Behavior Change

“The everyday choices we make — like what we eat, how active we are, or what substances we put in our bodies—are key to preventing, developing, and managing disease. That’s why behavior change is so important to our research."

Jennifer McClure, PhD, 
Kaiser Permanente Washington Health Research Institute Director of Investigative Science

Research overview

If you’re like most people, your health depends more on what you do every day than on what your health care provider can do for you. Nonetheless, making healthy lifestyle choices can be difficult, especially when it means changing your daily routine and then maintaining these changes over time. That’s why Kaiser Permanente Washington Health Research Institute (KPWHRI) researchers want to make the right choices the easy and sustainable ones.

“The evidence is clear,” says Jennifer B. McClure, PhD, KPWHRI senior investigator and director of investigative science. “The most effective way to prevent the leading causes of death in the United States is to address their underlying behavioral risk factors: physical inactivity, poor nutrition, tobacco use, and excessive alcohol use. Collectively, these four behaviors account for over one third of all deaths.” But other behaviors are also critical to health and well-being, such as not misusing prescription opioids or marijuana, getting routine cancer screenings, and following your providers’ medical advice. That’s why KPWHRI scientists focus not only on individual behavior but also on ways to change health care systems.

“Our research is not just about empowering people to adopt healthy habits,” says Joe Glass, PhD, MSW, associate investigator. “It’s also about changing medical systems to best support these behavior changes.”

KPWHRI’s behavioral medicine research includes:

  • reducing  unhealthy use or abuse of substances such as tobacco, alcohol, cannabis, and opioids;
  • promoting physical activity, healthy eating, and weight loss;
  • improving oral health care;
  • increasing treatment adherence and routine cancer screening;
  • improving chronic pain management; and
  • creating personalized, convenient, effective behavioral interventions that can be delivered using various digital technologies.

“Historically our work has tested different forms of behavioral counseling or novel ways to deliver this counseling,” Dr. McClure says. “Increasingly, we are now testing digital therapeutic interventions delivered via smartphone app or text — for example, to help people set and achieve their health goals. People like the convenience of digital interventions, but it remains to be seen how effective they are and for whom they work best. Our research is helping to answer these important questions.”

Recent Publications on Behavior Change

Trinh L, Alibhai SMH, Culos-Reed N, Sabiston CM, Jones JM, Rosenberg DE, Whitehorn A, Bastas D, Faulkner GE. Associations of light physical activity, moderate-to-vigorous physical activity and sedentary behavior with quality of life in men on androgen deprivation therapy for prostate cancer: a quantile regression analysis. J Behav Med. 2022 Jan 21. doi: 10.1007/s10865-022-00285-7. Online ahead of print. PubMed

Rosenberg DE, Greenwood-Hickman MA, Zhou J, Cook AJ, Mettert KD, Cooper J, Arterburn D, Green BB, Walsh-Bailey C, Kerr J, Owen N, Dunstan D, McClure JB. Protocol for a randomized controlled trial of sitting reduction to improve cardiometabolic health in older adults. Contemp Clin Trials. 2021 Dec;111:106593. doi: 10.1016/j.cct.2021.106593. Epub 2021 Oct 16. PubMed

Chastin S, Gardiner PA, Harvey JA, Leask CF, Jerez-Roig J, Rosenberg D, Ashe MC, Helbostad JL, Skelton DA. Interventions for reducing sedentary behaviour in community-dwelling older adults. Cochrane Database Syst Rev. 2021 Jun 25;6:CD012784. doi: 10.1002/14651858.CD012784.pub2. PubMed

Crist K, Jankowska MM, Schipperijn J, Rosenberg DE, Takemoto M, Zlatar ZZ, Natarajan L, Benmarhnia T. Change in GPS-assessed walking locations following a cluster-randomized controlled physical activity trial in older adults, results from the MIPARC trial. Health Place. 2021 Apr 29;69:102573. doi: 10.1016/j.healthplace.2021.102573. [Epub ahead of print]. PubMed

