Dean Schillinger
Biographic Data
| ID | 1726869 |
|---|---|
| NAME | Dean Schillinger |
| GIVEN NAMES | Dean |
| FAMILY NAME | Schillinger |
| SIGNATURE | SCHILLINGER D |
| AFFILIATIONS | University of California, San Francisco |
| ORCID | 0000-0002-7221-7327 |
| VERIFIED | Yes |
| TOTAL WORKS | 45 |
| TOTAL CITATIONS | 67 |
| AUTHOR COUNT | 45 |
| EDITOR COUNT | 0 |
| FIRST PUBLICATION YEAR | 2002 |
| LATEST PUBLICATION YEAR | 2025 |
| H-INDEX | 5 |
The Effectiveness of Empowerment Versus Fear Messaging on Sugary Beverage Consumption Intentions Among Young Adult Latinas
Excessive sugar-sweetened beverage (SSB) consumption poses a significant public health concern, particularly among historically marginalized populations targeted by industry marketing. This study compares the effectiveness of empowerment-based versus fear-based messaging on individual sugary beverage consumption intention and critical health literacy among Latinas aged 18 to 29 years ( N = 231). Participants were randomized online to view either …
Impact of the 2009 WIC revision on infant and maternal health
“Don’t think of a soda”
To show how sugar-sweetened beverage (SSB) taxes were framed in posts on Twitter (now known as X) through text and images, we conducted a content analysis on a sample of Tweets from California users posted between January 1, 2015 and December 31, 2018 about SSB taxes in Berkeley, San Francisco, Oakland, and/or Albany, California. We evaluated posts for information sources, arguments for or against SSB tax policies, and images used. We found that …
Evaluation of Changes in Prices and Purchases Following Implementation of Sugar-Sweetened Beverage Taxes Across the US
In this cross-sectional study, SSB taxes led to substantial, consistent declines in SSB purchases across 5 taxed cities following price increases associated with those taxes. Scaling SSB taxes nationally could yield substantial public health benefits
De-normalizing sugar-sweetened beverage consumption
Among lower-income populations, social norms and attitudes towards the healthfulness of SSBs meaningfully declined over time, with smaller tax-related effects. SSB taxes as well as the local media attention they generate appear to affect people's perceptions of SSBs. Pairing SSB taxes with messaging campaigns may be more effective in de-normalizing SSB consumption
Did a workplace sugar-sweetened beverage sales ban reduce anxiety-related sugar-sweetened beverage consumption during the Covid-19 pandemic
Objective: Workplace sugar-sweetened beverage (SSB) sales bans can reduce SSB consumption. Because stress and anxiety can promote sugar consumption, we examined whether anxiety among hospital employees during the COVID-19 pandemic was associated with changes in SSB consumption and explored whether this relationship varied by exposure to a workplace SSB sales ban. Design: In a prospective, controlled trial of workplace SSB sales bans, we examined …
The “Survival Pending Revolution” Covid-19 vaccination campaign
Introduction: We carried out a two-phase, qualitative evaluation of a novel public health campaign to promote COVID-19 vaccination among youth and young adults of color (YOC), called Survival Pending Revolution. The campaign, commissioned by California's Department of Public Health, was created by YOC spoken word artists, under the direction of the organization, Youth Speaks. Methods: In phase 1, we describe the communication attributes of the ca…
Automated strategy feedback can improve the readability of physicians’ electronic communications to simulated patients
Developing and Testing Automatic Models of Patient Communicative Health Literacy Using Linguistic Features
Patients with diabetes and limited health literacy (HL) may have suboptimal communication exchange with their health care providers and be at elevated risk of adverse health outcomes. These difficulties are generally attributed to patients' reduced ability to both communicate and understand health-related ideas as well as physicians' lack of skill in identifying those with limited HL. Understanding and identifying patients with barriers posed by …
To Adapt or Not to Adapt
Self-management education (SME) is a key determinant of diabetes treatment outcomes. While SME programs are often adapted for implementation, the impact of adaptations on diabetes SME effectiveness is not well documented. This study evaluated the impact of the implementation fidelity of diabetes SME programs on program effectiveness, exploring which factors influence implementation fidelity. Data from 33 type 2 diabetes SME program providers and …
Schillinger and Ramírez Respond
