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Brian P. Jenssen
PolicyLab and Center for Pediatric Clinical Effectiveness, Children's Hospital of Philadelphia

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Review
Published: 14 August 2021 in Academic Pediatrics
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In the last decade, there has been a robust increase in research using financial incentives to promote healthy behaviors as behavioral economics and new monitoring technologies have been applied to health behaviors. Most studies of financial incentives on health behaviors have focused on adults, yet many unhealthy adult behaviors have roots in childhood and adolescence. The use of financial incentives is an attractive but controversial strategy in childhood. In this review, we first propose five general considerations in designing and applying incentive interventions to children. These include: (1) the potential impact of incentives on intrinsic motivation, (2) ethical concerns about incentives promoting undue influence, (3) the importance of child neurodevelopmental stage, (4) how incentives interventions may influence health disparities, and (5) how to finance effective programs. We then highlight empirical findings from randomized trials investigating key design features of financial incentive interventions, including framing (loss versus gain), timing (immediate versus delayed), and magnitude (incentive size) effects on a range of childhood behaviors from healthy eating to adherence to glycemic control in type 1 diabetes. Though the current research base on these subjects in children is limited, we found no evidence suggesting that loss-framed incentives perform better than gain-framed incentives in children and isolated studies from healthy food choice experiments support the use of immediate, small incentives versus delayed, larger incentives. Future research on childhood incentives should compare the effectiveness of gain versus loss-framing and focus on which intervention characteristics lead to sustained behavior change and habit formation.

ACS Style

Chén C. Kenyon; Carina Flaherty; G. Chandler Floyd; Brian P. Jenssen; Victoria A. Miller. Promoting healthy childhood behaviors with financial incentives: A narrative review of key considerations and design features for future research. Academic Pediatrics 2021, 1 .

AMA Style

Chén C. Kenyon, Carina Flaherty, G. Chandler Floyd, Brian P. Jenssen, Victoria A. Miller. Promoting healthy childhood behaviors with financial incentives: A narrative review of key considerations and design features for future research. Academic Pediatrics. 2021; ():1.

Chicago/Turabian Style

Chén C. Kenyon; Carina Flaherty; G. Chandler Floyd; Brian P. Jenssen; Victoria A. Miller. 2021. "Promoting healthy childhood behaviors with financial incentives: A narrative review of key considerations and design features for future research." Academic Pediatrics , no. : 1.

Study protocol
Published: 15 July 2021 in Implementation Science
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Background Routine evidence-based tobacco use treatment minimizes cancer-specific and all-cause mortality, reduces treatment-related toxicity, and improves quality of life among patients receiving cancer care. Few cancer centers employ mechanisms to systematically refer patients to evidence-based tobacco cessation services. Implementation strategies informed by behavioral economics can increase tobacco use treatment engagement within oncology care. Methods A four-arm cluster-randomized pragmatic trial will be conducted across nine clinical sites within the Implementation Science Center in Cancer Control Implementation Lab to compare the effect of behavioral economic implementation strategies delivered through embedded messages (or “nudges”) promoting patient engagement with the Tobacco Use Treatment Service (TUTS). Nudges are electronic medical record (EMR)-based messages delivered to patients, clinicians, or both, designed to counteract known patient and clinician biases that reduce treatment engagement. We used rapid cycle approaches (RCA) informed by relevant stakeholder experiences to refine and optimize our implementation strategies and methods prior to trial initiation. Data will be obtained via the EMR, clinician survey, and semi-structured interviews with a subset of clinicians and patients. The primary measure of implementation is penetration, defined as the TUTS referral rate. Secondary outcome measures of implementation include patient treatment engagement (defined as the number of patients who receive FDA-approved medication or behavioral counseling), quit attempts, and abstinence rates. The semi-structured interviews, guided by the Consolidated Framework for Implementation Research, will assess contextual factors and patient and clinician experiences with the nudges. Discussion This study will be the first in the oncology setting to compare the effectiveness of nudges to clinicians and patients, both head-to-head and in combination, as implementation strategies to improve TUTS referral and engagement. We expect the study to (1) yield insights into the effectiveness of nudges as an implementation strategy to improve uptake of evidence-based tobacco use treatment within cancer care, and (2) advance our understanding of the multilevel contextual factors that drive response to these strategies. These results will lay the foundation for how patients with cancer who smoke are best engaged in tobacco use treatment and may lead to future research focused on scaling this approach across diverse centers. Trial registration Clinicaltrials.gov, NCT04737031. Registered 3 February 2021.