Heffner JL, Watson NL, Dahne J, Croghan I, Kelly MM, McClure JB, Bars M, Thrul J, Meier E. Recognizing and preventing participant deception in online nicotine and tobacco research studies: suggested tactics and a call to action. Nicotine Tob Res. 2021 Apr 20:ntab077. doi: 10.1093/ntr/ntab077. Online ahead of print. PubMed

Researchers in Behavior Change

Katharine A. Bradley, MD, MPH

Senior Investigator
206-287-2151
Katharine.A.Bradley@kp.org

Curriculum vitae (CV)

Paula Lozano, MD, MPH

Senior Investigator, Kaiser Permanente Washington Health Research Institute
206-287-2113
Paula.Lozano@kp.org

Curriculum vitae (CV)

Jennifer B. McClure, PhD

Director, Investigative Science
206-287-2737
Jennifer.B.Mcclure@kp.org

Curriculum vitae (CV)

Dori E. Rosenberg, PhD, MPH

Associate Investigator
206-287-2532
Dori.E.Rosenberg@kp.org

Curriculum vitae (CV)

James D. Ralston, MD, MPH

Senior Investigator
206-287-2076
James.D.Ralston@kp.org

Curriculum vitae (CV)

Nora Henrikson, PhD, MPH

Associate Investigator
206-287-4675
Nora.B.Henrikson@kp.org

Curriculum vitae (CV)

Ben Balderson, PhD

Senior Collaborative Scientist
206-287-2803
Benjamin.H.Balderson@kp.org

Curriculum vitae (CV)

Gwen Lapham, PhD, MPH, MSW

Assistant Investigator
206-287-2021
Gwen.T.Lapham@kp.org

Curriculum vitae (CV)

Melissa L. Anderson, MS

Senior Collaborative Biostatistician
206-287-2647
Melissa.L.Anderson@kp.org

Curriculum vitae (CV)

Paula R. Blasi, MPH

Collaborative Scientist
206-287-2094
Paula.R.Blasi@kp.org

Curriculum vitae (CV)

Cara C. Lewis, PhD

Senior Investigator
206-442-4076
Cara.C.Lewis@kp.org

Curriculum vitae (CV)

Joseph E. Glass, PhD, MSW

Associate Investigator
206-287-4266
Joseph.E.Glass@kp.org

Curriculum vitae (CV)

Beverly B. Green, MD, MPH

Senior Investigator
206-287-2997
Bev.B.Green@kp.org

Curriculum vitae (CV)

Julie E. Richards, PhD, MPH

Senior Collaborative Scientist
206-287-2100
Julie.E.Richards@kp.org

Curriculum vitae (CV)

Lynn DeBar, PhD

Senior Investigator
(206) 287-2942
Lynn.Debar@kp.org

Curriculum vitae (CV)

Leah K. Hamilton, PhD

Collaborative Scientist
206-287-2515
Leah.K.Hamilton@kp.org

Curriculum vitae (CV)

Chloe Krakauer, PhD

Collaborative Biostatistician II
chloe.a.krakauer@kp.org

Curriculum vitae (CV)

Mikael Anne Greenwood-Hickman, MPH

Collaborative Scientist
(206) 287-2908
Mikael.Anne.Greenwood-Hickman@kp.org

Pamela A. Shaw, PhD, MS

Senior Biostatistics Investigator
Pamela.A.Shaw@kp.org

Curriculum vitae (CV)

Affiliate researchers

Sheryl L. Catz, PhD
Professor, Health Care Innovation and Technology, Betty Irene Moore School of Nursing
University of California–Davis

Sue McCurry, PhD
University of Washington (UW) Department of Psychosocial and Community Health

Emily Williams, PhD, MPH
UW Department of Health Services; VA Health Services Research & Development Center of Excellence