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UCSF INSTITUTE FOR HEALTH & AGING   ◊   UNIVERSITY OF CALIFORNIA, SAN FRANCISCO

Anita L. Stewart, Ph.D.

Anita Stewart, photo
Anita Stewart

Email:  anita.stewart@ucsf.edu
Telephone:  (415) 502-5207

Anita L. Stewart, Ph.D., is Professor in Residence at the Institute for Health & Aging and the Department of Social and Behavioral Sciences.  At the Institute for Health & Aging her work concerns a broad range of studies whose central themes are health promotion and reducing health and health care disparities. 

Dr. Stewart has developed and examined the effectiveness of a choice-based intervention to increase the physical activity levels of under-active older adults (CHAMPS).  She conducted a project to adapt and establish this successful program in three community settings serving diverse segments of older adults including minority and low-income groups.  Information on the CHAMPS programs can be found at http://sbs.ucsf.edu/iha/champs (website).

She has also explored qualitatively how to diffuse physical activity promotion programs into community settings to reach ethnically diverse older adults, including identifying issues in improving infrastructure and resources for physical activity.  Currently, she is testing the effectiveness of an adapted CHAMPS program to increase physical activity, decrease weight, and improve diet, offered in community-based settings to primarily lower income, minority persons aged 40+ with "pre-diabetes" (fasting glucose 95-125 mg/dl).  This project is a partnership between UCSF and the City of Berkeley Division of Public Health (BPHD).  BPHD currently serves lower-income, minority communities with programs to reduce racial/ethnic health disparities.  Dr. Stewart is also Director of the Center for Healthy and Active Aging (website:  http://sbs.ucsf.edu/iha/chaa.htm), which aims to increase the proportion of older adults who lead fulfilling and active lives as they age.

Dr. Stewart has extensive experience conceptualizing and measuring health, functioning, well-being, social support, physical activity, quality of care, and other health-related concepts.  She is Co-director of the NIA-funded Center for Aging in Diverse Communities (CADC).  CADC aims to reduce the health gap between minority and low SES persons and their counterparts through advancing research that includes these populations.  As director of the Measurement and Methods Core, she identifies issues in using measures that have been tested primarily on mainstream groups in studies of diverse population groups, and how to test the conceptual and psychometric adequacy of those measures.

She has developed new patient-reported concepts and measures of interpersonal processes of care that incorporate perspectives of diverse population groups.  The measures are intended to support research on mechanisms by which low SES and minority populations have poorer health and quality of care then their counterparts.

Current Projects

Title:  Physical Activity and Diet to Reduce Disparities in Diabetes Risk
Project Period:  9/30/05 - 7/31/10
Funding Agency:  DHHS-NIH
Description:  Most racial-ethnic minority adults have higher rates of type 2 diabetes and its physiologic and behavioral risk factors than their White counterparts.  This study will test the effectiveness of a lifestyle program to increase physical activity, reduce weight, and improve diet, offered in community-based settings to primarily lower income, minority adults aged 40+ with "pre-diabetes" (fasting glucose 100-125 mg/dl).

Title:  Perceived AIDS Stigma: A Multinational African Study
Project Period:  6/1/03-5/31/08 (Co-Investigator)
Funding Agency:  DHHS-NIH, Fogarty International Center (Co-Investigator)
Description:  The aims of this project are: 1) to develop and validate two linguistically and culturally appropriate measures of perceived HIV/AIDS stigma appropriate for persons living with HIV/AIDS and nurses; 2) to explore potential relationships, over time, among stigma, quality of health care, and 3)to utilize community-based participatory research methods to intervene at a community level with five national nurses association and to track the impact of the community-level events on the perceived stigma of nurse members of those associations.

Title:  Resource Center for Aging Research in Diverse Populations
Project Period:  9/30/97-9/27/07 (Co-Investigator)
Funding Agency:   NIH/National Institute on Aging
Description:  The goal of this project is to foster the development of investigators who will conduct research with older minority persons, develop and implement strategies to diversify the investigator workforce conducting research on their health, advance the state-of-the-art of measurement in studies of diverse populations, and develop and implement strategies for recruiting and retaining minority group members in research dealing with the health of minority elderly.

Recent Projects

Title:  Promoting Effective Communication and Decision-Making for Diverse Populations
Project Period:  9/1/2003-8/31/2005 (Co-Investigator)
Funding Agency:  NIH/Agency for Healthcare Research and Quality
Description:  In this Program Project we will (1) identify elements of effective communication in diverse populations; (2) determine factors that enhance effective, patient-preference based, clinical decision-making (screening, diagnostic and treatment choices); (3) Evaluate methods for communicating risks in diverse populations; and (4) Lay the foundation for developing decision-assisting tool(s) for coronary disease evaluation and treatment, and for cancer screening.  The findings  will illuminate the elements of communication, expectations, values and interpersonal relationships that characterize the delivery and use of health care services.