ACS Style

Brian P. Jenssen; Robert Schnoll; Rinad Beidas; Justin Bekelman; Anna-Marika Bauer; Callie Scott; Sarah Evers-Casey; Jody Nicoloso; Peter Gabriel; David A. Asch; Alison Buttenheim; Jessica Chen; Julissa Melo; Lawrence N. Shulman; Alicia B. W. Clifton; Adina Lieberman; Tasnim Salam; Kelly Zentgraf; Katharine A. Rendle; Krisda Chaiyachati; Rachel Shelton; E. Paul Wileyto; Sue Ware; Frank Leone. Rationale and protocol for a cluster randomized pragmatic clinical trial testing behavioral economic implementation strategies to improve tobacco treatment rates for cancer patients who smoke. Implementation Science 2021, 16, 1 -12.

AMA Style

Brian P. Jenssen, Robert Schnoll, Rinad Beidas, Justin Bekelman, Anna-Marika Bauer, Callie Scott, Sarah Evers-Casey, Jody Nicoloso, Peter Gabriel, David A. Asch, Alison Buttenheim, Jessica Chen, Julissa Melo, Lawrence N. Shulman, Alicia B. W. Clifton, Adina Lieberman, Tasnim Salam, Kelly Zentgraf, Katharine A. Rendle, Krisda Chaiyachati, Rachel Shelton, E. Paul Wileyto, Sue Ware, Frank Leone. Rationale and protocol for a cluster randomized pragmatic clinical trial testing behavioral economic implementation strategies to improve tobacco treatment rates for cancer patients who smoke. Implementation Science. 2021; 16 (1):1-12.

Chicago/Turabian Style

Brian P. Jenssen; Robert Schnoll; Rinad Beidas; Justin Bekelman; Anna-Marika Bauer; Callie Scott; Sarah Evers-Casey; Jody Nicoloso; Peter Gabriel; David A. Asch; Alison Buttenheim; Jessica Chen; Julissa Melo; Lawrence N. Shulman; Alicia B. W. Clifton; Adina Lieberman; Tasnim Salam; Kelly Zentgraf; Katharine A. Rendle; Krisda Chaiyachati; Rachel Shelton; E. Paul Wileyto; Sue Ware; Frank Leone. 2021. "Rationale and protocol for a cluster randomized pragmatic clinical trial testing behavioral economic implementation strategies to improve tobacco treatment rates for cancer patients who smoke." Implementation Science 16, no. 1: 1-12.

Accepted manuscript
Published: 17 May 2021 in Nicotine & Tobacco Research
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ACS Style

Brian P Jenssen; Chloe Hannan; Mary Kate Kelly; Thomas Ylioja; Robert A Schnoll; Alexander G Fiks. Response to: More Detail Needed for Pilot E-Cigarette Treatment Trial in Youth and Young Adults. Nicotine & Tobacco Research 2021, 1 .

AMA Style

Brian P Jenssen, Chloe Hannan, Mary Kate Kelly, Thomas Ylioja, Robert A Schnoll, Alexander G Fiks. Response to: More Detail Needed for Pilot E-Cigarette Treatment Trial in Youth and Young Adults. Nicotine & Tobacco Research. 2021; ():1.

Chicago/Turabian Style

Brian P Jenssen; Chloe Hannan; Mary Kate Kelly; Thomas Ylioja; Robert A Schnoll; Alexander G Fiks. 2021. "Response to: More Detail Needed for Pilot E-Cigarette Treatment Trial in Youth and Young Adults." Nicotine & Tobacco Research , no. : 1.

Review
Published: 02 March 2021 in PEDIATRICS
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ACS Style

Brian P. Jenssen; Mary Kate Kelly; Maura Powell; Zoe Bouchelle; Stephanie L. Mayne; Alexander G. Fiks. COVID-19 and Changes in Child Obesity. PEDIATRICS 2021, 147, 1 .

AMA Style

Brian P. Jenssen, Mary Kate Kelly, Maura Powell, Zoe Bouchelle, Stephanie L. Mayne, Alexander G. Fiks. COVID-19 and Changes in Child Obesity. PEDIATRICS. 2021; 147 (5):1.

Chicago/Turabian Style

Brian P. Jenssen; Mary Kate Kelly; Maura Powell; Zoe Bouchelle; Stephanie L. Mayne; Alexander G. Fiks. 2021. "COVID-19 and Changes in Child Obesity." PEDIATRICS 147, no. 5: 1.

Corrected proof
Published: 25 February 2021 in Nicotine & Tobacco Research
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E-cigarette use among adolescents is epidemic, putting children at risk for significant harm.1,2 E-cigarettes are the most commonly used tobacco product among youth, with over 20% of high school students reporting current use.3 Harmful toxicants and known carcinogens are found in the solutions, emissions, and bodies of e-cigarette users.4 The absence of evidence-based treatment recommendations for adolescent e-cigarette use indicates the need for research designed to identify effective interventions.5 Furthermore, few lessons learned from clinical trial research to treat adolescents for combustible tobacco products can be applied to e-cigarette research. Progress has been limited by difficulty identifying adolescents interested in treatment, enrolling them in trials, and maintaining treatment engagement.6,7 A recent negative trial investigating varenicline use for adolescent cigarette cessation took 5 years to complete recruitment for a relatively small sample size (n = 157).8

ACS Style

Brian P Jenssen; Chloe Hannan; Mary Kate Kelly; Thomas Ylioja; Robert A Schnoll; Alexander G Fiks. Inability to Recruit Adolescents for a Vaping Cessation Clinical Trial Within a Large Pediatric Health System. Nicotine & Tobacco Research 2021, 23, 1633 -1634.

