Walter L. Calmbach, M.D., M.P.H., FAAFP

• Professional Background

  Education

  • 2008 - Postdoctoral Training - Clinical Research - Harvard School of Public Health
  • 1989 - Postdoctoral Fellowship - Academic Family Medicine (n/a) - Faculty Development Center
  • 1984 - Residency - Family Medicine (n/a) - Univ. of Texas Health Science Center at San Antonio
  • 1982 - Internship - Family Medicine (n/a) - Univ. of Texas Health Science Center at San Antonio

  Appointments

  • 10/2002 - Professor - Univ. of Texas Health Science Center at San Antonio, Family & Community Medicine, San Antonio

• Instruction & Training

  • 5/2009 - Present, UTHSCSA
  • 5/2009 - Present, UTHSCSA
  • 4/2007 - Present, UTHSCSA

• Research & Grants

  Behavioral change, Cancer Prevention, Obesity prevention, Practice based research

  Population Science and Prevention Program

  Research profile

  Grants

  Federal

  Funding Agency Agency for Healthcare Research & Quality (AHRQ) Title Meaningful Outcomes and Science to Advance Innovations Center of Excellence (MOSAIC) Status Complete Period 9/2012 - 8/2017 Role Consultant Grant Detail Project Summary
  The American Academy of Family Physicians National Research Network (AAFP NRN) is applying as a national Practice-based Research Network Center of Excellence. Members of the AAFP NRN that have participated in major projects from past 5 years include 335 practices in 41 states. This application also includes partnerships with two other national networks and 10 regional networks. Together, these networks and researchers have a proven track record of executing a range of PBRN projects utilizing varied research methods such as card studies, demonstration projects, cluster randomized trials, patient-level randomized trials, translation and implementation projects at the practice and clinician level, and observational and prospective comparative effectiveness trials. Supported by 25 staff members that work across an average of 17 open studies per year, the AAFP NRN is a leading-edge, multidisciplinary research group that has conducted national trials requiring complex patient-level data collection. This group has demonstrated ability to rapidly respond to short turnaround funding opportunities. Using a formal, effective team-based grant writing approach and taking advantage of a national pool of potential principal investigators, the AAFP NRN routinely produces 15-25 proposals/year, many of them on very constrained development timelines.
  Additionally, the AAFP NRN plays a crucial role in accelerating the pace of translational research and practice by nurturing learning collaboratives. The AAFP NRN has recently served a central role in the advancement of the re-use of electronic health record (EHR) data for research purposes though its administration of the DARTNet Collaborative. The Collaborative includes 80+ organizations, 400+ practices, and eight networks that contribute EHR data for research and quality improvement purposes. The DARTNet Collaborative, which has an established leadership core that has been meeting monthly for the last 18 months, will

  Private

  Funding Agency Texas Academy of Family Physicians Foundation Title Addressing Childhood Obesity in Primary Care: a STARNet Study Status Active Period 7/2012 - 12/2019 Role Principal Investigator Grant Detail Addressing Childhood Obesity in Primary Care Practice: a STARNet Study

  Abstract

  Background: Although childhood obesity is a major health problem in the United States, many physicians are not aware of all the elements in the American Academy of Pediatricians (AAP) Expert Committee recommendations on Assessment of Child and Adolescent Overweight and Obesity (Barlow 2007). At the same time, some parents can misclassify their children, thinking they appear healthy even when they are overweight or obese (Contento 2003).

  Purpose: the purpose of this survey study is two-fold: 1) assess physicians? knowledge, attitudes, and behaviors regarding the management of childhood obesity in their practices; and
  2) assess parents? perceptions of their child?s weight and body size, as well as usual diet, physical activity, and screen time (TV, computer, video games) behaviors in the household.

  Methods: We will recruit 20 STARNet practices for this survey study. We will begin by having member primary care physicians complete a 72-item questionnaire developed by the Dept. of Pediatrics at Columbia University to assess physicians? knowledge, attitudes, and practice behaviors regarding identifying and treating childhood obesity. This will be followed by each participating practice recruiting 20 parents at each of 20 sites to complete the Body Image Questionnaire developed in the Dept. of Pediatrics at Wright state University.

  Anticipated Results: We expect to find that some physicians will be relatively unaware of some of the Expert Committee recommendations, particularly, documenting BMI and BMI percentile, making the correct diagnosis of overweight or obesity, initiating treatment, or referring appropriately. In addition, we expect to find that some physicians are not comfortable with counseling children and parents regarding overweight and obesity, and we expect to find that approximately half of physicians surveyed are not providing ?anticipatory guidance? per Expert

   

  State

  Funding Agency Cancer Prevention Research Institute of Texas (CPRIT) Title Managing Obesity in Primary Care: Training Clinicians & Staff in Patient Behavior Change Skills Status Active Period 9/2013 - 3/2019 Role Principal Investigator Grant Detail Managing Obesity in Primary Care: Training Clinicians & Staff in Patient Behavior Change Skills

  Obesity is a major health problem in Texas, as well as a risk factor for developing cancer. Unfortunately, poor diet and physical inactivity may soon overtake tobacco as the leading cause of death in this country. These findings suggest that a more preventive approach is needed in U.S. health care. Primary care physicians are well-placed to approach their patients about safe weight loss, healthy diets, and regular physical activity, but often feel poorly prepared to do so.

  The goal of this educational project is to prevent or reduce obesity by providing primary care clinicians and practice staff with the counseling skills and patient-help resources needed to bring about behavior change among overweight or obese patients.

  We will recruit 30 primary care sites from among member practices of the South Texas Ambulatory Research Network (STARNet), and also recruit practices from the Southwest Research Network (a collaboration of 5 federally-qualified health centers who have expressed an interest in this project). We will work with educational experts to create a practice-friendly intervention to train clinicians and staff about 4 key ?microskills? essential to Motivational Interviewing, building on a similar program proven in another setting. We will train clinicians and practice staff in counseling skills, such as 1) inform physicians about ways to listen to and respond to issues that are important to their patients, 2) helping patients set a health agenda, 3) help doctors assess the importance of this agenda and help them assess whether their patients have the confidence to make needed changes, and 4) teach physicians skills for sharing information in a way that encourages patients to begin healthy changes.

  We will also provide practices with patient-level behavior-change toolkits that will help patients take advantage of the behavior-change counseling they rec

   

• Publications

  Journal Article

  Warriner AH, Mudano A, Wright NC, Melton ME, Sattui SE, Calmbach W, Curtis JR, Kilgore M, Lewis CE, Pace W, Saag KG. A pragmatic randomized trial comparing tablet computer informed consent to traditional paper-based methods for an osteoporosis study Contemporary Clinical Trials Communications 2016 Aug;3:32-38. Calmbach WL, Hutchens M. Head injuries in the young athlete: who plays? who sits? Texas Family Physician 2015 Oct;66(4):27-29. Calmbach WL. The preparticipation physical examination: what everyone needs to know San Antonio Medicine 2013 Aug;66(8):12-14. Calmbach WL, Ryan JG, Baldwin LM, Knox LM. Practice-based research networks (PBRNs): meeting the challenges of the future J Am Board Fam Med 2012 May;25(5):572-576. Katerndahl DA, Calmbach WL, Becho J. Effect of Comorbid Depression on Outcomes in Diabetes and Its Relationship to Quality of Care and Patient Adherence: A Statewide Primary Care Ambulatory Research and Resources Consortium Study Prim Care Companion CNS Disord 2012 Feb;14(3).