Preventive Medicine

"Preventive medicine focuses on the health of individuals, communities, and defined populations. Its goal is to protect, promote, and maintain health and well-being and to prevent disease, disability, and death." -From the American College of Preventive Medicine

A man and woman walking outdoors with text Preventive Medicine


Current Studies

Physical Activity Daily (PAD) Trial

Caroline R. Richardson, M.D., Co-Investigator

A randomized clinical trial to examine the effectiveness of an internet-based walking program compared to a telephone intervention, or the combination (internet-based with telephone counseling) for promotion of regular walking in patients with peripheral arterial disease.  NCT02767895

Trial protocol citation: Kumar AM, Lyden AK, Carlozzi NE, Sen A, Richardson CR, Jackson EA. The Physical Activity Daily (PAD) Trial: The rationale and design of a randomized controlled trial evaluating an internet walking program to improve maximal walking distance among patients with peripheral arterial disease. Contemporary Clinical Trials. December 2017. doi: 10.1016/j.cct.2017.12.009.

Effectiveness of an Automated Walking Program Targeting Veterans with COPD

Caroline R. Richardson, M.D., Principal Investigator

Funded by Veterans Administration Merit Award

This study is a two-arm randomized controlled trial of Stepping Up to Health (SUH), an automated Internet-mediated walking program. This study targets veterans with COPD. The three aims of the study are to evaluate the effectiveness of SUH to improve health-related quality of life and reduce hospitalizations in veterans with COPD, and to compare reach, participation and satisfaction between rural and urban subject.

Health Check-Up for Expectant Moms: Computer Intervention for HIV/STI Risk and Drug Use During Pregnancy

Golfo Tzilos, Ph.D., Principal Investigator

Funded by the Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD)

HIV and other sexually transmitted infections (STIs) risk and alcohol/drug use during pregnancy are interconnected problems - both are associated with numerous negative consequences for the woman and the developing fetus. Yet, virtually no interventions have been developed or tested to target both of these serious health concerns during pregnancy. This study will:

  • Design and develop Health Check-up for Expectant Moms (HCEM), a computer-delivered brief intervention that targets both the risk for HIV/STIs and alcohol/drug use among low-income pregnant women

  • Determine the effect of HCEM in two-group, RCT

  • Inform the development of integrated HIV/STI and substance use interventions that are cost-effective, high-reaching, and widely disseminable within prenatal care.

Telemonitoring Enhanced Informal Caregiving to Support Diabetes Self Management

James E. Aikens, Ph.D., Principal Investigator
Ananda Sen, Ph.D., Co-Investigator

Funded by National Institutes of Health

We propose a community-based RCT to test the hypothesis that providing formal support to "CarePartners" (CPs) (non-household family members) improves glycemic control, diabetes mellitus (DM)-related distress, and DM self-management.

MI-BP: mHealth to Improve Blood Pressure Control in Hypertensive African Americans

Lorraine Buis, PhD, MSI, Principal Investigator

Funded by the National Institutes of Health, National Heart, Lung, and Blood Institute ($2,970,128)

This study seeks to improve hypertension-related outcomes in a cohort of African Americans with uncontrolled hypertension between the ages of 25 and 55, through the use of MI-BP, a comprehensive, multiple health behavior change mobile intervention. This research is guided by three specific aims:

  • Determine the effect of MI-BP on blood pressure control at one year, compared with usual care controls, in a one-year RCT.
  • Determine the effect of MI-BP on secondary outcomes (physical activity, sodium intake, medication adherence) compared to usual care controls, in a one-year RCT.
  • Evaluate the cost-effectiveness of MI-BP compared to usual care methods.

Unveiling the role of physician implicit bias and communication behaviors in dissatisfaction, mistrust, and nonadherence in Black patients with Type 2 diabetes 

Michael D. Fetters, M.D., M.P.H., M.A., U-M Site Principal Investigator

Funded by the National Institutes of Health, National Institute Of Diabetes And Digestive And Kidney Diseases to Virginia Commonwealth University ($485,649) 

Study Dates: June 2018 - June 2021

The overall goal of this research is to identify physicians’ communication behaviors during medical interactions that are associated with physicians’ implicit racial bias and Black patients’ immediate (satisfaction, trust) as well as clinically important longer-term outcomes (adherence, healthcare utilization).

