About

Matthew D Kearney, PhD, MPH, is an Assistant Professor of Family Medicine and Community Health at the University of Pennsylvania, with an additional appointment as a Research Specialist at the Corporal Michael J. Crescenz Veterans Affairs Medical Center in Philadelphia. He serves as the Associate Director of the Mixed Methods Research Lab within the Department of Family Medicine and Community Health at Penn Medicine. His research expertise includes mixed methods, biostatistics, and qualitative research, with a methodological focus on integrated research methods. Since 2019, he has been a Research Fellow with Penn Medicine’s Center for Health Equity Advancement, working as a consultant, collaborator, and mentor on projects evaluating disparities in care quality and workforce inclusion. His scholarship concentrates on program evaluation, health promotion through community-engaged research, and social media surveillance and evaluation, particularly exploring the impact of health misinformation on social media and its influence on healthcare decision-making, including vaccination. Kearney has contributed to federally-funded projects employing mixed methods to understand program implementation barriers and facilitators, and to identify factors associated with program success.

Research topics

• Medicine
• Psychology
• Family medicine
• Medical education
• Nursing

Selected publications

• Implementing and evaluating a Paediatric Early Warning System (PEWS) at a National Referral Hospital in Botswana

  BMJ Paediatrics Open · 2025-10-01

  articleOpen access

  BACKGROUND: Mortality among hospitalised children in low-resource settings remains much higher than in high-resource environments. Paediatric Early Warning Systems (PEWSs) have been shown to improve vital signs collection, strengthen interprofessional communication, lower healthcare costs and reduce paediatric hospital mortality in multiple low- and middle-income countries. Providers at Botswana's national referral center, Princess Marina Hospital (PMH), face significant challenges in identifying children at risk for clinical deterioration. METHODS: We used PEWS previously validated in resource-limited settings to create the PMH PEWS. We piloted the PMH PEWS from December 2022 to March 2023. We assessed (1) effectiveness of PEWS at reducing unplanned escalations of care by comparing pre-implementation and post implementation rates of clinical deterioration events (unplanned intensive care unit (ICU) transfer; use of inotropic medications, mechanical ventilation or mannitol; cardiopulmonary resuscitation; non-palliative mortality), (2) acceptability and feasibility of PEWS adoption using the acceptability and feasibility of implementation measures and (3) barriers and facilitators to implementation through stakeholder interviews structured around Consolidated Framework for Implementation Research domains. RESULTS: The relative frequency of clinical deterioration events changed post-PEWS implementation (p=0.01) such that initiation of mechanical ventilation (12.3% vs 23.2%) and inotropes (18.5% vs 35.7%) decreased while ICU transfers increased (27.7% vs 8.9%). Both doctors and nurses found PEWS to be acceptable and feasible. Staff universally reported that PEWS improved patient care, increased clinician provider accountability for deteriorating patients and strengthened interprofessional communication. Nurses reported greater engagement with PEWS adaptation than doctors. Physical resource limitations and inter- and intra-professional hierarchies were widely endorsed barriers to implementation. CONCLUSIONS: PEWS has the potential to improve the care of hospitalised children in Botswana by strengthening interprofessional communication and increasing clinician accountability for deteriorating patients.

  PublisherOA PDFDOI

• Perceptions of Institutional Engagement and Inclusion by Sexual Orientation and Gender Identity

