Through stints as a lay midwife, health educator and teacher, Nancy Brown, Ph.D., found herself driven always by the same desire: "I wanted to give people the information they needed to be responsible for their own health." That belief ultimately drew her to a career in health services research. Her projects today cover diverse ground –- diabetes, HIV prevention, teen health, prostate cancer –- but all revolve around finding better ways to help patients make good decisions.

Can online tools, for example, help diabetes patients remember to take their medications and better keep their illness under control? That question lies behind a pilot project recently launched by PAMF clinical, research and informatics staff members, including Dr. Brown.

With online diabetes management, a patient might report her daily blood glucose levels to a computer program, which could then graph her results over time, helping her monitor progress toward medical goals. The online program could also remind her to take medication, check her reported prescription use against pharmacy records, and alert clinicians if it appears she is having trouble. If the pilot project is successful, "we will be able to keep track of patients more continuously, and they will be able to take charge of their care," said PAMF's Chief Medical Information Officer Paul Tang, M.D., who heads the project.

Improving health information for young people is another longtime interest for Dr. Brown. For several years, she has coordinated a group of PAMF staff members who oversee an Education Division Web site for teens that has received more than three million visits. In 2004, PAMF launched a companion Web site for preteens that has drawn more than 300,000 visitors to date.

Much of the new site's content is created by local youth, who write in a voice that appeals to their peers and younger siblings. Two of those teens have also obtained grants to develop health education modules for use in local schools. Backed with additional funds from the Lucile Packard Foundation for Children's Health, the group has created its first module on bullying, which teachers say is a major health concern for students in middle school.

"As funding has gone down in public schools, health education has been neglected. We help teachers fill the gap by giving them electronic resources they can work through with the kids or assign as homework," said Dr. Brown, who will also conduct studies of whether the modules improve health outcomes.

Targeting a very different population, Dr. Brown also works with clinicians from facilities within Sutter Health –- a network of health care organizations throughout Northern California to which PAMF belongs –- to help prostate cancer patients make better treatment decisions. Prostate cancer treatment options have different benefits and risks, and patients are given significant responsibility for the decision, an often overwhelming task without one right answer. The Sutter group is evaluating whether pairing patients with a "nurse navigator" helps them digest information about treatment alternatives, eases stress associated with the decision and improves satisfaction with treatment processes and outcomes.

"With all these projects, we are trying to help people make better decisions about their own health care, whether it is a teen, a diabetes patient or a man facing a frightening cancer diagnosis," she said. "The common theme is that everyone needs support when trying to be healthy."

Back to top