Gregory J Norman

Gregory J Norman
Dexcom · Global Access

PhD
Director of Health Economics & Outcomes Research at Dexcom, Inc.

About

195
Publications
70,215
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
11,473
Citations
Introduction
I am a research psychologist and my work has centered on the development and evaluation of health behavior change interventions for physical activity and diet to address obesity and other chronic health conditions. These intervention programs have incorporated interactive and mobile technologies to implement evidence-based behavior change strategies.
Additional affiliations
January 2015 - present
West Health
West Health
Position
  • Principal Investigator
January 2015 - April 2017
West Health
West Health
Position
  • Managing Director
January 2004 - present
University of California, San Diego
Position
  • Professor (Associate)

Publications

Publications (195)
Article
To review eHealth intervention studies for adults and children that targeted behavior change for physical activity, healthy eating, or both behaviors. Systematic literature searches were performed using five databases: MEDLINE, PsychInfo, CINAHL, ERIC, and the Cochrane Library to retrieve articles. Articles published in scientific journals were inc...
Article
Full-text available
To our knowledge, no studies have evaluated whether weight loss can be promoted in overweight adults through the use of an intervention that is largely based on daily SMS (Short Message Service: text) and MMS (Multimedia Message Service: small picture) messages transmitted via mobile phones. This paper describes the development and evaluation of a...
Article
Full-text available
Over the past few years, the world has witnessed an unprecedented growth in smartphone use. With sensors such as accelerometers and gyroscopes on board, smartphones have the potential to enhance our understanding of health behavior, in particular physical activity or the lack thereof. However, reliable and valid activity measurement using only a sm...
Article
Full-text available
Background: The COVID-19 pandemic has exposed vulnerabilities and placed tremendous financial pressure on nearly all aspects of the U.S. healthcare system. Diabetes care is an example of the confluence of the pandemic and heightened importance of technology in changing care delivery. It has been estimated the added total direct US medical cost bur...
Article
There is increasing recognition that older onset type 1 diabetes (T1D) is not uncommon. Although CGM use is rising dramatically among those with T1D, little is known regarding its use and benefits within this older T1D population. To address these questions, we identified new CGM users (new CGM sensor prescriptions for T1D developing after military...
Article
Background: Many patients with type 2 diabetes (T2D) have suboptimal control and are not meeting their glycemic targets. Use of CGM devices has increased substantially for patients with T2D. However, the effects of rtCGM on glycemia in T2D primary care patients, particularly those not on intensive insulin therapy, in real world settings has not bee...
Article
Evolution of CGM technology has equipped the market with different systems. This study compared two types of CGM devices, real-time (rt) CGM and intermittently scanned (is) CGM on clinical outcomes among persons with diabetes using intensive insulin therapy. A retrospective analysis was performed using Optum Clinformatics® Database comprised of adm...
Article
Real-time continuous glucose monitoring (rtCGM) and intermittently scanned CGM (isCGM) have both been shown to improve glycemic outcomes in people with T1D. In this retrospective analysis, we propensity score matched CGM naïve adults with T1D who initiated a rtCGM or an isCGM device. HbA1c and CGM metrics were assessed at 6-12-months. Among the 143...
Article
Use of CGM in T2D is rising rapidly, yet little is known regarding its effects on glucose management in the VHA. We thus identified new CGM users (new CGM sensor prescriptions for T2D on insulin) and non-users (T2D receiving glucose strips) during the years 2015-2020 and used national VHA healthcare data from visit encounters to compare change over...
Article
Full-text available
Introduction Trauma‐related guilt is common, associated with posttraumatic mental health problems, and can persist after posttraumatic stress disorder (PTSD) treatment. We compared the efficacy of two six‐session psychotherapies, Trauma‐Informed Guilt Reduction (TrIGR) and Supportive Care Therapy (SCT), for reducing trauma‐related guilt. TrIGR help...
Article
Little is known about the impact of real-time continuous glucose monitoring (rtCGM) on diabetes-related medical costs within the type 2 diabetes (T2D) population. A retrospective analysis of administrative claims data from the Optum Research Database was conducted. Changes in diabetes-related healthcare resource utilization costs were expressed as...
