Daniel Montano

Daniel Montano
University of Washington Seattle | UW · Department of Family and Child Nursing

34.7
 · 
PhD

About

87
Publications
132,316
Reads
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4,844
Citations
Research Experience
May 2016 - present
University of Washington Seattle
Position
  • Adjunct Research Professor
July 2015 - present
University of Washington Seattle
Position
  • Research Professor
December 2014 - June 2015
University of Washington Seattle
Position
  • Clinical Associate Professor
Education
September 1979 - June 1983
University of Washington Seattle
Field of study
  • Ph.D., Social Psychology
September 1978 - May 1979
University of Illinois, Urbana-Champaign
Field of study
  • M.A., Psychology
September 1972 - June 1976
University of Washington Seattle
Field of study
  • B.S., Psychology

Publications

Publications (87)
Article
National-level evaluations may fail to identify capacity improvements for detecting and responding to outbreaks which begin and are first detected at the local level. In response to this issue, we conducted a field-based assessment of the malaria outbreak surveillance system in Mashonaland East, Zimbabwe. We visited eleven clinics in Mudzi and Goro...
Article
Full-text available
Objective To conduct a field-based assessment of the malaria outbreak surveillance system in Mashonaland East, Zimbabwe.IntroductionInfectious disease outbreaks, such as the Ebola outbreak in West Africa, highlight the need for surveillance systems to quickly detect outbreaks and provide data to prevent future pandemics.1–3 The World Health Organiz...
Article
Slow adult male circumcision uptake is one factor leading some to recommend increased priority for infant male circumcision (IMC) in sub-Saharan African countries. This research, guided by the integrated behavioral model (IBM), was carried out to identify key beliefs that best explain Zimbabwean parents' motivation to have their infant sons circumc...
Article
Male circumcision (MC) significantly reduces HIV acquisition among men, leading WHO/UNAIDS to recommend high HIV and low MC prevalence countries circumcise 80% of adolescents and men age 15-49. Despite significant investment to increase MC capacity only 27% of the goal has been achieved in Zimbabwe. To increase adoption, research to create evidence...
Article
Full-text available
Background The World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS promote MC (male circumcision) as a key HIV prevention strategy where HIV prevalence and incidence are high and MC prevalence is low. In Zimbabwe, to achieve the 1.26 million circumcisions needed to be performed by 2015 to achieve optimal MC coverage, a...
Data
CONSORT checklist for the trial with match of questions to manuscript sections. (DOC)
Article
Latino immigrant men who have sex with men (MSM) are at risk for HIV and delayed diagnosis in the United States. This paper describes the evaluation of a pilot of the Tu Amigo Pepe, a multimedia HIV testing campaign aimed at Latino MSM in Seattle, WA particularly targeting immigrants who may not identify as gay, ages 18-30 years old. The 16-week ca...
Article
Male circumcision (MC), an effective HIV prevention tool, has been added to Zimbabwe's Ministry of Health and Child Care HIV/AIDS Prevention Program. A Phase I safety trial of a nonsurgical male circumcision device was conducted and extensive psychosocial variables were assessed. Fifty-three men (18 and older) were recruited for the device procedur...
Article
Full-text available
Male circumcision (MC) reduces HIV acquisition among men, leading WHO/UNAIDS to recommend a goal to circumcise 80 % of men in high HIV prevalence countries. Significant investment to increase MC capacity in priority countries was made, yet only 5 % of the goal has been achieved in Zimbabwe. The integrated behavioral model (IBM) was used as a framew...
Article
Understanding what factors contribute to alcohol abuse in resource-poor countries is important given its adverse health consequences. Past research shows that social peers influence substance abuse, suggesting that the social environment may be an effective target for reducing alcohol abuse across a population. This study investigates the determina...
Article
Full-text available
To compare colorectal cancer (CRC) screening use, including changes over time and demographic characteristics associated with screening receipt, between 2 insured primary care populations. Clinical and administrative records from 2 large health systems, one in New Mexico and the other in Michigan, were used to determine use of CRC screening tests b...