Title:  Measuring Interpersonal Processes in Diverse Populations
Project Period:  7/01/00-6/30/04
Funding Agency:  NIH/Agency for Healthcare Research and Quality
Description:  This project aims to finalize a conceptual framework and patient-reported survey of interpersonal processes to be conceptually and psychometrically equivalent for African American, Latino, and white patients.  The main purpose of the instrument is to enable examination of interpersonal processes as a mechanism by which to explain health and technical care disparities.  Interventions arising from such studies could contribute to quality improvements in caring for diverse groups.

Title: Evaluating Diffusion Models to Increase Physical Activity in Older Adults
Project Period:  2/1/02-1/31/04
Funding Agency:  Robert Wood Johnson Foundation
Description:  The goal of this project is to complete a comprehensive program evaluation of the current CHAMPS diffusion model, describe an alternative diffusion model, conduct formative studies on the alternative model with key stakeholders and integrate the program evaluation of the current model and the formative evaluation of the alternative model.

Title:  Healthy Aging in Diverse Community Settings
Project Period:  11/1/99-10/31/03
Funding Agency:  The California Endowment
Description:  The goal of this project was to establish an effective healthy aging physical activity promotion program in three community sites serving minority and low-income seniors, by assisting sites to develop cultural adaptations of the program.

Publications

(Organized by Type of Research)

Peer-reviewed articles, book chapters, and books are organized according to the following categories of research:

  1. DEVELOPMENT OF HEALTH-RELATED CONCEPTS AND CONCEPTUAL FRAMEWORKS
  2. DEVELOPMENT AND TESTING OF SPECIFIC MEASURES
    1. RAND Health Insurance Study measures (1978-1982)
    2. RAND Medical Outcomes Study (MOS) measures (1988-1992)
    3. Interpersonal processes of care measures (1999-2007)
    4. Other measures
  3. EVALUATION OF RELIABILITY AND VALIDITY OF VARIOUS MEASURES
  4. METHODOLOGICAL, RECRUITMENT, AND MEASUREMENT ISSUES IN AGING AND HEALTH DISPARITIES RESEARCH
  5. OUTCOMES AND PROCESSES OF INTERVENTIONS TO IMPROVE HEALTH
    1. CHAMPS (Community Healthy Activities Model Program for Seniors)
      1. CHAMPS I (Demonstration project)
      2. CHAMPS II (Randomized controlled trial)
      3. CHAMPS III (Diffusing CHAMPS into diverse communities)
    2. Other interventions
  6. PATHWAYS TO HEALTH
    1. Health care pathways
    2. Other pathways
  1. DEVELOPMENT OF HEALTH-RELATED CONCEPTS AND CONCEPTUAL FRAMEWORKS
  2. Stewart AL, Ware JE, Brook RH.  The meaning of health: Understanding functional limitations, Medical Care. 1977;15:939-52.
  3. Ware JE, Davies-Avery A, Stewart AL.  The measurement and meaning of patient satisfaction with medical care, Health and Medical Care Services Review. 1978;1:1-15.
  4. Aaronson NK, Bakker W, Stewart AL, van Dam FSAM, van Zandwijk N, Yarnold JR, Kirkpatrick A.  Multidimensional approach to the measurement of quality of life in lung cancer clinical trials.  In NK Aaronson and J Beckmann (Eds.) The Quality of Life of Cancer Patients. New York: Raven Press, 1987.
  5. Hays RD, Stewart AL. The structure of self-reported health in chronic disease patients. Psychological Assessment: A Journal of Consulting and Clinical Psychology. 1990;12:22-30.  (also in development of new measures – Medical Outcomes Study)
  6. Stewart AL, King AC.  Evaluating the efficacy of physical activity for influencing quality of life outcomes in older adults.  Annals of Behavioral Medicine. 1991;13:108-16
  7. Stewart AL, King AC.  Conceptualizing and measuring quality of life in older populations.  In Abeles RP, Gift HC and Ory MG. (Eds) Aging and Quality of Life. New York: Springer, p. 27-54, 1994.
  8. Stewart AL, Teno J, Patrick D, Lynn J.  The concept of quality of life of dying persons in the context of health care.  Journal of Pain and Symptom Management. 1999;17:93-108.
  9. Brod, M, Stewart, AL, Sands, L.  Conceptualization of quality of life in dementia.  Journal of Mental Health and Aging. 1999;5:7-19.
  10. Brod M, Stewart AL, Sands L, Walton P.  Conceptualization and measurement of quality of life in dementia: The Dementia - Quality of Life Instrument (DQoL). Gerontologist. 1999;39:25-35. (also in development of new measures)
  11. Painter P, Stewart AL, Carey S.  Physical functioning: Definitions, measurement, expectations.  Advances in Renal Replacement Therapy. 1999;6:110-23. 
  12. Stewart AL, Nápoles-Springer A, Pérez-Stable EJ, Posner S, Bindman AB, Pinderhughes HL, Washington AE  Interpersonal processes of care in diverse populations.  The Milbank Quarterly. 1999;77:305-39 (also in development of new  measures).
  13. Wong ST, Stewart AL, Gilliss C.  Evaluating advanced practice nursing care through use of a heuristic framework. Journal of Nursing Care Quality. 2000;14(2):21-32.
  14. Stewart AL. Conceptual challenges in linking physical activity and disability research.  American Journal of Preventive Medicine. 2003;25(Suppl 2), 137-40.
  15. Nápoles-Springer AM, Santoyo J, Houston K, Houston K, Pérez-Stable EJ, Stewart AL.  Patients' perceptions of cultural factors affecting the quality of their medical encounters.  Health Expectations. 2005;8:4-17.
  16. Swigris JJ, Stewart AL, Gould MK, Wilson SR.  Patients' perspectives on how idiopathic pulmonary fibrosis affects the quality of their lives.  Health Quality of Life Outcomes. 2005;3(61):1-9.
  17. Wong, ST, Yoo GJ, Stewart AL.  Examining the types of social support and the actual sources of social support in older Chinese and Koreans.  International Journal of Health and Human Development. 2005;61(2):105-21.
  18. Wong ST, Yoo GJ, Stewart AL.  The changing meaning of family support among older Chinese and Korean immigrants.  Journal of Gerontology: Social Sciences. 2006;61B:S4-9.
  19. Youmans SL, Schillinger D, Mamary E, and Stewart AL.  Older African Americans' perceptions of pharmacists.  Ethnicity and Disease. 2007;17:284-90.
  20. Holzemer WL, Uys LR,  Makoae LN, Stewart A, Phetlhu RD, Dlamini PS, Greeff M, Kohi TW, Chirwa M, Cuca Y, Naidoo J.   A conceptual model of HIV/AIDS stigma from five African countries.  J Adv Nurs, 2007;58(6):541-51.
  21. Yen IH, Stewart AL, Scherzer T, Pérez-Stable EJ. Older adults' perspectives on key domains of childhood social and economic experiences and opportunities: a first step to creating a multidimensional measure. Epidemiologic Perspectives & Innovations, 2007;4:4-14.
  22. DEVELOPMENT AND TESTING OF SPECIFIC MEASURES
