Lisa Klesges

Lisa Klesges
Washington University in St. Louis | WUSTL , Wash U · Department of Surgery

PhD

About

199
Publications
31,988
Reads
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8,971
Citations
Additional affiliations
July 2006 - August 2008
St. Jude Children's Research Hospital
Position
  • Associate Member
July 2004 - July 2006
Mayo Clinic - Rochester
Position
  • Professor
July 1995 - July 2004
The University of Tennessee Health Science Center
Position
  • Managing Director

Publications

Publications (199)
Article
Full-text available
Purpose Prior cancer research is limited by inconsistencies in defining rurality. The purpose of this study was to describe the prevalence of cancer risk factors and cancer screening behaviors across various county-based rural classification codes, including measures reflecting a continuum, to inform our understanding of cancer disparities accordin...
Preprint
BACKGROUND Hydroxyurea therapy is effective in reducing sickle cell disease (SCD)-related complications and is recommended by NHLBI care guidelines. However, hydroxyurea is underutilized, and adherence is suboptimal. We are testing a multi-level mobile health (mHealth) intervention to increase hydroxyurea adherence among patients and prescribing am...
Article
Purpose: Multidisciplinary lung cancer care is assumed to improve care delivery by increasing transparency, objectivity, and shared decision making; however, there is a lack of high-level evidence demonstrating its benefits, especially in community-based health care systems. We used implementation and team science principles to establish a colocat...
Article
Introduction Human papilloma virus (HPV) infection can cause cervical, anal, penile, vaginal, and oropharyngeal cancer. The CDC recommends HPV vaccination as a 2 or 3-dose series at <15 or ≥15 years, respectively. Completion of the vaccine series decreases rates of cervical cancer in young women by 29%(Guo, F. et al. American Journal of Preventive...
Article
Background: Sickle cell disease (SCD) is a chronic blood disorder, which disproportionately impacts Black individuals. Hydroxyurea therapy prevents SCD-related complications; yet it is underutilized, which contributes to further health inequities. Mobile health (mHealth) apps for patients and providers have the potential to improve hydroxyurea adhe...
Article
Full-text available
Objectives Sickle cell disease (SCD) leads to chronic and acute complications that require specialised care to manage symptoms and optimise clinical results. The National Heart Lung and Blood Institute (NHLBI) evidence-based guidelines assist providers in caring for individuals with SCD, but adoption of these guidelines by providers has not been op...
Article
Full-text available
Background Objectives were to describe barriers to pediatric cancer symptom management care pathway implementation and the impact of the COVID-19 pandemic on clinical research evaluating their implementation. Methods We included 25 pediatric oncology hospitals in the United States that supported a grant submission to perform a cluster randomized t...
Article
We recruited women (primarily non-Hispanic White) from 14 rural, segregated counties in a Northeastern US state for an explanatory sequential study: 100 women (ages 50–65 years) completed a survey, and 16 women participated in focus groups. We sought to identify personal (e.g., healthcare mistrust) and environmental (e.g., travel time to healthcare...
Article
Full-text available
Background There is a growing body of research and evidence for the efficacy of Internet-based eating disorder (ED) prevention interventions for adults. However, much less is known about the reach, adoption, implementation and maintenance of these interventions. The RE-AIM (reach, efficacy/effectiveness, adoption, implementation, maintenance) model...
Article
Full-text available
Background Online interventions to prevent mental health problems have proven to be effective. However, knowledge about their implementation in real-world practice as well as for dissemination to the target groups in different settings is scarce. The goal of the ‘ICare’ network is to establish a comprehensive model of eMental-health service deliver...
Article
Objective: To better address sociodemographic-related health disparities, this study examined which sociodemographic variables most strongly correlate with self-reported health in patients with chronic musculoskeletal pain. Design: This single-center, cross-sectional study examined adult patients followed by a physiatrist for chronic (≥4 years)...
Article
Background Historically, marginalized patients were prescribed less opioid medication than affluent, white patients. However, because of persistent differential access to non‐opioid pain treatments, this direction of disparity in opioid prescribing may have reversed. Objective To compare social disadvantage and health in patients with chronic pain...
Article
Full-text available
Introduction Suboptimal pathologic nodal staging prevails after curative-intent resection of lung cancer. We evaluated a lymph node specimen collection kit’s impact on lung cancer surgery outcomes in a prospective, population-based, staggered implementation study. Methods From January 1, 2014 to August 28, 2018, we implemented the kit in three hom...
Preprint
Full-text available
Background: To describe barriers to pediatric cancer symptom management care pathway implementation and the impact of the COVID-19 pandemic on clinical research evaluating their implementation. Methods: We included 25 pediatric oncology hospitals in the United States that supported a grant submission to perform a cluster randomized trial in which t...
Article
Full-text available
Background Individuals living with sickle cell disease often require aggressive treatment of pain associated with vaso-occlusive episodes in the emergency department. Frequently, pain relief is poor. The 2014 National Heart, Lung, and Blood Institute evidence-based guidelines recommended an individualized treatment and monitoring protocol to improv...
Preprint