Schillinger and Ramírez Respond Dean Schillinger MD, and A. Susana Ramírez PhD, MPH Affiliation Dean Schillinger is with the Health Communications Research Program, Center for Vulnerable Populations, San Francisco General Hospital, University of California, San Francisco. A. Susana Ramírez is with the Department of Public Health, School of Social Sciences, Humanities, and Arts, University of California, Merced.CopyRightCorrespondence should be se…
“It Gave Me Hope” Experiences of Diverse Safety Net Patients in a Group Acupuncture Intervention for Painful Diabetic Neuropathy
Purpose: To explore the experiences of living with painful diabetic neuropathy (PDN) and with a group acupuncture intervention in a sample of low-income, diverse patients. Methods: We conducted a randomized clinical trial of a 12-week group acupuncture intervention for PDN. Data included validated measures of patient-reported outcomes, including pain and quality of life (QOL), as well as semistructured qualitative interviews about participants' e…
From “Infodemics” to Health Promotion
Despite the ubiquity of health-related communications via social media, no consensus has emerged on whether this medium, on balance, jeopardizes or promotes public health. During the COVID-19 pandemic, social media has been described as the source of a toxic “infodemic” or a valuable tool for public health. No conceptual model exists for examining the roles that social media can play with respect to population health. We present a novel framework…
Sugar-Sweetened Beverage Consumption 3 Years After the Berkeley, California, Sugar-Sweetened Beverage Tax
Objectives. To estimate changes in sugar-sweetened beverage (SSB) and water consumption 3 years after an SSB tax in Berkeley, California, relative to unexposed comparison neighborhoods. Methods. Data came from repeated annual cross-sectional beverage frequency questionnaires from 2014 to 2017 in demographically diverse Berkeley (n = 1513) and comparison (San Francisco and Oakland; n = 3712) neighborhoods. Pretax consumption (2014) was compared wi…
Collaborative research and actions on both sides of the US-Mexico border to counteract type 2 diabetes in people of Mexican origin
BACKGROUND: Type 2 Diabetes (T2D) is now a massive epidemic in both California and Mexico, with serious consequences for social and economic well-being. A large proportion of these populations share common ethnic backgrounds. Yet diverse environmental and social conditions across regions create unique opportunities to explore the ways that T2D risk, incidence, management and outcomes manifest. MAIN TEXT: An action-oriented research consortium hea…
Do Low Income Youth of Color See “The Bigger Picture” When Discussing Type 2 Diabetes
Delivering TBP content to promote interactive reflection has potential to change behavioral norms and build capacity to confront the social, economic and structural factors that influence behaviors
Eating with others and meal location are differentially associated with nutrient intake by sex
Cancer genetic counseling communication with low-income Chinese immigrants
Legal, Practical, and Ethical Considerations for Making Online Patient Portals Accessible for All
Largely driven by the financial incentives of the HITECH Act’s Meaningful Use program as part of federal US health care reform, access to portal Web sites has rapidly expanded, allowing many patients to view their medical record information online. Despite this expansion, there is little attention paid to the accessibility of portals for more vulnerable patient populations—especially patients with limited health literacy or limited English profic…
A Doctor is in the House
Identifying Spanish Language Competent Physicians
The single-question self-reported medical proficiency tool is a low-cost tool useful for quickly identifying Spanish competent physicians and is potentially suitable for use in clinical settings. A reasonable approach for health systems is to designate only those physicians who self-assess their Spanish medical proficiency as "high" as competent to provide care without an interpreter
Associations of perceived neighborhood safety and crime with cardiometabolic risk factors among a population with type 2 diabetes
Little is known about how neighborhood crime may relate to health in diabetes patients. We examined associations between individuals' perceptions of neighborhood safety or violent crime and stress, physical activity, body mass index (BMI) or hemoglobin A1c (HbA1c) in a sample (n=721) of adults (mean age:63) with diabetes. Self-reported neighborhood safety, violent crime, physical activity, and stress were collected and linked to clinical measures…