    1. RAND Health Insurance Study Measures (1978-1982)
  23. Brook RH, Ware JE, Davies-Avery A, Stewart AL, Donald CA, Rogers WH, Williams K, Johnston SA.  Overview of Adult Health Status Measures Fielded in Rand's Health Insurance Study, Medical Care. 1979;17 (Supplement).
  24. Ware JE, Brook RH, Williams, KN, Davies-Avery A, Stewart AL, Rogers WH, Donald CA, Johnston SA.  Conceptualization and Measurement of Health for Adults in the Health Insurance Study: Vol. I, Model of Health and Methodology, Rand Corporation, R-1987/1-HEW, May 1980 (49 pp.).
  25. Stewart AL, Ware JE, Brook RH, Davies-Avery A.  Conceptualization and Measurement of Health for Adults in the Health Insurance Study: Vol. II, Physical Health in Terms of Functioning, Rand Corporation, R-1987/2-HEW, July 1978 (193pp).
  26. Brook RH, Ware JE, Davies-Avery A, Stewart AL, Johnston SA, Donald CA, Rogers WH, Williams KN.  Conceptualization and Measurement of Health for Adults in the Health Insurance Study: Vol. VIII, Overview, Rand Corporation, R-1987/8-HEW, October 1979 (131 pp.).
  27. Stewart AL, Brook RH, Kane RL.  Conceptualization and Measurement of Health Habits for Adults in the Health Insurance Study: Vol. I, Smoking, Rand Corporation, R-2374/1-HEW, September 1979 (62 pp.).
  28. Stewart AL, Brook RH, Kane RL.  Conceptualization and Measurement of Health Habits for Adults in the Health Insurance Study: Vol. II, Overweight, Rand Corporation, R-2374-2-HEW, July 1980 (152 pp.).
  29. Stewart AL, Ware JE, Brook RH.  Advances in the measurement of functional status: Construction of aggregate indexes, Medical Care. 1981;19:473-88.
    1. RAND Medical Outcomes Study Measures (1988-1992)
  30. Stewart AL, Hays RD, Ware JE. The MOS Short-Form General Health Survey: reliability and validity in a patient population, Medical Care. 1988;26:724-35.
  31. Hays RD, Stewart AL. The structure of self-reported health in chronic disease patients. Psychological Assessment: A Journal of Consulting and Clinical Psychology. 1990;2:22-30  (also in concept development).
  32. Sherbourne CD, Stewart AL. The MOS Social Support Survey: reliability and validity in a patient population. Social Science and Medicine. 1991;32:705-14.
  33. Stewart AL, JE Ware (eds.), Measuring Functioning and Well-being: The Medical Outcomes Study Approach. Durham NC: Duke University Press, 1992.  Authored chapters:
  34. The MOS framework of health indicators (Stewart AL)
  35. Methods of constructing health measures. (Stewart AL, Hays RD, Ware JE
  36. Methods of validating health measures. (Stewart AL, Hays RD, Ware JE)
  37. Psychological well-being and cognitive functioning measures: The MOS Mental Health Inventory (Stewart AL, Ware JE, Sherbourne CD, Wells K)
  38. Physical functioning measures (Stewart AL, Kamberg C)
  39. Role functioning measures (Sherbourne C, Stewart AL)
  40. Sleep measures (Hays RD and Stewart AL)
  41. Health perceptions, energy/fatigue, and health distress measures (Stewart AL, Hays RD, Ware JE)
  42. Construct validity of MOS health measures (Hays RD, Stewart AL)
  43. Summary and Discussion of MOS Measures (Stewart AL, et al.)
    1. Interpersonal Processes of Care Measures (1999-2007)
  44. Stewart AL, Nápoles-Springer A, Pérez-Stable EJ, Posner S, Bindman AB, Pinderhughes HL, Washington AE  Interpersonal processes of care in diverse populations.  The Milbank Quarterly. 1999;77:305-39 (also in concept development).
  45. Wong ST, Korenbrot CC, Stewart, AL. Consumer assessment of the quality of interpersonal processes of prenatal care among ethnically diverse low income women: development of a new measure.  Women's Health Issues. 2004;214(4):118-29.
  46. Stewart AL, Nápoles-Springer AL, Gregorich SE and Santoyo-Olsson J.  Interpersonal processes of care survey: patient-reported measures for diverse groups.  Health Services Research. 2007; 42 (3, Part I):1235-56.
    1. Other Measures
  47. Hays RD, Hayashi T, Stewart AL, A five-item measure of socially desirable response set. Educational and Psychological Measurement. 1989;49:629-36.
  48. Winograd CH, Lemsky CM, Nevitt MC, Nordstrom TM, Stewart AL, Miller CJ, Bloch DA.  Development of a Physical Performance and Mobility Examination (PPME).  Journal of the American Geriatrics Society. 1994;42:743-9.
  49. Lorig K, Stewart AL, Lynch J, Gonzales V, Ritter PL.  Concepts and Measures for Evaluating Outcomes of Health Education and Other Health Interventions.  Thousand Oaks, CA: Sage, 1996.
  50. Brod M, Stewart AL, Sands L, Walton P.  Conceptualization and measurement of quality of life in dementia: The Dementia - Quality of Life Instrument (DQoL). Gerontologist. 1999;39:25-35 (also in concept development).
  51. Brown JS, Posner SF, Stewart AL.  Urge incontinence: new health-related quality of life measures.  Journal of the American Geriatrics Society. 1999;47:980-8.
