Alex H S Harris
Dados Biográficos
| ID | 2283286 |
|---|---|
| NOME | Alex H S Harris |
| PRENOMES | Alex H S |
| SOBRENOME | Harris |
| ASSINATURA | HARRIS A H S |
| AFILIAÇÕES | VA Palo Alto Health Care System |
| ORCID | 0000-0001-7267-3077 |
| VERIFICADO | Sim |
| TOTAL DE OBRAS | 28 |
| TOTAL DE CITAÇÕES | 74 |
| TOTAL COMO AUTOR | 28 |
| TOTAL COMO EDITOR | 0 |
| PRIMEIRO ANO DE PUBLICAÇÃO | 1988 |
| ANO MAIS RECENTE DE PUBLICAÇÃO | 2026 |
| ÍNDICE H | 3 |
Purchasing Versus Providing Care at the VHA
BACKGROUND: The Veterans Health Administration (VHA) greatly expanded the proportion of health care services it purchases from community providers over the last decade, which could impact the quality of care and create care fragmentation. Continuity of care between inpatient and outpatient care delivery systems is critical for high-quality mental health care. OBJECTIVE: To compare rates of outpatient follow-up visits between VHA-purchased and VHA…
Predictive Accuracy of Natural Language Processing Extracted 3-Step Theory of Suicide Factor Scores Derived From Veterans’ Clinical Progress Notes
OBJECTIVES: To compare predictive accuracy of 3-step theory of suicide (3ST) factor scores derived from natural language processing of Veterans Health Administration (VHA) clinical progress notes versus a model that underlies VHA's Recovery Engagement and Coordination for Health-Veterans Enhanced Treatment (REACH VET) program retrained to predict the combined outcome of suicide attempt or suicide death, and to compare characteristics of patients …
Receipt of medications for opioid use disorders among veterans by race/ethnicity and legal involvement
Hospital Presumptive Eligibility Emergency Medicaid Programs
BACKGROUND: Lack of health insurance is a public health crisis, leading to foregone care and financial strain. Hospital Presumptive Eligibility (HPE) is a hospital-based emergency Medicaid program that provides temporary (up to 60 d) coverage, with the goal that hospitals will assist patients in applying for ongoing Medicaid coverage. It is unclear whether HPE is associated with successful longer-term Medicaid enrollment. OBJECTIVE: To characteri…
Using the Kitagawa Decomposition to Measure Overall—and Individual Facility Contributions to—Within-facility and Between-facility Differences
BACKGROUND: Identifying whether differences in health care disparities are due to within-facility or between-facility differences is key to disparity reductions. The Kitagawa decomposition divides the difference between 2 means into within-facility differences and between-facility differences that are measured on the same scale as the original disparity. It also enables the identification of facilities that contribute most to within-facility diff…
Comparing Postoperative Readmission Rates Between Veterans Receiving Total Knee Arthroplasty in the Veterans Health Administration Versus Community Care
BACKGROUND: There are growing concerns that Veterans' increased use of Veterans Health Administration (VA)-purchased care in the community may lead to lower quality of care. OBJECTIVE: We compared rates of hospital readmissions following elective total knee arthroplasties (TKAs) that were either performed in VA or purchased by VA through community care (CC) at both the national and facility levels. METHODS: Three-year cohort study using VA and CC…
Comparative Effectiveness of Risk-adjusted Cumulative Sum and Periodic Evaluation for Monitoring Hospital Perioperative Mortality
BACKGROUND: National surgical quality improvement (QI) programs use periodic, risk-adjusted evaluation to identify hospitals with higher than expected perioperative mortality. Rapid, accurate identification of poorly performing hospitals is critical for avoiding potentially preventable mortality and represents an opportunity to enhance QI efforts. METHODS: Hospital-level analysis using Veterans Affairs (VA) Surgical Quality Improvement Program da…
Treatment of Low Back Pain With Opioids and Nonpharmacologic Treatment Modalities for Army Veterans
BACKGROUND: In the Veterans Health Administration (VHA) there is growing interest in the use of nonpharmacologic treatment (NPT) for low back pain (LBP) as pain intensity and interference do not decrease with opioid use. OBJECTIVES: To describe overall and facility-level variation in the extent to which specific NPT modalities are used in VHA for LBP, either alone or as adjuncts to opioid medications, and to understand associations between vetera…
Iraq and Afghanistan Veterans’ Use of Veterans Health Administration and Purchased Care Before and After Veterans Choice Program Implementation
