Robert Penfold, PhD, is a health services research and health policy expert whose work focuses on developing and testing strategies to optimize behavioral health care delivery and patient outcomes—particularly in children and adolescents. His research addresses practical issues, such as how to reduce unnecessary use of antipsychotic medications in youth. He also studies the effects of cost-control policies on how clinicians deliver care, how people use care, and how those changes can promote or worsen their health.
Dr. Penfold is a co-investigator in the Mental Health Research Network (MHRN), a resource for studies on mental health conditions ranging from autism to postnatal depression. He leads the MHRN’s child and adolescent scientific interest group. He is also investigating reasons why similar patients receive different mental health treatment, such as different medications, depending on where they live or receive care.
His other recent and ongoing projects include:
Dr. Penfold has extensive experience gathering and analyzing information from large health databases, including those of Medicare, Medicaid, and the Health Care Systems Research Network’s Virtual Data Warehouse. These data and analyses allow rapid information sharing among Kaiser Permanente Washington and participating sites, which improves patient safety and timely access to effective, cutting-edge therapies.
He has also conducted several novel pragmatic clinical trials using the Epic electronic health record system.
Before joining KPWHRI in 2010, Dr. Penfold held research and teaching positions at Nationwide Children's Hospital in Columbus, Ohio; the Winnipeg Regional Health Authority; the Manitoba Centre for Health Policy; and most recently, at Harvard Medical School in the Department of Population Medicine and Harvard Pilgrim Health Care Institute.
Children and adolescents; anti-psychotics and anti-depressants; bipolar disorder, and depression
Comparative effectiveness; consumer-directed health plans; patient outcomes; costs of chronic illnesses; Medicare and Medicaid
Space-time surveillance; interrupted time series analysis
Penfold RB, Hilt RJ, Schwartz N, Thompson EE, Robb AS, Correll CU, Newton D, Rogalski K, Earls MF, Kowatch RA, Beck A, Yarborough BJ, Crystal S, Kelleher KJ. Development of a symptom-focused model to guide the prescribing of antipsychotics in children and adolescents: results of the first phase of the Safer and Targeted Use of Antipsychotics (SUAY) clinical trial. J Am Acad Child Adolesc Psychiatry. 2022 Jan;61(1):93-102. doi: 10.1016/j.jaac.2021.04.010. Epub 2021 May 4. PubMed
Ralston JD, Yu O, Penfold RB, Gundersen G, Ramaprasan A, Schartz EM. Changes in clinician attitudes toward sharing visit notes: surveys pre- and post-implementation. J Gen Intern Med. 2021 Apr 22;1-7. doi: 10.1007/s11606-021-06729-1. Online ahead of print. PubMed
Ramirez M, Duran MC, Pabiniak CJ, Hansen KE, Kelley A, Ralston JD, McCurry SM, Teri L, Penfold RB. Family caregiver needs and preferences for virtual training to manage behavioral and psychological symptoms of dementia: interview study. JMIR Aging. 2021;4(1):e24965. doi: 10.2196/24965. PubMed
Penfold RB, Thompson EE, Hilt RJ, Kelleher KJ, Schwartz N, Beck A, Clarke G, Ralston JD, Hartzler AL, Coley RY, Akosile M, Vitiello B, Simon GE. Safer Use of Antipsychotics in Youth (SUAY) pragmatic trial protocol. Contemp Clin Trials. 2020 Dec;99:106184. doi: 10.1016/j.cct.2020.106184. Epub 2020 Oct 20. PubMed
Lu CY, Penfold RB, Wallace J, Lupton C, Libby AM, Soumerai SB. Increases in suicide deaths among adolescents and young adults following US Food and Drug Administration antidepressant boxed warnings and declines in depression care. Psychiatr Res Clin Pract. 2020 Oct 7;2(2):43-52. doi: 10.1176/appi.prcp.20200012. eCollection 2020 Dec. PubMed
Models that are easier to explain, use could have better uptake in health care settings.
The HCSRN conference is a venue for collaborative work to improve health and health care.
Using doctor's notes to learn about drug reactions, dementia, and cannabis use.
Rob Penfold, PhD, writes about suicide trends in children and adolescents and what researchers are doing about them.