Suzanne E Mitchell

Boston Medical Center · Department of Family Medicine

Purpose The purpose of this study was to develop a new measure to evaluate the ability to receive medical services when needed among persons with type 2 diabetes mellitus. Methods The Healthcare Access measure was developed using data from 225 persons with type 2 diabetes mellitus who completed an item pool comprised of 54 questions pertaining to...

Purpose To develop a new computer adaptive test that evaluates important aspects of medication adherence for persons with type 2 diabetes mellitus. Methods Two hundred and twenty-five people with type 2 diabetes mellitus completed 41 items related to medication adherence. Results Exploratory analysis supported the essential unidimensionality of t...

PurposeThe purpose of this study was to develop a new measure, the Re-Engineered Discharge for Diabetes Computer Adaptive Test (REDD-CAT) Illness Burden item bank, to evaluate the impact that a chronic condition has on independent living, the ability to work (including working at home), social activities, and relationships.Methods Semi-structured i...

Purpose: To determine if hospitalized patients with depressive symptoms will benefit from post-discharge depression treatment with care transition support. Methods: This is a randomized controlled trial of hospitalized patients with patient health questionnaire-9 score of 10 or more. We delivered the Re-Engineered Discharge (RED) and randomized...

Background Incorporating physical activity into lifestyle routines is recommended for individuals with type 2 diabetes. Accelerometers offer a promising method for objectively measuring physical activity and for assessing interventions. However, the existing literature for accelerometer-measured physical activity among middle-aged and older adults...

Research Objectives To detail the development of patient-reported outcome measures (PROs) that capture social determinants of health (SDOH) among individuals with Type 2 diabetes mellitus (T2DM). Design Observational survey study. Setting Academic medical center. Participants 225 individuals with T2DM. Interventions N/A. Main Outcome Measures...

Background: The purpose of this study was to develop and administer surveys that assess patient and family caregiver experiences with care transitions and examine the psychometric properties of the surveys. The surveys were designed to ask about 1) the transitional care services that matter most to patients and their caregivers and 2) care outcome...

In recent years, a growing body of research has established that social determinants of health influence the health outcomes of patients, especially those with T2DM. We developed a new patient-reported outcome (PRO) measure of an important social determinant of behavior that is specific to persons with T2DM: illness burden. Qualitative and quantita...

Background: Comorbid depression is associated with poor diabetes control. DMGVs improve glycemic control and depressive symptoms among patients with type 2 diabetes (T2DM). The WIC2 study compared the effectiveness of an eight-week DGMV conducted in a virtual world platform vs. an in-person format to improve diabetes outcomes for 288 minority women...

Introduction: Immersive online technologies, such as virtual world (VW) platforms, can increase patient engagement in DSME/S. The Women in Control 2.0 (WIC2) trial compared DSME/S delivered in a VW vs. in-person for minority women with uncontrolled type 2 diabetes (HbA1c ≥8.0). We hypothesize the sense of presence afforded by a VW platform fosters...

Over 27 million Americans have type 2 diabetes mellitus (T2DM), accounting for >7.7 million hospital admissions. Social determinants of behavior, including medication adherence, play a critical role in their health outcomes. We developed a new patient-reported outcome (PRO) measure to evaluate medication adherence in people with T2DM, using establi...

Objective: We aim to explore how users' experience of presence in a virtual world (VW) learning environment enhanced patient engagement in DSME/S programs conducted in an online VW platform with minority women with type 2 diabetes. Methods: We conducted an embedded, mixed methods study, using a convergent study design to analyze qualitative fiel...

BACKGROUND: The development of evidence-based care geared towards Black and Latina women living with uncontrolled type 2 diabetes is contingent upon their active recruitment into clinical interventions. Well-documented impediments to recruitment include a historical mistrust of the research community and socioeconomic factors that limit awareness a...

Background The purpose of this study was to develop and administer surveys that assess patient and caregiver experience with care transitions and examine the psychometric properties of the surveys. The surveys were designed to include the transitional care services or components of care, provided in the hospital and at home, that matter most to pat...

BACKGROUND Background: The development of evidence-based care geared towards Black/African American and Latina women living with uncontrolled type 2 diabetes is contingent upon their active recruitment into clinical interventions. Well-documented impediments to recruitment include a historical mistrust of the research community and socioeconomic fa...

Background The development of evidence-based care geared towards Black and Latina women living with uncontrolled type 2 diabetes is contingent upon their active recruitment into clinical interventions. Well-documented impediments to recruitment include a historical mistrust of the research community and socioeconomic factors that limit awareness an...

Background As health systems transition to value-based care, improving transitional care (TC) remains a priority. Hospitals implementing evidence-based TC models often adapt them to local contexts. However, limited research has evaluated which groups of TC strategies, or transitional care activities, commonly implemented by hospitals correspond wit...