BACKGROUND: The Veterans Choice Program (VCP), enacted by Congress after concerns surfaced about access, enables veterans to receive care outside Veterans Health Administration (VHA) facilities. Veterans who face long wait times, large driving distances, or particular hardships are eligible for VCP. Prior purchased care programs were comparatively limited in scope. OBJECTIVES: We sought to describe utilization of VHA-provided and purchased outpat…
State-Level Relationships Cannot Tell Us Anything About Individuals
AffiliationsAlex H. S. Harris, Keith Humphreys, and John W. Finney are with the Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA. Keith Humphreys is also with Stanford University, Stanford, CA
Sex Differences in Mental Health and Substance Use Disorders and Treatment Entry Among Justice-involved Veterans in the Veterans Health Administration
BACKGROUND: Over half of veterans in the criminal justice system have mental health or substance use disorders. However, there is a critical lack of information about female veterans in the criminal justice system and how diagnosis prevalence and treatment entry differ by sex. OBJECTIVES: To document prevalence of mental health and substance use disorder diagnoses and treatment entry rates among female veterans compared with male veterans in the …
VHA Mental Health Information System
AIM: To describe the design and deployment of health information technology to support implementation of mental health services policy requirements in the Veterans Health Administration (VHA). METHODS: Using administrative and self-report survey data, we developed and fielded metrics regarding implementation of the requirements delineated in the VHA Uniform Mental Health Services Handbook. Finalized metrics were incorporated into 2 external facil…
Correlates of Specialty Substance Use Disorder Treatment Among Female Patients in the Veterans Health Administration
We examined patient- and facility-level correlates of specialty substance use disorder (SUD) outpatient treatment receipt (at least 1 visit) and engagement (visit count) for female Veterans Health Administration patients in 2008 Veterans Health Administration Handbook 1160.01. 2008. Uniform mental health services in VA medical centers and clinics, Washington, DC: Author. [Google Scholar]. Overall, 33% of 15,653 females with SUD received specialty…
Why Health Care Process Performance Measures Can Have Different Relationships to Outcomes for Patients and Hospitals
Relationships between health care process performance measures (PPMs) and outcomes can differ in magnitude and even direction for patients versus higher level units (e.g., health care facilities). Such discrepancies can arise because facility-level relationships ignore PPM–outcome relationships for patients within facilities, may have different confounders than patient-level PPM–outcome relationships, and may reflect facility effect modification …
Patterns of hopelessness among American Indian adolescents
Poor mental health among American Indian adolescents has been a matter of significant concern for the past two decades. This study extends the literature on acculturation within this population by investigating the relationship between hopelessness, levels of acculturation, and residence among American Indian adolescents. Utilizing data drawn from 438 adolescents across 67 American Indian tribes, our analyses show that American Indian adolescents…
Developing and Validating Process Measures of Health Care Quality
BACKGROUND: Health care process quality measures usually are designed by expert panels attempting to synthesize nuanced clinical evidence and subsequently operationalized using administrative data. Many quality measures are then adopted without directly validating their presumed links with outcomes. Later efforts to validate process measures often yield negative results, leaving policy makers without a defensible means of measuring quality. This …
Carl Thoresen
This interview with Carl E. Thoresen highlights the experiences, relationships, and ideas that have influenced this pioneering psychologist throughout the past half century. His scholarly work, professional service, teaching, and mentor-ship have motivated many counseling psychologists to radically expand their areas of inquiry. He was among the first to focus counseling on observable behaviors and to apply psychological science and interventions…
The Asthma Trigger Inventory
