Mary Cunningham

Can AI help make medical records less biased? New study suggests yes—with caveats

Heather Carroll — Fri, 10 Jul 2026 16:50:49 +0000

Can AI help make medical records less biased? New study suggests yes—with caveats Heather Carroll Fri, 07/10/2026 - 12:50

Large language models can identify judgmental language in clinical notes but the settings play a major role in accuracy.

Teenu Xavier PhD, RN. Photo provided

“Addict,” “non-compliant,” “failed treatment,” and “obese person” are examples of stigmatizing language that can appear in medical records. At 91��’s College of Public Health, researchers are exploring whether artificial intelligence (AI) can help identify this kind of language in clinical notes before it impacts patient care.

Nurse scientist Teenu Xavier and colleagues found that large language models (LLMs) show promise in identifying stigmatizing language in clinical documentation, but their performance is highly dependent on their settings. Model size, temperature settings, prompting strategies, and even note type can substantially influence results.

One finding was consistent across every model tested: Providing examples of stigmatizing language improved accuracy.

“Simply selecting an LLM is not enough when used for clinical documentation,” said Xavier, an assistant professor in the School of Nursing. “Careful attention must be paid to settings and prompting before these tools can be reliably used in health care environments.”

Why does this matter?

The use of stigmatizing language in clinical documentation can reinforce bias and affect a patient’s future care. AI tools may be able to help identify this kind of language, promoting more equitable care and improving patient trust and experience.

“Pre-trained models, when optimized for identifying stigmatizing language, could help enable more timely interventions and modifications to the documentation process,” Xavier said. “Our research highlights the need for continued collaboration between health care professionals and AI developers to create tools that improve communication, reduce bias, and improve the overall patient experience.”

What are the detailed study findings?

The largest LLM (trained on large amounts of data) was the best at predicting “stigmatizing” language (94%), but the worst at predicting “not stigmatizing” correctly (47%).
The smallest LLM was the best at predicting “not stigmatizing” correctly (99.7%), but worst at predicting “stigmatizing” correctly (2%).
When researchers gave the LLM an example of stigmatizing language, accuracy improved in all models.
Emergency provider notes were most accurately (69%) categorized as “stigmatizing” or “non-stigmatizing,” and plan of care notes had the lowest accuracy (56%). Misclassifications most commonly arose in long, clinically dense notes where neutral descriptions of complex illness or adverse events were mistaken by the models for judgmental language.
Larger models worked best at lower temperature (how predictable or random the LLMs’s output is when making a classification) and smaller models improved with higher temperature, which means the LLM took more risks in interpretation.

“Detecting stigmatizing language with large language models: mind the settings” was published in JAMIA Open in April 2026. Co-authors include Jane M. Carrington from the University of Florida and Joshua Lambert from the University of Cincinnati.

Thumbnail photo by issaronow from Adobe Stock.

Key Takeaways

A George Mason study found that large language models show promise in identifying stigmatizing language in clinical documentation, but their performance is highly dependent on their settings, such as model size, temperature settings, prompting strategies, and note type.
The ability to detect and correct stigmatizing language early can reduce bias in patient care and lead to improved patient trust and better health outcomes.
Continued collaboration between health care workers and AI developers is needed to create tools that enhance communication, reduce bias, and improve the overall patient experience.

Learn about Artificial Intelligence at George Mason

Topics

large language models

Machine Learning in Health Care

Health Care Services

College of Public Health

Artificial Intelligence

Research

Sleep problems in dementia care linked more to emotional well-being than fear of falling

Heather Carroll — Tue, 07 Jul 2026 17:27:48 +0000

Sleep problems in dementia care linked more to emotional well-being than fear of falling Heather Carroll Tue, 07/07/2026 - 13:27

Key Takeaways

For dementia care recipients, positive emotion was associated with better sleep, while psychological distress, like depression and anxiety, was associated with worse sleep among caregivers.
Though the study found that fear of falling was associated with poorer sleep for both partners, emotional well-being ultimately showed a stronger association with sleep than fear of falling itself.
This study by 91�� researcher Kyeung Mi Oh is the first to examine the relationships between fear of falling in older adults with probable or possible dementia and the subjective sleep quality of both care recipients and their spousal caregivers.

In This Story

Kyeung Mi Oh, PhD, MSN, RN, FAAN

While fear of falling has long been linked to poor sleep among older adults, new research from 91�� suggests emotional well-being may be an even stronger predictor of sleep quality for people with dementia and the spouses who care for them.

Dementia researcher Kyeung Mi Oh, professor in the School of Nursing. Photo provided.