  JAMA Network Open · 2025-06-04 · 4 citations

  articleOpen access

  Importance: There is a paucity of research regarding the experiences of self-identified lesbian, gay, bisexual, and transgender (LGBT+) individuals in academic medicine. Objective: To examine LGBT+ individuals' perceptions of institutional engagement and workplace inclusivity. Design, Setting, and Participants: In this survey study, in 2015, 2018, 2021, and 2023, the Diversity Engagement Survey (DES) supplemented with specific questions about LGBT+ visibility and engagement in the workplace was sent to faculty, students and trainees, and staff at a single academic medical center in Pennsylvania. Exposures: Sexual orientation was self-identified as heterosexual; lesbian, gay, or bisexual [LGB]; or other. Gender identity was self-identified as men; transgender, queer, or nonbinary [TQNB]; women; or other or unknown. Main Outcomes and Measures: Workplace culture inclusivity was assessed using 8 validated DES constructs summarized into 3 scores: perceptions of shared vision and purpose, camaraderie, and appreciation of contributions to the institution. Three questions evaluated statements about institutional welcoming of LGBT+ individuals, comfort working with LGBT+ colleagues, and LGBT+ institutional visibility. Potential attrition was assessed through a question about job change considerations due to inappropriate, disruptive, or unprofessional behavior by a coworker or supervisor. Results were weighted to account for nonresponse. Results: Among 23 708 respondents (15.9% of approximately 149 500 survey recipients), 2068 (8.7%) identified as LGB and 169 (0.7%) as TQNB. Compared with heterosexual respondents, LGB respondents reported lower institutional engagement (vision and purpose: adjusted difference (AD), -1.2 [95% CI, -1.6 to -0.9]; camaraderie: AD, -1.1 [95% CI, -1.3 to -0.9]; appreciation: AD, -0.9 [95% CI, -1.1 to -0.6]) and were less likely to agree with statements of LGBT+ institutional inclusivity (welcoming: adjusted relative ratio [ARR], 0.88 [95% CI, 0.85-0.90]; visibility: ARR, 0.90 [95% CI, 0.86-0.94]). Compared with men, TQNB respondents reported lower engagement (vision and purpose: AD, -4.1 [95% CI, -5.5 to -2.6]; camaraderie: AD, -3.2 [95% CI, -4.1 to -2.3]; appreciation: AD, -2.6 [95% CI, -3.5 to -1.7]) and were less likely to agree with LGBT+ institutional inclusivity statements (welcoming: ARR, 0.65 [95% CI, 0.53-0.80]; visibility: ARR, 0.78 [95% CI, 0.61-1.00]). LGB (vs heterosexual; ARR, 1.26 [95% CI, 1.15-1.38]) and TQNB (vs men; ARR, 1.48 [95% CI, 1.17-1.88]) respondents were more likely to report job change consideration. Conclusions and Relevance: In this survey study, the findings demonstrated a need for focused and subgroup-specific intentional initiatives to optimize productivity and improve workplace culture, sense of belonging, and retention for self-identified sexual and gender minority individuals within academic medical communities.

  PublisherOA PDFDOI

• Outcomes of Importance to Patients Living With Cutaneous Chronic Graft-vs-Host Disease

  JAMA Dermatology · 2025-01-02 · 2 citations

  articleOpen access

  Importance: Cutaneous chronic graft-vs-host disease (GVHD) is independently associated with morbidity and mortality after allogeneic hematopoietic cell transplant. However, the health-related quality-of-life (HRQOL) domains that are most important to patients are poorly understood. Objective: To perform a concept elicitation study to define HRQOL in cutaneous chronic GVHD from the patient perspective and to compare experiences of patients with epidermal vs sclerotic disease. Design, Setting, and Participants: A single-center qualitative analysis from open-ended, semistructured interviews and free-listing terms conducted between April and September 2023. Participants were 18 years or older with a diagnosis of active cutaneous chronic GVHD, purposefully sampled for epidermal and sclerotic disease features, with ongoing sampling until thematic saturation. Main Outcomes: HRQOL domains and codes from patient perspectives of living with cutaneous chronic GVHD were identified by inductive analysis of semistructured interviews. Smith salience index (Smith S) score, a measure of saliency for each list term, was calculated from free-listing terms from deidentified patient interviews. Results: A total of 31 adults with cutaneous chronic GVHD (median [IQR] age, 61.1 [52.9-68.7] years) participated in interviews; 17 participants (54.8%) were male and 14 (45.2%) were female. Nine participants (29.0%) had epidermal, 13 (41.9%) sclerotic, and 9 (29.0%) a combination of disease types. The study identified 40 codes of importance grouped within 5 HRQOL domains: skin changes and symptoms, social functioning, psychological and emotional functioning, physical functioning, and general health perceptions. The most frequent symptoms were dry skin (n = 20 [65%]), tight skin (n = 19 [61%]), itch (n = 15 [48%]), and discoloration (n = 14 [45%]), which were seen in all disease subtypes. Impairment in social functioning was noted by all participants. Psychological and emotional functioning, including frustration (Smith S score, 0.32) and worry or concern (Smith S score, 0.12), and symptoms including discomfort (Smith S score, 0.20) were the most salient to patients. Individual and environmental factors, such as social comparison, illness comparison with cancer, anatomic location of disease involvement, and disease duration, affected the relationship between skin changes and symptoms and downstream functioning and general health perceptions. Conclusions and Relevance: This qualitative analysis demonstrated the direct relationship between cutaneous chronic GVHD and HRQOL domains and identified codes not represented in existing GVHD- and dermatology-specific patient-reported outcome measures. These results can guide patient-reported outcome development and instrument selection for clinical trials and improve clinical decision-making.

