About

Erin Cooney is an Assistant Adjunct Professor in the Department of European Languages and Transcultural Studies at UCLA. She has a background in philosophy, French studies, graphic design, and media arts. Professor Cooney teaches experimental humanities courses that focus on ecological crisis, biodiversity collapse, environmental injustice, food studies, colonial history, media studies, and ecological arts and design. Before joining UCLA, she taught food justice courses in the Environmental Studies Program at Rice University and developed courses on media studies, ecological arts and justice, and visual communication as a lecturer in UCLA’s Department of Design Media Arts. From 2020 to 2022, Erin served as Associate Director of UCLA’s Counterforce Lab, a transdisciplinary studio that uses art and design to engage with the global ecological crisis and its links to environmental injustice. She is also a multimedia artist working in video installation, performance, and community-based practices. Her current project, Aire Libre, is a dance-based video installation examining air pollution in Los Angeles County and its disproportionate effects on lower-income communities of color living amidst industrial infrastructure. This project involves collaboration with East Yard Communities for Environmental Justice, CONTRA-TIEMPO Activist Dance Company, and poet Rocío Carlos, and aims to highlight environmental harm while reclaiming sites of extraction through community engagement and artistic expression.

Research topics

• Medicine
• Internal medicine
• Psychiatry
• Nursing
• Immunology
• Physical therapy
• Family medicine
• Emergency medicine

Selected publications

• A survey on the perspectives of Irish pharmacists on the implementation of pharmacogenetics into pharmacy practice

  International Journal of Pharmacy Practice · 2024-04-01

  articleOpen access1st authorCorresponding

  Abstract Introduction Pharmacogenetics is the use of an individual’s genetic data to determine their response to a drug.[1] The incorporation of pharmacogenetic information into the prescribing process has the potential to improve patient outcomes by reducing adverse drug reactions and non-response to drugs.[1] Aim This study aims to evaluate the potential to implement pharmacogenetic testing and counselling into pharmacy practice in Ireland, by looking at the opinions of registered pharmacists on the potential new service. Methods A web-based survey, adapted from a previous survey,[2] was sent out to 6,236 pharmacists on the Pharmaceutical Society of Ireland’s mailing list using the software ‘Limesurvey’ in September 2019. Information was collected anonymously on demographics, knowledge, confidence, attitudes toward pharmacogenetic testing, and barriers and facilitators of pharmacogenetic testing. Quantitative analysis was undertaken using SPSS version 26, including descriptive analysis, correlations (Spearman’s Rho) and comparison of means (ANOVA). Knowledge scores were derived (number of correct questions out of 5), and converted to percentages. Responses to the open-ended question were analysed for recurring themes using qualitative content analysis. Results A response rate of 7.8% was attained with 486 analysable responses, 446 of which were full responses. Responses were submitted by 2.5 times more females than males and the majority came from pharmacists practising in community (56.4%) or hospital (25.3%). There was also a diversity of roles, ages and levels of experience represented. The mean knowledge score was 2.71 out of 5 (54.3%). However, the knowledge score of younger participants was significantly greater than those in the 61+ age bracket (p=0.007), with mean knowledge scores of 58% (20-30 years), 48% (41-50 years) and 40% (61+ years). A majority of respondents (60%) disagreed that their pharmacy education had prepared them sufficiently to counsel on pharmacogenetics. There was a significant relationship between a participant’s knowledge score and their self-reported confidence to discuss pharmacogenetics with other healthcare professionals (p<0.001). Many participants (>80%) agreed that pharmacogenetic testing had potential benefits for patient care. The open-ended question was answered by 17.4% of respondents. Barriers to introducing pharmacogenetic testing into pharmacy practice included ethical issues such as unauthorised access to private data and discrimination by insurance companies. A lack of resources including time and reimbursement were also noted as potential obstacles. Facilitators included an overall positive attitude towards the idea of pharmacogenetic testing. Conclusion Pharmacists already play an important role in medication management and health services. Given their knowledge and experience in the area, pharmacists are ideal candidates to introduce the idea of pharmacogenetic-guided prescribing into routine practice. From this study, it is apparent that for this implementation to occur, further education and training needs to be provided to pharmacists, as well as greater resources. While this study had the limitation of a low response rate, it was the first survey in Ireland to gather the perspectives of pharmacists on implementing pharmacogenetics in Ireland. As the survey was sent to all registered pharmacists, pharmacists from diverse settings and with varied years and types of experience answered this survey. References 1. Rollinson V, Turner R, Pirmohamed M. Pharmacogenomics for primary care: an overview. Genes. 2020;11(11):1337. 2. Tuteja S, Haynes K, Zayac C, Sprague JE, Bernhardt B, Pyeritz R. Community pharmacists ‘attitudes towards clinical utility and ethical implications of pharmacogenetic testing.’ Personalized Medicine. 2013;10(8):793–800.