In what is believed to be the first study of its kind, dementia researcher Kyeung Mi Oh examined how fear of falling and sleep quality interact within dementia caregiving couples where one partner has probable or possible dementia and the other serves as caregiver.

Falls are a common concern among older adults and can lead to reduced mobility, more frequent hospital visits, and limits on daily activities. Many individuals also develop a persistent fear of falling, causing them to avoid activities even when they are physically able. In dementia care, that fear can further increase caregiver burden and affect sleep for both partners.

Though the study found that fear of falling was associated with poorer sleep for both partners, emotional well-being ultimately was more strongly linked to sleep outcomes.

Why does this matter?

“These findings suggest that improving emotional well-being may be more important for sleep health in dementia care dyads than addressing physical health factors alone,” said Oh, professor of Nursing in 91��’s College of Public Health.

For care recipients, positive emotion was associated with better sleep, while psychological distress, like depression and anxiety, was associated with worse sleep among caregivers.

The results highlight the importance of assessing both physical and emotional factors in dementia care.

“Routine assessment of fear of falling, fall history, and psychological distress in both members of dementia care couples could help identify those at risk for poor sleep,” said Oh. “Clinically, interventions that promote emotional well-being and reduce psychological distress may improve sleep for both care recipients and caregivers, highlighting the need for a family-centered approach to dementia care.”

Key Findings:

Fear of falling was associated with poor sleep; however, after factoring in demographic, lifestyle, and health-related factors, positive emotion predicted lower insomnia severity in care recipients, while psychological distress predicted higher insomnia severity in caregivers.
Both fear of falling and recent falls were linked to worse insomnia for people with dementia and their caregivers.

Yeonsu Song from the University of California, Los Angeles co-authored the paper, “Fear of Falling and Sleep Disturbances in Spousal Care Dyads Affected by Dementia,” which was first published online in January 2026 in the Journal of Applied Gerontology.

Thumbnail photo By Koto Amatsukami from Adobe Stock.

Topics

College of Public Health

Karen Drenkard announced as Acting Divisional Dean of the 91�� School of Nursing

Taylor Thomas — Fri, 06 Mar 2026 16:59:44 +0000

Karen Drenkard announced as Acting Divisional Dean of the 91�� School of Nursing Taylor Thomas Fri, 03/06/2026 - 11:59

In This Story

Melissa J. Perry, Sc.D., MHS, MBA

Key Takeaways:

Karen Drenkard has been announced as the 91�� School of Nursing Acting Divisional Dean.
Drenkard, a George Mason School of Nursing alumna (PhD '06), boasts an impressive career as a leader in nursing education and health care innovation across academic, clinical, and organizational settings.
As Acting Divisional Dean, Drenkard's expertise will further the School of Nursing's mission to produce nursing leaders who will contribute to the health of all populations through innovative and impactful research, practice, and service.

Karen Drenkard. Photo provided.

The College of Public Health welcomes Karen Drenkard, PhD, RN, NEA-BC, FAAN as its new Acting Divisional Dean of the School of Nursing. A George Mason alum (PhD ’06), Drenkard brings exceptional leadership, national recognition, and deep expertise across academic nursing, clinical practice, health care innovation, and strategic program development. As President of Drenkard Healthcare Consulting, LLC, she has guided large integrated health care systems, schools of nursing, technology companies, and national organizations in strategic planning, academic–practice partnership development, quality management, and leadership advancement.

"Dr. Drenkard's distinguished career and transformative leadership in nursing education and health care innovation will help advance key initiatives in the School of Nursing. We welcome her vast expertise and visionary approach, which are well-aligned with our mission to advance health and well-being through education and innovation,” said Dean of the College of Public Health Melissa Perry.

Most recently, Drenkard served as professor and associate dean of clinical practice and community engagement at The George Washington University School of Nursing, where she led major clinical initiatives, including the school’s COVID-19 response efforts. Her prior leadership includes a decade as Chief Nurse at Inova Health System, as well as executive roles at GetWell and the American Nurses Credentialing Center, where she served as Executive Director of the Magnet Recognition® Program.

Drenkard is recognized nationally for her transformative leadership and service. She currently chairs the Inova Alexandria Hospital Board Quality and Safety Committee and serves on the boards of the American Organization for Nurse Leaders, the Northern Virginia Workforce Investment Board, and the Watson Caring Science Institute. She is also a member of the Dean’s Advisory Councils for the Indiana University School of Nursing and Russell Sage College, and serves as visiting faculty at the UCSF School of Nursing.

Her thought leadership extends across the country through hundreds of keynote presentations and her extensive faculty work with the UCSF Leadership Institute, where she teaches executive sessions on strategic planning, succession planning, and the integration of human caring into leadership practice. She has also developed comprehensive leadership modules for major health care organizations, spanning executive presence, business planning, financial management, career mapping, and media engagement.