Article
Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur. Integrated treatments are effective, but not all patients respond and predicting outcome remains difficult. In this study, latent class analysis (LCA) identified symptom-based subgroups of comorbid PTSD/AUD among 119 veterans with PTSD/AUD from a randomized con...
Article
Full-text available
Background Caregiving is a demanding role that can negatively impact a person’s health and well-being. As such, adequate access to health care is important for maintaining the family caregiver’s own personal health. The aims of this study were to identify if family caregivers of older adults had more difficulty accessing health care services than n...
Article
Full-text available
Background: Many health and social needs can be assessed and met in community settings, where lower-cost, person-centered, preventative and proactive services predominate. This study reports on the development and implementation of a person-centered care model integrating dental, social, and health services for low-income older adults at a communi...
Article
Full-text available
Purpose Health-related social needs (HRSNs) can make older adults’ more vulnerable and impact their health, well-being, and ability to age-in-place. The current study assessed the prevalence of potential HRSNs (pHRSNs) across several domains (e.g., transportation, social isolation) and explored the associations with health and well-being outcomes i...
Article
Full-text available
Background Dental utilization patterns and costs of providing comprehensive oral healthcare for older adults in different settings have not been examined. Methods Retrospective longitudinal cohort data from Apple Tree Dental (ATD) were analyzed (N = 1,159 total; 503 outpatients, 656 long-term care residents) to describe oral health status at prese...
Article
Full-text available
Background: Home-bound patients in New York State requiring long-term care services have seen significant changes to their benefits due to turmoil in the Managed Long Term Care (MLTC) market. While there has been research conducted regarding the effect of MLTC challenges on beneficiaries, the impact of MLTC regulatory changes on home health aides...
Article
Background: Home-based primary care (HBPC) provides team-based clinical care for homebound patients who have difficulty accessing typical outpatient care. Interdisciplinary team members also provide social and emotional support and serve as a resource for family caregivers, who often experience significant emotional stress. Objectives: This qual...
Article
Full-text available
Background Weight loss interventions based solely on text messaging (short message service [SMS]) have been shown to be modestly effective for short periods of time and in some populations, but limited evidence is available for positive longer-term outcomes and for efficacy in Hispanic populations. Also, little is known about the comparative effica...
Article
Full-text available
Background: Novel and sustainable approaches to optimizing home-based primary care (HBPC) programs are needed to meet the medical needs of a growing number of homebound older adults in the United States. Telehealth may be a viable option for scaling HBPC programs. Objective: The purpose of this qualitative study was to gain insight into the pers...
Article
Full-text available
The purpose of this study was to develop the Motivation for Exergame Play Inventory (MEPI) as a publicly available and validated measure of psychological and motivational constructs specific to increase the duration of exergame play. This study is an ancillary analysis of data from a randomized trial of sixty-one adolescents assigned to one of four...
Article
Full-text available
Importance Co-occurrence of posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) is common and associated with psychiatric and functional problems. Understanding whether exposure therapy is tolerable and efficacious for treating PTSD and AUD is critical to ensure that best practice treatments are available. Objective To compare the...
Article
Objectives: To evaluate the role of contact with older adults in explaining expectations about aging and attitudes toward own aging. Method: A representative sample of 3,026 U.S. adults aged 30-89 years completed a survey online or by telephone. The survey assessed types of contact with older adults, anticipated need for help during aging, and a...
Article
Full-text available
Background Medically complex vulnerable older adults often face social challenges that affect compliance with their medical care plans, and thus require home and community-based services (HCBS). This study describes how non-medical social needs of homebound older adults are assessed and addressed within home-based primary care (HBPC) practices, and...
Preprint
BACKGROUND Novel and sustainable approaches to scale Home-Based Primary Care (HBPC) programs are needed to meet the medical needs of a growing number of homebound older adults in the US. Telehealth may be a viable option for scaling HBPC programs. OBJECTIVE The purpose of this qualitative study was to gain insight into the perspectives of HBPC sta...
