Jonathan N Tobin

• PhD
• Managing Director at Rockefeller University

Introduction Social determinants of health (SDOH) are an important contributor to health status and health outcomes. In this analysis, we compare SDOH measured both at the individual and population levels in patients with high comorbidity who receive primary care at Federally Qualified Health Centers in New York and Chicago and enrolled in the Tipp...

Background Some of the most promising strategies to reduce hospital readmissions in heart failure (HF) is through the timely receipt of home health care (HHC), delivered by Medicare-certified home health agencies (HHAs), and outpatient medical follow-up after hospital discharge. Yet national data show that only 12% of Medicare beneficiaries receive...

Background One‐third of people living with dementia (PLWD) have highly fragmented care (i.e., care spread across many ambulatory providers without a dominant provider). It is unclear whether PLWD with fragmented care and their caregivers perceive gaps in communication among the providers involved and whether any such gaps are perceived as benign in...

Background Hybrid effectiveness-implementation designs evaluate the effectiveness and implementation of interventions. We retrospectively evaluated the implementation of a stepped-wedge cluster randomized controlled trial (RCT) of a facilitated telemedicine model (experimental) integrated into opioid treatment programs (OTPs) compared to offsite re...

The Dietary Approach to Stop Hypertension (DASH) diet, with its low sodium and high potassium content, acts like a diuretic by reducing sodium reabsorption in the kidney's distal convoluted tubule but without the side effects. Previous studies based on animal models didn't explore changes in human ion channel proteins. Recent insights into urinary...

Importance Facilitated telemedicine may promote hepatitis C virus elimination by mitigating geographic and temporal barriers. Objective To compare sustained virologic responses for hepatitis C virus among persons with opioid use disorder treated through facilitated telemedicine integrated into opioid treatment programs compared with off-site hepat...

Stress First Aid is an evidence-informed peer-to-peer support intervention to mitigate the effect of the COVID-19 pandemic on the well-being of health care workers (HCWs). OBJECTIVE To evaluate the effectiveness of a tailored peer-to-peer support intervention compared with usual care to support HCWs’ well-being at hospitals and federally qualified...

Background: Although home health aides and attendants (HHAs) frequently provide care to community-dwelling adults with heart failure (HF), they have rarely been the focus of interventions aimed at improving patient outcomes. Engaging HHAs and other key home health care stakeholders in the research process is essential to designing user-friendly int...

(1) Background: With increasing international travel and mass population displacement due to war, famine, climate change, and immigration, pathogens, such as Staphylococcus aureus (S. aureus), can also spread across borders. Methicillin-resistant S. aureus (MRSA) most commonly causes skin and soft tissue infections (SSTIs), as well as more invasive...

Background: Negative interpersonal interactions are associated with acute increases in ambulatory blood pressure (ABP). Yet, the mechanisms underlying this relationship are unclear. Purpose: This study tested whether negative interpersonal interactions predict higher ABP both in the moment and during subsequent observations, and whether increase...

Introduction Clinical trials are a vital component of translational science, providing crucial information on the efficacy and safety of new interventions and forming the basis for regulatory approval and/or clinical adoption. At the same time, they are complex to design, conduct, monitor, and report successfully. Concerns over the last two decades...

Objective: To examine longitudinal changes in activation, HIV health outcomes, and social and psychological determinants of adherence to antiretroviral therapy (ART) among peer trainers with HIV. Methods: A multi-method case study. The study population included peers (n = 4) from a randomized controlled trial about peers training patients with H...

The Dietary Approach to Stop Hypertension (DASH) diet is a proven intervention to treat hypertension, yet its mechanism is not clearly known. We investigated the change in protein abundance patterns in urine extracellular vesicles (uEV’s) following DASH diet implementation. A pilot study was carried out to compare uEVs isolated using three differen...

Low-income, minority seniors face high rates of hypertension that increase cardiovascular risk. Senior centers offer services, including congregate meals, that can be a valuable platform to reach older adults in underserved communities. We implemented two evidence-based interventions not previously tested in this setting: DASH-aligned congregate me...

