Kimberly Johnson

Positions:

Professor of Medicine

Medicine, Geriatrics
School of Medicine

Senior Fellow in the Center for the Study of Aging and Human Development

Center for the Study of Aging and Human Development
School of Medicine

Member of the Duke Cancer Institute

Duke Cancer Institute
School of Medicine

Education:

M.D. 1997

Johns Hopkins University

Medical Resident, Me Dicine

Duke University

Chief Medical Resident-Ambulatory Services, Medicine

Duke University

Fellow in Geriatrics, Medicine

Duke University

Grants:

PCplanner: operationalizing needs-focused palliative care for older adults in intensive

Administered By
Medicine, Pulmonary, Allergy, and Critical Care Medicine
Awarded By
National Institutes of Health
Role
Investigator
Start Date
End Date

Duke Center for REsearch to AdvanCe Healthcare Equity (REACH EQUITY)

Administered By
Medicine, Geriatrics
Awarded By
National Institutes of Health
Role
Principal Investigator
Start Date
End Date

IPA-Kimberly Johnson

Administered By
Medicine, Geriatrics
Awarded By
Durham Veterans Affairs Medical Center
Role
Physician
Start Date
End Date

Implementing Best Practice in Palliative Care

Administered By
Center for the Study of Aging and Human Development
Awarded By
Agency for Healthcare Research and Quality
Role
Principal Investigator
Start Date
End Date

IPA - Kimberly Johnson

Administered By
Medicine, Geriatrics
Awarded By
Durham Veterans Affairs Medical Center
Role
Investigator
Start Date
End Date

Publications:

Interventions to promote dementia knowledge among racial/ethnic minority groups: A systematic review.

BACKGROUND: Certain racial/ethnic minority groups have a higher risk of developing dementia, yet studies have demonstrated that they often have limited knowledge and understanding of this disease. An increasing number of educational and advocacy programs have been developed to promote dementia knowledge. We aimed at assessing current evidence and quality regarding educational interventions for promoting dementia knowledge. METHODS: We searched for intervention studies published in English that focused on educational interventions for promoting dementia knowledge among racial/ethnic minority groups. We identified 25 relevant studies through PubMed, PsycINFO, CINAHL, and Scopus, using tailored search terms. We screened titles and abstracts, reviewed full texts, synthesized relevant evidence, and evaluated the studies' quality based on the Mixed Methods Appraisal Tool. Relevant intervention studies took place in communities, hospitals or clinics, and schools, and online. RESULTS: Most studies were conducted in the United States (n = 21), followed by the UK (n = 3). Over half of the studies included Asian/Pacific Islander groups (n = 14), followed by Black groups (n = 12) and Hispanic groups (n = 11). The intervention delivery mode varied across studies-from workshops hosted in a faith community to talk shows on YouTube. Target populations included middle-aged and older adults, caregivers and family members, health students and professionals, and elementary school students. Common content included symptoms and signs of dementia, protective and risk factors, and local resources. The assessment of study outcomes varied across studies. Improvement in dementia knowledge and attitudes towards dementia was reported in many studies. Among the included studies, intervention satisfaction was high. The overall quality of the interventions was low. CONCLUSION: Formally evaluated educational interventions promoting dementia knowledge are at an early stage. Existing published interventions showed adequate acceptability and promise in promoting better understanding and awareness of dementia in minority groups. More well-designed randomized controlled trials are needed.
Authors
Huggins, LKL; Min, SH; Dennis, C-A; Østbye, T; Johnson, KS; Xu, H
MLA Citation
Huggins, Lenique K. L., et al. “Interventions to promote dementia knowledge among racial/ethnic minority groups: A systematic review.J Am Geriatr Soc, Oct. 2021. Pubmed, doi:10.1111/jgs.17495.
URI
https://scholars.duke.edu/individual/pub1498177
PMID
34628641
Source
pubmed
Published In
Journal of the American Geriatrics Society
Published Date
DOI
10.1111/jgs.17495

ADVANCE: Methodology of a qualitative study.

