Margaret A. Handley

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BACKGROUND Although randomized controlled trials are often a gold standard for determining intervention effects, in the area of practice-based research (PBR), there are many situations in which individual randomization is not possible. Alternative approaches to evaluating interventions have received increased attention, particularly those that can retain(More)
OBJECTIVE Despite the importance of self-management support (SMS), few studies have compared SMS interventions, involved diverse populations, or entailed implementation in safety net settings. We examined the effects of two SMS strategies across outcomes corresponding to the Chronic Care Model. RESEARCH DESIGN AND METHODS A total of 339 outpatients with(More)
OBJECTIVE This paper explores the behavior change method of goal-setting and reviews the literature on goal-setting in primary care for patients with chronic conditions. METHODS A literature search was conducted resulting in eight articles meeting the criteria of goal-setting interventions in primary care for adults or adolescents with chronic conditions.(More)
BACKGROUND Health information technology can enhance self-management and quality of life for patients with chronic disease and overcome healthcare barriers for patients with limited English proficiency. After a randomized controlled trial of a multilingual automated telephone self-management support program (ATSM) improved patient-centered dimensions of(More)
BACKGROUND Clinical trials conducted in real world settings can improve the translation of research into practice. Although many experts have outlined strategies to conduct effectiveness research in primary care practices, there are few case studies describing how decisions and trade-offs influence the design and implementation of practical clinical trials.(More)
BACKGROUND Studies of the quality of tuberculosis (TB) diagnostic evaluation of patients in high burden countries have generally shown poor adherence to international or national guidelines. Health worker perspectives on barriers to improving TB diagnostic evaluation are critical for developing clinic-level interventions to improve guideline implementation.(More)
Background. Low-income minority women with prior gestational diabetes mellitus (pGDM) or high BMIs have increased risk for chronic illnesses postpartum. Although the Diabetes Prevention Program (DPP) provides an evidence-based model for reducing diabetes risk, few community-based interventions have adapted this program for pGDM women. Methods. STAR MAMA is(More)
BACKGROUND Tuberculosis (TB) remains under-diagnosed in many countries, in part due to poor evaluation practices at health facilities. Theory-informed strategies are needed to improve implementation of TB evaluation guidelines. We aimed to evaluate the impact of performance feedback and same-day smear microscopy on the quality of TB evaluation at 6 health(More)
BACKGROUND Chronic kidney disease (CKD) is common and is associated with excess mortality and morbidity. Better management could slow progression of disease, prevent metabolic complications, and reduce cardiovascular outcomes. Low patient awareness of CKD and ineffective patient-provider communication can impede such efforts. We developed provider and(More)
The NIH CTSA program (Clinical and Translational Science Awards) supports over 60 research centers working to accelerate scientific discovery, development and implementation to improve health. The CTSA initiative was launched in 2006 to accelerate progress along the research pipeline by overcoming the " translational roadblocks " identified by the Institute(More)