Police-Recorded Crime and Perceived Stress among Patients with Type 2 Diabetes
Ethnic Differences in Geriatric Conditions and Diabetes Complications Among Older, Insured Adults With Diabetes
Among these insured older adults, ethnic health patterns varied substantially; differences were frequently small and rates were often better among select minority groups, suggesting progress toward the Healthy People 2020 objective to reduce health disparities
Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes
BACKGROUND: The purpose of this study is to determine the prevalence of diabetes distress and its relationship with health behaviours and clinical outcomes in low-income patients. METHODS: Secondary analyses were conducted using baseline data from a clinical trial evaluating a diabetes self-management intervention. Interviews were conducted with 666 participants receiving care at nine safety net clinics in Missouri. Distress was measured using th…
Place matters
From “Infodemics” to Health Promotion
Despite the ubiquity of health-related communications via social media, no consensus has emerged on whether this medium, on balance, jeopardizes or promotes public health. During the COVID-19 pandemic, social media has been described as the source of a toxic “infodemic” or a valuable tool for public health. No conceptual model exists for examining the roles that social media can play with respect to population health. We present a novel framework…
The influence of indigenous status and community indigenous composition on obesity and diabetes among Mexican adults
Sugar-Sweetened Beverage Consumption 3 Years After the Berkeley, California, Sugar-Sweetened Beverage Tax
Objectives. To estimate changes in sugar-sweetened beverage (SSB) and water consumption 3 years after an SSB tax in Berkeley, California, relative to unexposed comparison neighborhoods. Methods. Data came from repeated annual cross-sectional beverage frequency questionnaires from 2014 to 2017 in demographically diverse Berkeley (n = 1513) and comparison (San Francisco and Oakland; n = 3712) neighborhoods. Pretax consumption (2014) was compared wi…
Correlates of Patient-Reported Racial/Ethnic Health Care Discrimination in the Diabetes Study of Northern California (Distance)
In addition to race/ethnicity, health literacy and English proficiency may be bases of discrimination. Evaluation is needed to determine whether patients are treated differently or more apt to perceive discrimination, and whether depression fosters and/or follows perceived discrimination
Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes
BACKGROUND: The purpose of this study is to determine the prevalence of diabetes distress and its relationship with health behaviours and clinical outcomes in low-income patients. METHODS: Secondary analyses were conducted using baseline data from a clinical trial evaluating a diabetes self-management intervention. Interviews were conducted with 666 participants receiving care at nine safety net clinics in Missouri. Distress was measured using th…
Eating with others and meal location are differentially associated with nutrient intake by sex
Legal, Practical, and Ethical Considerations for Making Online Patient Portals Accessible for All
Largely driven by the financial incentives of the HITECH Act’s Meaningful Use program as part of federal US health care reform, access to portal Web sites has rapidly expanded, allowing many patients to view their medical record information online. Despite this expansion, there is little attention paid to the accessibility of portals for more vulnerable patient populations—especially patients with limited health literacy or limited English profic…
Associations of perceived neighborhood safety and crime with cardiometabolic risk factors among a population with type 2 diabetes
Little is known about how neighborhood crime may relate to health in diabetes patients. We examined associations between individuals' perceptions of neighborhood safety or violent crime and stress, physical activity, body mass index (BMI) or hemoglobin A1c (HbA1c) in a sample (n=721) of adults (mean age:63) with diabetes. Self-reported neighborhood safety, violent crime, physical activity, and stress were collected and linked to clinical measures…
Police-Recorded Crime and Perceived Stress among Patients with Type 2 Diabetes
Association of Health Literacy With Diabetes Outcomes
CONTEXT: Health literacy is a measure of patients' ability to read, comprehend, and act on medical instructions. Poor health literacy is common among racial and ethnic minorities, elderly persons, and patients with chronic conditions, particularly in public-sector settings. Little is known about the extent to which health literacy affects clinical health outcomes. OBJECTIVES: To examine the association between health literacy and diabetes outcome…