Introduction The Asthma Impairment and Risk Questionnaire (AIRQ®) is a 10 item, yes/no, impairment- and risk-based control assessment. Scores of 0-1 indicate well-controlled (WC), 2-4 not-well controlled (NWC), and 5-10 very poorly controlled (VPC) asthma. The Asthma Checklist is a decision support tool designed to facilitate implementation of Guid...

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...

Low-income women of color receive fewer cancer screenings and have higher rates of depression, which can interfere with cancer screening participation. This study assessed the comparative effectiveness of two interventions for improving colorectal, breast, and cervical cancer screening participation and reducing depression among underserved women i...

Background Some patients’ depression persists despite evidence-based interventions; understanding factors associated with depression persistence could inform screening and treatment. We used a novel mixed-methods approach to examine demographic, clinical, and social factors affecting depression persistence among older, low-income women; we also ass...

Background and Aims Cardiovascular Disease (CVD) poses significant health risks for seniors, especially among low-income and minority communities. Senior centers offer multiple services. We tested whether implementing two evidence-based interventions- DASH-aligned meals provided through an existing congregate meal program, and support for home Self...

Background: Dietary approach to stop hypertension (DASH) diet reduces blood pressure (BP) as effectively as one antihypertensive drug, yet its mechanism of action was never fully characterized. Methods: We designed a translational inpatient trial to elucidate the biological pathway leading from nutritional change, through hormonal response, reve...

Introduction The COVID-19 pandemic has placed health care workers at unprecedented risk of stress, burnout, and moral injury. This paper describes the design of an ongoing cluster randomized controlled trial to compare the effectiveness of Stress First Aid (SFA) to Usual Care (UC) in protecting the well-being of frontline health care workers. Meth...

Introduction Clinical and Translational Science Award (CTSA) Program hubs are well-positioned to advance dissemination and implementation (D&I) research and training capacity nationally, though little is known about what D&I research support and services CTSAs provide. To address this gap, the CTSA Dissemination, Implementation, and Knowledge Trans...

Introduction: Obesity is more prevalent among African American individuals, increasing the risk for cardiorenal morbidity. We explored interactions between race, BMI, and the risk of hyperfiltration associated with obesity-related glomerulopathy (ORG). Methods: We created a cohort of female adolescents from electronic health records. Glomerular...

OBJECTIVES/GOALS: To test whether implementing DASH-aligned meals in a congregate meal program, combined with Self-Measured Blood Pressure (SMBP) monitoring, lowers systolic blood pressure in community-living seniors at two senior centers. Secondary Aims included cognitive and behavioral change, and attention to client preferences. METHODS/STUDY PO...

OBJECTIVES/GOALS: Dietary approach to stop hypertension (DASH) is a proven intervention to treat hypertension. Despite years of research the immediate physiologic response to its implementation was never characterized.This translational trial describes the biological pathway from nutrition through hormons, urine electrolytes and blood pressure redu...

Background: Methicillin-resistant or methicillin-sensitive Staphylococcus aureus skin and soft tissue infections pose serious clinical and public health challenges. Few protocols exist for outpatient education, decolonization and decontamination. Objectives: This trial implemented infection prevention protocols in homes via community health work...

Objective: To examine whether depression status before metabolic and bariatric surgery (MBS) influenced 5-year weight loss, diabetes, and safety/utilization outcomes in the PCORnet Bariatric Study. Summary of background data: Research on the impact of depression on MBS outcomes is inconsistent with few large, long-term studies. Methods: Data w...

The Dietary Approaches to Stop Hypertension (“DASH diet”) has been proven in research settings to lower blood pressure, but its implementation is untested among seniors in congregate meals settings. We report the planning, implementation, impact of COVID-19, and results of an Administration of Community Living-funded study to test whether two evide...

Introduction: Obesity is more prevalent among minorities, increasing the risk for cardio-renal morbidity. Hypothesis: We explored interactions between race, body mass index (BMI), and the risk of hyperfiltration associated with Obesity Related Glomerulopathy (ORG). Methods: We created a cohort of women and girls ages 12-21 from the New York Metropo...

Background: Adolescent obesity, a risk factor for cardiorenal morbidity in adulthood, has reached epidemic proportions. Obesity-related glomerulopathy (ORG) has an early reversible stage of hyperfiltration. Age-appropriate formulae for eGFR, which are standardized to ideal body surface area (BSA) and provide assessment of kidney function in ml/min...