BACKGROUND: Asthma patients' perceptions of triggers have been explored in a largely unstructured fashion in the past. We therefore developed and validated a questionnaire of commonly perceived asthma triggers. METHODS: Two hundred forty-seven primary care patients with asthma filled in an asthma trigger survey together with questionnaires on demographics, asthma-relevant information, perceived control of asthma, and general health status. Factor…
Does Writing Affect Asthma? A Randomized Trial
OBJECTIVE: Nonpharmacologic treatments for asthma may act as useful adjuncts to pharmacotherapy but should be recommended to patients only after several well-controlled studies provide evidence of efficacy. Research demonstrating that written emotional expression can improve pulmonary function in patients with asthma consists of one impressive yet unreplicated study. Our main objective was to test and extend previous research finding that written…
Continuity of Care Practices and Substance Use Disorder Patients’ Engagement in Continuing Care
BACKGROUND: Substance use disorder (SUD) patients who engage in more continuing care have better outcomes, but information on practices associated with greater patient engagement and retention in continuing care remains elusive. OBJECTIVES: The objectives of this study were to determine if staff's continuity of care practices predict patients' engagement in continuing care in the 6 months after discharge from intensive SUD treatment and to determ…
Volunteering is Associated with Delayed Mortality in Older People
The Longitudinal Study of Aging (LSOA) assessed the health and social functioning of a representative sample of 7527 American community-dwelling older people (> 70 years). We tested the hypothesis that frequent volunteering is associated with less mortality risk when the effects of socio-demographics, medical status, physical activity and social integration are controlled. We used Cox proportional hazards analyses to assess the unadjusted and adj…
Spirituality and health
In this article, we familiarize readers with some recent empirical evidence about possible associations between religious and/or spiritual (RS) factors and health outcomes. In considering this evidence, we believe a healthy skepticism is in order One needs to remain open to the possibility that RS-related beliefs and behaviors may influence health, yet one needs empirical evidence based on well-controlled studies that support these claims and con…
Incidence of Critical Events in Professional Practice
The goal was to tabulate the incidences of clients' suicide, attack by a client, and sexual contact with clients in an Alaskan sample of masters and doctoral-level psychotherapy providers (excluding psychiatrists) and to assess which, if any, demographic or professional characteristics were associated with each critical event. Results from 151 respondents (response rate 43.5%) indicated that 42.7% of providers had experienced at least one client'…
Psychometric Properties of the Life Regard Index–Revised
A validation study of the English version of the 28-item Life Regard Index-Revised was undertaken with a sample of 91 participants from the general population. All previous studies of the Index have examined the Dutch version. The test-retest reliabilities at 8 wk. for the total Index (r =.87), Framework (r =.82), and Fulfillment (r =.81) subscales were very high. Cronbach alphas were .92, .83, and .87, respectively. A significant restriction of …
Incidence of Critical Events in Professional Practice-a Statewide Survey of Psychotherapy Providers
The goal was to tabulate the incidences of clients' suicide, attack by a client, and sexual contact with clients in an Alaskan sample of masters and doctoral-level psychotherapy providers (excluding psychiatrists) and to assess which, if any, demographic or professional characteristics were associated with each critical event. Results from 151 respondents (response rate 43.5%) indicated that 42.7% of providers had experienced at least one client'…
Volunteering is Associated with Delayed Mortality in Older People
The Longitudinal Study of Aging (LSOA) assessed the health and social functioning of a representative sample of 7527 American community-dwelling older people (> 70 years). We tested the hypothesis that frequent volunteering is associated with less mortality risk when the effects of socio-demographics, medical status, physical activity and social integration are controlled. We used Cox proportional hazards analyses to assess the unadjusted and adj…
Patterns of hopelessness among American Indian adolescents