Closing the Loop
BACKGROUND: Patients recall or comprehend as little as half of what physicians convey during an outpatient encounter. To enhance recall, comprehension, and adherence, it is recommended that physicians elicit patients' comprehension of new concepts and tailor subsequent information, particularly for patients with low functional health literacy. It is not known how frequently physicians apply this interactive educational strategy, or whether it is …
Health Insurance Status, Cost-Related Medication Underuse, and Outcomes Among Diabetes Patients in Three Systems of Care
BACKGROUND: Chronically ill patients often experience difficulty paying for their medications and, as a result, use less than prescribed. OBJECTIVES: The objectives of this study were to determine the relationship between patients with diabetes' health insurance coverage and cost-related medication underuse, the association between cost-related underuse and health outcomes, and the role of comorbidity in this process. RESEARCH DESIGN: We used a p…
Front-line Bureaucracies and the Moral Mechanics of US Health Care
From the University California San Francisco, San Francisco General Hospital Reprints: Dean Schillinger, MD, Associate Professor of Clinical Medicine, Division of General Internal Medicine, UCSF at San Francisco General Hospital, Primary Care Research Center, Ward 95, 995 Potrero Avenue, San Francisco, CA 94110. E-mail: [email protected]
Is Self-Efficacy Associated With Diabetes Self-Management Across Race/Ethnicity and Health Literacy?
OBJECTIVE—Although prior research demonstrated that improving diabetes self-efficacy can improve self-management behavior, little is known about the applicability of this research across race/ethnicity and health literacy levels. We examined the relationship between diabetes self-efficacy and self-management behavior in an urban, diverse, low-income population with a high prevalence of limited health literacy. RESEARCH DESIGN AND METHODS—We admin…
Babel Babble
Facilitating Behavior Change With Low-literacy Patient Education Materials
Developing low-literacy health education materials that will activate patients toward healthier behaviors requires attention to factors beyond reading level
The Influence of Depressive Symptoms on Clinician–Patient Communication Among Patients With Type 2 Diabetes
BACKGROUND: Depression is associated with poor chronic illness outcomes, but it is unknown whether depression influences the quality of communication during the clinical encounter. We investigated whether diabetes patients with depressive symptoms, compared with those without depressive symptoms, report worse clinician-patient communication, and which domains of communication are most affected. METHODS: We surveyed 231 ethnically diverse, English…
Hunger and Socioeconomic Disparities in Chronic Disease
Each year just before Thanksgiving, the U.S. Department of Agriculture (USDA) reports the number of U.S. households that are at risk for going hungry because of an inability to afford food — a condition termed “food insecurity.” After a stable prevalence for the past decade, the rate of food insecurity rose by 32% in 2008, to 14.6% of U.S. households — the highest level since the first food-security survey was conducted in 1995. About 21% of U.S.…
Recommendations for intrauterine contraception
Accuracy of Physician Self-Report of Spanish Language Proficiency
As health systems strive to meet the needs of linguistically diverse patient populations, determining a physician's non-English language proficiency is becoming increasingly important. However, brief, validated measures are lacking. To determine if any of four self-reported measures of physician Spanish language proficiency are useful measures of fluency in Spanish. Physician self-report of Spanish proficiency was compared to Spanish-speaking pat…
Smoking behavior among Hispanic adults with diabetes on the United States-Mexico border
Smoking interventions should focus on Mexicans with diabetes in the border region, especially younger adults and men. Identifying sources of differences in smoking behaviors among border groups with diabetes may further inform intervention
Blood pressure control, hypertension, awareness, and treatment in adults with diabetes in the United States-Mexico border region
Co-occurrence of diabetes and hypertension is a major public health problem among U.S.-Mexico border residents. The low rate of blood pressure control among various border groups, especially younger U.S.-born Hispanics, suggests that initiatives should aggressively target blood pressure control