AMA Style

Brian P Jenssen, Chloe Hannan, Mary Kate Kelly, Thomas Ylioja, Robert A Schnoll, Alexander G Fiks. Inability to Recruit Adolescents for a Vaping Cessation Clinical Trial Within a Large Pediatric Health System. Nicotine & Tobacco Research. 2021; 23 (9):1633-1634.

Chicago/Turabian Style

Brian P Jenssen; Chloe Hannan; Mary Kate Kelly; Thomas Ylioja; Robert A Schnoll; Alexander G Fiks. 2021. "Inability to Recruit Adolescents for a Vaping Cessation Clinical Trial Within a Large Pediatric Health System." Nicotine & Tobacco Research 23, no. 9: 1633-1634.

Journal article
Published: 27 July 2020 in Academic Pediatrics
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Objective Message framing can be leveraged to motivate adult smokers to quit, but its value for parents in pediatric settings is unknown. Understanding parents' preferences for smoking cessation messages may help clinicians tailor interventions to increase quitting. Methods We conducted a discrete choice experiment in which parent smokers of pediatric patients rated the relative importance of 26 messages designed to increase smoking cessation treatment. Messages varied on who the message featured (child, parent, family), whether the message was gain- or loss-framed (emphasizing benefits of engaging or costs of failing to engage in treatment), and the specific outcome included (e.g. general health, cancer, respiratory illnesses, financial impact). Participants included 180 parent smokers at 4 pediatric primary care sites. We used latent class analysis of message ratings to identify groups of parents with similar preferences. Multinomial logistic regression described child and parent characteristics associated with group membership. Results We identified 3 groups of parents with similar preferences for messages: Group 1 prioritized the impact of smoking on the child (n=92, 51%), Group 2 favored gain-framed messages (n=63, 35%), and Group 3 preferred messages emphasizing the financial impact of smoking (n=25, 14%). Parents in Group 2 were more likely to have limited health literacy and have a child over age 6 and with asthma, compared to Group 1. Conclusions We identified 3 groups of parent smokers with different message preferences. This work may inform testing of tailored smoking cessation messages to different parent groups, a form of behavioral phenotyping supporting motivational precision medicine.

ACS Style

Brian P. Jenssen; Mary Kate Kelly; Jennifer Faerber; Chloe Hannan; David A. Asch; Justine Shults; Robert A. Schnoll; Alexander G. Fiks. Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping. Academic Pediatrics 2020, 21, 129 -138.

AMA Style

Brian P. Jenssen, Mary Kate Kelly, Jennifer Faerber, Chloe Hannan, David A. Asch, Justine Shults, Robert A. Schnoll, Alexander G. Fiks. Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping. Academic Pediatrics. 2020; 21 (1):129-138.

Chicago/Turabian Style

Brian P. Jenssen; Mary Kate Kelly; Jennifer Faerber; Chloe Hannan; David A. Asch; Justine Shults; Robert A. Schnoll; Alexander G. Fiks. 2020. "Pediatrician Delivered Smoking Cessation Messages for Parents: A Latent Class Approach to Behavioral Phenotyping." Academic Pediatrics 21, no. 1: 129-138.

Journal article
Published: 22 June 2020 in Pediatrics
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Video Abstract BACKGROUND AND OBJECTIVES: Insights from behavioral economics suggests that the effectiveness of health messages depends on how a message is framed. Parent preferences for smoking cessation messaging has not been studied in pediatrics, warranting further exploration to maximize benefit. We sought to assess parents’ perceptions regarding the relative importance of distinct message framings to promote their smoking cessation. METHODS: We conducted a cross-sectional discrete choice experiment in which parent smokers rated the relative importance of 26 messages designed to encourage them to begin cessation treatment. Messages varied on who was featured (child, parent, or family), whether the message was gain or loss framed, and what outcome was included (general health, cancer, respiratory illnesses, child becoming a smoker, or financial impact). The participants were 180 parent smokers attending primary care visits with their children at 4 diverse pediatric sites. The main outcome was the importance of smoking cessation messages based on who was featured, gain or loss framing, and the outcome emphasized. RESULTS: Parent smokers highly prioritized cessation messages emphasizing the impact of quitting smoking on their child versus parent or family. Messages focusing on respiratory illness, cancer, or general health outcomes consistently ranked highest, whereas messages focused on the financial benefits of quitting ranked lowest. Gain versus loss framing did not meaningfully influence rankings. CONCLUSIONS: Parent smokers identified smoking cessation messages that emphasized the impact on their child, with outcomes focused on respiratory health, cancer, or general health, as most important. The clinical impact of these messages should be tested in future research.

