Karen Donelan

Brandeis University · Florence Heller Graduate School

This study examined COVID-19 infection and hospitalizations among people with serious mental illness who resided in residential care group homes in Massachusetts during the first year of the COVID-19 pandemic. The authors analyzed data on 2261 group home residents and COVID-19 data from the Massachusetts Department of Public Health. Outcomes includ...

Objectives: Individuals living in group homes during the COVID-19 pandemic faced unique challenges and health risks related to living in shared spaces. This study aimed to assess the experiences of living and working in a group home during the pandemic and to explore the role of the built environment. Study design and methods: We conducted longi...

Rationale: The informal caregivers who provide unpaid support for persons living with dementia (PLWD) are often unprepared to appropriately manage symptoms and navigate health services to support themselves or the PLWD. Aim: To understand informal caregivers' perceived capabilities of handling dementia symptomology and perceived support from pro...

Hospitals are an important setting to provide harm reduction services to people who inject drugs (PWID). This study aimed to characterize PWID's injection practices, the perceived risk and benefits of those practices, and the immediate IDU risk environment among individuals seeking medical care. Surveys were administered to 120 PWID seeking medical...

Objective: IgG4-related disease (IgG4-RD), a multi-organ autoimmune disease, causes diverse manifestations that can lead to symptoms and distress. We developed and validated the Symptom Severity Index (SSI) to assess symptom burden. Methods: A pilot SSI was tested in n = 5; several gaps were identified. Twenty semi-structured qualitative intervi...

People with Down syndrome (DS) have a unique medical profile which may impact views of health. We aimed to study the use of global health measures for DS in a national cohort. We prospectively surveyed parents of individuals with DS from the DS-Connect® registry with validated Patient Reported Outcomes Measurement Information System (PROMIS)® instr...

Importance: Direct reports of the experiences of staff working in group homes for people with serious mental illness (SMI) and/or intellectual or developmental disabilities (ID/DD) are rarely reported. Hearing from workers about their experiences in the COVID-19 pandemic may inform future workforce and public policy. Objective: To gather baselin...

Background Heart failure (HF) is one of the leading causes of hospital admissions. Clinical (eg, complex comorbidities and low ejection fraction) and social needs factors (eg, access to transportation, food security, and housing security) have both contributed to hospitalizations, emphasizing the importance of increased clinical and social needs su...

BACKGROUND Heart failure (HF) is one of the leading causes of hospital admissions. Clinical (eg, complex comorbidities and low ejection fraction) and social needs factors (eg, access to transportation, food security, and housing security) have both contributed to hospitalizations, emphasizing the importance of increased clinical and social needs su...

Background: In January 2021, Massachusetts granted nurse practitioners (NPs) full-practice authority (FPA). Little is known about how FPA changes the day-to-day work of NPs. Purpose: To examine changes in practice barriers and care delivery in the early stages of FPA. Methodology: Descriptive analysis of a web-based survey of clinically active...

Background: Coaching has been shown to decrease physician burnout; however, coachee outcomes have been the focus. We report the impact of coaching on women-identifying surgeons who participated as coaches in a 9-month virtual program. Methods: A coaching program was implemented in the Association of Women Surgeons (AWS) to determine the effects...

Background: Down syndrome is the most common liveborn genetic condition. However, there are no surveys measuring societal services and supports for people with Down syndrome. We developed a questionnaire so that initiatives could be targeted towards countries most in need of assistance. Method: We formed a geographically diverse group of physici...

Background: Down syndrome (DS) has a unique medical and psychological profile that could impact how health is defined on three dimensions: physical, social and mental well-being. Methods: In 2021, we presented our proposed conceptual model to three expert panels, four focus groups of parents of individuals with DS age 0-21 years and four focus g...

Background Nurse care managers (NCM) operate through care management programs to provide care for persons living with dementia (PLWD) and interact regularly with their family caregivers; however, most do not receive formal instruction in dementia care or caregiver support. CRESCENT (CaReEcoSystem primary Care Embedded demeNtia Treatment) is a telep...

Injection drug use carries significant risks for injury and infection, particularly when injection supplies are reused or shared. Syringe service programs and pharmacy nonprescription sale of syringes minimize this risk by promoting access to supplies. This study aimed to characterize how individuals accessing medical care obtain supplies and the i...