A Fellow of the American Academy of Nursing and the National Academies of Practice, Drenkard earned her PhD in nursing administration, policy, and ethics from 91�� and is both a Wharton Nurse Executive Fellow and a Robert Wood Johnson Executive Nurse Fellow.

Topics

Nursing Leadership

Nursing Faculty

College of Public Health

Alumni

Faculty and Staff News

Health administration and policy trailblazing leader P.J. Maddox retires after 30 years at George Mason

Mary Cunningham — Fri, 04 Apr 2025 13:32:38 +0000

Health administration and policy trailblazing leader P.J. Maddox retires after 30 years at George Mason Mary Cunningham Fri, 04/04/2025 - 09:32

In This Story

After 30 years of outstanding service to 91��’s health administration and policy programs, distinguished leader and cherished member of the College of Public Health P.J. Maddox will retire at the end of the 2024-25 academic year. Maddox, who has served for 20 years as chair of the Department of Health Administration and Policy and is co-director of the Virginia Center for Health Workforce, leaves behind a legacy of unparalleled dedication, innovation, and impact.

P.J. Maddox, PhD, professor and chair, Health Administration and Policy

Maddox's illustrious career at George Mason has been nothing short of transformative. Starting as an assistant professor in 1995, Maddox oversaw creation and growth, establishing the Office of Health Services Research in the Center for Health Policy and a few years later, the Department of Health Administration and Policy and its many award-winning programs. Under her visionary leadership, the department flourished. P.J. launched innovative programs where she and the faculty have received prestigious accolades.

Dean Melissa Perry expressed her profound gratitude for Maddox's contributions, stating, "Dr. P.J. Maddox has been a beacon of excellence and innovation at 91��. Her visionary leadership, tireless dedication, and unwavering commitment to advancing health education have left an indelible mark on our institution. Maddox's impact on the College of Public Health and the broader community is immeasurable. She has inspired countless students, faculty, and professionals, and her legacy will continue to guide us for generations to come. P.J., we are deeply grateful for your years of service and wish you all the best in your well-deserved retirement."

Maddox's achievements have been recognized widely. Awards and recognition include being named the 2021 George Mason Faculty of the Year and the 2025 George Mason Legacy Award winner, as testament to her legacy through her contributions to the university's mission, values, and growth, shaping the institution in meaningful ways.

Throughout her acclaimed career, Maddox, who holds and Doctor of Education; Master of Science, Nursing; and a Master of Science in Nursing, has made significant contributions to academia. Maddox’s academic career has included numerous peer-reviewed academic papers and book chapters and has been awarded prestigious research grants from organizations such as the Centers for Disease Control, Health Resources and Services Administration, Claude Moore Foundation, Northern Virginia Area Health Education Council, Virginia Joint Commission on Healthcare, U.S. Office of Domestic Preparedness, and National Institutes of Health. Her research has advanced the field of health administration and policy, earning her recognition as one of the Top Health Administration Faculty in the U.S. by Modern Healthcare.

“Where to I begin on my adoration for Dr. P.J. Maddox? P.J. has been a mentor, friend, coach and advisor since I started my master’s program in the late 1990s and is to this very day. Her perspective, passion for education, advancement of our field, community service, and mentorship puts P.J. on a pedestal all by herself. I cannot imagine the Mason Nation without P.J. in the faculty! Wishing P.J. well on her retirement, thanks for her years of service to our field, the thousands of students she has helped educate, advance and support. Happy retirement my dear friend and know you are in our hearts always!” said David Goldberg, College Advisory Board member; president and CEO, Mon Health System, Davis Health System-Vandalia Northern Region; and MHA alum.

Under Maddox's guidance, the Department of Health Administration and Policy has flourished. A vanguard for online education, she was instrumental in launching the university’s first online program partnership, resulting in the enrollment of over 300 students in the online master's in health administration and MS in Health Informatics programs since 2018. The department has been an early adopter of George Mason’s efforts to expand access to academic programs, participating in Mason Advance and Advance Online undergraduate programs, as well as expedited matriculation pathways such as bachelor-to-accelerated masters and articulation pathways with Northern Virginia Community College.

Maddox's vision and leadership established the Department of Health Administration and Policy as a separate entity from the School of Nursing in 2005. Since then, the department has grown from five full-time faculty to 21 faculty and three administrative support staff, with student enrollment increasing by more than 180 percent since 2010. Under her stewardship, the department has developed and implemented six new degree programs, earning accolades such as the Sustainability in Healthcare Management Education award from the Commission on Accreditation of Healthcare Management Education (CAHME) in 2022 and CAHME Herzlinger innovation in education award in 2025.