  52. Stewart AL, Mills KM, King AC, Haskell WL, Gillis D, Ritter PL. CHAMPS Physical Activity Questionnaire for older adults: outcomes for interventions.  Medicine and Science in Sports and Exercise.  2001;33(7):1126-41.
  53. Wasserman DA, Stewart AL, Delucchi KL.  Social support and abstinence from opiates and cocaine during opioid maintenance treatment.  Drug and Alcohol Dependence. 2001;65:65-75.
  54. Shumway-Cook A, Patla A, Stewart AL, Ferrucci L, Ciol MA, Guralnik JM.  Assessing environmentally determined mobility disability: self-report versus observed community mobility. Journal of the American Geriatrics Society. 2005;53(4):700-4.
  55. Li WW, Stewart AL, Stotts N, and Froelicher ES.  Cultural factors and medication compliance in Chinese immigrants who are taking antihypertensive medications: instrument development.  Journal of Nursing Measurement. 2006;13(3):231-52.
  56. Fongwa MN, Hays RD, Gutierrez PR, Stewart AL.  Psychometric characteristics of a patient satisfaction instrument tailored to the concerns of African Americans.  Ethnicity and Disease. 2006;16(3):948-55.
  57. Wong ST, Yoo GJ, Stewart AL.  An empirical evaluation of social support and psychological well-being in older Chinese and Korean immigrants.  Ethnicity and Health. 2007;12(1):43-67.
  58. Holzemer WL, Uys LR, Chirwa ML, Greeff M, Makoae L, Kohi TW, Dlamini PS, Stewart AL, Mullan J, Phetlhu RD, Wantland D, and Durrheim K.  Validation of the HIV/AIDS Stigma Instrument – PLWA (HASI-P), AIDS Care, 2007;19(8):1002-1012.  
  59. Uys LR, Holzemer WL, Chirwa ML, Dlamini PS, Greeff M, Kohi TW, Makoae LN, Stewart AL, Mullan J, Phetlhu RD, Wantland D, and Naidoo, J.  The Development and Validation of the HIV/AIDS Stigma Instrument - Nurse (HASI-N), AIDS Care, in press, 2008.
  60. EVALUATION OF RELIABILITY AND VALIDITY OF VARIOUS MEASURES
  61. Stewart AL, The reliability and validity of self-reported weight and height, Journal of Chronic Diseases. 1982;35:295-309.
  62. Gonzalez V, Lorig K, Stewart A, Ritter P.  Spanish outcome measures: translation and validation.  Arthritis and Rheumatism. 1996;38:1429-46.
  63. Thom DH, Ribisl KM, Stewart,AL, Luke DA, and the Stanford Trust Study Physicians.  further validation and reliability testing of the Trust in Physician scale.  Medical Care. 1999;37: 510-17.
  64. Harada ND, Chiu V, Stewart AL Mobility-related function in older adults: assessment with a six-minute walk test.  Journal of Physical Medicine and Rehabilitation.  1999;80:837-841L.
  65. Fischer D, Stewart AL, Bloch DA, Lorig K, Laurent D, Holman HR  Capturing the patient's view of change as a clinical outcome measure.  Journal of the American Medical Association. 1999;282:1157-62.
  66. Osmond DH. Vranizan K. Schillinger D, Stewart AL, Bindman AB.  Measuring the need for medical care in an ethnically diverse population.  Health Services Research. 1996;31:551-71.
  67. Ritter PL, Stewart AL, Kaymaz H, Sobel DS, Bloch DA, Lorig KR.  Self-reports of health care utilization compared to provider records.  Journal of Clinical Epidemiology. 2001; 54:136-41.
  68. Harada ND, Chiu V, Stewart AL. An evaluation of three self-report physical activity instruments for older adults. Medicine and Science in Sports and Exercise. 2001;33(6):962-70.
  69. Posner SF, Stewart AL, Marín G, Pérez-Stable EJ. Factor variability of the Center for Epidemiological Studies Depression Scale (CES-D) among urban Latinos. Ethnicity and Health.  2001;6:137-44.
  70. Sands L., Ferreira P, Stewart AL, Brod M, and Yaffe K.  What explains differences between dementia patients' and their caregivers' ratings of patients' quality of life?  American Journal of Geriatric Psychiatry. 2004;12:272-80.
  71. Froelicher ES, Li WW, Mahrer-Imhof R, Christopherson D, Stewart AL.  Women's Initiative for Nonsmoking (WINS) VI: Reliability and validity of health and psychosocial measures in women smokers with cardiovascular disease.  Heart Lung: 2004;33;162-75.
  72. Wong S, Gregorich S, Stewart AL.  Measurement adequacy of parenting and children's functional status in African American and Latino families.  Journal of Nursing Measurement. 2005;12(1): 47-62.
  73. Dailey DE and Stewart AL.  Psychometric characteristics of the Spiritual Perspectives Scale in low-income African American women.  Research in Nursing and Health. 2007;30(1):61-71. 
  74. METHODOLOGICAL, RECRUITMENT, AND MEASUREMENT ISSUES IN AGING AND HEALTH DISPARITIES RESEARCH
  75. Hays RD, Stewart AL, Sherbourne CD, Marshall GN.  The ‘states versus weights' dilemma in quality of life measurement.  Editorial, Quality of Life Research.
    1993;2:167-8.
  76. Dickey B, Wagenaar H, Stewart AL.  Using health status measures with the seriously mentally ill in health services research.  Medical Care. 1996;34:112-16.
  77. Stewart AL, Sherbourne CD, Brod M. Measuring health-related quality of life in older and demented populations.  In B. Spilker (Ed.) Quality of Life and Pharmocoeconomics in Clinical Trials.  Philadelphia: Lippincott-Raven Publishers, 1996.