Background Telemedicine has the potential to increase healthcare access especially for vulnerable populations. Telemedicine for Evaluation, Adherence, and Medication for Hepatitis C (TEAM-C) is comparing telemedicine access to specialty medical care to usual care for management of hepatitis C virus (HCV) infection among persons with opioid use diso...

Recurrent skin and soft tissue infections (SSTI) caused by Community-Associated Methicillin-Resistant Staphylococcus aureus (CA-MRSA) or Methicillin-Sensitive Staphylococcus aureus (CA-MSSA) present treatment challenges. This community-based trial examined the effectiveness of an evidence-based intervention (CDC Guidelines, topical decolonization,...

The ability to effectively lead an interdisciplinary translational team is a crucial component of team science success. Most KL2 Clinical Scholars have been members of scientific teams, but few have been team science leaders. There is a dearth of literature and outcome measures of effective Team Science Leadership in clinical and translational rese...

Background Shortening time between office visits for patients with uncontrolled hypertension represents a potential strategy for improving blood pressure (BP).Objective We evaluated the impact of multimodal strategies on time between visits and on improvement in systolic BP (SBP) among patients with uncontrolled hypertension.DesignWe used a stepped...

Roughly half of the adults in the United States are diagnosed with hypertension (HTN). Unfortunately, less than one-third have their condition under control. Clinicians generally have positive regard for the use of HTN guidelines to achieve HTN treatment goals; however, actual uptake remains low. Factors underpinning clinician variation in practice...

Introduction Obesity is more prevalent among minorities, increasing the risk for cardio-renal morbidity. We explored interactions between race, body mass index (BMI), and the risk of hyperfiltration associated with Obesity Related Glomerulopathy (ORG). Methods We created a cohort of women and girls ages 12-21 from the New York Metropolitan area us...

Self-tracking can help personalize self-management interventions for chronic conditions like type 2 diabetes (T2D), but reflecting on personal data requires motivation and literacy. Machine learning (ML) methods can identify patterns, but a key challenge is making actionable suggestions based on personal health data. We introduce GlucoGoalie, which...

Health coaching can be an effective intervention to support self-management of chronic conditions like diabetes, but there are not enough coaching practitioners to reach the growing population in need of support. Conversational technology, like chatbots, presents an opportunity to extend health coaching support to broader and more diverse populatio...

Although hepatitis C virus (HCV) infection has high prevalence and incidence in persons with opioid use disorder (PWOUD), their engagement in HCV care has been limited due to a variety of factors. In an ongoing multisite study at 12 opioid treatment programs (OTPs) throughout New York State (NYS), we have been evaluating telemedicine accompanied by...

ABSTRACT IMPACT: Our implementation model translates two evidence-based nutritional and behavioral interventions to lower blood pressure, into a community-based intervention program for seniors receiving congregate meals. OBJECTIVES/GOALS: The Rockefeller University, Clinical Directors Network, and Carter Burden Network received an Administration f...

IMPACT: This change will improve primary care physicians and pediatrics ability to identify, intervene and prevent obesity related renal damage in the vulnerable population of young adults OBJECTIVES/GOALS: Obesity related glomerulopathy has a reversible stage manifested as hyperfiltration. Early intervention depends on the ability to identify hype...

IMPACT: Understanding the mechanism underlying the DASH diet may shed light on the physiologic process by which nutrition influences blood pressure and potentially lead the way to new therapeutics that target ion channels. OBJECTIVES/GOALS: Hypertension is a disease of the westernized world, as it stems from lifestyle habits. Lower salt consumption...

The recipients of NIH’s Clinical and Translational Science Awards (CTSA) have worked for over a decade to build informatics infrastructure in support of clinical and translational research. This infrastructure has proved invaluable for supporting responses to the current COVID-19 pandemic through direct patient care, clinical decision support, trai...

Importance: Obesity related glomerulopathy (ORG), part of the cardiorenal spectrum, has an early reversible stage of hyperfiltration. Early identification in the obese adolescent population provides an opportunity to reverse the damage. Objective: Age appropriate formulae for estimated glomerular filtration rate (eGFR), are standardized to ideal bo...