Her efforts have also led to the launch of the first stand-alone Bachelor of Science in Health Informatics degree in Virginia in 2021 and the reaccreditation of the Bachelor of Science in Health Administration (BSHA) by the Association of University Programs in Health Administration (AUPHA) with Full Certified Undergraduate Program Status in 2020 for an additional six years.

Maddox, along with Caroline Sutter, established the Mason Center for the Health Workforce in 2022. In April 2024, the Center received $921,000 in federal funding from the Health Resources and Services Administration (HRSA) and has been featured in several news outlets for addressing the health care worker shortage.

“After decades of visionary leadership, unwavering dedication, and transformative impact, my esteemed co-director of the Center for Health Workforce at Mason, Dr. PJ Maddox, is retiring from 91��. With deep admiration and a touch of bittersweet pride, I celebrate her extraordinary contributions not only to the CPH programs she helped to shape, but to the health workforce across Virginia. P.J.’s brilliance, compassion, and pioneering spirit elevated our Center, inspired countless students, and strengthened our mission to advance healthcare talent and innovation. As my partner and mentor, she leaves a legacy woven into the fabric of our community—one that will guide us for years to come. As she embarks on this well-earned next chapter, I wish her joy, discovery, and the same passion she brought to our work every day. Thank you, P.J., for everything,” said Caroline Sutter, co-director of the Center for Health Workforce with Maddox.

Within the College and University, Maddox has held pivotal roles, including professor, assistant and acting dean, program coordinator, director for the Office of Research Center for Health Policy Research and Ethics, coordinator for the Health Systems Management graduate program and director for the Office of Research Center for Health Policy Research and Ethics, assistant dean then acting director of Graduate Health Science Programs, and most recently, and co-acting director of the School of Nursing. Her legacy of excellence and unwavering commitment to the field will continue to guide and inspire future generations.

Maddox's retirement marks the end of an era, but her legacy will continue to inspire and guide us. Her contributions to 91�� and the field of health administration and policy are immeasurable, and her impact will be felt for generations to come. We extend our deepest gratitude for her years of service, dedication, and unwavering commitment to excellence. As she embarks on this new chapter, we wish her all the best in her retirement and future endeavors.

Topics

HAP Faculty

CPH awards

Faculty and Staff News

George Mason becomes new home for 400,000 biological specimens from Inova Health Systems

Mary Cunningham — Wed, 17 Jul 2024 00:07:11 +0000

George Mason becomes new home for 400,000 biological specimens from Inova Health Systems Mary Cunningham Tue, 07/16/2024 - 20:07

91��’s College of Public Health is the new home of 400,000 biological specimens through a partnership with Inova Health Systems. This repository of specimens, called a biobank, is an extensive collection of obstetrical and perinatal samples, along with follow-up health information, providing a rare and invaluable asset in public health and in the education of our future health, science, and technology care workforce.

“The biorepository creates opportunities for Mason to expand its collaborations with Inova, biotechnology partners, and other universities in Virginia, as well as unique educational opportunities,” said Melissa Perry, dean of the college.

Larry Maxwell, president of the Women’s Service Line at Inova Health System, said, “The investment by Inova Health System as well as additional support from the Fairfax County Government have created an unprecedented resource of placenta as well as blood specimens from mother, father, and baby [trios] corresponding to over 4,000 families. These biospecimens and corresponding data continue to support scientific research to better understand the obstetrical diseases that contribute to rising rates of maternal morbidity and mortality locally, regionally, and nationally.”

A range of specimens (e.g., saliva, urine, and blood) were collected with consent from an Inova cohort study that followed more than 4,000 women, their partners, and their children from pregnancy into early childhood to examine maternal health, pregnancy outcomes, and children’s growth and development.

Biobank program leads Carolyn Drews-Botsch and Michael S. Bloom. Photo by Evan Cantwell/Office of University Branding

“The transfer of the biobank from Inova Health System to the College of Public Health serves as a testament to our strong public–private partnership, and underscores George Mason’s dedication to advancing health in pregnancy and early childhood,” said Alison Cuellar, College of Public Health associate dean for research. The biobank is housed at the university’s Science and Technology Campus in Manassas, Virginia.

The biobank offers an unprecedented opportunity for George Mason researchers to engage with and involve Virginia’s undergraduate and graduate students in health and public health science, to expand Virginia’s health, science, and technology workforce pipeline and enhance its diversity.

“The availability of such comprehensive and diverse datasets within a single biobank is rare, making it an attractive asset for collaboration and groundbreaking research endeavors,” said Michael S. Bloom, program lead of the College of Public Health Biobank and George Mason professor.