ACS Style

Brian P. Jenssen; Mary Kate Kelly; Jennifer Faerber; Chloe Hannan; David A. Asch; Justine Shults; Robert A. Schnoll; Alexander G. Fiks. Parent Preferences for Pediatric Clinician Messaging to Promote Smoking Cessation Treatment. Pediatrics 2020, 146, e20193901 .

AMA Style

Brian P. Jenssen, Mary Kate Kelly, Jennifer Faerber, Chloe Hannan, David A. Asch, Justine Shults, Robert A. Schnoll, Alexander G. Fiks. Parent Preferences for Pediatric Clinician Messaging to Promote Smoking Cessation Treatment. Pediatrics. 2020; 146 (1):e20193901.

Chicago/Turabian Style

Brian P. Jenssen; Mary Kate Kelly; Jennifer Faerber; Chloe Hannan; David A. Asch; Justine Shults; Robert A. Schnoll; Alexander G. Fiks. 2020. "Parent Preferences for Pediatric Clinician Messaging to Promote Smoking Cessation Treatment." Pediatrics 146, no. 1: e20193901.

Journal article
Published: 21 May 2019 in American Journal of Preventive Medicine
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Introduction Quitlines are effective in helping smokers quit, but pediatrician quitline referral rates are low, and few parents who smoke use the service. This study compared enrollment of parents who smoke in the quitline using electronic referral with that using manual referral. Study design The study was designed as a pragmatic RCT. Setting/participants Participants were recruited from one large, urban pediatric primary care site in Philadelphia, Pennsylvania with a high percentage of low-income families. Participants included adult parents who smoked and were present at their child's healthcare visit. Intervention Pediatricians screened for tobacco use; smokers were given brief advice to quit and, if interested in quitting, were referred to the quitline. The eReferral ("warm handoff") involved electronically sending parent information to the quitline (parent received a call within 24–48 hours). Control group procedures were identical to eReferral, except the quitline number was provided to the parent. Data were collected between March 2017 and February 2018 and analyzed in 2018. Main outcome measures The primary outcome was the proportion of parents enrolled in quitline treatment. Secondary outcomes included parent factors (e.g., demographics, nicotine dependence, and quitting motivation) associated with successful enrollment. Number of quitline contacts was also explored. Results During the study period, in the eReferral group, 10.3% (24 of 233) of parents who smoked and were interested in quitting enrolled in the quitline, whereas only 2.0% (5 of 251) of them in the control group enrolled in the quitline—a difference of 8.3% (95% CI=4.0, 12.6). Parents aged ≥50 years enrolled in the quitline more frequently. Although more parents in the eReferral group connected to the quitline, among parents who had at least one quitline contact, there was no significant difference in the mean number of quitline contacts between eReferral and control groups (mean, 2.04 vs 2.40 calls; difference, 0.36 [95% CI=0.35, 1.06]). Conclusions Smoking parent eReferral from pediatric primary care may increase quitline enrollment and could be adopted by practices interested in increasing rates of parent treatment. Trial registration This study is registered at www.clinicaltrials.gov NCT02997735.

ACS Style

Brian P. Jenssen; Naveen Muthu; Mary Kate Kelly; Hilary Baca; Justine Shults; Robert W. Grundmeier; Alexander G. Fiks. Parent eReferral to Tobacco Quitline: A Pragmatic Randomized Trial in Pediatric Primary Care. American Journal of Preventive Medicine 2019, 57, 32 -40.

AMA Style

Brian P. Jenssen, Naveen Muthu, Mary Kate Kelly, Hilary Baca, Justine Shults, Robert W. Grundmeier, Alexander G. Fiks. Parent eReferral to Tobacco Quitline: A Pragmatic Randomized Trial in Pediatric Primary Care. American Journal of Preventive Medicine. 2019; 57 (1):32-40.

Chicago/Turabian Style

Brian P. Jenssen; Naveen Muthu; Mary Kate Kelly; Hilary Baca; Justine Shults; Robert W. Grundmeier; Alexander G. Fiks. 2019. "Parent eReferral to Tobacco Quitline: A Pragmatic Randomized Trial in Pediatric Primary Care." American Journal of Preventive Medicine 57, no. 1: 32-40.

Review
Published: 20 February 2019 in Children
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E-cigarettes have emerged and soared in popularity in the past ten years, making them the most common tobacco product used among youth in the United States (US). In this review, we discuss what the Surgeon General has called a public health “epidemic”—the precipitous increase in youth use of e-cigarettes and the health consequences of this behavior. Further, we review tobacco control policy efforts (e.g., Tobacco 21, banning flavors, advertising restrictions, and clean indoor air laws)—efforts proven to be critical in reducing cigarette smoking and smoking-related disease and death among US children and adults—including their potential and challenges regarding managing and mitigating the emergence of e-cigarettes. Finally, we close with a discussion of the efforts of transnational tobacco companies to rebrand themselves using e-cigarettes and other new products.