To achieve this goal, we target medical interactions involving Black patients with Type 2 diabetes mellitus (T2DM) because nonadherence in Black patients with T2DM is particularly prevalent. Additionally, the patient-physician communication quality has been found to predict patient adherence to T2DM treatment regimens. We will use a mixed-methods design that integrates the strengths of inductive reasoning to explore which physicians’ communication behaviors during medical interactions matter from Black patients’ perspectives and deductive reasoning to identify theoretically and clinically important behaviors.

Our aims are:

  • To explore which physician communication behaviors during medical interactions are perceived negatively or positively by Black patients and why
  • To identify which physician communication behaviors identified in Aim 1 are associated with physicians’ implicit racial bias
  • To examine how physicians’ implicit racial bias impacts Black patients’ satisfaction, trust, adherence, and healthcare utilization through physicians’ communication behaviors.

Study Protocol Citation: Hagiwara N, Mezuk B, Lafata JE, Vrana SR, Fetters MD. Study protocol for investigating physician communication behaviours that link physician implicit racial bias and patient outcomes in Black patients with type 2 diabetes using an exploratory sequential mixed methods design. BMJ Open. 2018;8(10). doi:10.1136/bmjopen-2018-022623.


Infographics and Media

 a low cost high impact intervention to increase produce access and consumption for low income communities
Cohen et al. Increasing Use of a Healthy Food Incentive: A Waiting Room Intervention Among Low-Income Patients. American Journal of Preventive Medicine, February 2017. #VisualAbstract


Recent Publications

  1. Mahmoudi E, Cohen A, Buxbaum J, Richardson CR, Tarraf W. Gaining Medicaid Coverage During ACA Implementation: Effects on Access to Care and Preventive Services. Journal of Health Care for the Poor and Underserved. 2018;29(4):1472-1487. doi: 10.1353/hpu.2018.0107.
  2. Bobb-Semple AA, Williams AF, Boggs ME, Gold KJ. Prenatal Point-of-Care Tobacco Screening and Clinical Relationships. The Annals of Family Medicine. 2018;16(6):507-514. Doi: 10.1370/afm.2290.
  3. Lee PG, Damschroder LJ, Holleman R, Moin T, Richardson CR. Older Adults and Diabetes Prevention Programs in the Veterans Health Administration. Diabetes Care. 2018:dc181141. doi: 10.2337/dc18-1141.
  4. Goodrich DE, Lowery JC, Burns JA, Richardson CR. The Phased Implementation of a National Telehealth Weight Management Program for Veterans: Mixed-Methods Program Evaluation. JMIR Diabetes. 2018;3(3). doi: 10.2196/diabetes.9867.
  5. Saslow LR, Summers C, Aikens JE, Unwin DJ. Outcomes of a Digitally Delivered Low-Carbohydrate Type 2 Diabetes Self-Management Program: 1-Year Results of a Single-Arm Longitudinal Study. JMIR Diabetes. 2018;3(3). doi: 10.2196/diabetes.9333.
  6. Mackey C, Plegue MA, Deames M, Kittle M, Sonneville KR, Chang T. Family physicians’ knowledge, attitudes, and behaviors regarding the weight effects of added sugar. SAGE Open Medicine. 2018;6:205031211880124. doi:10.1177/2050312118801245.