Article
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This paper explores the roles of acute infection and concurrent partnerships in HIV transmission dynamics among young adults in Zimbabwe using realistic representations of the partnership network and all published estimates of stage-specific infectivity. We use dynamic exponential random graph models to estimate partnership network parameters from...
Article
Objective: To determine whether community populations in community popular opinion leader intervention venues showed greater reductions in sexual risk practices and lower HIV/sexually transmitted disease (STD) incidence than those in comparison venues. Methods: A 5-country group-randomized trial, conducted from 2002 to 2007, enrolled cohorts fro...
Article
Because high-risk HPV is highly prevalent in the general population, usually transient, and rarely causes clinical symptoms, and because diagnostic and treatment options for HPV in men are lacking, partner notification is not useful for preventing transmission or protecting the health of male partners. We conducted a nationally representative surve...
Article
To determine whether patient race, ethnicity, or insurance status was associated with access to cervical cancer screening with liquid-based cytology (LBC) and with human papillomavirus (HPV) DNA testing and with access to on-site colposcopy at the provider's principal practice site. We conducted a nationally representative survey of clinicians in s...
Article
To describe current practices of primary care (PC) clinicians for STD/HIV control services: risk assessment, prevention counseling, and offering tests. We identified clinical strategies through qualitative interviews. We then surveyed by mail a random sample of Washington State family physicians, general internists, obstetrician-gynecologists, nurs...
Article
This study was conducted to describe clinicians serving women in the National Breast and Cervical Cancer Early Detection Program (NBCCEDP) with regard to demographic and practice characteristics and their usual practices in cervical cancer screening and abnormal cytology management, as well as human papillomavirus (HPV) test use. The authors analyz...
Article
To examine messages US clinicians use when counseling patients diagnosed with anogenital warts. In mid-2004, we conducted a confidential mail survey of nationally representative samples of physicians practicing internal and adolescent medicine, family/general practice, obstetrics/gynecology, urology, or dermatology; nurse midwives; physician assist...
Article
Full-text available
Since 1999, human papillomavirus (HPV) DNA tests have been approved only for abnormal cervical cytology management and as an adjunct to cervical cytology screening. To assess HPV DNA testing practices, we mailed surveys to 6906 randomly selected clinicians in mid-2004. Awareness (87%) and ever use (67%) of HPV DNA tests was high. Test users were mo...
Article
We assessed clinician knowledge and practices since the marketing of tests for sexually transmitted human papillomavirus (HPV) and the release of HPV testing guidelines for two indications: 1) as an adjunct to cytologic screening and 2) to guide colposcopic triage of patients with atypical squamous cells of undetermined significance (ASC-US) cytolo...
Article
Full-text available
An integrated theoretical model using constructs from multiple behavioral models was applied to understand and predict condom use among a sample of injecting drug users, commercial sex workers, men who have sex with men, and multipartnered heterosexuals. Elicitation interviews were conducted to develop a questionnaire to measure model constructs th...
Article
Full-text available
Information about human papillomavirus (HPV) has evolved rapidly and HPV DNA tests are now available. Little is known about family physicians' knowledge about HPV and how it relates to HPV test use and counseling practices. In mid-2004, confidential surveys were mailed to a nationally representative sample of 760 family physicians. We assessed and...
Conference Paper
Background: Human papillomavirus (HPV) causes anogenital warts and anogenital cancer, including cervical cancer. Nationwide, 20 million people have HPV infection and 6.2 million new infections are acquired annually. Several national organizations have guidelines recommending HPV tests for: 1) women with ASCUS (atypical cells of undetermined signifi...
Article
Sexually transmitted diseases in the United States are frequently diagnosed by private, as well as public, physicians. However, we know little about the decision processes that physicians employ when faced with people who may or may not be infected. To address this gap, we compared physicians' responses to different patient vignettes to assess how...