BACKGROUND/OBJECTIVES: Quantitative studies have documented persistent regional, facility, and racial differences in the intensity of care provided to nursing home (NH) residents with advanced dementia including, greater intensity in the Southeastern United States, among black residents, and wide variation among NHs in the same hospital referral region (HRR). The reasons for these differences are poorly understood, and the appropriate way to study them is poorly described. DESIGN: Assessment of Disparities and Variation for Alzheimer's disease Nursing home Care at End of life (ADVANCE) is a large qualitative study to elucidate factors related to NH organizational culture and proxy perspectives contributing to differences in the intensity of advanced dementia care. Using nationwide 2016-2017 Minimum DataSet information, four HRRs were identified in which the relative intensity of advanced dementia care was high (N = 2 HRRs) and low (N = 2 HRRs) based on hospital transfer and tube-feeding rates among residents with this condition. Within those HRRs, we identified facilities providing high (N = 2 NHs) and low (N = 2 NHs) intensity care relative to all NHs in that HRR (N = 16 total facilities; 4 facilities/HRR). RESULTS/CONCLUSIONS: To date, the research team conducted 275 h of observation in 13 NHs and interviewed 158 NH providers from varied disciplines to assess physical environment, care processes, decision-making processes, and values. We interviewed 44 proxies (black, N = 19; white, N = 25) about their perceptions of advance care planning, decision-making, values, communication, support, trust, literacy, beliefs about death, and spirituality. This report describes ADVANCE study design and the facilitators and challenges of its implementation, providing a template for the successful application of large qualitative studies focused on quality care in NHs.
Authors
Lopez, RP; McCarthy, EP; Mazor, KM; Hendricksen, M; McLennon, S; Johnson, KS; Mitchell, SL
MLA Citation
Lopez, Ruth Palan, et al. “ADVANCE: Methodology of a qualitative study.J Am Geriatr Soc, vol. 69, no. 8, Aug. 2021, pp. 2132–42. Pubmed, doi:10.1111/jgs.17217.
URI
https://scholars.duke.edu/individual/pub1482059
PMID
33971029
Source
pubmed
Published In
Journal of the American Geriatrics Society
Volume
69
Published Date
Start Page
2132
End Page
2142
DOI
10.1111/jgs.17217

Identifying high-risk surgical patients: A study of older adults whose code status changed to Do-Not-Resuscitate.

BACKGROUND: There is a paucity of data on older adults (age ≥65 years) undergoing surgery who had an inpatient do-not-resuscitate (DNR) order, and the association between timing of DNR order and outcomes. METHODS: This was a retrospective analysis of 1976 older adults in the American College of Surgeons National Surgical Quality Improvement Program geriatric-specific database (2014-2018). Patients were stratified by institution of a DNR order during their surgical admission ("new-DNR" vs. "no-DNR"), and matched by age (±3 years), frailty score (range: 0-1), and procedure. The main outcome of interest was occurrence of death or hospice transition (DoH) ≤30 postoperative days; this was analyzed using bivariate and multivariable methods. RESULTS: One in 36 older adults had a new-DNR order. After matching, there were 988 new-DNR and 988 no-DNR patients. Median age and frailty score were 82 years and 0.2, respectively. Most underwent orthopedic (47.6%), general (37.6%), and vascular procedures (8.4%). Overall DoH rate ≤30 days was 44.4% for new-DNR versus 4.0% for no-DNR patients (p < 0.001). DoH rate for patients who had DNR orders placed in the preoperative, day of surgery, and postoperative setting was 16.7%, 23.3%, and 64.6%, respectively (p < 0.001). In multivariable analysis, compared to no-DNR patients, those with a new-DNR order had a 28-fold higher adjusted odds of DoH (odds ratio [OR] 28.1, 95% confidence interval: 13.0-60.1, p < 0.001); however, odds were 10-fold lower if the DNR order was placed preoperatively (OR: 5.8, p = 0.003) versus postoperatively (OR: 52.9, p < 0.001). Traditional markers of poor postoperative outcomes such as American Society of Anesthesiologists class and emergency surgery were not independently associated with DoH. CONCLUSIONS: An inpatient DNR order was associated with risk of DoH independent of traditional markers of poor surgical outcomes. Further research is needed to understand factors leading to a DNR order that may aid early recognition of high-risk older adults undergoing surgery.
Authors
Kazaure, HS; Truong, T; Kuchibhatla, M; Lagoo-Deenadayalan, S; Wren, SM; Johnson, KS
MLA Citation
Kazaure, Hadiza S., et al. “Identifying high-risk surgical patients: A study of older adults whose code status changed to Do-Not-Resuscitate.J Am Geriatr Soc, July 2021. Pubmed, doi:10.1111/jgs.17391.
URI
https://scholars.duke.edu/individual/pub1492783
PMID
34331702
Source
pubmed
Published In
Journal of the American Geriatrics Society
Published Date
DOI
10.1111/jgs.17391