  PublisherOA PDFDOI

• Effectiveness and Ethics of Incentives for Research Participation

  JAMA Internal Medicine · 2021 · 77 citations

  • Medicine
  • Family medicine
  • Physical therapy

  Importance: Incentivizing research participation is controversial and variably regulated because of uncertainty regarding whether financial incentives serve as undue inducements by diminishing peoples' sensitivity to research risks or unjust inducements by preferentially increasing enrollment among underserved individuals. Objective: To determine whether incentives improve enrollment in real randomized clinical trials (RCTs) or serve as undue or unjust inducements. Design, Setting, and Participants: Two RCTs of incentives that were embedded in 2 parent RCTs, 1 comparing smoking cessation interventions (conducted at smoking cessation clinics in 2 health systems) and 1 evaluating an ambulation intervention (conducted across wards of the Hospital of the University of Pennsylvania) included all persons eligible for the parent trials who did not have prior knowledge of the incentives trials. Recruitment occurred from September 2017 to August 2019 for the smoking trial and January 2018 through May 2019 for the ambulation trial; data were analyzed from January 2020 to July 2020. Interventions: Patients were randomly assigned to incentives of $0, $200, or $500 for participating in the smoking cessation trial and $0, $100, or $300 for the ambulation trial. Main Outcomes and Measures: The primary outcome of each incentive trial was the proportion of people assigned to each recruitment strategy that consented to participate. Each trial was powered to test the hypotheses that incentives served neither as undue inducements (based on the interaction between incentive size and perceived research risk, as measured using a 10-point scale, on the primary outcome), nor unjust inducements (based on the interaction between incentive size and participants' self-reported income). Noninferiority methods were used to test whether the data were compatible with these 2 effects of incentives and superiority methods to compare the primary and other secondary outcomes. Results: There were a total of 654 participants (327 women [50.0%]; mean [SD] age, 50.6 [12.1] years; 394 Black/African American [60.2%], 214 White [32.7%], and 24 multiracial individuals [3.7%]) in the smoking trial, and 642 participants (364 women [56.7%]; mean [SD] age, 46.7 [15.6] years; 224 Black/African American [34.9%], 335 White [52.2%], and 5 multiracial individuals [0.8%]) in the ambulation trial. Incentives significantly increased consent rates among those in the smoking trial in 47 of 216 (21.8%), 78 of 217 (35.9%), and 104 of 221 (47.1%) in the $0, $200, and $500 groups, respectively (adjusted odds ratio [aOR] for each increase in incentive, 1.70; 95% CI, 1.34-2.17; P < .001). Incentives did not increase consent among those in the ambulation trial: 98 of 216 (45.4%), 102 of 212 (48.1%), and 92 of 214 (43.0%) in the $0, $100, and $300 groups, respectively (aOR, 0.88; 95% CI, 0.64-1.22; P = .45). In neither trial was there evidence of undue or unjust inducement (upper confidence limits of ORs for undue inducement, 1.15 and 0.99; P < .001 showing noninferiority; upper confidence limits of ORs for unjust inducement, 1.21 and 1.26; P = .01 and P < .001, respectively). There were no significant effects of incentive size on the secondary outcomes in either trial, including time spent reviewing the risk sections of consent forms, perceived research risks, trial understanding, perceived coercion, or therapeutic misconceptions. Conclusions and Relevance: In these 2 randomized clinical trials, financial incentives increased trial enrollment in 1 of 2 trials and did not produce undue or unjust inducement or other unintended consequences in either trial. Trial Registration: ClinicalTrials.gov Identifier: NCT02697799.

  PublisherOA PDFDOI

• The Effectiveness and Ethics of Incentives for Research Participation: Two Embedded Randomized Recruitment Trials

  SSRN Electronic Journal · 2020-01-01

  articleOpen access
  PublisherDOI

• Clinical Outcome Event Adjudication in a 10-Year Prospective Study of Nucleos(t)ide Analogue Therapy for Chronic Hepatitis B

  Journal of Clinical and Translational Hepatology · 2020 · 5 citations

  • Medicine
  • Internal medicine
  • Immunology

  ClinicalTrials.gov NCT00388674.