Full-text available
BACKGROUND Individuals living with sickle cell disease (SCD) often require aggressive treatment of pain associated with vaso-occlusive episodes (VOEs) in the emergency department (ED). Frequently pain relief is poor. The 2014 National Heart, Lung, and Blood Institute (NHLBI) evidence-based guidelines recommended an individualized treatment and moni...
Article
Cancer in the United States accounts for $600 billion in health care costs, lost work time and productivity, reduced quality of life, and premature mortality. The future of oncology delivery must mend disconnects to equitably improve patient outcomes while constraining costs and burden on patients, caregivers, and care teams. Embedding learning hea...
Article
Background: Sickle cell disease (SCD) is an inherited blood disorder causing acute complications and chronic progressive end organ damage. SCD is associated with significant morbidity, early mortality, impaired health-related quality of life, and increased acute health care utilization. Hydroxyurea is a US Food and Drug Administration-approved medi...
Preprint
BACKGROUND Hydroxyurea therapy prevents disease complications among patients with sickle cell disease (SCD). Despite the evidence for its efficacy and endorsement by the National Health Lung and Blood Institute (NHLBI) evidence-based guidelines, adoption of this therapy is low, both by patients with SCD and their providers. Mobile health (mHealth)...
Article
Full-text available
Background: Hydroxyurea prevents disease complications among patients with sickle cell disease (SCD). Although its efficacy has been endorsed by the National Health Lung and Blood Institute evidence-based guidelines, its adoption is low, both by patients with SCD and providers. Mobile health (mHealth) apps provide benefits in improving medication...
Article
Full-text available
Background: Past research has yielded promising results on the effectiveness of Internet-based interventions to prevent eating disorders (EDs) in adolescents, but further information is needed to evaluate the public health impact of their large-scale dissemination. This article used an established framework to systematically review the extent to w...
Preprint
BACKGROUND Sickle cell disease (SCD) is an inherited blood disorder causing acute complications and chronic progressive end organ damage. SCD is associated with significant morbidity, early mortality and impaired health-related quality of life as well as increased acute healthcare utilization. Hydroxyurea is an FDA-approved medication that reduces...
Article
Background: Sickle cell disease (SCD) is an inherited blood disorder causing acute complications and chronic progressive end organ damage. SCD is associated with significant morbidity, early mortality, impaired health-related quality of life, and increased acute health care utilization. Hydroxyurea is a US Food and Drug Administration-approved med...
Article
6549 Background: LC is common and lethal; care-delivery is complex, varies in quality and outcomes, stimulating calls for multidisciplinary treatment planning (MTP) involving key specialists. This much-advocated model lacks rigorous evaluation. We conducted a prospective cohort study of MTP v Serial Care (SC) in a community healthcare system. Metho...
Article
The Society for Behavioral Medicine (SBM) recommends expanding access to high-speed, high-definition internet and increasing broadband width for rural communities in the USA to increase telehealth opportunities for populations facing geographic barriers to accessing quality healthcare. High-speed telehealth will allow healthcare providers to care f...
Article
Full-text available
Behavior change research to promote health and prevent disease increasingly relies on a complex set of interacting characteristics across levels of influence such as biological, psychological, behavioral, interpersonal, and environmental. How to best develop health-related interventions that incorporate the individual, the macro-environment, and th...
Article
Full-text available
Background: Child obesity is a major public health challenge, increasing the risk of chronic medical conditions such as type 2 diabetes, metabolic syndrome, and hypertension. Among U.S. states, Tennessee has one of the highest rates of child obesity. Emerging communication technologies can help to deliver highly disseminable population-level inter...
Article
Full-text available
Background: Responsible for 25% of all US cancer deaths, lung cancer presents complex care-delivery challenges. Adoption of the highly recommended multidisciplinary care model suffers from a dearth of good quality evidence. Leading up to a prospective comparative-effectiveness study of multidisciplinaryvs.serial care, we studied the implementation...
Poster
Full-text available
With a 17% prevalence rate, pediatric obesity is a public health challenge in Tennessee, increasing the risk for type 2 diabetes, metabolic syndrome, and hypertension among children. cUsing graphic design and media, a demonstration project, Memphis FitKids, was developed and implemented in the Greater Memphis Area, Tennessee, to educate parents abo...
Poster
With a 17% prevalence rate, pediatric obesity is a public health challenge in Tennessee, increasing the risk for type 2 diabetes, metabolic syndrome, and hypertension among children. Using graphic design and media, a demonstration project, Memphis FitKids (http://memphisfitkids.org/), was developed and implemented in the Greater Memphis Area, Tenne...
Article
Background: Whereas children's active travel to school (ATS) has confirmed benefits, only a few large national surveys of ATS exist. Methods: Using data from the Health Behavior in School-aged Children (HBSC) 2009-2010 US survey, we conducted a logistic regression model to estimate the odds ratios of ATS and a linear regression model to estimate...
Article
Improving quality of care in lung cancer, the leading cause of cancer death worldwide and in the United States, is a major public health challenge. Such improvement requires accurate and meaningful measurement of quality of care. Preliminary indicators have been derived from clinical practice guidelines and expert opinions, but there are few standa...