Poor mental health among American Indian adolescents has been a matter of significant concern for the past two decades. This study extends the literature on acculturation within this population by investigating the relationship between hopelessness, levels of acculturation, and residence among American Indian adolescents. Utilizing data drawn from 438 adolescents across 67 American Indian tribes, our analyses show that American Indian adolescents…
Spiritually and Religiously Oriented Health Interventions
Controlled intervention studies offer considerable promise to better understand relationships and possible mechanisms between spiritual and religious factors and health. Studies examining spiritually augmented cognitive-behavioral therapies, forgiveness interventions, different meditation approaches, 12-step fellowships, and prayer have provided some evidence, albeit modest, of efficacy in improving health under specific conditions. Researchers n…
State-Level Relationships Cannot Tell Us Anything About Individuals
AffiliationsAlex H. S. Harris, Keith Humphreys, and John W. Finney are with the Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA. Keith Humphreys is also with Stanford University, Stanford, CA
Carl Thoresen
This interview with Carl E. Thoresen highlights the experiences, relationships, and ideas that have influenced this pioneering psychologist throughout the past half century. His scholarly work, professional service, teaching, and mentor-ship have motivated many counseling psychologists to radically expand their areas of inquiry. He was among the first to focus counseling on observable behaviors and to apply psychological science and interventions…
A World Unsuspected
Spiritually and Religiously Oriented Health Interventions
Controlled intervention studies offer considerable promise to better understand relationships and possible mechanisms between spiritual and religious factors and health. Studies examining spiritually augmented cognitive-behavioral therapies, forgiveness interventions, different meditation approaches, 12-step fellowships, and prayer have provided some evidence, albeit modest, of efficacy in improving health under specific conditions. Researchers n…
Incidence of Critical Events in Professional Practice
The goal was to tabulate the incidences of clients' suicide, attack by a client, and sexual contact with clients in an Alaskan sample of masters and doctoral-level psychotherapy providers (excluding psychiatrists) and to assess which, if any, demographic or professional characteristics were associated with each critical event. Results from 151 respondents (response rate 43.5%) indicated that 42.7% of providers had experienced at least one client'…
Psychometric Properties of the Life Regard Index–Revised
A validation study of the English version of the 28-item Life Regard Index-Revised was undertaken with a sample of 91 participants from the general population. All previous studies of the Index have examined the Dutch version. The test-retest reliabilities at 8 wk. for the total Index (r =.87), Framework (r =.82), and Fulfillment (r =.81) subscales were very high. Cronbach alphas were .92, .83, and .87, respectively. A significant restriction of …
Incidence of Critical Events in Professional Practice-a Statewide Survey of Psychotherapy Providers
The goal was to tabulate the incidences of clients' suicide, attack by a client, and sexual contact with clients in an Alaskan sample of masters and doctoral-level psychotherapy providers (excluding psychiatrists) and to assess which, if any, demographic or professional characteristics were associated with each critical event. Results from 151 respondents (response rate 43.5%) indicated that 42.7% of providers had experienced at least one client'…
Psychometric Properties of the Life Regard Index-Revised
Spirituality and health
In this article, we familiarize readers with some recent empirical evidence about possible associations between religious and/or spiritual (RS) factors and health outcomes. In considering this evidence, we believe a healthy skepticism is in order One needs to remain open to the possibility that RS-related beliefs and behaviors may influence health, yet one needs empirical evidence based on well-controlled studies that support these claims and con…
Does Writing Affect Asthma? A Randomized Trial
OBJECTIVE: Nonpharmacologic treatments for asthma may act as useful adjuncts to pharmacotherapy but should be recommended to patients only after several well-controlled studies provide evidence of efficacy. Research demonstrating that written emotional expression can improve pulmonary function in patients with asthma consists of one impressive yet unreplicated study. Our main objective was to test and extend previous research finding that written…