ACS Style

Brian Jenssen; Rachel Boykan. Electronic Cigarettes and Youth in the United States: A Call to Action (at the Local, National and Global Levels). Children 2019, 6, 30 .

AMA Style

Brian Jenssen, Rachel Boykan. Electronic Cigarettes and Youth in the United States: A Call to Action (at the Local, National and Global Levels). Children. 2019; 6 (2):30.

Chicago/Turabian Style

Brian Jenssen; Rachel Boykan. 2019. "Electronic Cigarettes and Youth in the United States: A Call to Action (at the Local, National and Global Levels)." Children 6, no. 2: 30.

Review
Published: 30 August 2018 in Academic Pediatrics
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Pediatric clinical practice often involves improving child health by changing parents' behavior. Strategies from behavioral economics - a field that leverages predictable patterns in human decision-making to overcome barriers to behavior change - can improve health outcomes in adults. Though more research is needed, the application of these approaches to parent behavior change in pediatric settings has the potential to improve the clinical effectiveness of child healthcare. We review the foundational concepts of behavioral economics and identify the unique role of pediatricians in motivating parent behavior change. We then discuss how to apply four key strategies in practice - message framing, use of defaults, enhanced active choice, and harnessing social forces - to support parent decision-making to improve child health. Leveraging behavioral economic principles around parental decision-making has the potential to supercharge program effectiveness and improve patient and family health.

ACS Style

Brian P. Jenssen; Alison M. Buttenheim; Alexander G. Fiks. Using Behavioral Economics to Encourage Parent Behavior Change: Opportunities to Improve Clinical Effectiveness. Academic Pediatrics 2018, 19, 4 -10.

AMA Style

Brian P. Jenssen, Alison M. Buttenheim, Alexander G. Fiks. Using Behavioral Economics to Encourage Parent Behavior Change: Opportunities to Improve Clinical Effectiveness. Academic Pediatrics. 2018; 19 (1):4-10.

Chicago/Turabian Style

Brian P. Jenssen; Alison M. Buttenheim; Alexander G. Fiks. 2018. "Using Behavioral Economics to Encourage Parent Behavior Change: Opportunities to Improve Clinical Effectiveness." Academic Pediatrics 19, no. 1: 4-10.

Review
Published: 12 December 2017 in Pediatrics
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The IQOS is not yet sold in the United States, but in December 2016, Philip Morris submitted a modified risk tobacco product application to the US Food and Drug Administration (FDA). If its application is successful, Philip Morris will face looser restrictions in marketing HNB tobacco products than it does for conventional tobacco cigarettes. Moreover, Philip Morris seeks to make affirmative safety statements on packaging and advertising for IQOS, including “Scientific studies have shown that switching completely from conventional cigarettes to the IQOS system can reduce the risks of tobacco-related diseases.”3 …

ACS Style

Brian P. Jenssen; Susan C. Walley; Sharon A. McGrath-Morrow. Heat-not-Burn Tobacco Products: Tobacco Industry Claims No Substitute for Science. Pediatrics 2017, 141, e20172383 .

AMA Style

Brian P. Jenssen, Susan C. Walley, Sharon A. McGrath-Morrow. Heat-not-Burn Tobacco Products: Tobacco Industry Claims No Substitute for Science. Pediatrics. 2017; 141 (1):e20172383.

Chicago/Turabian Style

Brian P. Jenssen; Susan C. Walley; Sharon A. McGrath-Morrow. 2017. "Heat-not-Burn Tobacco Products: Tobacco Industry Claims No Substitute for Science." Pediatrics 141, no. 1: e20172383.

Review
Published: 06 January 2017 in Academic Pediatrics
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Tobacco use is the leading cause of preventable death in the United States, and exposure to tobacco smoke harms children from conception forward. There is no safe level of tobacco exposure. Although overall smoking rates have declined, the advent of new products, such as electronic cigarettes, threatens to perpetuate nicotine addiction without clear health benefits. In addition to reviewing traditional and new tobacco products, we discuss the unique role that pediatricians should play in tobacco treatment and control efforts. New policies and technologies can empower pediatric clinicians and pediatric health care systems to help parent smokers quit, and new policies outside of the health care setting might help prevent smoking initiation as well as improve cessation treatments. Future research is needed to continue to study the consequences of tobacco use exposure as well as the best ways to help patients and parents stop tobacco use.

ACS Style

Brian P. Jenssen; Karen M. Wilson. Tobacco Control and Treatment for the Pediatric Clinician: Practice, Policy, and Research Updates. Academic Pediatrics 2017, 17, 233 -242.

AMA Style

Brian P. Jenssen, Karen M. Wilson. Tobacco Control and Treatment for the Pediatric Clinician: Practice, Policy, and Research Updates. Academic Pediatrics. 2017; 17 (3):233-242.