Purpose: To characterize Latina experiences of a Spanish-language DSME program delivered in the VW versus a F2F format. Methods: Qualitative analysis of transcripts from three semi-structured focus groups conducted with 22 randomly selected Latina women enrolled in the Women in Control (WIC) DSME comparative effectiveness study. Two researchers cod...

Background: DSME improves diabetes outcomes, however participation is low. Virtual world (VW) technology is a scalable and engaging platform for DSME. The WIC study compared the effectiveness of DSME Medical Group Visits conducted in a VW platform vs. in-person to improve diabetes outcomes for minority women with uncontrolled type 2 diabetes (T2DM)...

Background: Research is needed to improve diabetes care of minority women who are disproportionately affected by type 2 diabetes. Yet, barriers exist that hinder efforts to include minority women in research. Evidence suggests that successful study enrollment requires multiple recruitment strategies. Little is known about the correlation between re...

Background Current treatment options for chronic pain and depression are largely medication-based, which may cause adverse side effects. Integrative Medical Group Visits (IMGV) combines mindfulness techniques, evidence based integrative medicine, and medical group visits, and is a promising adjunct to medications, especially for diverse underserved...

Purpose: Despite concerted actions to streamline care transitions, the journey from hospital to home remains hazardous for patients and caregivers. Remarkably little is known about the patient and caregiver experience during care transitions, the services they need, or the outcomes they value. The aims of this study were to (1) describe patient an...

Objectives Little is known about the acceptance of non-pharmacological group strategies delivered to low income racially diverse patients with chronic pain and depression. This paper examines how the Integrative Medical Group Visit (IMGV) addresses many of the deficits identified with usual care. Design and setting Six IMGVs cohorts were held at a...

Background Care transitions between clinicians or settings are often fragmented and marked by adverse events. To increase patient safety and deliver more efficient and effective health care, new ways to optimize these transitions need to be identified. A study was conducted to delineate facilitators and barriers to implementation of transitional ca...

Background Hospitalized patients are frequently unprepared to care for themselves after discharge often leading to unplanned hospital readmission. One strategy to reduce readmission rates is improving the quality of patient education and preparation before hospital discharge. The ReEngineered Discharge (RED) is a standardized hospital-based program...

Background Project Re-Engineered Discharge (RED) is an evidence-based strategy to reduce readmissions disseminated and adapted by various health systems across the country. To date, little is known about how adapting Project RED from its original protocol impacts RED implementation and/or sustainability. The goal of this study was to identify and c...

Transitional care (TC) has received widespread attention from researchers, health system leaders, clinicians, and policy makers as they attempt to improve health outcomes and reduce preventable hospital readmissions, yet little is known about the critical elements of effective TC and how they relate to patients' and caregivers' needs and experience...

Background: Given the public health crisis of opioid overprescribing for pain, there is a need for evidence-based non pharmacological treatment options that effectively reduce pain and depression. We aim to examine the effectiveness of the Integrative Medical Group Visits (IMGV) model in reducing chronic pain and depressive symptoms, as well as in...

Background: The current state of diabetes self-management (DSM) education and support for diabetic patients is inadequate, especially for minority women who experience disproportionately high rates of diabetes mellitus (DM) in the US. While DSM education and support enables individuals with diabetes to make positive lifestyle choices and achieve cl...

Background: The current state of diabetes self-management (DSM) education and support for diabetic patients is inadequate, especially for minority women who experience disproportionately high rates of diabetes mellitus (DM) in the US. While DSM education and support enables individuals with diabetes to make positive lifestyle choices and achieve c...

Purpose: The Integrative medicine group visits program (IMGV) is a 9-week intensive outpatient medical group visit program for chronic pain patients combining principles of mind-body techniques with group discussions on wellness topics. Methods: We conducted three focus groups (N=20) with participants with chronic pain and depression who had partic...

Background: The Re-Engineered Discharge (Project RED) reduces 30-day readmission rates by 30%. However, our data indicates that for patients displaying depressive symptoms during hospitalization, Project RED is less effective in preventing unplanned readmission. We aim to examine the effectiveness of RED-D, a modified brief Cognitive behavioral th...

Shared decision-making is a key determinant of patient-centered care. A lack of patient involvement in treatment decisions may explain persistent racial disparities in rates of cardiac catheterization (CCATH). To date, limited evidence exists to demonstrate whether patients who engage in shared decision-makingare more or less likely to undergo non-...

Systems and tools are needed to identify and mitigate preconception health (PCH) risks, particularly for African American (AA) women, given persistent health disparities. We developed and tested "Gabby," an online preconception conversational agent system. One hundred nongravid AA women 18-34 years of age were screened for over 100 PCH risks and ra...