Continuity of Care Practices and Substance Use Disorder Patients’ Engagement in Continuing Care
BACKGROUND: Substance use disorder (SUD) patients who engage in more continuing care have better outcomes, but information on practices associated with greater patient engagement and retention in continuing care remains elusive. OBJECTIVES: The objectives of this study were to determine if staff's continuity of care practices predict patients' engagement in continuing care in the 6 months after discharge from intensive SUD treatment and to determ…
Volunteering is Associated with Delayed Mortality in Older People
The Longitudinal Study of Aging (LSOA) assessed the health and social functioning of a representative sample of 7527 American community-dwelling older people (> 70 years). We tested the hypothesis that frequent volunteering is associated with less mortality risk when the effects of socio-demographics, medical status, physical activity and social integration are controlled. We used Cox proportional hazards analyses to assess the unadjusted and adj…
The Asthma Trigger Inventory
BACKGROUND: Asthma patients' perceptions of triggers have been explored in a largely unstructured fashion in the past. We therefore developed and validated a questionnaire of commonly perceived asthma triggers. METHODS: Two hundred forty-seven primary care patients with asthma filled in an asthma trigger survey together with questionnaires on demographics, asthma-relevant information, perceived control of asthma, and general health status. Factor…
Carl Thoresen
This interview with Carl E. Thoresen highlights the experiences, relationships, and ideas that have influenced this pioneering psychologist throughout the past half century. His scholarly work, professional service, teaching, and mentor-ship have motivated many counseling psychologists to radically expand their areas of inquiry. He was among the first to focus counseling on observable behaviors and to apply psychological science and interventions…
Developing and Validating Process Measures of Health Care Quality
BACKGROUND: Health care process quality measures usually are designed by expert panels attempting to synthesize nuanced clinical evidence and subsequently operationalized using administrative data. Many quality measures are then adopted without directly validating their presumed links with outcomes. Later efforts to validate process measures often yield negative results, leaving policy makers without a defensible means of measuring quality. This …
Patterns of hopelessness among American Indian adolescents
Poor mental health among American Indian adolescents has been a matter of significant concern for the past two decades. This study extends the literature on acculturation within this population by investigating the relationship between hopelessness, levels of acculturation, and residence among American Indian adolescents. Utilizing data drawn from 438 adolescents across 67 American Indian tribes, our analyses show that American Indian adolescents…
Why Health Care Process Performance Measures Can Have Different Relationships to Outcomes for Patients and Hospitals
Relationships between health care process performance measures (PPMs) and outcomes can differ in magnitude and even direction for patients versus higher level units (e.g., health care facilities). Such discrepancies can arise because facility-level relationships ignore PPM–outcome relationships for patients within facilities, may have different confounders than patient-level PPM–outcome relationships, and may reflect facility effect modification …
Correlates of Specialty Substance Use Disorder Treatment Among Female Patients in the Veterans Health Administration
We examined patient- and facility-level correlates of specialty substance use disorder (SUD) outpatient treatment receipt (at least 1 visit) and engagement (visit count) for female Veterans Health Administration patients in 2008 Veterans Health Administration Handbook 1160.01. 2008. Uniform mental health services in VA medical centers and clinics, Washington, DC: Author. [Google Scholar]. Overall, 33% of 15,653 females with SUD received specialty…
VHA Mental Health Information System
AIM: To describe the design and deployment of health information technology to support implementation of mental health services policy requirements in the Veterans Health Administration (VHA). METHODS: Using administrative and self-report survey data, we developed and fielded metrics regarding implementation of the requirements delineated in the VHA Uniform Mental Health Services Handbook. Finalized metrics were incorporated into 2 external facil…