Article
Full-text available
The United States has relied upon partner notification strategies to help break the chain of infection and re-infection for sexually transmitted diseases (STD). Physicians are a vital link in the system of STD control, but little is known of physician opinions about partner notification strategies. We collected opinions about partner notification f...
Article
This study was conducted in the Kaiser Permanente Medical Care Program of Northern California to identify patient characteristics that explain interest in flexible sigmoidoscopy (FS) screening. A mailed screening invitation to 6837 age-eligible patients elicited responses from 49%. Efforts to reach and interview both eligible respondents and non-re...
Article
Full-text available
This study presents results from a national survey of US physicians that assessed screening, case reporting, partner management, and clinical practices for syphilis, gonorrhea, chlamydia, and HIV infection. Surveys were mailed to a random sample of 7300 physicians to assess screening, testing, reporting, and partner notification for syphilis, gonor...
Article
To assess compliance with practice guidelines and to determine the extent of missed opportunities for sexually transmitted disease (STD) prevention by describing screening practices of a national sample of obstetricians and gynecologists and comparing them to the practices of other specialists. Physicians (n = 7300) in five specialties that diagnos...
Article
Full-text available
The utility of the Theory of Planned Behaviour as a predictor of condom use behaviours is investigated and a revised integrative behavioural prediction model is suggested. According to the revised model, there are five immediate determinants of condom use intentions: Attitude, subjective norm, partner norm, perceived behavioural control and the mea...
Article
Full-text available
This paper discusses the factors influencing female commercial sex workers' (N = 172) intentions to use condoms with their regular partners during vaginal sex. While 73 of these women were at risk for HIV/STD transmission and acquisition primarily because of their commercial sex work (CSWonly), 99 were at risk because of both commercial sex work an...
Article
Full-text available
A revised behavioural prediction model integrating components of several psychosocial theories was used to predict men who have sex with mens' (MSM) (N = 139) intentions to always use condoms with their regular partner for anal, oral and vaginal sex. The behavioural model successfully predicted MSMs' condom use intentions for all three behaviours (...
Article
Full-text available
This paper describes the theoretical and methodological approach underlying Project SAFER, a longitudinal study to predict and understand condom use behaviours among populations at high risk for HIV (i.e. men who have sex with men (MSM), injecting drug users (IDUs), commercial sex workers (CSWs) and multi-partnered heterosexuals (MPHs)). Based on a...
Article
Full-text available
High response rates from physicians are key to obtaining valid and generalizable data regarding their sexually transmitted disease (STD) diagnosis, treatment, and control practices. A factorial (3 x 2) study was designed using varying cash incentives ($0, $15, $25) and delivery modes (Federal Express, U.S. mail). Surveys, with three follow-up maili...
Article
Full-text available
One of the most reliable and perplexing findings from surveys of sexual behavior is that men report substantially more sexual partners than women do. We use data from national sex surveys and studies of prostitutes and their clients in the United States to examine sampling bias as an explanation for this disparity. We find that prostitute women are...
Article
Full-text available
Colorectal cancer is the third most frequent cancer, yet screening rates for this cancer remain low. This study was designed to identify factors associated with family physicians' rates of recommending or providing flexible sigmoidoscopy. We applied a behavioral model consisting of three components: physician attitude toward providing the test, fac...
Article
People may not take protective action (e.g. use condoms) either because they have no intention to engage in the protective behaviour, or because they have the appropriate intention but are unable to act upon it. This paper examines variations in intentions to use condoms for vaginal intercourse with main and casual partners as a function of gender,...
Article
ObjectiveThe objective was to evaluate the effect of a clinic-based intervention program on mammography use by inner-city women. DesignA randomized controlled trial employing firm system methodology was conducted. SettingThe study setting was a general internal medicine clinic in the university-affiliated county hospital serving metropolitan Seat...
Article
Low-income, minority, and inner city women have breast cancer screening rates that are below those of the general population. The authors surveyed women who received primary care at Seattle's county hospital about their mammography behaviors in early 1995. Data were analyzed within the context of the PRECEDE framework. Only half (48%) of the women...