  78. Stewart AL, Hays RD. Conceptual, measurement, and analytic issues in assessing health status in older populations.  In T Hickey, M Speers, and T Prohaska (Eds.) Public Health and Aging. Baltimore: The Johns Hopkins University Press, 1997.
  79. Stewart AL, Painter PL.  Issues in measuring physical functioning and disability in arthritis patients. Arthritis Care and Research. 1997;10:395-405. 
  80. Stewart AL, Nápoles-Springer A.  Health-related quality of life assessments in diverse population groups in the United States. Medical Care. 2000;38(9)(Suppl II):II-102-24.
  81. Verboncoeur CJ, Stewart AL, King AC, Rush S, McLellan BY, Mills K.  The use of refusal postcards in recruiting older adults.  Annals of Behavioral Medicine.  2000;22(4):330-3.
  82. Nápoles-Springer AM, Stewart AL.  Use of health-related quality of life measures in older and ethnically diverse U.S. populations, Journal of Mental Health & Aging. 2001;7(1):173-9.
  83. Skinner JH, Teresi JA, Holmes D, Stahl SM, Stewart AL (Eds.)  Multicultural Measurement in Older Populations.  New York: Springer Publishing Company, 2002.
  84. Stewart AL, Nápoles-Springer AM.  Advancing health disparities research: can we afford to ignore measurement issues? Medical Care. 2003;41(11):1207-20.
  85. Nápoles-Springer AM, Fongwa MN, Stewart AL, Gildengorin G, Pérez-Stable EJ.  The effectiveness of an advance notice letter on the recruitment of African Americans and Whites for a mailed patient satisfaction survey. Journal of Aging and Health. 2004;16 (Suppl):124S-136S. 
  86. Nápoles-Springer AM, Santoyo J, Stewart AL.  Recruiting ethnically diverse general internal medicine patients for a telephone survey on physician-patient communication.  Journal of General Internal Medicine. 2005;20(5):438-43.
  87. Ramirez M, Ford ME, Stewart AL, Teresi JA.  Measurement issues in health disparities research. Health Services Research. 2005;40:1640-57.
  88. Nápoles-Springer AM, Stewart AL.  Overview of qualitative methods in research with diverse populations: making research reflect the population, Medical Care. 2006;44(Suppl 3):S5-9.
  89. Nápoles-Springer AM, Santoyo J, O'Brien H, Stewart AL. Using cognitive interviews to develop surveys in diverse populations. Medical Care. 2006;44(Suppl 3):S21-30.
  90. Teresi JA, Stewart AL, Morales LS, and Stahl SM.  Measurement in a multi-ethnic society: overview to the special issue. Medical Care. 2006;44(Suppl 3):S3-4.
  91. INTERVENTIONS TO IMPROVE HEALTH: OUTCOMES AND PROCESSES
    1. CHAMPS (Community Healthy Activities Model Program for Seniors)
  1. Sepsis PG, Stewart AL, McLellan B, Mills K, Roitz K, Shoumaker W, King AC.  Seniors' ratings of the helpfulness of health promotion features in starting and maintaining physical activity.  Journal of Aging and Physical Activity. 1995;3:193-207. 
  2. Mills KM, Stewart AL, King AC, Roitz K, Sepsis PG, Ritter PL, Bortz WM.  Factors associated with enrollment of older adults into a physical activity promotion program.  Journal of Aging and Health. 1996;8:96-113.
  3. Stewart AL, Mills KM, Sepsis PG, King AC, McLellan B, Roitz K, Ritter PL.  Evaluation of CHAMPS, a physical activity promotion program for seniors. Annals of Behavioral Medicine. 1997;19: 353-61.
  4. Mills KM, Stewart AL, Sepsis PG, King AC.  Consideration of older adults' preferences for format of physical activity. Journal of Aging and Physical Activity. 1997;5:50-58. 
  1. Mills KM, Stewart AL, McLellan BY, Verboncoeur CJ, King AC, Brown BW.  Evaluation of enrollment bias in a physical activity promotion program for seniors.  Journal of Aging and Physical Activity. 2001;9(4):398-413.
  2. Stewart AL, Verboncoeur CJ, McLellan BY, Gillis DE, Rush S, Mills K, King AC, Ritter P, Brown B, Bortz WM.  Physical activity outcomes of CHAMPS II: a physical activity promotion program for older adults. Journal of Gerontology: Biological Science Medical Science. 2001:56;465-70.
  3. Gillis DE, Grossman, MD, McLellan BY, King AC, Stewart AL. Participants' evaluations of components of a physical activity promotion program for seniors (CHAMPS II). Journal of Aging and Physical Activity. 2002;10(3): 336-53.
  4. Grossman MD, Stewart AL. "You aren't going to get better by just standing around:" physical activity perceptions, motivations, and barriers in adults 75 years of age or older. American Journal of Geriatric Cardiology. 2003;12(1):33-37.
  5. Bera N, Stewart AL, Kahn J, Bortz WM, Ritter P, and Brown WB (deceased).  Can a physical activity promotion program for older adults save health plans money?  A cost-savings analysis of the Community Healthy Activities Model Program for Seniors (CHAMPS).  Managed Care Interface, 2008, in press.
  1. Stewart AL, Grossman M, Bera N, Gillis DE, Sperber N, Castrillo M, Pruitt L, McLellan B, Milk M, Clayton K, and Cassady D.  Multi-level perspectives on diffusing a physical activity promotion program to reach diverse older adults.  Journal of Aging and Physical Activity. 2006;14(3):270-87.