Breast cancer and cardiovascular-specific mortality are higher among blacks compared with whites, but disparities in cancer therapy-related adverse cardiovascular outcomes have not been well studied. We assessed for the contribution of race and socioeconomic status on cardiotoxicity among women with HER2-positive breast cancer. This retrospective c...

Leadership is an essential competency for clinicians; however, these skills are not a standard part of health professionals’ education and training. Access to resources (time, money) is frequently cited as a barrier for clinicians to participate in leadership development programs. We aimed to tackle this barrier within postgraduate health professio...

Background: Low-income and minority women are significantly more likely to be diagnosed with preventable, late-stage cancers and suffer from depression than the general population. Intervention studies aiming to reduce depression to increase cancer screening among underserved minority women are sparse. Methods: This patient-centered outcomes tri...

Background The Rockefeller University Center for Clinical and Translational Science (RU-CCTS) and Clinical Directors Network (CDN), a Practice-Based Research Network (PBRN), fostered a community–academic research partnership involving Community Health Center (CHCs) clinicians, laboratory scientists, clinical researchers, community, and patient part...

Virtual technologies can facilitate clinical monitoring, clinician-patient interactions, and enhance patient-centered approaches to healthcare delivery. Telemedicine, two-way communication between a healthcare provider and a patient not in the same physical location, emphasizes patient preference and convenience by substituting the transportation o...

Background Women from low-income, racial/ethnic minority backgrounds receive fewer cancer screenings than other women and have higher rates of depression, which can interfere with cancer screening participation. Objective Assess the comparative effectiveness of two interventions to improve breast, cervical, and colorectal cancer screening and redu...

Objective The goal of this study was to determine if a 6-week, peer-led intervention improves health literacy and numeracy among people living with HIV (PLWH). Methods We used a randomized controlled trial with repeated measurements, which included six, 90-minute, group-based training sessions. We recruited PLWH participants (n = 359) from safety-...

Background Methicillin-Resistant (MRSA) or Methicillin-Sensitive (MSSA) Staphylococcus aureus skin and soft tissue infections (SSTIs) pose serious clinical and public health challenges. Few protocols exist for outpatient education, decolonization and decontamination. Objectives This trial implemented infection prevention protocols in homes via Comm...

BACKGROUND: Recurrent skin and soft tissue infections (SSTI) caused by Community-Associated Methicillin-Resistant (CA-MRSA) or Methicillin-Sensitive Staphylococcus aureus (CA-MSSA) present treatment challenges. OBJECTIVES: Can an evidence-based intervention (CDC Guidelines, topical decolonization, surface decontamination) reduce SSTI recurrence, mi...

Introduction Recognition of faces of family members, friends, and colleagues is an important skill essential for everyday life. Individuals affected by prosopagnosia (face blindness) have difficulty recognizing familiar individuals. The prevalence of prosopagnosia has been estimated to be as high as 3%. Prosopagnosia can severely impact the quality...

Life course research embraces the complexity of health and disease development, tackling the extensive interactions between genetics and environment. This interdisciplinary blueprint, or theoretical framework, offers a structure for research ideas and specifies relationships between related factors. Traditionally, methodological approaches attempt...

Introduction to the JCTS special issue on Dissemination and Implementation Sciences - Volume 4 Issue 3 - Kathleen R. Stevens, Jonathan N. Tobin

OBJECTIVES/GOALS: The Rockefeller University CCTS, Clinical Directors Network (CDN), and Carter Burden Network (CBN) received a DHHS-Administration for Community Living Nutrition Innovation grant to test whether implementation of DASH-concordant meals and a program to enhance self-efficacy, could lower blood pressure among seniors aging in place. M...

OBJECTIVES/GOALS: 1. Examine the associations among BMI and markers of cardiometabolic risk, including blood pressure, lipids and blood glucose. 2. Assess prevalence of kidney function deterioration, identified as hyperfiltration and moderately increased albuminuria (MIA), in obese compared to normal weight adolescents. METHODS/STUDY POPULATION: D...