Article
Primary care-based approaches to address concurrent obesity and cardiovascular disease risk factors (CVDRFs) that begin with a high intensity intervention that is subsequently decreased (i.e., stepped-down) if weight loss is achieved have not been rigorously examined. Our study is a 20-month, single-blind randomized controlled trial at five primary...
Article
Full-text available
Objective Despite data linking the social environment to physical inactivity in Latinas, research on social network predictors of physical activity (PA) is limited. This study examined social network predictors of PA change in Latinas. Methods Egocentric network data were collected from 102 adult Latinas (egos) participating in a randomized contro...
Data
Egocentric network questionnaire. (PDF)
Article
Objective: Shared behaviors have been implicated in the clustering of obesity among socially connected people. This study determined how weight and weight control behaviors of participants and their social ties are related and how these factors are associated with weight change in participants. Method: Adult Latinas participating in a lifestyle...
Article
Full-text available
Background: Home-based primary care (HBPC) is a multidisciplinary, ongoing care strategy that can provide cost-effective, in-home treatment to meet the needs of the approximately four million homebound, medically complex seniors in the U.S. Because there is no single model of HBPC that can be adopted across all types of health organizations and U....
Article
There is a consensus that our current hospital-intensive approach to care is deeply flawed. This review article describes the research evidence for developing a better system of care for high-cost, high-risk patients. It reviews the evidence that home-centered care and integration of health care with social services are the cornerstones of a more h...
Article
Background: Improved understanding of sedentary time's impact on cardiometabolic health can help prioritize intervention targets. Objective: We investigated cross-sectional and longitudinal relations of reported screen time and objectively measured total percent of time spent sedentary with cardiometabolic health in obese youth. Methods: Parti...
Article
Objectives: We explored the relationship between obesity and neighborhood-related, social, and cultural variables and possible moderation by acculturation and cross-national practices. Methods: We obtained data from the 2009 San Diego Prevention Research Center's community survey, which used multistage sampling methods to recruit 397 adult respo...
Article
Background: Few weight loss interventions are evaluated for longer than a year, and even fewer employ social and mobile technologies commonly used among young adults. We assessed the efficacy of a 2 year, theory-based, weight loss intervention that was remotely and adaptively delivered via integrated user experiences with Facebook, mobile apps, te...
Article
Objectives: We explored the relationship between obesity and neighborhood-related, social, and cultural variables and possible moderation by acculturation and cross-national practices. Methods: We obtained data from the 2009 San Diego Prevention Research Center's community survey, which used multistage sampling methods to recruit 397 adult respo...
Article
Objectives: To investigate whether walking mediates neighborhood built environment associations with weight status in middle- and older-aged women. Methods: Participants (N=5085; mean age=64±7.7; 75.4% White non-Hispanic) were from the Women's Health Initiative San Diego cohort baseline visits. Body mass index (BMI) and waist circumference were...
Article
Full-text available
Background: Many studies have examined the consequences of prolonged television viewing, but few studies have examined the psychological states that contribute to this behavior. In this study, we evaluated the construct and predictive validity of psychosocial correlates of television viewing in a population of African American breast cancer survivo...
Article
Full-text available
This study evaluates the reliability and validity of the strategies for weight management (SWM) measure, a questionnaire that assesses weight management strategies for adults. The SWM includes 20 items that are categorized within the following subscales: (1) energy intake, (2) energy expenditure, (3) self-monitoring, and (4) self-regulation. Baseli...
Article
Full-text available
Physical activity provides numerous health benefits, including reducing risk factors that contribute to the leading causes of morbidity and mortality. Many employers offer incentives to employees to motivate engagement in wellness program activities. Two incentive designs to reward employees for achieving step goals were evaluated. This study used...
Article
Full-text available
Project FIT was a two-year multi-component nutrition and physical activity intervention delivered in ethnically-diverse low-income elementary schools in Grand Rapids, MI. This paper reports effects on children's nutrition outcomes and process evaluation of the school component. A quasi-experimental design was utilized. 3rd, 4th and 5th-grade studen...
Article
Full-text available
Advances in information technology and near ubiquity of the Internet have spawned novel modes of communication and unprecedented insights into human behavior via the digital footprint. Health behavior randomized controlled trials (RCTs), especially technology-based, can leverage these advances to improve the overall clinical trials management proce...