Background: People with serious mental illness (SMI) and intellectual disabilities and/or developmental disabilities (ID/DD) living in group homes (GHs) and residential staff are at higher risk for COVID-19 infection, hospitalization, and death compared with the general population. Methods: We describe a hybrid type 1 effectiveness-implementatio...

Introduction: As individual interventions, home-based care and remote monitoring have been shown to help prevent hospitalizations for those with heart failure (HF) although both interventions have been limited by scalability and technical constraints, respectively. Few qualitative studies have explored patient perspectives, including acceptability...

Objective: To evaluate existing federal survey data infrastructure pertaining to firearms and firearm-related violence. Summary background data: Firearm-related violence results in more than 40,000 deaths in the United States (US) each year. Limited federal investments over the past 25 years have restricted a systematic approach to federal data...

OBJECTIVE Using the reach, effectiveness, adoption, implementation and maintenance (RE-AIM) framework for implementation science, we describe the implementation and impact of a virtual coaching program designed and conducted through a national surgical organization. DESIGN The Association of Women Surgeons recruited and trained surgical faculty as...

Objective: Evaluate the effect of a virtual coaching program offered to women surgery residents in a surgical society. Summary background data: Randomized controlled experiments evaluating the effect of coaching on trainee well-being and burnout is lacking. Methods: Women surgery residents in the Association of Women Surgeons were recruited to...

6508 Background: Childhood cancer survivors are vulnerable to being underinsured and health insurance-related financial burden. Low health insurance literacy reduces survivors’ ability to utilize health insurance. We conducted a pilot randomized controlled trial (RCT) to assess a virtually delivered health insurance navigation tool (HINT) intervent...

Background: Views can be collected from individuals (self-report) or others on their behalf (proxy-report). Objective: We aimed to review the literature on methods and statistical approaches used to evaluate observer versus self-report responses from individuals with intellectual disability or Down syndrome. Methods: A series of key questions...

Background: Early intervention (EI) providers work with parents of children with or who have risk factors of developmental delay or disability through Part C of the Individuals with Disabilities Education Act. Many parents in the United States have low health literacy; therefore, EI providers should be aware of and address families' health literac...

Background As the United States population is aging, there is a chronic shortage of geriatrics- and gerontology- trained clinicians despite a variety of incentives. With primary care clinicians also in short supply, health systems are trying to cope with the increasing demand for care for older adults Purpose The purpose of this study was to exami...

Analysis of Current Population Survey data suggests a tightening labor market for registered nurses, licensed practical nurses, and nursing assistants, marked by falling employment and rising wages through June 2021. Unemployment rates remain higher in nonhospital settings and among registered nurses and nursing assistants who are members of racial...

The Care Ecosystem (CareEco) model is a telephone-based dementia care program providing standardized, personalized and scalable support and education for caregivers and persons living with dementia (PLWD), medication guidance, and promotion of proactive decision-making. It has demonstrated improvement in quality of life for PLWD and reduced unneces...

Purpose: Through a survey-based approach, we sought to investigate regional differences in gender-affirming hormone therapy (GAHT) prescribing practices, as well as HIV screening and prevention practices among clinicians providing care to transgender individuals. Methods: Our survey was disseminated between December 2019 and January 2021 to clin...

Background: Audio recordings of oncology clinic discussions can help patients retain and understand information about their disease and treatment decisions. Access to this tool relies on acceptance of recordings by oncologists. This is the first study to evaluate experience and attitudes of oncologists toward patients recording clinic visits. Met...

Different staffing configurations in primary and geriatric care practices could have implications for how best to deliver services that are essential for a growing population of older adults. Using data from a 2018 survey of physicians (MDs) and nurse practitioners (NPs) working in primary and geriatric care, we assessed whether different configura...

Objectives: To identify areas where transition from hospital to community could be improved, with a special focus on racial, ethnic, and language differences. Study design: A cross-sectional survey administered by postal mail and bilingual telephone interviewers. Methods: Patients were randomly selected within strata by race, ethnicity, and la...

Background Recruitment of volunteers is a major challenge for clinical trials. There has been increasing development and use of Internet-based portals in recruitment for clinical research. There has been little research on researcher use and perceptions of these portals. Objectives This study evaluated researcher perceptions of use of Rally, an Int...