Chicago/Turabian Style

Brian P. Jenssen; Karen M. Wilson. 2017. "Tobacco Control and Treatment for the Pediatric Clinician: Practice, Policy, and Research Updates." Academic Pediatrics 17, no. 3: 233-242.

Journal article
Published: 14 April 2016 in Pediatrics
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OBJECTIVES: We created a clinical decision support (CDS) tool and evaluated its feasibility, acceptability, usability, and clinical impact within the electronic health record to help primary care pediatricians provide smoking cessation treatment to parents/caregivers who smoke.METHODS: This prospective study of pediatric clinicians and parents was conducted at 1 urban primary care site. Clinicians received training in smoking cessation counseling, nicotine replacement therapy (NRT) prescribing, referral to an adult treatment program, and use of the CDS tool. The tool prompted clinicians to ask about secondhand smoke exposure, provide an electronic NRT prescription, and refer. Feasibility was measured by using electronic health record utilization data, and acceptability and usability were assessed with the use of clinician surveys. Parents reported clinical impact, including NRT accepted and used.RESULTS: From June to August 2015, clinicians used the tool to screen for secondhand smoke exposure at 2286 (76%) of 3023 visits. Parent smokers were identified at 308 visits, and 165 parents (55% of smokers) were interested in and offered treatment. Twenty-four (80%) of 30 eligible pediatric clinicians used the tool. Ninety-four percent of clinicians surveyed (n = 17) were satisfied with the tool, and the average system usability scale score was 83 of 100 (good to excellent range). We reached 69 of 100 parents sampled who received treatment; 44 (64%) received NRT, and 17 (25%) were currently using NRT.CONCLUSIONS: A CDS tool to help urban primary care pediatric clinicians provide smoking cessation treatment was feasible, acceptable, usable, and influenced clinical care. A larger scale investigation in varied practice settings is warranted.

ACS Style

Brian P. Jenssen; Tyra Bryant-Stephens; Frank T. Leone; Robert W. Grundmeier; Alexander G. Fiks. Clinical Decision Support Tool for Parental Tobacco Treatment in Primary Care. Pediatrics 2016, 137, 1 .

AMA Style

Brian P. Jenssen, Tyra Bryant-Stephens, Frank T. Leone, Robert W. Grundmeier, Alexander G. Fiks. Clinical Decision Support Tool for Parental Tobacco Treatment in Primary Care. Pediatrics. 2016; 137 (5):1.

Chicago/Turabian Style

Brian P. Jenssen; Tyra Bryant-Stephens; Frank T. Leone; Robert W. Grundmeier; Alexander G. Fiks. 2016. "Clinical Decision Support Tool for Parental Tobacco Treatment in Primary Care." Pediatrics 137, no. 5: 1.

Journal article
Published: 01 April 2016 in Applied Clinical Informatics
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Summary To create and evaluate the feasibility, acceptability, and usability of a clinical decision support (CDS) tool within the electronic health record (EHR) to help pediatricians provide smoking cessation counseling and treatment to parents of hospitalized children exposed to secondhand smoke (SHS). Mixed method study of first-year pediatric residents on one inpatient unit. Residents received training in smoking cessation counseling, nicotine replacement therapy (NRT) prescribing, and use of a CDS tool to aid in this process. The tool, which alerted when a patient was identified as exposed to SHS based on the history taken on admission or during a prior encounter, had the following capabilities: adding SHS exposure to the patient’s problem list; referral to Free Quitline through discharge instructions; and linking to a printable NRT prescription form. We measured feasibility by EHR utilization data. We measured acceptability and usability of the tool by administering questionnaires to residents. From June-August 2015, the alert triggered for 106 patients, and the tool was used for 52 (49%) patients. 41 (39%) patients had SHS exposure added to the problem list, 34 (32%) parents were referred to the Quitline through discharge instructions, and 15 (14%) parents were prescribed NRT. 10 out of 15 (67%) eligible pediatricians used the tool. All clinicians surveyed (9 out of 10) found the tool acceptable and rated its usability good to excellent (average System Usability Scale score was 85 out of 100, 95% CI, 76-93). A non-interruptive CDS tool to help residents provide smoking cessation counseling in the hospital was feasible, acceptable, and usable. Future work will investigate impacts on patient outcomes.

ACS Style

Eric D Shelov; Christopher P Bonafide; Steven L Bernstein; Alexander G Fiks; Tyra Bryant-Stephens; Brian P Jenssen. Clinical Decision Support Tool for Parental Tobacco Treatment in Hospitalized Children. Applied Clinical Informatics 2016, 07, 399 -411.

AMA Style

Eric D Shelov, Christopher P Bonafide, Steven L Bernstein, Alexander G Fiks, Tyra Bryant-Stephens, Brian P Jenssen. Clinical Decision Support Tool for Parental Tobacco Treatment in Hospitalized Children. Applied Clinical Informatics. 2016; 07 (02):399-411.