Article
Full-text available
Compliance with California's smoke-free restaurant and bar policies may be more a function of social contingencies and less a function of legal contingencies. The aims of this study were: 1) to report indications of compliance with smoke-free legislation in Korean bars and restaurants in California; 2) to examine the demographic, smoking status, an...
Article
Full-text available
Objectives: To examine the validity and reliability of a modified Sedentary Behavior Strategy Self-Management Scale (SBSMS) in a sample of breast cancer survivors. Methods: A total of 291 African-American (AA) breast cancer survivors completed the SBSMS, which was subjected to tests of reliability, structural validity, and tests of measurement equi...
Article
Background Stepped-care approaches to weight loss have shown some success among adults. A ‘stepped-down’ version of the stepped-care approach to adolescent weight loss has never been evaluated.Objectives We conducted a one-year randomized controlled trial to compare a stepped-down weight loss intervention versus enhanced usual care (EUC).Methods St...
Article
Objectives: Understanding the characteristics of young adults who have difficulty achieving a healthy weight may help develop more effective interventions. Methods: Signal detection was conducted to identify subgroups of overweight/obese young adults more or less likely to lose weight (5% weight loss) over 6 months. Data were collected from a di...
Article
Full-text available
Background Living near major roadways has been linked with increased risk of cardiovascular events and worse prognosis. Residential proximity to major roadways may also be associated with increased risk of hypertension, but few studies have evaluated this hypothesis. Methods and Results We examined the cross‐sectional association between residenti...
Article
Full-text available
Background: Identifying factors associated with effective treatment for childhood obesity is important to improving weight loss outcomes. The current study investigated whether child or parent motivation throughout the course of treatment predicted reductions in BMI. Methods: Fifty 8- to 12-year-old children with overweight and obesity (BMI perc...
Article
Full-text available
Purpose: Overweight and obese adolescents are at risk for low health-related quality of life (HRQOL). We examined the role of individual- and environmental-level variables on the relationship between body mass index (BMI kg/m(2)) and HRQOL in adolescents. Methods: Linear regressions were performed to conduct mediation and moderation analyses on...
Article
Full-text available
Some attributes of neighborhood environments are associated with physical activity among older adults. This study examined whether the associations were moderated by driving status. Older adults from neighborhoods differing in walkability and income completed written surveys and wore accelerometers (N = 880, mean age = 75 years, 56% women). Neighbo...
Article
Full-text available
Background: Overweight or obesity is prevalent among college students and many gain weight during this time. Traditional face-to-face weight loss interventions have not worked well in this population. Facebook is an attractive tool for delivering weight loss interventions for college students because of its popularity, potential to deliver strateg...
Article
Full-text available
Abstract The objective was to examine employee engagement in worksite wellness activities at 2 large US companies that differed in engagement strategy and incentive plan. Inclusion criteria were US employees aged 18 to 65 who were eligible to receive wellness benefits throughout 2012. Company B's incentive was twice the dollar value of Company A's...
Article
Full-text available
Background: Adolescents with chronic disease (ACD) must develop independent disease self-management and learn to communicate effectively with their health care team to transition from pediatric to adult-oriented health care systems. Disease-specific interventions have been implemented to aid specific ACD groups through transition. A generic approa...
Article
Full-text available
Children surviving acute lymphoblastic leukemia (ALL) are at increased risk for overweight and obesity over that of the general population. Whether a generic or tailored approach to weight management is needed for cancer survivors has yet to be tested. Thirty-eight youth 8-18 years with BMI ≥ 85% who had survived ALL were recruited for a randomized...
Article
Introduction: Unhealthy weight loss practices are common among female college students. It is unknown if these practices are also most common among women in the subset of overweight or obese college students or if these practices are related to depression. We examined the relationship between gender, depression, and unhealthy weight loss practices...
Article
Full-text available
Purpose: There is a need for a self-report measure that assesses use of recommended strategies related to weight management. Design: Cross-sectional analysis. Setting: Universities, community. Subjects: Exploratory factor analysis (EFA) involved data from 404 overweight/obese young adults (mean age = 22 years, 48% non-Hispanic white, 68% eth...