Background Coaching has been shown to improve resident well-being; however, not all benefit equally.Objective Assess predictors of changes in resident physician well-being and burnout in a multisite implementation of a Professional Development Coaching Program.DesignPre- and post-implementation surveys administered to participant cohorts at impleme...

Background Mobility limitations are the most common disability type among the 61 million Americans with disability. Studies of patients with mobility limitations suggest that inaccessible medical diagnostic equipment poses significant barriers to care. Methods We surveyed randomly selected U.S. physicians nationwide representing 7 specialties abou...

Background: We are currently facing unprecedented humanitarian crises. With diabetes at record-high levels and projected increases in humanitarian crises globally, data on the burden and management of DM in humanitarian crises is needed to stop unnecessary disability and death. Methods: We surveyed data on diabetes care provision in humanitarian me...

Importance Value-based care within accountable care organizations (ACOs) has magnified the importance of reducing preventable hospital readmissions. Community health worker (CHW) interventions may address patients’ unmet psychosocial and clinical care needs but have been underused in inpatient and postdischarge care. Objective To determine if pair...

Purpose People with Down syndrome (DS) have a unique medical profile which may impact views of health. We aimed to explore the use of global health measures in DS. Methods Prospective survey in the Mass General Hospital Down Syndrome Program (MGH DSP) from December 2018 to July 2019 with Patient Reported Outcomes Measurement Information System (PR...

The COVID‐19 pandemic necessitated a rapid transition from in‐person office visits to virtual visits in the Down syndrome specialty program at Massachusetts General Hospital (MGH DSP). We describe the clinic transition to virtual visits in April 2020 and reflect on our six‐month experience in virtual visits. Clinic metrics were tracked. Electronic...

More than sixty-one million Americans have disabilities, and increasing evidence documents that they experience health care disparities. Although many factors likely contribute to these disparities, one little-studied but potential cause involves physicians' perceptions of people with disability. In our survey of 714 practicing US physicians nation...

There is growing recognition of the importance of engaging patients early in the design of research studies. For studies involving patients with intellectual and cognitive disabilities, researchers may consider engaging with family caregivers, health professionals, community advocates, and/or subject matter experts to provide a more multifaceted, s...

Background Population aging and physician shortages have motivated recommendations of increased use of registered nurses in care provision; little is known about RN and NP employment in primary care and geriatric practices or service types each provide. Purpose Determine current RN and NP employment frequency in practices in the U.S., identify ser...

A mobile addiction-focused outreach program designed to improve access to care for people experiencing homelessness was implemented in response to the opioid overdose crisis. This innovative program was readily accepted among participants and can inform the development of similar programs delivering addiction-focused care to people experiencing hom...

Rationale and Objectives Although the evidence for the benefits of breastfeeding is strong, parents are often unable to continue breastfeeding upon returning from maternity leave for a variety of reasons. Breastfeeding parents in medicine face unique challenges upon returning to the workforce after maternity leave. Current research on breastfeeding...

Rationale and Objectives To assess resident and fellowship program director (PD) perceptions of the abdominal radiology fellowship application process following the first cycle in which an embargo on interviews until December 1, 2019 was set according to the Society of Chairs of Academic Radiology Departments (SCARD) timeline for the 2021–2022 abdo...

Background The U.S. health care system faces increasing pressures for reform. The importance of nurses in addressing health care delivery challenges cannot be overstated. Purpose To present a Nursing Health Services Research (NHSR) agenda for the 2020s. Method A meeting of an interdisciplinary group of 38 health services researchers to discuss fi...

An amendment to this paper has been published and can be accessed via a link at the top of the paper.

290 Background: The high prevalence of smartphone use means that most patients can easily audio record medical consultations. Oncologists’ attitudes towards recording visits are unknown yet may impact patient care. Methods: A mail survey of oncologists practicing at 5 U.S. Alliance for Clinical Trials in Oncology sites collected information on clin...

Purpose: We sought to determine if a novel online health tool, called Down Syndrome Clinic to You (DSC2U), could improve adherence to national Down syndrome (DS) guidelines. We also sought to determine if primary care providers (PCPs) and caregivers are satisfied with this personalized online health tool. Methods: In a national, randomized contr...