State-Level Relationships Cannot Tell Us Anything About Individuals
AffiliationsAlex H. S. Harris, Keith Humphreys, and John W. Finney are with the Center for Innovation to Implementation, VA Palo Alto Health Care System, Menlo Park, CA. Keith Humphreys is also with Stanford University, Stanford, CA
Sex Differences in Mental Health and Substance Use Disorders and Treatment Entry Among Justice-involved Veterans in the Veterans Health Administration
BACKGROUND: Over half of veterans in the criminal justice system have mental health or substance use disorders. However, there is a critical lack of information about female veterans in the criminal justice system and how diagnosis prevalence and treatment entry differ by sex. OBJECTIVES: To document prevalence of mental health and substance use disorder diagnoses and treatment entry rates among female veterans compared with male veterans in the …
Iraq and Afghanistan Veterans’ Use of Veterans Health Administration and Purchased Care Before and After Veterans Choice Program Implementation
BACKGROUND: The Veterans Choice Program (VCP), enacted by Congress after concerns surfaced about access, enables veterans to receive care outside Veterans Health Administration (VHA) facilities. Veterans who face long wait times, large driving distances, or particular hardships are eligible for VCP. Prior purchased care programs were comparatively limited in scope. OBJECTIVES: We sought to describe utilization of VHA-provided and purchased outpat…
Treatment of Low Back Pain With Opioids and Nonpharmacologic Treatment Modalities for Army Veterans
BACKGROUND: In the Veterans Health Administration (VHA) there is growing interest in the use of nonpharmacologic treatment (NPT) for low back pain (LBP) as pain intensity and interference do not decrease with opioid use. OBJECTIVES: To describe overall and facility-level variation in the extent to which specific NPT modalities are used in VHA for LBP, either alone or as adjuncts to opioid medications, and to understand associations between vetera…
Comparative Effectiveness of Risk-adjusted Cumulative Sum and Periodic Evaluation for Monitoring Hospital Perioperative Mortality
BACKGROUND: National surgical quality improvement (QI) programs use periodic, risk-adjusted evaluation to identify hospitals with higher than expected perioperative mortality. Rapid, accurate identification of poorly performing hospitals is critical for avoiding potentially preventable mortality and represents an opportunity to enhance QI efforts. METHODS: Hospital-level analysis using Veterans Affairs (VA) Surgical Quality Improvement Program da…
Comparing Postoperative Readmission Rates Between Veterans Receiving Total Knee Arthroplasty in the Veterans Health Administration Versus Community Care
BACKGROUND: There are growing concerns that Veterans' increased use of Veterans Health Administration (VA)-purchased care in the community may lead to lower quality of care. OBJECTIVE: We compared rates of hospital readmissions following elective total knee arthroplasties (TKAs) that were either performed in VA or purchased by VA through community care (CC) at both the national and facility levels. METHODS: Three-year cohort study using VA and CC…
Using the Kitagawa Decomposition to Measure Overall—and Individual Facility Contributions to—Within-facility and Between-facility Differences
BACKGROUND: Identifying whether differences in health care disparities are due to within-facility or between-facility differences is key to disparity reductions. The Kitagawa decomposition divides the difference between 2 means into within-facility differences and between-facility differences that are measured on the same scale as the original disparity. It also enables the identification of facilities that contribute most to within-facility diff…
Hospital Presumptive Eligibility Emergency Medicaid Programs
BACKGROUND: Lack of health insurance is a public health crisis, leading to foregone care and financial strain. Hospital Presumptive Eligibility (HPE) is a hospital-based emergency Medicaid program that provides temporary (up to 60 d) coverage, with the goal that hospitals will assist patients in applying for ongoing Medicaid coverage. It is unclear whether HPE is associated with successful longer-term Medicaid enrollment. OBJECTIVE: To characteri…
Medicine (21 obras) · Psychology (13 obras) · Health care (10 obras) · Psychiatry (10 obras) · Family medicine (7 obras) · Internal Medicine (7 obras) · Clinical Psychology (5 obras) · Clinical Psychology (5 obras) · Demography (5 obras) · Healthcare Policy and Management (5 obras)