  2. Stewart AL, Gillis D, Grossman M, Castrillo M, Pruitt L, McLellan B, and Sperber N.  Diffusing a research-based physical activity promotion program for seniors into diverse communities (CHAMPS III).  Preventing Chronic Disease [serial online] 2006 Apr.  Available from URL: http://www.cdc.gov/pcd/issues/2006/apr/05_0091.htm. 
    1. Other interventions
  3. Stewart AL, King AC, Killen JD, Ritter PL.  Does smoking cessation improve health-related quality of life?  Annals of Behavioral Medicine. 1996;17:331-8.
  4. Lorig KR, Sobel DS, Stewart AL, Brown WB, Bandura A, Ritter P, Gonzalez VM, Laurent DD, and Holman HR.  Evidence suggesting that a chronic disease self-management program can improve health status while reducing health care utilization and costs.  Medical Care. 1999;37:5-14
  5. Lorig KR, Ritter P, Stewart AL, Sobel DS, Brown WB Jr., Bandura A, Gonzalez VM, Laurent DD, Holman HR.  Chronic disease self-management program: 2-year health status and health care utilization outcomes.  Medical Care. 2001:39;1217-23.
  6. Gillis D, Stewart AL A new approach to designing exercise programs for older adults. In C Jones and D Rose (eds.) Physical Activity Instruction of Older Adults. Chapter 9, pages 131-40, Human Kinetics: Champaign, IL, 2004. 
  7. Kuppermann M, Varner RE, Summitt RL, Learman LA, Ireland C, Vittinghoff E, Stewart AL, Lin F, Richter HE, Hulley S, Washington AE.  Effect of hysterectomy vs medical treatment on health-related quality of life and sexual functioning: The Medicine or Surgery (Ms) randomized trial.  Journal of the American Medical Association, 2004;291(12):1447-55.
  8. Hooker SP, Seavey W, Weidmer,CE, Harvey DJ, Stewart AL, Gillis DE, Nicholl KL, King AC.  The California Active Aging Community Grant Program: translating science into practice to promote physical activity in older adults, Annals of Behavioral Medicine. 2005;29(3):155-65.
  9. Anderson RT, King A, Stewart AL, Camacho F, Rejeski WJ.  Physical activity counseling in primary care and patient well-being: do patients benefit?  Annals of Behavioral Medicine. 2005;30(2):146-54.
  10. Alvidrez J, Areán P, Stewart AL.  Psychoeducation to increase psychotherapy entry for older African Americans.  American Journal of Geriatric Psychiatry. 2005;13:554-61. 
  11. Katzman WB, Sellmeyer DE, Stewart AL, Wanek L and Hamel KA.  Changes in flexed posture, musculoskeletal impairments and physical performance after group exercise in community-dwelling older women.  Archives of Physical Medicine and Rehabilitation. 2007;88:192-9.
  12. PATHWAYS TO HEALTH AND HEALTH BEHAVIORS
    1. Health Care Pathways
  13. Stewart AL, Sherbourne CD, Wells KB, Burnam MA, Rogers WH, Hays RD, Ware JE. Do depressed patients in different health care systems have different levels of well-being and functioning?  Journal of Consulting and Clinical Psychology.  1993;61:849-57.
  14. Bindman AB, Grumbach K, Osmond D, Komaromy M, Vranizan K, Lurie N, Billings J, Stewart AL.  Preventable hospitalization rates and access to health care. Journal of the American Medical Association. 1995;274:305-11.
  15. Bindman AB, Grumbach K, Osmond D, Vranizan K, Stewart AL.  Primary care and receipt of preventive services.  Journal of General Internal Medicine. 1996;11:269-76.
  16. Stewart AL, Grumbach K, Osmond DH, Vranizan K, Komaromy M, Bindman AB.  Primary care and patients perceptions of access to care.  Journal of Family Practice. 1997;44:177-85.
  17. Damush TM, Stewart AL, Mills K, King AC, Ritter P. Prevalence and correlates of physician recommendations to exercise among older adults.  Journal of Gerontology: Medical Sciences. 1999;54A:M423-27.
  18. Schillinger D, Bindman A, Wang F, Stewart AL, Piette J.  Functional health literacy and the quality of physician-patient communication among diabetes patients. Patient Education and Counseling. 2004;52:315-23.
  19. Fernandez A, Schillinger D, Grumbach K, Rosenthal A, Stewart AL, Wang F, Pérez-Stable EJ.  Physician language ability and cultural competence: an exploratory study of communication with Spanish-speaking patients.  Journal of General Internal Medicine. 2004;19:167-74.
  20. Korenbrot CC, Wong S, Stewart AL.  Health promotion and psychosocial services and women's assessments of interpersonal prenatal care in Medicaid managed care.  Maternal and Child Health Journal. 2005;9(2):135-49. 
  21. Swenson SL, Mohaghegh M, Vittinghoff E, Stewart A, Schillinger D.  The influence of depressive symptoms on clinician-patient communication among patients with type 2 diabetes.  Medical Care, 2007;46(3):257-265.
    1. Other Pathways to Health
  22. Stewart AL, and Brook RH.  Effects of being overweight. American Journal of Public Health. 1982;73:171-8.