See more

  1. Moin T, Damschroder LJ, Auyoung M, et al. Results From a Trial of an Online Diabetes Prevention Program Intervention. American Journal of Preventive Medicine. September 2018. doi:10.1016/j.amepre.2018.06.028.
  2. Wakai T, Simasek M, Nakagawa U, Saijo M, Fetters MD. Screenings during Well-Child Visits in Primary Care: A Quality Improvement Study. The Journal of the American Board of Family Medicine. 2018 August;31(4):558-569. doi:10.3122/jabfm.2018.04.170222.
  3. Jenkins KR, Fakhoury N, Richardson CR, Segar M, Krupka E, Kullgren J. Characterizing Employees’ Preferences for Incentives for Healthy Behaviors: Examples to Improve Interest in Wellness Programs. Health Promotion Practice. 2018:152483991877664. doi:10.1177/1524839918776642.
  4. Wan ES, Kantorowski A, Homsy D, Kadri R, Richardson CR, et al. Self-reported task-oriented physical activity: A comparison with objective daily step count in COPD. Respiratory Medicine. 2018;140:63-70. doi:10.1016/j.rmed.2018.05.012.
  5. Goold SD, Tipirneni R, Kieffer E, Haggins A, Salman C, Szymecko L, Chang T, et al. Primary Care Clinicians’ Views About the Impact of Medicaid Expansion in Michigan: A Mixed Methods Study. Journal of General Internal Medicine. December 2018. doi:10.1007/s11606-018-4487-6.
  6. Abdul-Aziz AA, Altawil M, Lyon A, MacEachern M, Richardson CR, et al. Lifestyle Therapy for the Management of Atrial Fibrillation. The American Journal of Cardiology. 2018;121(9):1112-1117. doi:10.1016/j.amjcard.2018.01.023.
  7. Dejonckheere M, Robinson CH, Evans L, et al. Designing for Clinical Change: Creating an Intervention to Implement New Statin Guidelines in a Primary Care Clinic. JMIR Human Factors. 2018;5(2). doi:10.2196/humanfactors.9030.
  8. Janney CA, Greenberg JM, Moin T, Kima HM, Holleman RG, Hughes M, Damschroder LJ, Richardson CR, Young AS. Does mental health influence weight loss in adults with prediabetes? Findings from the VA Diabetes Prevention Program. General Hospital Psychiatry. April 2018. doi: 10.1016/j.genhosppsych.2018.04.001.
  9. Lajoie AS, Kerr JC, Clover RD, Harper DM. Influencers and preference predictors of HPV Vaccine Uptake among US Male and Female Young Adult College Students. Papillomavirus Research. Available online 23 March 2018. doi:10.1016/j.pvr.2018.03.007.
  10. Senteio C, Veinot T, Adler-Milstein J, Richardson CR. Physicians’ perceptions of the impact of the EHR on the collection and retrieval of psychosocial information in outpatient diabetes care. International Journal of Medical Informatics. 2018;113:9-16. doi:10.1016/j.ijmedinf.2018.02.003.
  11. Braciszewski JM, Wernette GKT, Moore RS, et al. Developing a tailored substance use intervention for youth exiting foster care. Child Abuse & Neglect. 2018;77:211-221. doi:10.1016/j.chiabu.2018.01.013.
  12. Kumar AM, Lyden AK, Carlozzi NE, Sen A, Richardson CR, Jackson EA. The Physical Activity Daily (PAD) Trial: The rationale and design of a randomized controlled trial evaluating an internet walking program to improve maximal walking distance among patients with peripheral arterial disease. Contemporary Clinical Trials. 2017. doi:10.1016/j.cct.2017.12.009.
  13. Cohen AJ, Lachance LL, Richardson CR, Mahmoudi E, et al. “Doubling Up” on Produce at Detroit Farmers Markets: Patterns and Correlates of Use of a Healthy Food Incentive. American Journal of Preventive Medicine. In-Press Corrected Proof available online 12 Dec 2017. doi: 10.1016/j.amepre.2017.10.005