Article
Full-text available
U.S. Preventive Services Task Force (USPSTF) clinical guidelines at present rarely assign the highest grade recommendation to behavioral counseling interventions for chronic disease prevention or risk reduction because of concerns about the certainty and quality of the evidence base. As a result, the broad integration of behavioral counseling inter...
Article
Objectives: This study explored potential correlates of physical activity (PA) in African-American (AA) girls. Methods: PA was measured by accelerometry in 301 AA girls who also completed a written log. Demographic, psychosocial, and physical measures were entered into a hierarchical multiple linear regression to determine influences on PA. Ten ind...
Article
As the field of public health advances toward addressing complex, systemic problems, future public health professionals must be equipped with leadership and interprofessional skills that support collaboration and a culture of health. The University of Memphis School of Public Health has infused innovative strategies into graduate education via expe...
Article
Full-text available
Research often fails to find its way into practice or policy in a timely way, if at all. Given the current pressure and pace of health care change, many authors have recommended different approaches to make health care research more relevant and rapid. An emerging standard for research, the "5 R's" is a synthesis of recommendations for care deliver...
Article
Full-text available
Objectives: Elevated body mass index (BMI) has been reported in pediatric cancer survivors. It is unclear whether this is related to altered energy intake (via disordered eating), decreased energy expenditure (via limited exercise), or treatment-related direct/indirect changes. The aims of this study are to describe the occurrence of overweight an...
Article
Many grant proposals identify the use of a given evaluation model or framework but offer little about how such models are implemented. The authors discuss what it means to employ a specific model, RE-AIM, and key dimensions from this model for program planning, implementation, evaluation, and reporting. The authors report both conceptual and conten...
Article
Background: The objective of this study was to determine the longitudinal prevalence and predictors of dietary underreporting in African-American preadolescent girls and the association of baseline dietary underreporting with changes in BMI over a 2-year period as part of the Girls health Enrichment Multi-site Studies (GEMS). Methods: Energy was...
Article
Full-text available
In the dissemination and implementation literature, there is a dearth of information on the sustainability of community-wide physical activity (PA) programs in general and of the '10,000 Steps' project in particular. This paper reports a longitudinal evaluation of organizational and individual sustainability indicators of '10,000 Steps'. Among proj...
Article
To aid translation of childhood obesity interventions evidence into practice, research studies must report results in a way that better supports pragmatic decision making. The current review evaluated the extent to which information on key external validity dimensions, participants, settings, interventions, outcomes, and maintenance of effects, was...
Article
Full-text available
Context—To aid translation of childhood obesity research interventions evidence into practice, research studies must report results in a way that better supports pragmatic decision making. The current review evaluated the extent to which information on key external validity dimensions, participants, settings, interventions, outcomes, and maintenanc...
Conference Paper
Full-text available
Effective strategies for prevention of obesity, particularly in youths, have been elusive since the recognition of obesity as a major public health issue two decades ago. In general, obesity is a result of chronic, quantitative imbalance between energy intake and energy expenditure, which is influenced by a combination of genetic, environmental, ps...
Article
To examine family context in relation to body image, weight concerns, and weight control behaviors in preadolescent African American girls. Cross-sectional baseline data were analyzed from 303 African American girls 8 to 10 years old and a caregiver in the Girls health Enrichment Multi-site Studies Phase 2(GEMS), an obesity prevention intervention...
Data
Full-text available
Organizational survey. Organizational_survey_10000Steps.pdf Survey to assess organizational project awareness, adoption, implementation and long-term maintenance of '10,000 Steps'.
Data
Full-text available
Questionnaire for citizens. Questionnaire_citizens_10000Steps.pdf Questionnaire to assess individual project awareness and PA levels (including IPAQ).
Article
Full-text available
There are insufficient research reports on the wide-scale dissemination of effective whole-community physical activity (PA) programs. The purpose of this paper is to evaluate the impact of the wide-scale dissemination of '10,000 Steps', using the RE-AIM framework. Dissemination efforts targeted a large region of Belgium and were concentrated on med...
Article
Full-text available
To determine the efficacy of a 2-year obesity prevention program in African American girls. Memphis GEMS (Girls' health Enrichment Multi-site Studies) was a controlled trial in which girls were randomly assigned to an obesity prevention program or alternative intervention. Local community centers and YWCAs (Young Women's Christian Associations) in...
Article
Treatment studies provide minimal support for nicotine replacement therapy (NRT) with youth; however, survey studies suggest that adolescents use NRT, and may engage in inappropriate use. The current study sought to examine patterns of NRT use and risk factors for use to further aid smoking cessation efforts including prevention of potential misuse...