"Shouldn't You Spend Your Time Curing Cancer or Something?" Why an African American Female Physician Chose a Career in Palliative Care.

Authors
MLA Citation
Johnson, Kimberly S. “"Shouldn't You Spend Your Time Curing Cancer or Something?" Why an African American Female Physician Chose a Career in Palliative Care.J Palliat Med, vol. 24, no. 7, July 2021, pp. 1109–10. Pubmed, doi:10.1089/jpm.2020.0777.
URI
https://scholars.duke.edu/individual/pub1485842
PMID
34128707
Source
pubmed
Published In
Journal of Palliative Medicine
Volume
24
Published Date
Start Page
1109
End Page
1110
DOI
10.1089/jpm.2020.0777

Diversifying the Research Workforce as a Programmatic Priority for a Career Development Award Program at Duke University.

The National Institutes of Health (NIH) has prioritized efforts to increase diversity in the biomedical research workforce. NIH-funded institutional career development awards may serve as one mechanism to facilitate these efforts. In 2013, the Duke University KL2 program, an internal career development program funded by the National Center for Advancing Translational Sciences, set a goal to increase the number of investigators from underrepresented racial and ethnic groups (UREGs) to ≥ 50% of KL2 awardees. From 2013 to 2019, 133 KL2 applications were received, 38% from UREG investigators. Of the 21 scholars selected, 10 (47.6%) were UREG investigators; all were Black/African American. This represents a threefold increase in the proportion of UREG applications and a sixfold increase in the proportion of UREG KL2 scholars compared with Duke's previous KL2 cycles (2003-2012), during which only 13% of applicants and 8.3% of funded scholars were UREGs. Of the 12 KL2 scholars (7 UREG) who completed the program, 5 have received NIH funding as principal investigators of an external K award or R01, and 4 of them are UREG investigators; this constitutes a post-KL2 NIH funding success rate of 57% (4/7) for UREG scholars. Achieving this programmatic priority was facilitated by institutional support, clear communication of goals to increase the proportion of UREG KL2 awardees, and intentional strategies to identify and support applicants. Strategies included targeted outreach to UREG investigators, partnerships with other institutional entities, structured assistance for investigators with preparing their applications, and a KL2 program structure addressing common barriers to success for UREG investigators, such as lack of consistent mentorship, protected research time, and peer support. The authors' experience suggests that KL2 and other internal career development programs may represent a scalable, national strategy to increase diversity in the biomedical research workforce.
Authors
Johnson, KS; Gbadegesin, R; McMillan, AE; Molner, S; Boulware, LE; Svetkey, LP
MLA Citation
Johnson, Kimberly S., et al. “Diversifying the Research Workforce as a Programmatic Priority for a Career Development Award Program at Duke University.Acad Med, vol. 96, no. 6, June 2021, pp. 836–41. Pubmed, doi:10.1097/ACM.0000000000004002.
URI
https://scholars.duke.edu/individual/pub1482995
PMID
34031305
Source
pubmed
Published In
Acad Med
Volume
96
Published Date
Start Page
836
End Page
841
DOI
10.1097/ACM.0000000000004002