  14. Min L, Cigolle CT, Bernstein SJ, et al. Diabetes Care Improvement in Pharmacist- Versus Nurse-Supported Patient-Centered Medical Homes. Am J Manag Care. 2017;23(11):e374-e381.
  15. Janney CA, Brzoznowski KF, Richardson CR, et al. Moving Towards Wellness: Physical activity practices, perspectives, and preferences of users of outpatient mental health service. General Hospital Psychiatry. 2017;49:63-66. doi:10.1016/j.genhosppsych.2017.07.004.
  16. Buis LR, Roberson DN, Kadri R, et al. Utilizing Consumer Health Informatics to Support Management of Hypertension by Clinical Pharmacists in Primary Care: Study Protocol. JMIR Research Protocols. 2017;6(10). doi:10.2196/resprot.8059.
  17. Wan ES, Kantorowski A, Homsy D, Teylan M, Kadri R, Richardson CR, et al. Promoting physical activity in COPD: Insights from a randomized trial of a web-based intervention and pedometer use. Respiratory Medicine. 2017 Sept; 130:102-110. doi: 10.1016/j.rmed.2017.07.057.
  18. Assari S, Lee D, Nicklett EJ, Moghani Lankarani M, Piette J, and Aikens J. Gender, racial discrimination in health care, and glycemic control among Black patients with diabetes. Front. Public Health. 5 Aug 2017 (in-press, abstract available online). doi: 10.3389/fpubh.2017.00235
  19. Sarinopoulos I, Bechel-Marriott DL, Malouin JM, Zhai S, Forney JC, Tanner CL. Patient Experience with the Patient-Centered Medical Home in Michigan's Statewide
    Multi-Payer Demonstration: A Cross-Sectional Study. J Gen Intern Med. 2017 Aug 14. doi: 10.1007/s11606-017-4139-2.
  20. Assari S, Lankarani MM, Piette JD, Aikens JE. Self-Rated Health and Glycemic
    Control in Type 2 Diabetes: Race by Gender Differences. J Racial Ethn Health
    Disparities. 2017 Aug 4. doi: 10.1007/s40615-017-0416-3. [Epub ahead of print]
  21. Assari S, Lee DB, Nicklett EJ, Lankarani MM, Piette JD, Aikens JE. Racial Discrimination in Health Care Is Associated with Worse Glycemic Control among Black Men but Not Black Women with Type 2 Diabetes. Frontiers in Public Health. 2017;5. doi:10.3389/fpubh.2017.00235.
  22. Damschroder LJ, Reardon CM, AuYoung M, Moin T, Datta SK, Sparks JB, Maciejewski ML, Steinle NI, Weinreb JE, Hughes M, Pinault LF, Xiang XM, Billington C, Richardson CR. Implementation findings from a hybrid III implementation-effectiveness trial of the Diabetes Prevention Program (DPP) in the Veterans Health Administration (VHA). Implement Sci. 2017 Jul 26;12(1):94. doi: 10.1186/s13012-017-0619-3.
  23. Wan ES, Kantorowski A, Homsy D, Teylan M, Kadri R, Richardson CR, et al. Promoting physical activity in COPD: Insights from a randomized trial of a web-based intervention and pedometer use (in-press). Respiratory Medicine, Available online 25 July 2017. doi: 10.1016/j.rmed.2017.07.057
  24. Byhoff E, Cohen AJ et al. Screening for Social Determinants of Health in Michigan Health Centers. J Am Board Fam Med, 2017 Jul-Aug; 30(4):418-427. doi: 10.3122/jabfm.2017.04.170079.
  25. Tzilos GK, Hade EM, Ruffin IV MT, et al. Correlates of Risky Alcohol Use Among Women From Appalachian Ohio. Journal of Rural Mental Health, 8 June 2017. DOI: 10.1037/rmh0000067
  26. Djuric Z, Segar M, Orizondo C, Mann J, Faison M, Peddireddy N, Paletta M, Locke A. Delivery of Health Coaching by Medical Assistants in Primary Care. J Am Board Fam Med. 2017 May-Jun;30(3):362-370. doi: 10.3122/jabfm.2017.03.160321
  27. Braciszewski JM, Tran TB, Moore RS,Bock BC, Tzilos GK, Chamberlain P, Stout RL. Developing a Tailored Texting Preventive Intervention: A Card Sort Methodology. Journal of Applied Biobehavioral Research. 19 April 2017. doi: 10.1111/jabr.12060 [Epub ahead of print]