Chicago/Turabian Style

Eric D Shelov; Christopher P Bonafide; Steven L Bernstein; Alexander G Fiks; Tyra Bryant-Stephens; Brian P Jenssen. 2016. "Clinical Decision Support Tool for Parental Tobacco Treatment in Hospitalized Children." Applied Clinical Informatics 07, no. 02: 399-411.

Multicenter study
Published: 18 September 2015 in Journal of General Internal Medicine
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As primary care moves toward a system of population health management, providers will need to engage patients outside traditional office-based interactions. We assessed patient attitudes regarding technology use to communicate with their primary care team or to engage with other patients outside typical office settings. Design/Participants/Main Measures We conducted a national survey using GfK KnowledgePanel® to examine attitudes on the use of digital technology (email, text messaging, and social media such as Facebook and Twitter) to communicate with primary care teams about health behavior goals and test results. We also assessed attitudes toward the use of digital technologies to engage with other patients in activities such as peer coaching. Of the 5119 panel members invited to participate, 3336 completed the survey (response rate, 65.2 %). Among respondents, more than half (58 %) reported using Facebook, and nearly two-thirds (64.1 %) used text messaging. Overall, few participants were willing to communicate about health goals via social media (3.1 %) or text messaging (13.3 %), compared to email (48.8 %) or phone (75.5 %) (results were similar for communication about test results). Among those that used text messaging, race/ethnicity was the only factor independently associated with greater support for text messaging [African American (OR 1.44; 95 % CI, 1.01–2.06) and Hispanic (OR 1.8; 95 % CI, 1.25–2.59)] in multivariate models. Participants interested in engaging in peer coaching through Facebook (11.7 %) were more likely to be younger (p < 0.0001), female (p < 0.001), and a racial/ethnic minority (African American, non-Hispanic or Hispanic, p < 0.0004). Despite regular use of new digital technology such as text messaging and social media, few participants supported using these tools for communicating with their physicians’ practice. Participants were most supportive of using email for communication. Contrary to previous studies, among users of technology, low socioeconomic status and racial/ethnic minorities were equally or more likely to support use.

ACS Style

Brian P Jenssen; Nandita Mitra; Anand Shah; Fei Wan; David Grande. Using Digital Technology to Engage and Communicate with Patients: A Survey of Patient Attitudes. Journal of General Internal Medicine 2015, 31, 85 -92.

AMA Style

Brian P Jenssen, Nandita Mitra, Anand Shah, Fei Wan, David Grande. Using Digital Technology to Engage and Communicate with Patients: A Survey of Patient Attitudes. Journal of General Internal Medicine. 2015; 31 (1):85-92.

Chicago/Turabian Style

Brian P Jenssen; Nandita Mitra; Anand Shah; Fei Wan; David Grande. 2015. "Using Digital Technology to Engage and Communicate with Patients: A Survey of Patient Attitudes." Journal of General Internal Medicine 31, no. 1: 85-92.

Case reports
Published: 14 September 2015 in Pediatrics
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A 6-year-old girl presented with a history of leg pain and cramping that progressively worsened over a 2- to 3-week period of time. Her examination was notable for normal vital signs, limited range of motion of her left hip, and a limp. Inflammatory markers were slightly elevated, but the serum electrolytes, calcium, and magnesium, complete blood cell count and differential, and creatine kinase level were normal. She was hospitalized for further diagnostic evaluation and was noted to have abnormal muscle movements classified as myokymia (continuous involuntary quivering, rippling, or undulating movement of muscles). Electromyography confirmed the myokymia but did not reveal evidence of a myopathy or neuropathy, prompting additional evaluation for a systemic etiology.

ACS Style

Brian P. Jenssen; Andrew J. Lautz; Jennifer L. Orthmann-Murphy; Sabrina W. Yum; Angela Waanders; Elizabeth Fox. A 6-Year-Old With Leg Cramps. Pediatrics 2015, 136, 732 -739.

AMA Style

Brian P. Jenssen, Andrew J. Lautz, Jennifer L. Orthmann-Murphy, Sabrina W. Yum, Angela Waanders, Elizabeth Fox. A 6-Year-Old With Leg Cramps. Pediatrics. 2015; 136 (4):732-739.

Chicago/Turabian Style

Brian P. Jenssen; Andrew J. Lautz; Jennifer L. Orthmann-Murphy; Sabrina W. Yum; Angela Waanders; Elizabeth Fox. 2015. "A 6-Year-Old With Leg Cramps." Pediatrics 136, no. 4: 732-739.

Case reports
Published: 01 July 2015 in Hospital Pediatrics
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B. P. Jenssen; C. C. Kenyon; Mshp. Probability, Uncertainty, and Value in Inpatient Diagnosis: Connecting the Dots. Hospital Pediatrics 2015, 5, 403 -405.