Disparities in undiagnosed diabetes among United States-Mexico border populations
Efforts to improve diabetes diagnosis should concentrate on Mexican and Mexican immigrant populations on the U.S.-Mexico border
The Wrong Tool for the Job
We surveyed state diabetes programs to determine whether they develop and disseminate diabetes guidelines. We found they largely disseminate clinical practice guidelines developed from subspecialty organizations, do not prioritize among the many recommendations contained in diabetes guidelines, and have not adapted guidelines to focus on population rather than individual health. An opportunity exists for state diabetes control programs to better …
Correlates of Patient-Reported Racial/Ethnic Health Care Discrimination in the Diabetes Study of Northern California (Distance)
In addition to race/ethnicity, health literacy and English proficiency may be bases of discrimination. Evaluation is needed to determine whether patients are treated differently or more apt to perceive discrimination, and whether depression fosters and/or follows perceived discrimination
The influence of indigenous status and community indigenous composition on obesity and diabetes among Mexican adults
Language Barriers and Understanding of Hospital Discharge Instructions
BACKGROUND: Effective communication at hospital discharge is necessary for an optimal transition and to avoid adverse events. We investigated the association of a language barrier with patient understanding of discharge instructions. METHODS: Spanish-speaking, Chinese-speaking, and English-speaking patients admitted to 2 urban hospitals between 2005 and 2008, comparing patient understanding of follow-up appointment type, and medication category a…
Place matters
Disease-related distress, self-care and clinical outcomes among low-income patients with diabetes
BACKGROUND: The purpose of this study is to determine the prevalence of diabetes distress and its relationship with health behaviours and clinical outcomes in low-income patients. METHODS: Secondary analyses were conducted using baseline data from a clinical trial evaluating a diabetes self-management intervention. Interviews were conducted with 666 participants receiving care at nine safety net clinics in Missouri. Distress was measured using th…
Use of the Refill Function Through an Online Patient Portal is Associated With Improved Adherence to Statins in an Integrated Health System
BACKGROUND: Online patient portals are being widely implemented, but their impact on health behaviors are not well-studied. OBJECTIVE: To determine whether statin adherence improved after initiating use of the portal refill function. RESEARCH DESIGN: Observational cohort study within an integrated health care delivery system. SUBJECTS: Diabetic patients on statins who had registered for online portal access by 2010. A total of 8705 subjects initi…
Ethnic Differences in Geriatric Conditions and Diabetes Complications Among Older, Insured Adults With Diabetes
Among these insured older adults, ethnic health patterns varied substantially; differences were frequently small and rates were often better among select minority groups, suggesting progress toward the Healthy People 2020 objective to reduce health disparities
Identifying Spanish Language Competent Physicians
The single-question self-reported medical proficiency tool is a low-cost tool useful for quickly identifying Spanish competent physicians and is potentially suitable for use in clinical settings. A reasonable approach for health systems is to designate only those physicians who self-assess their Spanish medical proficiency as "high" as competent to provide care without an interpreter
Associations of perceived neighborhood safety and crime with cardiometabolic risk factors among a population with type 2 diabetes
Little is known about how neighborhood crime may relate to health in diabetes patients. We examined associations between individuals' perceptions of neighborhood safety or violent crime and stress, physical activity, body mass index (BMI) or hemoglobin A1c (HbA1c) in a sample (n=721) of adults (mean age:63) with diabetes. Self-reported neighborhood safety, violent crime, physical activity, and stress were collected and linked to clinical measures…
Police-Recorded Crime and Perceived Stress among Patients with Type 2 Diabetes
Medicine (44 works) · Psychology (19 works) · Environmental health (17 works) · Health care (17 works) · Diabetes mellitus (16 works) · Demography (15 works) · Internal Medicine (15 works) · Nursing (15 works) · Public health (15 works) · Gerontology (14 works)