  28. Kahler CW, Cioe PA, Tzilos GK, Spillane NS, Leggio L, Ramsey SE, Brown RA, O'Malley SS. A Double-Blind Randomized Placebo-Controlled Trial of Oral Naltrexone for Heavy Drinking Smokers Seeking Smoking Cessation Treatment. Alcohol Clin Exp Res. 2017 Apr 12. doi: 10.1111/acer.13396 [Epub ahead of print]
  29. Hafez D, Nelson DB, Martin EG, Cohen AJ, Northway R,Kullgren JT. Understanding type 2 diabetes mellitus screening practices among primary care physicians: a qualitative chart-stimulated recall study. BMC Family Practice. 4 April 2017. doi: 10.1186/s12875-017-0623-3
  30. Kullgren JT, Youles B, Shetty S, Richardson CR, Fagerlin A, Heisler M. ForgIng New paths in DIabetes PrevenTion (FINDIT): Study Protocol for a Randomized Controlled Trial. Trials. 2017 Apr 8;18(1):167. doi: 10.1186/s13063-017-1887-6
  31. AuYoung M, Damschroder LJ, Kinsinger L, Moin T, Richardson CR. Practical partnered research to improve weight loss among overweight/obese veterans: lessons from the trenches. BMC Med Res Methodol. 2017 Mar 29;17(1):50. doi: 10.1186/s12874-017-0321-9
  32. Lee PG, Jackson EA, Richardson CR. Exercise Prescriptions in Older Adults. Am Fam Physician. 2017 Apr 1;95(7):425-432.
  33. Bian RR, Piatt GA, Sen A, Plegue MA, De Michele ML, Hafez D, Czuhajewski CM, Buis LR, Kaufman N, Richardson CR. The Effect of Technology-Mediated Diabetes Prevention Interventions on Weight: A Meta-Analysis. J Med Internet Res 2017;19(3):e76 DOI: 10.2196/jmir.4709
  34. Janney CA, , Robin M. Masheb RM, Lesley D. Lutes LD, Robert G. Holleman RG, Kim HM, Gillon LR, Damschroder LJ, Richardson CR. Mental health and behavioral weight loss: 24-month outcomes in Veterans. Journal of Affective Disorders. Available online 11 March 2017. doi: 10.1016/j.jad.2017.03.003
  35. Lutes LD, Damschroder LJ, Masheb R, Kim HM, Gillon L, Holleman RG, Goodrich DE, Lowery JC, Janney C, Kirsh S, Richardson CR. Behavioral Treatment for Veterans with Obesity: 24-Month Weight Outcomes from the ASPIRE-VA Small Changes Randomized Trial. J Gen Intern Med. 7 March 2017 in-press. doi: 10.1007/s11606-017-3987-0
  36. Buis L, Hirzel L, Dawood RM, et al. Text Messaging to Improve Hypertension Medication Adherence in African Americans From Primary Care and Emergency Department Settings: Results From Two Randomized Feasibility Studies.  J Med Internet Res. 2017 Feb; 5(2). doi: 10.2196/mhealth.6630(link is external)
  37. Schwartz DD, Stewart SD, Aikens JE, et al. Seeing the Person, Not the Illness: Promoting Diabetes Medication Adherence Through Patient-Centered Collaboration. Clinical Diabetes 2017 Jan; 35(1): 35-42. doi: 10.2337/cd16-0007
  38. Cohen AJ, Richardson CR, Heisler M, Sen A, Murphy EC, Hesterman OB, Davis MM, Zick SM. Increasing Use of a Healthy Food Incentive: A Waiting Room Intervention Among Low-Income Patients. American Journal of Preventive Medicine Volume 52, Issue 2, February 2017, Pages 154–162. DOI: 10.1016/j.amepre.2016.11.008
  39. Moin T, Damschroder LJ, AuYoung M, Maciejewski ML, Datta SK, Weinreb JE, Steinle NI, Billington C6, Hughes M, Makki F, Holleman RG, Kim HM, Jeffreys AS, Kinsinger LS, Burns JA, Richardson CR. Diabetes Prevention Program Translation in the Veterans Health Administration. Am J Prev Med. 2017 Jan 13. pii: S0749-3797(16)30584-0. doi: 10.1016/j.amepre.2016.11.009.
