks of intervention, operation, endoscopy, hospitalization, and mortality up to 5 years after 2 bariatric surgical procedures. Design, Setting, and Participants Adults wh...
Article
We consider the critical problem of pharmacosurveillance for adverse events once a drug or medical product is incorporated into routine clinical care. When making inference on comparative safety using large‐scale electronic health records, we often encounter an extremely rare binary adverse outcome with a large number of potential confounders. In t...
Preprint
BACKGROUND Studies assessing the impact of built environments on body weight are often hobbled by limited power to detect residential effects that are modest for individuals but may nonetheless comprise large attributable risks. OBJECTIVE We used data extracted from electronic health records to construct a large retrospective cohort of patients wh...
Article
Full-text available
Background Studies assessing the impact of built environments on body weight are often limited by modest power to detect residential effects that are small for individuals but may nonetheless comprise large attributable risks. Objective We used data extracted from electronic health records to construct a large retrospective cohort of patients. Thi...
Article
Purpose: We conducted a randomized controlled trial to compare the effectiveness of adding various forms of enhanced external support to practice facilitation on primary care practices' clinical quality measure (CQM) performance. Methods: Primary care practices across Washington, Oregon, and Idaho were eligible if they had fewer than 10 full-tim...
Article
Full-text available
Importance Colorectal cancer screening rates are suboptimal, particularly among sociodemographically disadvantaged groups. Objective To examine whether guaranteed money or probabilistic lottery financial incentives conditional on completion of colorectal cancer screening increase screening uptake, particularly among groups with lower screening rat...
Article
Objective In-depth example of two new group sequential methods for postmarket safety monitoring of new medical products. Study Design and Setting Existing trial-based group sequential approaches have been extended to adjust for confounders, accommodate rare events, and address privacy-related constraints on data sharing. Most adaptations have invo...
Article
Background: The US Preventive Services Task Force recommends out-of-office blood pressure (BPs) before making a new diagnosis of hypertension, using 24-h ambulatory (ABPM) or home BP monitoring (HBPM), however this is not common in routine clinical practice. Blood Pressure Checks and Diagnosing Hypertension (BP-CHECK) is a randomized controlled di...
Article
Full-text available
Improving the built environment (BE) is viewed as one strategy to improve community diets and health. The present goal is to review the literature on the effects of BE on health, highlight its limitations, and explore the growing use of natural experiments in BE research, such as the advent of new supermarkets, revitalized parks, or new transportat...
Article
Full-text available
Purpose Sharing of detailed individual-level data continues to pose challenges in multi-center studies. This issue can be addressed in part by using analytic methods that require only summary-level information to perform the desired multivariable-adjusted analysis. We examined the feasibility and empirical validity of 1) conducting multivariable-ad...
Article
Full-text available
Background: There has been a dramatic shift in use of bariatric procedures, but little is known about their long-term comparative effectiveness. Objective: To compare weight loss and safety among bariatric procedures. Design: Retrospective observational cohort study, January 2005 to September 2015. (ClinicalTrials.gov: NCT02741674). Setting:...
Article
Background: The STarT Back strategy for categorizing and treating patients with low back pain (LBP) improved patients' function while reducing costs in England. Objective: This trial evaluated the effect of implementing an adaptation of this approach in a US setting. Design: The Matching Appropriate Treatments to Consumer Healthcare needs (MAT...
Article
Full-text available
Background Bariatric surgery has been used for treatment of severe obesity in adolescents but most studies have been small and limited in follow up. Objectives We hypothesized that electronic health record data could be used to compare effectiveness of bariatric procedures in adolescents. Setting Data were obtained from clinical research networks...
Article
Full-text available
Objective The aim of this study is to map obesity prevalence in Seattle King County at the census block level. Methods Data for 1,632 adult men and women came from the Seattle Obesity Study I. Demographic, socioeconomic and anthropometric data were collected via telephone survey. Home addresses were geocoded, and tax parcel residential property va...
Article
Full-text available
Background: Although bariatric procedures are commonly performed in clinical practice, long-term data on the comparative effectiveness and safety of different procedures on sustained weight loss, comorbidities, and adverse effects are limited, especially in important patient subgroups (eg, individuals with diabetes, older patients, adolescents, an...
Article
Importance: The US Preventive Services Task Force recommends screening adults for high blood pressure (BP). If BP is high, out-of-office BPs are recommended before making a new diagnosis of hypertension, preferably using 24 hour ambulatory BP monitoring (ABPM), because over 30% have normal BPs outside of clinic or “White coat” hypertension with ris...
Article
Background: Screening over many years is required to optimize reductions in colorectal cancer (CRC) mortality. However, no prior trials have compared strategies for obtaining long-term adherence. Methods: Systems of Support to Increase Colorectal Cancer Screening and Follow-Up was implemented in an integrated health care organization in Washingt...
Article
Full-text available
Smokers are at high risk for oral disease. As a result, they represent an important target group for population-level, public oral health promotion efforts. While dental health professionals often address smoking with their patients, no systematic efforts have been made to offer smokers an intervention to improve their use of oral health care. This...
Article
The need for effective treatment options for chronic low back pain has spurred interest in “mind-body” approaches including cognitive behavioral therapy (CBT) and mindfulness-based stress reduction (MBSR). We previously reported that, compared with usual care, MBSR and CBT reduced functional limitations and pain bothersomeness for up to 1 year amon...
Article
Full-text available
Background Little attention has been paid to quality improvement (QI) capacity within smaller primary care practices which comprise nearly half of all primary care settings. Strategies for external support to build such capacity include practice facilitation (PF), shared learning opportunities, and educational outreach. Although PF has proven effec...