OBJECTIVES/GOALS: 1. analyze urinary protein exosome content pattern before and during DASH diet. 2. characterize urine electrolyte changes associated with changes in protein profiles, and hormonal changes before/after DASH diet. 3. analyze the association of these changes to the DASH-related BP response. METHODS/STUDY POPULATION: In this proof of...

Problem There is a lack of leadership training in health care despite it being an essential competency for providers to deliver accessible, high quality healthcare and navigate a continually changing system. The barriers to adding leadership development to the various stages of medical training are numerous. A specific barrier is the lack of access...

Although highly involved in heart failure (HF) patients' care, home care workers (HCWs) lack HF training and are poorly integrated into the healthcare team. For its potential to address these challenges, we examined the role of technology among HCWs caring for HF patients. We conducted 38 interviews with key stakeholders. Overall, four themes emerg...

Purpose The aim of the study was to estimate distinct trajectories of depressive symptoms among adolescent women across the perinatal period. Methods Using longitudinal depressive symptom data (Center for Epidemiologic Studies Depression Scale) from control participants in the Centering Pregnancy Plus Project (2008–2012), we conducted group-based...

The National Institutes of Health requires data and safety monitoring boards (DSMBs) for all phase III clinical trials. The National Heart, Lung and Blood Institute requires DSMBs for all clinical trials involving more than one site and those involving cooperative agreements and contracts. These policies have resulted in the establishment of DSMBs...

Antiretroviral therapy (ART) prevented premature mortality and improved the quality of life among people living with the human immunodeficiency virus (PLWH), such that now more than half of PLWH in the United States are 50 years of age and older. Increased longevity among PLWH has resulted in a significant rise in chronic, comorbid diseases. Howeve...

People living with HIV (PWH) are at higher risk for cardiovascular disease (CVD) and stroke in comparison to their non-infected counterparts. The ABCS (aspirin-blood pressure control-cholesterol control-smoking cessation) reduce atherosclerotic (ASCVD) risk in the general population, but little is known regarding strategies for promoting the ABCS a...

Background Little is known about strategies to improve patient activation, particularly among persons living with HIV (PLWH). Objective To assess the impact of a group intervention and individual coaching on patient activation for PLWH. Design Pragmatic randomized controlled trial. Sites Eight practices in New York and two in New Jersey serving...

Background Intimate partner violence (IPV) during pregnancy is associated with adverse maternal and child health outcomes, including poor mental health. Previous IPV research has largely focused on women’s victimization experiences; however, evidence suggests young women may be more likely to engage in bilateral violence (report both victimization...

Background To address an urgent need to advance the field of community engaged research, faculty at Vanderbilt University Medical Center and Meharry Medical College organized the national meeting "Advancing the Science of Community Engaged Research (CEnR): Innovative & Effective Methods of Stakeholder Engagement in Translational Research, Washingto...

OBJECTIVES/SPECIFIC AIMS: The Rockefeller University Center for Clinical and Translational Science (RU-CCTS), Clinical Directors Network (CDN), and Carter Burden Network (CBN), a multi-site senior services organization serving East Harlem, NY, formed a community-academic research partnership to characterize the health of the CBN seniors (many who a...

Objective This longitudinal study examined access to, and factors associated with, receipt of sexual and reproductive health services deemed essential by the World Health Organization among pregnant adolescents in New York City. Methods Participants included 649 pregnant adolescents, ages 14–21 who were enrolled in a clustered randomized controlle...

Background Electronic health records (EHR) present a research opportunity to provide “rapid assays” for building prospective (historical cohort) studies. However, there are significant challenges to extracting and harmonizing data from different hospital and ambulatory care systems that need to be overcome before EHRs can be readily used to study n...

Introduction Early life exposures affect health and disease across the life course and potentially across multiple generations. The Clinical and Translational Research Institutes (CTSIs) offer an opportunity to utilize and link existing databases to conduct lifespan research. Methods A survey with Lifespan Domain Taskforce expert input was created...

Objective To measure the association of preconception health insurance status with preconception health among women in New York City, and examine whether this association is modified by race/ethnicity. Methods Using data from the New York City Pregnancy Risk Assessment Monitoring System 2009–2011 (n = 3929), we created a “Preconception Health Score...