Space at the SciTech Campus for the biobank was renovated to hold the 11 tanks (called dewars) and freezers full of specimens. Photo by Evan Cantwell/Office of University Branding

Bloom and co-lead Carolyn Drews-Botsch started the work for the biobank transfer in 2021. Inova chose Bloom and Drews-Botsch after extensive vetting of their prior research experience, including involvement in large cohort studies, such as those from which these specimens are drawn. Space at the SciTech Campus for the biobank was renovated to hold the 11 tanks (called dewars) and freezers full of specimens. The containers are kept between -80 degrees C and -190 degrees C to maintain specimen integrity during long-term storage.

“These specimens will be vital for public health researchers who are looking to identify associations and factors that support healthy pregnancy and child health and ultimately benefit the public’s health,” said Drews-Botsch, a professor in the College of Public Health.

The professors expect the biobank to become a leading resource for collaborative projects once a research database is developed, with other researchers analyzing the data to answer important public health questions.

“By actively fostering these partnerships, George Mason can position itself as a leader in research around maternal health and early childhood and contribute to the advancement of public health on a larger scale,” Perry said.

Uncover more research at the College of Public Health

In This Story

Michael S. Bloom, PhD, MS, FACE

Alison Evans Cuellar, PhD, MBA

Melissa J. Perry, Sc.D., MHS, MBA

Topics

Maternal Child Health

Science and Technology Campus

Songs from adolescence and early adulthood enhance mood and social engagement among people with dementia, according to new study

Mary Cunningham — Mon, 24 Jun 2024 21:18:46 +0000

Songs from adolescence and early adulthood enhance mood and social engagement among people with dementia, according to new study Mary Cunningham Mon, 06/24/2024 - 17:18

Around 46% of residents in U.S. nursing homes have Alzheimer's or other dementias, and 13% of them are treated with antipsychotic medications, according to the National Partnership to Improve Dementia Care in Nursing Homes.

Photo by Getty Images

Antipsychotic medications that affect a person’s mental state have been widely prescribed for people living with dementia in nursing facilities to treat their behavioral (social) and psychological (mood) symptoms, though positive results are limited, and the drugs can come with serious side effects. 91�� College of Public Health faculty are part of a growing group of researchers who are seeking therapeutic ways to improve the quality of life of these residents without medication.

New research, led by principal investigator Megumi Inoue, found that personalized music intervention is effective at reducing the use of antipsychotic and antianxiety medication, alleviating agitation levels, and enhancing mood and social engagement among residents.

Personalized playlists were developed based on family member suggestions regarding what songs, artists, and/or genres the participants listened to when they were around 15 to 25 years old, an age when more memories are available for potential recollection. Facility staff played the personalized playlists for the intervention group twice a week, aiming for at least 30 minutes each session, for four weeks. Participants in the control group continued their usual schedule during these four weeks.

Associate Professor of Social Work Megumi Inoue

“This study provides evidence that personalized music intervention can be used to manage distressing behavioral and psychological symptoms associated with dementia,” said Inoue, an associate professor in the Department of Social Work. "This low-cost, easily implementable intervention, requiring no special licensure for administration, can significantly enhance the quality of life for nursing facility residents

Overall, the intervention group experienced a decrease in average antipsychotic medication use after the intervention, and the control group, which did not receive any music, had an increase in medication use during the same time period. The observational data also revealed that this intervention can improve the mood of residents living with dementia and help them connect with others, while surveys from administrative staff and activity directors highlighted their positive views of the intervention.

“In addition to improving patients’ quality of life, this intervention can create an improved environment throughout the nursing home,” said Inoue. "For example, if personalized music helps reduce residents’ challenging symptoms, they will become easier to work with for direct care workers. In addition, the reduction of medications to treat residents’ psychological and behavioral symptoms will contribute to creating an overall safer facility because such medications have sedating effects that can cause falls."

She added, "Using the personalized music intervention may be perceived as extra work by some staff members, but ultimately, it can ease their work processes as its positive effects have indirect impacts on their work and facility environment."

“A Personalized Music Intervention in Nursing Home Residents Living With Dementia: Findings From a Randomized Study” was published online in the Journal for Applied Gerontology in June 2024. This research was supported by a Civil Money Penalty (CMP) Fund from the Centers for Medicare and Medicaid Services through the Virginia Department of Medical Assistance Services.

Additional authors include Emily S. Ihara, Catherine J. Tompkins, Shannon Layman, Sarah Nosrat, Morgan Moore, and Kimberly A. McNally from George Mason’s College of Public Health; Meng-Hao Li from George Mason’s Schar School of Policy and Government; Samreen Mehak from George Mason’s Department of Biology; George Mason alumna Kendall Barrett from Wise Mind Psychotherapy; and Catherine Magee from Paving the Way MSI.