  23. Stewart AL, Greenfield S, Hays RD, Wells K, Rogers WH, Berry SD, McGlynn EA, Ware JE. Functional status and well-being of patients with chronic conditions: results from the Medical Outcomes Study. Journal of the American Medical Association.
    1989;262:907-13.
    1. Also JAMA: India 1989;6:143-9.
    2. Also JAMA: Japan April 4, 1990, pages 40-47.
  24. Wells KB, Stewart AL, Hays RD, Burnam MA, Rogers W, Daniels M, Berry S, Greenfield S, Ware JE. The functioning and well-being of depressed patients: results from the Medical Outcomes Study. Journal of the American Medical Association.
    1989;262:914-19.
    1. Also JAMA: India 1989;6:153-8.
    2. Also JAMA: Japan April 4, 1990, pages 72-78.
  25. Stewart AL, King AC, Haskell WL  Endurance exercise and health-related quality of life outcomes in 50-65 Year Old Adults.  Gerontologist. 1993;33:782-9.
  26. Stewart AL, Hays RD, Wells K, Rogers WH, Greenfield S.  Long-term functioning and well-being outcomes associated with physical activity and exercise in patients with chronic conditions in the Medical Outcomes Study.  Journal of Clinical Epidemiology. 1994;47:719-30.
  27. Kuppermann M, Lubeck DP, Mazonson PD, Patrick DL, Stewart AL, Buesching DP, Fifer SK.  Sleep problems and their correlates in a working population.  Journal of General Internal Medicine. 1995;10:25-32.
  28. Harada N, Meredith L, Liu H, Stewart AL, Makinodan T, Kahn K. Does acculturation influence physical activity in Japanese American older adults? Asian American and Pacific Islander Journal of Health. Summer-Autumn 2000;8(2):130-7.
  29. Stewart AL. Community-based physical activity programs for adults aged 50 and older. Journal of Aging and Physical Activity. 2001:9(Suppl);S71-91.
  30. Bennett JA, Stewart AL, Kayser-Jones J, Glaser D. The mediating effect of pain and fatigue on level of functioning in older adults. Nursing Research. 2002;51:254-65.
  31. Sands L, Yaffe K, Lui LY, Stewart A, Eng C, Covinsky K.  The effects of acute illness on ADL decline over 1 year in frail older adults with and without cognitive impairment.  Journal of Gerontology: Biological Sciences. 2002;57(7): M449-54.
  32. Shumway-Cook A, Patla AE, Stewart AL, Ferucci L, Ciol MA, Guralnik JM.  Environmental demands associated with community mobility in older adults with and without mobility disability.  Physical Therapy. 2002;82(7): 670-81.
  33. Shumway-Cook A, Patla A, Stewart A, Ferucci L, Liao S, Guralnik J.  Environmental components of mobility disability in community-living older persons.  Brief Report. Journal of the American Geriatrics Society. 2003;51(3):393-8.
  34. Covinsky KE, Palmer RM, Fortinsky RH, Counsell SR, Stewart A, Kresevic D, Burant C, Landefeld CS.  Loss of independence in activities of daily living in older adults hospitalized with medical illnesses:  Increased vulnerability with age.  Clinical investigation, Journal of the American Geriatrics Society. 2003;51(4):451-8.
  35. Haas JS, Fuentes-Afflick E, Stewart AL, Jackson RA, Dean ML, Brawarsky P, Escobar GJ.  Pre-pregnancy health status and the risk of preterm delivery.  Archives of Pediatric and Adolescent Medicine. 2005;159:58-63.
  36. Haas JS, Jackson RA, Fuentes-Afflick E, Stewart AL, Dean ML, Brawarsky P, Escobar GJ.  Changes in the health status of women during and after pregnancy. Journal of General Internal Medicine. 2005;20:45-51.
  37. Moody-Ayers SY, Stewart AL, Covinsky KE, and Inouye SK.  Prevalence and correlates of perceived societal racism in older African American adults with type 2 diabetes mellitus.  Journal of the American Geriatrics Society. 2005;53:2202-8. 
  38. Li WW, Stewart AL, Stotts N, and Froelicher ES.  Cultural factors associated with antihypertensive medication adherence in Chinese immigrants.  Journal of Cardiovascular Nursing. 2006:21(5):354-62.
  39. Stewart AL, Dean ML, Gregorich SE, Brawarsky P, and Haas JS.  Race/ethnicity, socioeconomic status, and the health of pregnant women.  Journal of Health Psychology. 2007;12(2): 285-300.
  40. Mehta KM, Yaffe K, Pérez-Stable E, Stewart A, Barnes D, Kurland BF, Miller BL.  Race/ethnic differences in AD survival in US Alzheimer's Disease Centers. Neurology, 2008;70:1158-60.
  41. Choi S, Rankin S, Stewart A, Oka R.  Effects of acculturation on smoking behavior in Asian Americans.  Journal of Cardiovascular Nursing, 2008;23:67-73.
  42. Macabasco-O'Connell A, Crawford MH, Stotts N, Stewart A, Froelicher ES.  Self-care behaviors in indigent patients with heart failure.  Journal of Cardiovascular Nursing, 2008;23:223-230.
  43. Choi A, Rankin S, Stewart A, and Oka R.  Perceptions of coronary heart disease risk in Korean immigrants with type 2 diabetes.  The Diabetes Educator, 2008;34:484-492.
  44. Seligman HK, Grossman MD, Bera N, Stewart AL.  Improving Physical Activity Resource Guides to Bridge the Divide Between the Clinic and the Community.  Preventing Chronic Disease (CDC online journal). In press, 2008.

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