  PublisherOA PDFDOI

• Effect of Default Options in Advance Directives on Hospital-Free Days and Care Choices Among Seriously Ill Patients

  JAMA Network Open · 2020 · 50 citations

  • Medicine
  • Emergency medicine
  • Nursing

  Importance: There is limited evidence regarding how patients make choices in advance directives (ADs) or whether these choices influence subsequent care. Objective: To examine whether default options in ADs influence care choices and clinical outcomes. Design, Setting, and Participants: This randomized clinical trial included 515 patients who met criteria for having serious illness and agreed to participate. Patients were enrolled at 20 outpatient clinics affiliated with the University of Pennsylvania Health System and the University of Pittsburgh Medical Center from February 2014 to April 2016 and had a median follow-up of 18 months. Data analysis was conducted from November 2018 to April 2019. Interventions: Patients were randomly assigned to complete 1 of the 3 following ADs: (1) a comfort-promoting plan of care and nonreceipt of potentially life-sustaining therapies were selected by default (comfort AD), (2) a life-extending plan of care and receipt of potentially life-sustaining therapies were selected by default (life-extending AD), or (3) no choices were preselected (standard AD). Main Outcomes and Measures: This trial was powered to rule out a reduction in hospital-free days in the intervention groups. Secondary outcomes included choices in ADs for an overall comfort-oriented approach to care, choices to forgo 4 forms of life support, patients' quality of life, decision conflict, place of death, admissions to hospitals and intensive care units, and costs of inpatient care. Results: Among 515 patients randomized, 10 withdrew consent and 13 were later found to be ineligible, leaving 492 (95.5%) in the modified intention-to-treat (mITT) sample (median [interquartile range] age, 63 [56-70] years; 279 [56.7%] men; 122 [24.8%] black; 363 [73.8%] with cancer). Of these, 264 (53.7%) returned legally valid ADs and were debriefed about their assigned intervention. Among these, patients completing comfort ADs were more likely to choose comfort care (54 of 85 [63.5%]) than those returning standard ADs (45 of 91 [49.5%]) or life-extending ADs (33 of 88 [37.5%]) (P = .001). Among 492 patients in the mITT sample, 57 of 168 patients [33.9%] who completed the comfort AD, 47 of 165 patients [28.5%] who completed the standard AD, and 35 of 159 patients [22.0%] who completed the life-extending AD chose comfort care (P = .02), with patients not returning ADs coded as not selecting comfort care. In mITT analyses, median (interquartile range) hospital-free days among 168 patients assigned to comfort ADs and 159 patients assigned to life-extending default ADs were each noninferior to those among 165 patients assigned to standard ADs (standard AD: 486 [306-717] days; comfort AD: 554 [296-833] days; rate ratio, 1.05; 95% CI, 0.90-1.23; P < .001; life-extending AD: 550 [325-783] days; rate ratio, 1.03; 95% CI, 0.88-1.20; P < .001). There were no differences among groups in other secondary outcomes. Conclusions and Relevance: In this randomized clinical trial, default options in ADs altered the choices seriously ill patients made regarding their future care without changing clinical outcomes. Trial Registration: ClinicalTrials.gov Identifier: NCT02017548.

  PublisherOA PDFDOI

• Automated versus Manual Machine Learning with Small Data for Predictions of Six-Month Outcomes Among Patients in the Intensive Care Unit

  2019-12-12

  article
  Publisher

• A pilot randomized trial of five financial incentive strategies to increase study enrollment and retention rates

  Contemporary Clinical Trials Communications · 2019-06-04 · 9 citations

  articleOpen access

  BACKGROUND: Enrollment and retention difficulties remain major barriers to conducting clinical trials. Financial incentives may promote clinical trial enrollment, however delivery methods to maximize enrollment, maximize retention, and minimize cost remains uncertain. METHODS: We conducted a single-blind, web-based randomized controlled trial of five financial incentive strategies on enrollment and retention rates in a longitudinal study of advance directives among community-dwelling older adults. Participants were eligible to receive a fixed total financial incentive, but the disbursement amounts at each study timepoint (baseline, 2-weeks, 4-weeks, and 6-weeks) differed between study arms. At each timepoint, participants completed a different advance directive. We conducted an intention-to-treat analysis for the primary and secondary outcomes of enrollment and retention. RESULTS: 1803 adults were randomized to one of five incentive strategies: constant n = 361; increasing n = 357; U-shaped n = 361; surprise n = 360; self-select n = 364. Overall, 989 (54.9%) participants elected to enroll in the advance directive study. There were no differences in enrollment rates between the control (constant 53.5%) and any of the four intervention study arms (increasing 54.3%, p = 0.81; U-shaped 57.3%, p = 0.30; surprise 56.9%, p = 0.35; and self-select 52.2%, p = 0.73). There were no differences in retention rates between the control (constant 2.1%) and any of the four intervention study arms (increasing 5.2%, p = 0.09; U-shaped 3.9%, p = 0.23; surprise 2.4%, p = 0.54; self-select 2.1%, p = 0.63). CONCLUSIONS: Financial incentive programs for trial enrollment informed by behavioral economic insights were no more effective than a constant-payment approach in this web-based pilot study.

