Research Projects - Health Care Delivery

Nurses pushing hospital bed, gurneyPHREI is a leader in the multidisciplinary investigation of the organizational structures and processes that affect the quality and cost of health care. Our Investigators examine social factors, personal behaviors, financing systems, health technologies, access to care, and health outcomes.

Cell Phone-Based Expert Systems for Smoking Cessation

This project aims to deliver a theory-based, computerized tailored intervention (CTI) or expert system via cell phone. The ubiquity and sophistication of today's wireless mobile technologies represent new modes of delivery for empirically based smoking cessation and other behavioral health interventions. The smoking cessation program is based on the Transtheoretical Model of Behavior Change (TTM), a leading model in smoking cessation interventions.  The pilot study is a randomized, controlled trial to assess the cell phone's feasibility as an intervention modality for changing smoking behaviors. This will be the first study to adapt a smoking cessation Internet-based CTI to provide personalized feedback on a cell phone to reduce smoking behaviors in military veterans.

Reducing Cost-Related Medication Nonadherence in Persons with Diabetes

In a statewide physician survey, 9 in 10 physicians said difficulty knowing drug costs prevented them from helping patients with medication costs.  Non-adherence to medication regimens is an important and persistent public health challenge in patients with chronic diseases and cost-related mediation non-adherence is an important area of research. 

This study will examine the effectiveness of a hardcopy/web-based physician Prescribing Guide (PG) developed by the investigator in improving medication adherence and lowering medication costs for patients with diabetes by helping physicians easily know drug costs when prescribing.  The PG summarizes multiple formularies in a standard format, highlights widely covered drugs, gives retail prices from discount pharmacies, and has links to assistance programs. Hawaii’s BlueCross BlueShield - HMSA medical insurance provider and the University of Hawaii John A. Burns School of Medicine are collaborators on the study.