Discover more from the College of Public Health

In This Story

Megumi Inoue, PhD

College of Public Health receives NIH grant to pilot AI chatbot for African Americans with depression

Mary Cunningham — Mon, 10 Jun 2024 17:03:05 +0000

College of Public Health receives NIH grant to pilot AI chatbot for African Americans with depression Mary Cunningham Mon, 06/10/2024 - 13:03

In This Story

Farrokh Alemi, PhD

Janusz Wojtusiak, PhD

Kevin Lybarger

As a leader in innovative health solutions, 91��’s College of Public Health received a National Institutes of Health (NIH) AIM-AHEAD program grant to pilot an artificial intelligence (AI) chatbot for Black and African Americans with depression. Professor Farrokh Alemi will enhance his first-of-its-kind, evidence-based artificial intelligence tool to address the medication needs of African Americans with depression.

Professor of Health Informatics Farrokh Alemi

The existing AI tool recommends antidepressants for 16,775 general-population patient subgroups, each representing a unique combination of medical history. For each of these subgroups, the current project will analyze the effectiveness and appropriateness of the recommendations for African Americans, using the NIH All of Us database and existing published literature.

To the researchers' knowledge, this is the first research focused on developing and evaluating an antidepressant recommendation system for Black and African American people.

“Antidepressant medications are a first-line treatment for depression; however, a majority of depressed patients do not experience improvement with their first antidepressant. Additionally, minority populations, including Black and African Americans, are not well represented in antidepressant studies, contributing to reduced antidepressant effectiveness in these populations,” said Alemi. “There is a significant need to synthesize available evidence regarding antidepressant effectiveness and provide personalized treatment recommendations, and this project addresses a major gap in the management of Black and African Americans with depression.”

Researchers will develop a Knowledge-enhanced Antidepressant Recommendation Dialogue System (KARDS), which will engage users in a back-and-forth conversation to acquire the patient information needed to identify the appropriate antidepressant medication. The AI will provide the patient with a list of recommended medications, list of the relevant studies, and an explanation for the medication decisions. The system will automatically send the patient’s clinician a brief point-of-care recommendation and explanation, with an option to examine a complete record of the conversation and the supporting evidence.

“Chatbots—or patient-facing dialogue systems like the one we will create—hold transformative potential for the health care sector and are increasingly prominent in psychiatric applications, predominantly through therapy-bot implementations,” said Alemi. “Our chatbot will help improve the detailed, time-consuming, medical history intake process, and provide point-of-care summary and prescription recommendations to the patients’ clinicians. The chatbot will make patients more comfortable because the natural language modality provides an intuitive, empathetic, stigma-free interface.”

Once the AI chatbot is developed, the team will test the dialogue system with Black and African American patients to evaluate system functionality and user preferences. Additionally, the project will train a Black or African American doctoral or master’s student in AI, expanding the available workforce and building the community’s capacity to address AI.

Alemi will lead the research team, which includes Janusz Wojtusiak, a George Mason professor of Health Informatics and the director of the Machine Learning and Inference Laboratory, and Kevin Lybarger, a George Mason assistant professor in the Department of Information Sciences and Technology in the College of Engineering and Computing. All three members have collaborated previously to diagnose COVID at home from presenting symptoms.

The $70,906 grant is part of the NIH’s AIM-AHEAD (Artificial Intelligence/Machine Learning Consortium to Advance Health Equity and Researcher Diversity) program, which aims “to establish mutually beneficial and coordinated partnerships to increase the participation and representation of researchers and communities currently underrepresented in the development of AI/machine learning models and enhance the capabilities of this emerging technology, beginning with electronic health record data.”

Innovate for Good is an ongoing series that examines how George Mason faculty in the College of Public Health are harnessing technology to improve health outcomes.

If you have stories to share as part of the Innovate for Good series, email Mary Cunningham at mcunni7@gmu.edu.

Topics

Tech Talent Investment Program (TTIP)

Artificial Intelligence

New research describes the leisure motivations that underpin young U.S. adults' recreational cannabis use

Mary Cunningham — Mon, 10 Jun 2024 15:40:21 +0000

New research describes the leisure motivations that underpin young U.S. adults' recreational cannabis use Mary Cunningham Mon, 06/10/2024 - 11:40

In This Story

Iulia Fratila, PhD

As of 2024, 24 states including Virginia, Maryland, and Washington, D.C., have legalized the adult recreational use of cannabis. As laws change, citizens' perceptions of the drug and reasons for using the drug have also shifted. In 2020, 34.5% of adults aged 18–25 reported using cannabis in the previous 12 months, according to the Substance Abuse and Mental Health Services Administration. Health experts seek to better understand the broader implications of legalization and individuals’ motivations and attitudes related to cannabis use.