Background Drug allergy is frequently reported, but uncommonly confirmed with diagnostic testing. Although drug allergy assessments can improve clinical care, patient concerns may impact the optimal diagnostic approach and/or the clinical effectiveness of diagnostic testing. Objective To assess drug allergy patient concerns. Methods Using data fr...

Background Massachusetts One Care was the first program approved among the Centers for Medicare & Medicaid Financial Alignment Demonstrations for dually eligible beneficiaries. The only program focusing on dually eligible beneficiaries ages 21–64, One Care espouses an independent living philosophy for persons with disabilities. Researchers engaged...

Importance The delivery of emergency, trauma, critical and intensive care services requires coordination among all members of the care team. Perceived teamwork and role clarity may vary among physicians (MDs) and nurse practitioners (NPs). Objective To examine differences in perceived roles and responsibilities of NPs and MDs practicing in emergen...

Background: We sought to understand differences in surgical practice, compensation, personal life, and health and wellness between male and female trauma surgeons. Methods: An electronic survey study of members of The Eastern Association for the Surgery of Trauma was carried out. Using univariate and bivariate analyses, we compared the differenc...

Objective: The impact of mammography screening recall on quality-of-life (QOL) has been studied in women at average risk for breast cancer, but it is unknown whether these effects differ by breast cancer risk level. We used a vignette-based survey to evaluate how women across the spectrum of breast cancer risk perceive the experience of screening...

Purpose: After the Society of Chairs of Academic Radiology Departments timeline and guidelines were released for the 2021-2022 fellowship application cycle, the Society of Abdominal Radiology conducted a survey of residents, fellows and abdominal imaging fellowship program directors (PDs) to assess stakeholders' perceptions of changes in the fello...

Social workers (SW) and community health workers (CHW) have emerged as key workforce personnel in efforts to care for elders in the U.S. However, little is known about the presence and roles of SW and CHW in primary care practices. This paper presents findings from a nationally representative survey of geriatrics and primary care practices. Physici...

As the US population ages, primary care is expected to be the health care “home” for older adults, and several initiatives are aimed at helping to transform primary care practice to care for this population. Wide variation in staffing has been observed. Meyers et al proposed ideal models of primary care staffing for a general population and for a f...

Social workers (SW) and community health workers (CHW) have emerged as key workforce personnel in efforts to care for elders in the U.S. However, little is known about the presence and roles of these professionals in outpatient practices. This paper presents findings from a nationally representative survey of geriatrics and primary care practices....

In 2017, as part of a study to understand the evolving roles of nurses, physicians and social workers in leading and working in teams, our interprofessional team explored 22 sites of care for frail elderly adults in five US regions (Chicago IL, Denver CO, Tampa/Orlando FL, San Diego CA, New England).. The purpose of these site visits was to underst...

This symposium will include 3 papers that provide critical interprofessional and interdisciplinary perspectives on our work to understand and measure staffing in health care teams caring for older adults, and frail older adults. The Health Teams for Frail Elders project was funded by the Gordon and Betty Moore Foundation from August 2016 to October...

Care management programs have become more widely adopted as health systems try to improve the coordination and integration of services across the continuum of care, especially for frail older adults. Several models of care suggest the inclusion of registered nurses (RNs) and social workers to assist in these activities. In a 2018 national survey of...

Purpose: The aim of this study was to identify potential barriers to building a diverse workforce in radiology and radiation oncology by conducting a national survey of physicians in these fields and studying their reported career experiences. Methods: An electronic survey of ACR members (February 27, 2018, to April 26, 2018) was conducted in wh...

Background: Preventable hospital readmissions are costly and erode the quality of care delivery. Few efforts to incorporate the patient perspectives and social factors associated with readmission preventability exist. Objective: To identify patient perceptions and social barriers to care related to readmission. Methods: Prospective cohort stud...

Objectives: The increasing and widespread availability of personal technology offers patients and clinicians the opportunity to utilize real-time virtual communication to enhance access to health services. Understanding the perceived value of different modes of care may help to shape the future use of technology. Study design: Cross-sectional su...

Objective: The purpose of this study is to determine both the frequency of repeat CT performed within 1 month after a patient visits the emergency department (ED) and undergoes CT evaluation for abdominal pain and the frequency of worsened or new CT-based diagnoses. Subjects and methods: Secondary analysis was performed on data collected during...