Article
Full-text available
Most research on mammography utilization has been conducted among middle-class women. There is a need for research to identify factors affecting mammography utilization among low-income women to develop effective interventions for this underserved subgroup. An expanded theory of reasoned action guided this research among low-income inner-city women...
Article
Full-text available
Although overall use of mammography is steadily increasing, low-income and minority women consistently have relatively lower screening rates than white, middle-class women. To assess the mammography-seeking behavior of low-income women using an urban public hospital, this study sought to understand why women in this population decide whether or not...
Article
Full-text available
To reduce breast cancer mortality, ways to promote the use of mammography screening among women age 50 and above are needed. Community organization may be a useful approach. The Washington State Community Breast Cancer Screening Project involved implementation of promotional activities initiated by physician and lay community boards in two communit...
Article
Full-text available
This study measured the cancer screening rates of family physicians and compared the measures obtained through physician self-reports, chart audits, and patient surveys. A cancer screening survey was sent to 50% of the members of the Washington Academy of Family Physicians, with 326 family physicians (74% response rate) completing the survey. Sixty...
Article
Careful attention to factors that affect women and their physicians is necessary to achieve the national goal that, by the year 2000, 60 percent of women should have had a screening mammogram in the previous 2 years. This report evaluates factors that differentiate primary care physicians who regularly order mammograms from those who do not. The st...
Article
Full-text available
In a health maintenance organization that mails letters to women recommending that they schedule mammograms, we conducted a randomized trial to evaluate simple methods of increasing the use of screening mammography. Using a 2 x 2 factorial design, we tested the effects of (1) mailing the recommendation letter from each woman's primary care physicia...
Article
While physician endorsement has been shown to be highly important in motivating women to obtain screening mammograms, there is evidence that doctors do not refer women for the procedure as often as they should. The objective of this study was to help understand why physicians do not routinely utilize screening mammography. Randomly selected Washing...
Article
Full-text available
To address the needs of older women, we investigated age-specific attitudes toward mammography that might be influenced by written or verbal communications. Attitudinal scores for women aged 40 through 64 years and 65 years and older were calculated prospectively from responses to a mailed questionnaire based on the theory of reasoned action. Age-g...
Article
Full-text available
This paper presents the results of a prospective study testing an expanded theory of reasoned action (TRA) to predict mammography participation. A questionnaire was developed to measure each of the expanded TRA model components. A sample was identified of 946 women age 40 and above who were invited to obtain a mammogram at the Group Health Cooperat...
Article
A survey of 414 Washington state physicians board certified in one of seven non-primary care specialties (gastroenterology, cardiology, dermatology, otolaryngology, orthopedics, psychiatry, and general surgery) assessed physician attitudes towards capitation-based health plans with primary care gatekeepers. Responses indicated significant differenc...
Article
To improve rates at which physicians provide cancer control procedures, it is first necessary to identify physician and environmental characteristics that explain variations in those rates. This study used an attitude-behavior model as a guiding framework to identify beliefs, sources of influence, facilitating conditions, and critical events that m...
Article
This paper reports the results of a prospective investigation of 100 women during their pregnancies to test the hypothesis that social and psychological factors influence pregnancy outcome after controlling for demographic, biomedical, and lifestyle variables. Subjects completed questionnaires that assessed family social supports, life events, and...
Article
Recent years have brought many changes in health care financing, including health care insurance plans based on capitation allowances to physicians. This study describes a survey examining physician attitudes toward such plans. The survey was distributed to a random sample of 30% of the family physicians, general practitioners, general internists,...
Article
Traditional wisdom suggests that academic medical centers attract sicker patients than nonacademic facilities, thereby incurring greater risk when caring for patients enrolled in prepaid health care plans. This study examines the affiliation of an academic medical center with a prepaid capitation-based medical plan in western Washington state and f...
Article
The potential omission of indicated tests for patients enrolled in prepaid health care plans has been raised as a possibility. This study reviewed the charts of 149 adult patients seen for routine physical examinations or checkups in university-based family medicine or internal medicine clinics. Of the patients included, 67 were enrolled in a capit...