Iulia Fratila, assistant professor in 91��’s College of Public Health

New qualitative research by Iulia Fratila, assistant professor in 91��’s College of Public Health, and Liza Berdychevsky, associate professor at the University of Illinois Urbana–Champaign, describes in what ways young adults (aged 18–30) view cannabis as a recreational and leisure pursuit.

“Recreational cannabis legalization and liberalization is shifting across U.S. states. More holistic approaches to understanding perceptions of cannabis benefits and leisure motivations are scarce due to the longstanding criminalization of cannabis,” said Fratila, the principal investigator. “This research provides novel insights into cannabis users' leisure motivations of use and perceived benefits, which can be leveraged strategically in public health and drug education efforts in the societal transition from criminalization to normalization and commercialization trends concerning cannabis.”

Participants in Fratila and Berdychevsky’s study suggest cannabis can offer a leisure state of mind (e.g., experiencing flow, relaxation, and meditative state), as well as represent a leisure pursuit reserved for free time (e.g., using cannabis as a reward for free, post-obligations time outside of daily demands). Additionally, participants described how cannabis serves as a leisure activity itself (i.e., the act of getting high) and/or as an activity that accompanies other leisure pursuits and socialization (e.g., getting high and going to the movies), while providing pleasurable outcomes (e.g., feeling enjoyment, engaging in humor, enhancing senses).

“Participants discussed the ways that their recreational cannabis consumption represents a controlled and calculated risk-benefit leisure choice that is successfully managed for their overall well-being. Their narratives highlight that this perceived leisure pursuit does not necessarily interfere with their otherwise productive lives,” said Fratila.

These insights can inform harm reduction approaches to cannabis education that may be more effective considering the cannabis legalization and liberalization landscape. Health educators and health promoters can discuss cannabis risks and potential negative health outcomes while acknowledging the desired benefits cannabis users anticipate.

Fratila warns about the impacts of widespread legalization and the emerging recreational cannabis markets, which highlights another meaningful implication connected to the study findings. “Under prohibitory regulations, recreational cannabis use has been explicitly framed as deviant, criminal, harmful, life-wrecking, and void of any potentially desirable leisure qualities (e.g., pleasure, socialization). This study showcases the cannabis users’ understanding of cannabis as normative recreation and the anticipated leisure benefits,” said Fratila.

She further explained, “However, this is a cautionary tale because these desirable qualities may be easily exploited. More specifically, society may be facing a new conundrum with the commercialization of recreational cannabis as the switch from criminalization to commercialization overly simplifies and glamorizes the leisure meanings of cannabis for profitable gain.”

Public health experts and scholars will need to be at the front lines, in collaboration with other fields, to monitor how cannabis is repositioned and accommodated in a cannabis-friendly society, according to Fratila. Specifically, it will be important to spearhead effective health promotion efforts that minimize any related harms and maximize well-being.

This was a qualitative research project utilizing hermeneutic phenomenology, a research method to study how experiences affect everyday practices, and in-depth interviewing with 16 individuals (ages 18–30) living in the U.S. states with legalized recreational cannabis.

“Phenomenological Exploration of Young Adults’ Recreational Cannabis Use Experiences and Associated Leisure Meanings” was published in the Journal of Leisure Research in June 2024. This research was not funded.

Topics

George Mason researchers harness the power of artificial intelligence to match patients with the most effective antidepressant for their unique needs

Mary Cunningham — Wed, 29 May 2024 19:46:58 +0000

George Mason researchers harness the power of artificial intelligence to match patients with the most effective antidepressant for their unique needs Mary Cunningham Wed, 05/29/2024 - 15:46

Researchers in 91��’s College of Public Health have leveraged the power of artificial intelligence (AI) analytical models to match a patient’s medical history to the most effective antidepressant, allowing patients to find symptom relief sooner. The free website, MeAgainMeds.com, provides evidence-based recommendations, allowing clinicians and patients to find the optimal antidepressant the first time.

Farrokh Alemi, principal investigator and professor of health informatics at 91��’s College of Public Health

“Many people with depression must try multiple antidepressants before finding the right one that alleviates their symptoms. Our website reduces the number of medications that patients are asked to try. The system recommends to the patient what has worked for at least 100 other patients with the same exact relevant medical history,” said Farrokh Alemi, principal investigator and professor of health informatics at 91��’s College of Public Health.

AI helped to simplify the very complex task of making the thousands of guidelines easily accessible to patients and clinicians. The guidelines that researchers created are complicated because of the amount of clinical information that is relevant in prescribing an antidepressant; AI seamlessly simplifies the task.