AMA Style

B. P. Jenssen, C. C. Kenyon, Mshp. Probability, Uncertainty, and Value in Inpatient Diagnosis: Connecting the Dots. Hospital Pediatrics. 2015; 5 (7):403-405.

Chicago/Turabian Style

B. P. Jenssen; C. C. Kenyon; Mshp. 2015. "Probability, Uncertainty, and Value in Inpatient Diagnosis: Connecting the Dots." Hospital Pediatrics 5, no. 7: 403-405.

Journal article
Published: 01 June 2014 in Journal of Graduate Medical Education
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Background Awareness of the primary literature is important for clinicians. Lack of time, poor access to information, and lack of personal initiative may be barriers for some trainees. Really Simple Syndication (RSS) readers aggregate web content, such as journal abstracts, in a single location for easy viewing. Objective We assessed whether use of an RSS reader would increase resident reading frequency, familiarity, and understanding of the primary literature. Methods We conducted a single-center, prospective, randomized, nonblinded, controlled trial of the effect of RSS reader use on knowledge of recent literature among pediatrics residents. Residents were randomly assigned to the RSS group (education in RSS use and receipt of the Pediatrics RSS feed) or a control group that followed standard reading practices. Outcome measures were differences on baseline and monthly surveys of reading frequency, familiarity with recent publications, and knowledge of recent articles (familiarity validation). Results Of 144 eligible residents, 79 (55%) were enrolled in the survey, with 81% (64 of 79) of participants completing all surveys. The RSS reader use was correlated with greater familiarity with selected articles, but not with improved understanding (as measured by ability to answer multiple-choice questions about content). Participants reported satisfaction with the RSS reader based on its ease of use, accessibility, and as an aid in supplementing reading. Conclusions The RSS reader use was accepted by residents and associated with increased familiarity with the primary literature but not with increased understanding.

ACS Style

Brian P. Jenssen; Bimal R. Desai; James M. Callahan. Randomized Controlled Trial of RSS Reader Use and Resident Familiarity With Primary Literature. Journal of Graduate Medical Education 2014, 6, 341 -344.

AMA Style

Brian P. Jenssen, Bimal R. Desai, James M. Callahan. Randomized Controlled Trial of RSS Reader Use and Resident Familiarity With Primary Literature. Journal of Graduate Medical Education. 2014; 6 (2):341-344.

Chicago/Turabian Style

Brian P. Jenssen; Bimal R. Desai; James M. Callahan. 2014. "Randomized Controlled Trial of RSS Reader Use and Resident Familiarity With Primary Literature." Journal of Graduate Medical Education 6, no. 2: 341-344.

Research article
Published: 01 January 2014 in SAGE Open
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Social networking sites (SNS) provide adolescents with opportunities for content generation on a wide range of social issues, providing unique insight into the psychosocial development of adolescence. We explored SNS webpages viewed by a random sample of adolescents during the initial uptake of SNS use (2005) to describe their general language use. Adolescents aged 14 to 17 with home Internet access were recruited using list-assisted random digit dialing methods. All SNS (MySpace) webpages viewed by participants were captured, and a large, structured set of texts (text corpus) was created from the profiles and message boards therein. Using concordance software, word frequency and keyword associations were analyzed. The 346 participants viewed approximately 28,000 MySpace pages, yielding a 1,147,432-word text corpus. Profile sections presented information about the content creator, while message boards focused more on short conversations with recipients. The most common content word was the term love. Profile owners would profess their love for activities, such as dancing, partying, or shopping, followed by their love for family, friends, and significant others. SNS offer teens an opportunity to describe and share feelings about people, places, and things connected to a range of activities and social contacts within their online and offline environments. Better understanding of SNS can offer strategies to adolescents and health care providers for insight into what connects young people in a community.

ACS Style

Brian P. Jenssen; Nicola J. Gray; Kevin Harvey; Ralph J. DiClemente; Jonathan D. Klein. Language and Love. SAGE Open 2014, 4, 1 .

AMA Style

Brian P. Jenssen, Nicola J. Gray, Kevin Harvey, Ralph J. DiClemente, Jonathan D. Klein. Language and Love. SAGE Open. 2014; 4 (1):1.

Chicago/Turabian Style

Brian P. Jenssen; Nicola J. Gray; Kevin Harvey; Ralph J. DiClemente; Jonathan D. Klein. 2014. "Language and Love." SAGE Open 4, no. 1: 1.

Journal article
Published: 27 January 2010 in JAMA: The Journal of the American Medical Association
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Brian P. Jenssen. Medical Students and Unprofessional Online Content. JAMA: The Journal of the American Medical Association 2010, 303, 328 -328.

AMA Style

Brian P. Jenssen. Medical Students and Unprofessional Online Content. JAMA: The Journal of the American Medical Association. 2010; 303 (4):328-328.

Chicago/Turabian Style

Brian P. Jenssen. 2010. "Medical Students and Unprofessional Online Content." JAMA: The Journal of the American Medical Association 303, no. 4: 328-328.