Research

Can public health services really be person-centered? Our view is that not only that we can, but that we must if we want services to be optimally effective, sustainable and successful. We have found evidence that patients have strong preferences for caring providers, even at the expense of considerable inconveniences. We recently completed a field experiment testing this hypothesis – with encouraging results. Read more on the measurements and design of the approach.

For many behaviors we seek to influence for health, there are no silver bullets. Adaptive interventions or strategies can help through offering relatively low-intensity interventions to all, and then escalating or intensifying assistance for those who demonstrate need over time, while drawing down assistance for those who are doing well. By pegging interventions to patient needs over time, adaptive interventions can meet both the needs of individuals (through responding to their behavior) but also the needs of public health (by intensifying only where needed reducing efforts where patients are doing well). We recently completed a sequential multiple assignment randomized trial on retention. More on analytical methods and upcoming work.

Our group is working to support local, regional as well international health agencies in the COVID-19 response. With colleagues in California, we have produced a local modeling platform for COVID-19. In Missouri we have carried out a population-based survey of COVID-19 burden as well as social harms and also worked to assess regional epidemiological and implementation directions, including characterizing illness course, community burden, structural drivers of racial disparities and policy effects. Our work seeks to change the narrative: “vaccine hesitancy” misdirects our attention to the decisions (faulty or not) of individuals, whereas the real solutions have to do with improving health systems and relations.

We are working to synthesize use narrative, scoping and systematic reviews, ongoing and emerging research on implementation the global HIV treatment, and provide support and evidence synthesis for the World Health Organization Guideline Development Group. In this project, we are also examining ways and methods to improve synthesis of implementation research. Traditional methods that assume one effect (or one distribution of effects) for a pharmacological intervention are a poor fit for implementation strategies, which are expected to have different effects (and effect sizes) in different contexts.