Purpose: Survivors of childhood cancer require life-long outpatient healthcare, which may be impacted by health insurance. This study sought to understand survivors' utilization of outpatient healthcare provider services. Methods: The study examined cross-sectional survey data using an age-stratified sample from the Childhood Cancer Survivor Stu...

Background: In 2011, there were approximately 3.3 million adult 30-day all-cause hospital readmissions in the US generating $41.3 billion in hospital costs. Community health worker (CHW) care delivery is one of very few interventions demonstrated to reduce health care utilization among populations with chronic disease. While there are a number of...

Quality measures are increasingly used to measure the performance of providers, hospitals, and health care systems. Intensive care units (ICUs) are an important clinical area in hospitals, given that they generate high costs and present high risks to patients. Yet, currently, few valid and clinically significant ICU-specific outcome measures are re...

Introduction One in two physicians experiences professional burnout. Resident coaching is a novel method to provide emotional support and professional development to residents. The feasibility of implementing coaching at a community hospital has not been reported. This curricular innovation examined the feasibility and impact of integrating positiv...

Background: In October 2013, Massachusetts initiated the One Care demonstration, which enrolls beneficiaries ages 21 to 64 dually-eligible for Medicare and Medicaid. Local disability advocates argued that persons with disability should assess their own One Care quality. Objectives: To test the comparative effectiveness for improving patient-repo...

Background. A preference-based quality-of-life index for non–small cell lung cancer was developed with a subset of Functional Assessment of Cancer Therapy (FACT)–General (G) and FACT–Lung (L) items, based on clinician input and the literature. Design. A total of 236 non–small cell lung carcinoma patients contributed their preferences, randomly allo...

The purpose of this project was to examine the interaction effect of diversity climate and respectful treatment on employee turnover intention.

Objective Although mentorship is essential for the professional development of physicians, the literature on trainees’ mentorship experiences and perceptions of effective mentoring is more limited. This descriptive study examines residents’ experiences of mentoring and their perceptions about the impact of mentorship on professional development, co...

Objective Hospital readmissions comprise nearly a third of US healthcare expenditures. Fifteen to 20 per cent of this spending is considered to be potentially preventable. Risk prediction models have suboptimal accuracy and typically exclude patient experience data. No studies have explored patient perceptions of the likelihood of readmission durin...

Importance Childhood cancer survivors may be reluctant to make changes in their employment because of access to health insurance. Objective To examine the prevalence of “job lock” (staying at a job to keep work-related health insurance) in a sample drawn from an established, multi-institutional cohort of full-time employed childhood cancer survivo...

Advances in treatment have resulted in a growing population of more than 375 000 adult survivors of childhood cancer who are at high risk for long-term, treatment-related morbidity requiring ongoing medical surveillance.¹ Previous research with the multi-institutional Childhood Cancer Survivor Study (CCSS) revealed that childhood survivors were vul...

Objective: To assess the impact of hospital substance use disorder (SUD) initiative, which, beginning in October 2014, implemented an inpatient addiction consult team, a postdischarge addiction clinic, recovery coaches, and SUD treatment within primary care on general internists' attitudes, clinical practice, and preparedness to care for SUD. Met...

Objective: The objective of our study was to determine whether specific patient and physician factors-known before CT-are associated with a diagnosis of nonspecific abdominal pain (NSAP) after CT in the emergency department (ED). Materials and methods: We analyzed data originally collected in a prospective multicenter study. In the parent study,...

Background: When assessing results of health care delivery system reforms targeting persons with disability, quality metrics must reflect the experiences and perspectives of this population. Objective: For persons with disability and researchers to develop collaboratively a survey that addresses critical quality questions about a new Massachuset...

The Affordable Care Act includes financial assistance that reduces both premiums and cost-sharing amounts for lower-income Americans, to increase the affordability of health insurance coverage and care. To receive both types of assistance, enrollees must purchase a qualified health plan through a public insurance exchange, and those eligible for th...

Background: Thyroid cancer incidence is increasing. The effect of diagnosis and treatment on health related quality of life (HRQoL) is an essential variable given no change in life span for the majority of patients. HRQoL instruments, with data useful for between-disease comparisons, are being increasingly used for health policy and outcomes evalu...