  40. Zivin K, Sen A, Plegue MA, Maciejewski ML, Segar ML, AuYoung M, Miller EM, Janney CA, Zulman DM, Richardson CR. Comparative Effectiveness of Wellness Programs: Impact of Incentives on Healthcare Costs for Obese Enrollees. Am J Prev Med. March 2017, 52(3):347–352. DOI: 10.1016/j.amepre.2016.10.006
  41. Stetson B, Minges KE, Richardson CR. New directions for diabetes prevention and management in behavioral medicine. J Behav Med. 2016 Oct 14.DOI: 10.1007/s10865-016-9802-2
  42. Chaddha A, Jackson EA, Richardson CR, Franklin BA. Technology to Help Promote Physical Activity. Am J Cardiol. 2016 Sep 29. pii: S0002-9149(16)31586-7. DOI: 10.1016/j.amjcard.2016.09.025
  43. Vogel ME, Kanzler KE, Aikens JE, Goodie JL. Integration of behavioral health and primary care: current knowledge and future directions. J Behav Med. 2016 Sep 30. DOI: 10.1007/s10865-016-9798-7
  44. Auyoung M, Linke SE, Pagoto S, Buman MP, Craft LL, Richardson CR, et al. Integrating Physical Activity in Primary Care Practice. Am J Med. 2016;129(10):1022-9. DOI: 10.1016/j.amjmed.2016.02.008
  45. Damschroder LJ, Goodrich DE, Kim HM, Hollerman R, Gillon L, Kirsh S, Richardson CR, Lutes LD. Development and validation of the ASPIRE-VA coaching fidelity checklist (ACFC): a tool to help ensure delivery of high-quality weight management interventions. Transl Behav Med. 2016;6(3):369-85. DOI: 10.1007/s13142-015-0336-x
  46. Moy ML, Martinez CH, Kadri R, Roman P, Holleman RG, Kim HM, Nguyen HQ, Cohen MD, Goodrich DE, Giardino ND, Richardson CR. Long-Term Effects of an Internet-Mediated Pedometer-Based Walking Program for Chronic Obstructive Pulmonary Disease: Randomized Controlled Trial. J Med Internet Res. 2016;18(8):e215. DOI: 10.2196/jmir.5622
  47. Chang T, Ravi N, Plegue MA, Sonneville KR, Davis MM. Inadequate Hydration, BMI, and Obesity Among US Adults: NHANES 2009-2012. Ann Fam Med. 2016;14(4):320-4. DOI: 10.1370/afm.1951
  48. Wu JP, Gundersen DA, Pickle S. Are the Contraceptive Recommendations of Family Medicine Educators Evidence-Based? A CERA Survey. Fam Med. 2016;48(5):345-52. PMID: 27159092
  49. Wu JP, Kusunoki Y, Ela EJ, Barber JS. Patterns of Contraceptive Consistency among Young Adult Women in Southeastern Michigan: Longitudinal Findings Based on Journal Data. Womens Health Issues. 2016;26(3):305-12. DOI: 10.1016/j.whi.2016.02.007
  50. Braciszewski JM, Stout RL, Tzilos GK, Moore RS, Bock BC, Chamberlain P. Testing a Dynamic Automated Substance Use Intervention Model for Youths Exiting Foster Care. J Child Adolesc Subst Abuse. 2016;25(3):181-187. DOI: 10.1080/1067828X.2014.981771
  51. Heapy AA, Higgins DM, Lachappelle KM, Kirlin J, Goulet JL, Czlapinski RA, Buta E, Piette JD, Krein SL, Richardson CR, Kerns RD. Cooperative pain education and self-management (COPES): study design and protocol of a randomized non-inferiority trial of an interactive voice response-based self-management intervention for chronic low back pain. BMC Musculoskelet Disord. 2016;17:85. DOI: 10.1186/s12891-016-0924-z
  52. Janney CA, Kilbourne AM, Germain A, Lai Z, Hoerster KD, Goodrich DE, Klingaman EA, Verchinina L, Richardson CR. The Influence of Sleep Disordered Breathing on Weight Loss in a National Weight Management Program. Sleep. 2016;39(1):59-65. DOI: 10.5665/sleep.5318
  53. Stirratt MJ, Dunbar-jacob J, Crane HM, Simoni JM, Czajkowski S, Hilliard ME, Aikens JE, et al. Self-report measures of medication adherence behavior: recommendations on optimal use. Transl Behav Med. 2015;5(4):470-82. DOI: 10.1007/s13142-015-0315-2

Collaborative Partners and External Affiliations











     Principal Investigators