Article
Full-text available
Introduction: The large-scale assembly of electronic health care data combined with the use of sequential monitoring has made proactive postmarket drug- and vaccine-safety surveillance possible. Although sequential designs have been used extensively in randomized trials, less attention has been given to methods for applying them in observational el...
Article
Full-text available
Background Despite numerous options for treating back pain and the increasing healthcare resources devoted to this problem, the prevalence and impact of back pain-related disability has not improved. It is now recognized that psychosocial factors, as well as physical factors, are important predictors of poor outcomes for back pain. A promising new...
Article
Purpose: This study aims to determine whether radiologists who perform well in screening also perform well in interpreting diagnostic mammography. Materials and methods: We evaluated the accuracy of 468 radiologists interpreting 2,234,947 screening and 196,164 diagnostic mammograms. Adjusting for site, radiologist, and patient characteristics, w...
Article
Background/aims: Pragmatic clinical trials embedded within health care systems provide an important opportunity to evaluate new interventions and treatments. Networks have recently been developed to support practical and efficient studies. Pragmatic trials will lead to improvements in how we deliver health care and promise to more rapidly translat...
Article
Cognitive-behavioral therapy (CBT) is believed to improve chronic pain problems by decreasing patient catastrophizing and increasing patient self-efficacy for managing pain. Mindfulness-based stress reduction (MBSR) is believed to benefit chronic pain patients by increasing mindfulness and pain acceptance. However, little is known about how these t...
Article
Importance: Mindfulness-based stress reduction (MBSR) has not been rigorously evaluated for young and middle-aged adults with chronic low back pain. Objective: To evaluate the effectiveness for chronic low back pain of MBSR vs cognitive behavioral therapy (CBT) or usual care. Design, setting, and participants: Randomized, interviewer-blind, cl...
Article
Purpose: The objective of this study was to evaluate regression, matching, and stratification on propensity score (PS) or disease risk score (DRS) in a setting of sequential analyses where statistical hypotheses are tested multiple times. Methods: In a setting of sequential analyses, we simulated incident users and binary outcomes with different...
Article
Full-text available
Objective: To examine whether self-reported sitting time is related to various health indicators, health costs, and utilization in adults over age 65. Methods: A retrospective cross-sectional cohort study was conducted using the electronic health record (EHR) from an integrated health system in Washington State. Members who completed an online h...
Article
Background: Higher socioeconomic status (SES) has been linked with higher-quality diets. New GIS methods allow for geographic mapping of diet quality at a very granular level. Objective: To examine the geographic distribution of two measures of diet quality: Healthy Eating Index (HEI 2005 and HEI 2010) in relation to residential property values...
Article
This is the first study to systematically evaluate the value of a longer treatment period for massage. We provide a framework of how to conceptualize an optimal dose in this challenging setting of non-pharmacological treatments. To determine the optimal dose of massage for neck pain. Two-phase randomized trial for persons with chronic non-specific...
Article
Sequential methods are well established for randomized clinical trials (RCTs), and their use in observational settings has increased with the development of national vaccine and drug safety surveillance systems that monitor large healthcare databases. Observational safety monitoring requires that sequential testing methods be better equipped to inc...
Article
Full-text available
Background Obesity rates in the USA show distinct geographical patterns. The present study used spatial cluster detection methods and individual-level data to locate obesity clusters and to analyse them in relation to the neighbourhood built environment.Methods The 2008–2009 Seattle Obesity Study provided data on the self-reported height, weight, a...
Article
Post-market medical product surveillance is important for detecting rare adverse events that are not identified during preapproval. The goal of surveillance is to assess over time for elevated rates of adverse events for new medical products. These studies utilize administrative databases from multiple large health plans. We propose a group sequent...
Article
Full-text available
Background The self-reported health and functional status of persons with back pain in the United States have declined in recent years, despite greatly increased medical expenditures due to this problem. Although patient psychosocial factors such as pain-related beliefs, thoughts and coping behaviors have been demonstrated to affect how well patien...
Article
We evaluated the role of home monitoring, communication with pharmacists, medication intensification, medication adherence and lifestyle factors in contributing to the effectiveness of an intervention to improve blood pressure control in patients with uncontrolled essential hypertension. We performed a mediation analysis of a published randomized t...
Article
Pharmacist- or nurse-led team care decreases patient blood pressure (BP) and cardiovascular disease (CVD) risk. To evaluate whether a Web-based dietitian-led (WD) team care intervention was feasible and resulted in decreased BP, CVD risk, and weight compared to usual care (UC). Electronic health record (EHR) data identified patients aged 30-69 year...
Article
Full-text available
Objectives: We examined whether supermarket choice, conceptualized as a proxy for underlying personal factors, would better predict access to supermarkets and fruit and vegetable consumption than mere physical proximity. Methods: The Seattle Obesity Study geocoded respondents' home addresses and locations of their primary supermarkets. Primary s...
Article
Full-text available
Purpose: This trial was designed to evaluate the optimal dose of massage for individuals with chronic neck pain. Methods: We recruited 228 individuals with chronic nonspecific neck pain from an integrated health care system and the general population, and randomized them to 5 groups receiving various doses of massage (a 4-week course consisting...
Article
Background/Aims In September 2012, NIH funded the Health Care Systems (HCS) Research Collaboratory to engage health care systems as research partners in conducting large-scale pragmatic clinical studies. The goals of the HSC Collaboratory are to provide leadership and technical expertise to support innovative pragmatic clinical trials leveraging he...
Article
Background: Web-based collaborative approaches to managing chronic illness show promise for both improving health outcomes and increasing the efficiency of the healthcare system. Objective: Analyze the cost-effectiveness of the Electronic Communications and Home Blood Pressure Monitoring to Improve Blood Pressure Control (e-BP) study, a randomiz...