Associate Professor, Department of Family Medicine
ACCORDS Investigator and Education Program Lead
Director of Quality & Process Improvement & Co-Director of Dissemination & Implementation, Colorado Clinical & Translational Sciences Institute (CCTSI

Dr. Bethany Kwan’s research concerns the application of behavior change and D&I (Dissemination & Implementation) theories and
frameworks to the study of implementation and effectiveness of chronic disease management and prevention in health care settings, with an emphasis on stakeholder engaged research methods. She has led multiple projects involving engaging patients and practices in the design, implementation and evaluation of personalized health care interventions, including a PCORI funded patient-centered diabetes and distress self-management support intervention.

1. Why is your area of science important?
I am a social psychologist who studies health care delivery and health behavior change. Social psychology refers to the study of individual and group factors in social interaction and behavior. This is important to our work at ACCORDS because so much of what we do involves some degree of human behavior change and/or social interaction! The hard clinical and translational questions and problems we seek to address can be informed by theories and evidence from social psychology, including motivation, self-regulation, attitudes and persuasion, stereotypes and prejudice, and judgment and decision making. Social psychology contributes to many methods used in ACCORDS, such as psychometrics, ecological momentary assessment, and analysis of mechanisms of change using structural equation models, multi-level models and longitudinal trends.

2. What was important in your Health Services Research training?
My graduate training was in public health and social health psychology. While similar from a research methods perspective, each field approaches levels of behavior change differently. Public health tends to think more “big picture” – systems and populations. Psychology tends to think at the level of the individual and the group. The combination of these perspectives has really helped me in the transdisciplinary and multilevel nature of my work in ACCORDS and in dissemination and implementation science. Most important, though, has been my experience working in real-world clinical and community health settings, in one capacity or another, since I was 14 years old. It’s so important to see how health care works, and doesn’t work, to know how it might be improved.

3. What are the major take home messages your current research provides?
The major take-home point from my work is that individual motivation or intention to change isn’t enough. Systems, resources, and processes that support taking action at opportune times are needed. The more we can make healthy behaviors be automatic through supportive environments, and the less people have to exert self-control, the better. There are also differences in the quality of motivation, such people tend to be more likely to follow through on intentions when they have a choice and feel like health providers care about them as individuals.

4. What are your goals or areas for future research?
My goals are to advance the science of personalized behavioral health. This means learning how to use “big data” (like from wearable devices or electronic health records) and “little data” (like from patient-reported outcomes) to figure out what types of behavioral health services people need and want, and when those services are most warranted.

5. What advice do you have for researchers who want to work in this area?
My advice is to find a great team that you work well with, that get you and how you think, and are equally passionate about a shared mission. This includes staff, other investigators, and most importantly – patients and other stakeholders.