  PublisherDOI

• Outcomes of Long-term Treatment of Chronic HBV Infection With Entecavir or Other Agents From a Randomized Trial in 24 Countries

  Clinical Gastroenterology and Hepatology · 2019-07-12 · 111 citations

  articleOpen access
  PublisherOA PDFDOI

• Court Finds No Bias When Funding is Based on Decisions Made

  UKnowledge (University of Kentucky) · 2019-01-01

  article1st authorCorresponding
  Publisher

• Intuitive vs Deliberative Approaches to Making Decisions About Life Support

  JAMA Network Open · 2019-01-25 · 19 citations

  articleOpen access

  Importance: Patients with serious illnesses are often encouraged to actively deliberate about the desirability of life support. Yet it is unknown whether deliberation changes the substance or quality of such decisions. Objective: To identify differences in decisions about life support interventions and goals of care made intuitively vs deliberatively by patients with serious illnesses. Design, Setting, and Participants: Randomized clinical trial in which patients were asked to express treatment preferences in a series of clinical scenarios. Participants were 199 hospitalized patients aged 60 years and older with serious oncologic, cardiac, and pulmonary illnesses treated in a large, urban academic hospital from July 1, 2015, through March 15, 2016. Interventions: Patients in the intuitive group were subjected to a cognitive load and instructed to answer each question immediately based on gut instinct. Patients in the deliberative group were not cognitively loaded, were instructed to think carefully about their answers, and were required to explain their answers. Main Outcomes and Measures: Choices regarding life support (4 scenarios) and goals of care (1 scenario), concordance of these choices with patients' valuations of health states that could follow from them, and decisional uncertainty. Results: Of 199 patients, 132 (66%) were male and the mean (SD) age was 67.2 (5.0) years. Similar proportions of patients in the intuitive group (n = 97) and the deliberative group (n = 102) said they would accept a feeding tube for chronic aspiration (42% vs 44%, respectively; difference, -2%; 95% CI, -16% to 12%; P = .79), antibiotics for life-threatening infection in the event of terminal illness (39% vs 43%, respectively; difference, -4%; 95% CI, -18% to 10%; P = .57), a trial of mechanical ventilation (59% vs 60%, respectively; difference,-1%; 95% CI, -15% to 13%; P = .88), and a tracheostomy tube (37% vs 41%, respectively; difference, -4%; 95% CI, -22% to 13%; P = .64). Patients in the deliberative group were slightly more likely than patients in the intuitive group to choose a palliative approach to treatment in the event of serious illness (45% vs 30%, respectively; difference, 15%; 95% CI, 1%-29%; P = .04). Across scenarios, decisional uncertainty was similar between the 2 groups (all P > .05), and intuitive decisions were either equally or more closely aligned with patients' health state valuations than deliberative decisions. Conclusions and Relevance: In this study, encouraging hospitalized patients with serious illnesses to deliberate on end-of-life decisions did not change the content or improve the quality of these decisions. It is important to evaluate whether decision aids and structured communication interventions improve seriously ill patients' choices. Trial Registration: ClinicalTrials.gov Identifier: NCT02487810.

  PublisherOA PDFDOI

Frequent coauthors

• Scott D. Halpern

  University of Pennsylvania

  71 shared

• Nicole B. Gabler

  Wilmington University

  31 shared

• Katherine R. Courtright

  University of Pennsylvania

  20 shared

• Nicole Herbst

  17 shared

• Vanessa Madden

  University of Pennsylvania

  17 shared

• Jennifer Kim

  Center for Drug Evaluation and Research

  16 shared

• Michael E. Detsky

  University of Toronto

  16 shared

• Lauren Burgoon

  Boston University

  16 shared