With AI at its core, MeAgainMeds.com analyzes clinician or patient responses to a few anonymous medical history questions to determine which oral antidepressant would best meet the specific needs. The website does not ask for any personal identifiable information and it does not prescribe medication changes. Patients are advised to visit their primary health care provider for any changes in medication.

In 2018, the Centers for Disease Control reported that more than 13% of adults use antidepressants, and the number has only increased since the pandemic and other epidemics since 2020. This website could help millions of people find relief more quickly.

Alemi and his team analyzed 3,678,082 patients who took 10,221,145 antidepressants. The oral antidepressants analyzed were amitriptyline, bupropion, citalopram, desvenlafaxine, doxepin, duloxetine, escitalopram, fluoxetine, mirtazapine, nortriptyline, paroxetine, sertraline, trazodone, and venlafaxine. From the data, they created 16,770 subgroups of at least 100 cases, using reactions to prior antidepressants, current medication, history of physical illness, history of mental illness, key procedures, and other information. The subgroups and remission rates drive the AI to produce an evidence-based medication recommendation.

“By matching patients to the subgroups, clinicians can prescribe the medication that works best for people with similar medical history,” said Alemi. The researchers and website recommend that patients who use the site take the information to their clinicians, who will ultimately decide whether to prescribe the recommended medicine.

Alemi and his team tested a protype version of the site in 2023, which they advertised on social media. At that time, 1,500 patients used the website. Their goal is to improve the website and expand its user base. The initial research was funded by the Commonwealth of Virginia and by the Robert Wood Johnson Foundation.

The researchers’ most recent paper in a series of papers on response to antidepressants analyzed 2,467 subgroups of patients who had received psychotherapy. “Effectiveness of Antidepressants in Combination with Psychotherapy” was published online in March 2024. Additional authors include Tulay G Soylu from Temple University, and Mary Cannon and Conor McCandless from Royal College of Surgeons in Dublin, Ireland.

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Farrokh Alemi, PhD

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Mason CARES intervention reduces stress and feelings of burden of family caregivers of older adults with dementia

Mary Cunningham — Wed, 29 May 2024 15:50:53 +0000

Mason CARES intervention reduces stress and feelings of burden of family caregivers of older adults with dementia Mary Cunningham Wed, 05/29/2024 - 11:50

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Dr. Cathy Tompkins

Gilbert Gimm, PhD, FGSA

According to the U.S. Centers for Disease Control and Prevention, 80% of those living with dementia receive informal care from family members or friends. This equates to 16 million family caregivers in the U.S. However, caring for family members with dementia is often associated with increased caregiver burden (which includes emotional, physical, and financial strain), stress, and worse physical health for the caregiver.

Catherine Tompkins, principal investigator, professor of social work, and associate dean of faculty and staff affairs in the College of Public Health.

A recent study published in the Journal of Applied Gerontology, led by 91�� researchers, found that a 9-week online stress management intervention program for family caregivers reduced burden scores by 15% for 97 family caregivers of older adults living with dementia. The Stress-Busting Program for Family Caregivers TM, intervention was specifically designed to help family caregivers manage their own stress when caring for older adults living with dementia or a chronic illness

“In this study, we found evidence of a range in average caregiver burden levels based on the dementia severity category of care recipients. The findings show that an online Zoom intervention in a peer group setting can be beneficial for family caregivers of older adults with mild, moderate, or severe dementia,” said Catherine Tompkins, principal investigator, professor of social work, and associate dean of faculty and staff affairs in the College of Public Health.

The intervention provided family caregivers with education and strategies to manage stress when caring for someone living with dementia. Examples of self-care techniques included breathing and meditation; troubleshooting behaviors associated with dementia; and peer-to-peer support within a virtual group setting.

Associate Professor Gilbert Gimm

“Reducing caregiver burden and managing stress are critical to the well-being of families. These findings show that effective stress management interventions for family caregivers can be facilitated through online peer groups,” said Gilbert Gimm, first author and associate professor of health administration and policy.

“Mason Caregivers Aiming for Resilience, Empowerment, and Support Study: Assessing Family Caregiver Burden Post-Intervention” was published online in April 2024. Co-authors include George Mason Associate Professor Megumi Inoue, Professor Emily Ihara, Mason CARES Project Manager Shannon Layman, and Master of Social Work alumna graduate Harveen Pantleay. This study was supported by a grant (#2021048) from the Retirement Research Foundation (RRF).

The study is part of a larger project, entitled Mason CARES (Caregivers Aiming for Resilience, Empowerment, and Support), that implemented and assessed interventions for family caregivers.

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