Article
With a decline in the proportion of medical students pursuing family practice careers, it is necessary to better understand the factors influencing their career decisions. The Fishbein model of attitude formation was used as a framework for developing a questionnaire to measure students' attitudes toward a career in family practice and the social s...
Article
This report describes a study of the content and uses of the University of Washington Affiliated Residency Network documentation system for future hospital privileges. The selected procedures and problems considered important to document for future hospital privileges were validated by means of a graduate survey conducted in 1985. Fifty percent of...
Article
A survey of 310 graduates of eight university-affiliated family medicine residencies in the northwestern United States conducted in 1985 revealed several significant differences between male and female graduates. The female graduates were significantly (p less than .05) more likely than male graduates to practice in urban settings, taking salaried...
Article
This article summarizes the practice content and continuity for 35 senior residents in six family medicine residency model teaching units utilizing a computerized information management system. Comparisons are drawn with the content of family practices in the National Ambulatory Medical Care Survey (NAMCS), showing that family medicine third-year r...
Article
This paper describes an evaluation of the University of Washington family practice project to document resident experiences in training. The production of aggregate reports using clustering techniques and peer group comparisons were well received by residents and faculty. A questionnaire survey and personal interview with a sample of faculty and re...
Article
Full-text available
Recent reviews indicate that attempts to validate the Health Belief Model (HBM) have produced only modest support for it and that the HBM may be incomplete in its organization and development as an expectancy-value model. As an alternative, the Fishbein and Triandis models are discussed. The author investigated the utilities of the Fishbein and Tri...
Article
The synthesis of two separate lines of inquiry--research on information integration and longitudinal studies of attitudes--prompted the hypothesis that the degree of consistency between attitudes and behavior will increase as a function of the amount of information available about the attitude object. The hypothesis was tested in three separate lon...
Article
Full-text available
Recent research on crowding has not always separated the situational from the affective and behavioral components of this construct. The present study represents an attempt to distinguish among these components, and to explore the dimensions underlying the perception of crowded interpersonal situations and the behavioral and affective responses to...
Article
This paper describes a pilot study of biomedical and psychosocial risk and the outcome of pregnancy. Ninety-three pregnant women completed four instruments to identify three types of psychosocial risk: life events, family function and social support. Biomedical risk was identified through analysis of self-reported health histories and hospital reco...
Article
Full-text available
This report describes the development and initial validation of a self-report instrument designed to measure beliefs about psychosocial aspects of patient care held by primary care physicians. The strategy used was borrowed from psychological measurement: a rational scale was constructed based on an existing theoretical framework concerning the phy...
Article
The relationship of life change to the onset of cancer was studied in 22 pairs of HLA-identical siblings who were discordant for hematologic malignancies. The twin pairs were hospitalized for bone marrow transplantation. Life change was measured using a well-validated instrument, the Schedule of Recent Experiences (SRE). Contrary to our expectation...
Article
Thesis (Ph. D.)--University of Washington, 1983. Vita. Includes bibliographical references (leaves [101]-107). Photocopy.
Article
Full-text available
This paper offers evidence to support the use of the Family APGAR as a reliable, validated, utilitarian instrument to measure a subject's satisfaction with five components of family function. Mean total Family APGAR scores for several population groups are reported along with associated validity and reliability studies. A study from Taiwan supports...
Article
A study was conducted to examine the effect of sex of subject, sex of majority and minority influence source, and male or female relatedness of the issue on conformity, Male and female subjects indicated their agreement (or disagreement) with male and female related statements following an influence attempt by either four male or four female confed...
Article
224 newspaper articles were sampled from four newspapers, extrapolating to about 2850 nuclear power articles from 1972 to 1976. 124 magazine articles were found in four magazines (Time, Business Week, Scientific American, Environment). The newspapers wee found to run close coverage of nuclear power issues. The articles were mainly (45%) focused on...