The Re-Engineered Discharge (RED) program is a hospital-based initiative shown to decrease hospital reutilization. We implemented the RED in 10 hospitals to study the implementation process. We recruited 10 hospitals from different regions of the United States to implement the RED and provided training for participating hospital leaders and impleme...

Purpose The purpose was to characterize participants’ experiences of a diabetes self-management (DSM) education program delivered via a virtual world (VW) versus a face-to-face (F2F) format. Methods Participants included a randomly selected sample of participants who completed the Women in Control study. Four focus groups were conducted with 32 pa...

Background: Despite frequent encounters with the healthcare system and high risk for secondary conditions, it is unclear how frequently individuals living with serious physical disabilities document advance directives (AD) or engage in advance care planning (ACP). Their perspectives on these topics are largely unknown. Objective: We aimed to cha...

BACKGROUND Evidence suggests depression increases hospital readmission risk. OBJECTIVE Determine whether depressive symptoms are associated with unplanned readmission within 30 days of discharge of general medical patients. DESIGNSecondary analysis of the Project Re-Engineered Discharge (RED) randomized controlled trials. SETTINGUrban academic safe...

Limited research has been done to understand outcomes of continuing medical education offered in three-dimensional, immersive virtual worlds. We studied a case of a virtual world workshop on motivational interviewing (MI) applied to smoking cessation counseling and its educational impact. To facilitate content development and evaluation, we specifi...

Little is known about what students perceive they are taught about suffering in medical school. We sought to explore medical student perceptions of their medical school education about suffering. We used an online survey of medical students enrolled in four US medical schools with chi-square analysis of responses by gender and preclinical/clinical...

Little is known about the relationship between health literacy and complementary and alternative medicine (CAM) use in low-income racially diverse patients. The authors conducted a secondary analysis of baseline data from 581 participants enrolled in the Re-Engineered Discharge clinical trial. The authors assessed sociodemographic characteristics,...

Patient activation is linked to better health outcomes and lower rates of health service utilization. The role of patient activation in the rate of hospital readmission within 30 days of hospital discharge has not been examined. A secondary analysis using data from the Project RED-LIT randomized controlled trial conducted at an urban safety net hos...

Background: Innovative methods for overcoming ambivalence about contraceptive use to prevent unintended pregnancies in vulnerable populations are needed. Motivational interviewing (MI) has been found to be effective for resolving ambivalence about health behavior change, but implementation has been limited by the time, training and funding required...

Purpose: To develop an interactive decision aide using web-accessed relational agent technology, known as a virtual patient advocate (VPA), to support shared decision making and the uptake of contraception use for the prevention of unplanned pregnancy among young African American women. Method: The VPA is a computerized, animated character design...

Low health literacy is associated with higher mortality, higher rates of hospitalization, and poor self-management skills for chronic disease. Early, unplanned hospital reutilization after discharge is a common and costly occurrence in U.S. hospitals. Still, few studies have examined the relation between health literacy and 30-day hospital reutiliz...

In the 30 days after hospital discharge, hospital utilisation is common and costly. This study evaluated the association between gender and hospital utilisation within 30 days of discharge. Secondary data analysis using Poisson regression stratified by gender. 737 English-speaking hospitalised adults from general medical service in urban, academic...

: Hospital discharge may be an opportunity to intervene among patients with substance use disorders to reduce subsequent hospital utilization. This study determined whether having a substance use disorder diagnosis was associated with subsequent acute care hospital utilization. : We conducted an observational cohort study among 738 patients on a ge...

Motivational interviewing (MI) is an evidence-based, patient-centered counseling strategy proven to support patients seeking health behavior change. Yet the time and travel commitment for MI training is often a barrier to the adoption of MI by health care professionals. Virtual worlds such as Second Life (SL) are rapidly becoming part of the educat...

Little evidence exists to determine whether depression predicts hospital utilization following discharge among adult inpatients on a general medical service. We aimed to determine whether a positive depression screen during hospitalization is significantly associated with an increased rate of returning for hospital services. A secondary analysis wa...

In April 2006, the US Centers for Disease Control and Prevention (CDC) published clinical guidelines for preconception health and healthcare to promote improvements in pregnancy outcomes in the US. However, integrating preconception care (PCC) into clinical practice has proven challenging to clinicians. This is partly due to the perception that PCC...

Depression affects approximately 15% of the US population, and is recognized as an important risk factor for poor outcomes among patients with various illnesses. Automated health education and behavior change programs have the potential to help address many of the shortcomings in health care. However, the role of these systems in the care of patien...

To determine relationships between physical fitness and academic achievement in diverse, urban public school children. This cross-sectional study used public school data from 2004 to 2005. Academic achievement was assessed as a passing score on Massachusetts Comprehensive Assessment System (MCAS) achievement tests in Mathematics (fourth, sixth, and...