  PublisherOA PDFDOI

• Perception of neurosurgery among surgical patients with essential tremor: A qualitative mixed methods study

  World Neurosurgery X · 2025-08-11

  articleOpen accessSenior author

  There is a dearth of evidence on knowledge and perceptions of procedures among patients with essential tremor (ET). The objective of this study was to utilize a mixed methods design incorporating in-depth individual interviews to investigate the perception of procedures among patients with ET who underwent surgical intervention. Semi-structured, in-depth individual interviews paired with survey questionnaires were conducted among participants with ET who had a prior surgical procedure for the disorder. Thematic analysis of qualitative data was conducted using an approach based on grounded theory methodology. Of the 20 patients interviewed, nine patients (45 %) had undergone magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy, nine patients (45 %) had undergone deep brain stimulation (DBS) implantation, and two patients (10 %) had undergone both DBS implantation and MRgFUS thalamotomy. In ranking factors from most to least important in deciding which type of surgery to undergo, patients most frequently selected safety as the most important factor (9/20, 45 %). Hair shave required was most frequently selected as the least important factor (14/20, 70 %). Seven patients (35 %) reported having zero or minimal knowledge of the risks and benefits of either MRgFUS thalamotomy or DBS before their surgery. Patients discussed their surgical outcomes including adverse effects of surgery. In deciding which type of surgery to undergo for tremor, participants discussed the role of safety, perceived invasiveness, and follow-up care required. Participants reflected on the life-changing benefits of tremor control but also discussed detrimental adverse effects such as dysarthria and gait instability following surgery.

  PublisherDOI

• Assessing Family Medicine Obstetrics Training Needs to Strengthen Maternal Health in Underserved and Rural US Communities

  Journal of Primary Care & Community Health · 2025-07-01 · 1 citations

  articleOpen access1st authorCorresponding

  BACKGROUND: Family medicine obstetricians (FMOBs) are essential for providing maternity care in underserved communities, yet their numbers have sharply declined, contributing to maternity care deserts and persistent inequities. To address the FMOB workforce gap, a large urban residency implemented the PROMOTE OB track (PRimary care Obstetrics and Maternal Outcomes Training Enhancement). We explored FMOB residents' training needs, practice barriers, and perceived patient needs from the perspectives of faculty and graduates involved in obstetrics training. METHODS: We conducted 7 focus groups with university FMOB faculty, non-OB FM graduates, FMOB graduates, obstetrics and gynecology (OB/GYN) faculty and fellows, and maternal-fetal medicine (MFM) faculty and fellows. Discussions were guided by a semi-structured protocol exploring training gaps, collaborative care, structural and cultural barriers, and unmet patient needs. Focus groups were audio-recorded and transcribed verbatim, and transcripts were then analyzed thematically. RESULTS: During focus group discussions (n = 7), participants emphasized that FMOB training must go beyond procedural competencies to include cultural humility, structural competency, and interprofessional collaboration. Five thematic domains emerged: (1) FMOB training needs and curriculum gaps; (2) building collaborative care teams in residency; (3) preparing FMOBs to address structural barriers to care; (4) navigating cultural barriers to care; and (5) responding to unmet provider-perceived patient needs in underserved settings. CONCLUSIONS: FMOB training must prepare residents for the clinical and contextual realities of underserved maternity care. Programs should standardize competencies, expand mentorship, and ensure structured exposure to diverse care settings. Sustained policy-level investment is needed to strengthen training infrastructure and expand the FMOB workforce. Aligning curricula with community needs and national policy priorities may improve access to equitable, comprehensive maternity care.

  PublisherDOI

• Firearm Violence and Health in Policymaker Discourse: Mixed Methods Social Media Analysis

  JMIR Formative Research · 2025-11-11

  articleOpen access

  Background: Since 2019, firearm violence has remained the leading cause of death for US children and adolescents aged 1-19 years. This crisis has spurred action from policymakers, health professionals, and advocates. However, political polarization has contributed to divergent views on the causes and appropriate responses to firearm violence. Communication by elected officials, especially on social media, plays a critical role in shaping public opinion and policy agendas. Understanding how state policymakers discuss firearm violence, including the use of causal blame, calls to action, and health-related narratives, can inform more effective public health strategies. Objective: This study aimed to examine how Pennsylvania state legislators discuss firearms and firearm violence on social media and assess the extent to which their messaging aligns with public health perspectives. Methods: We conducted a 2-phase mixed methods analysis of X (formerly known as Twitter; X Corp) posts by Pennsylvania state legislators from May 27, 2017, to July 26, 2022. Posts were grouped into 3 time periods surrounding the Tree of Life Synagogue mass shooting in Pittsburgh. Using a Boolean search strategy, we identified 4573 posts related to firearms and firearm violence. After removing reposts and non-English content, we randomly sampled 1491 (32.6%) original posts authored by 152 unique legislators. Posts were coded using a structured codebook based on the Multiple Streams Framework to capture rhetorical framing, causal blame, and policy content. Interrater reliability was high (Holsti coefficient >0.8). We used chi-square tests and multivariable logistic regression to assess associations between rhetorical elements and policy mentions, adjusting for time period. Results: Mass shootings were the most frequently referenced category of firearm violence, peaking after the Tree of Life shooting (22/43, 51% vs 91/118, 77.1% vs 140/220, 63.6%; P=.004), while firearm suicide was rarely discussed. Posts using advocacy frames were nearly 5 times more likely to mention policy (adjusted odds ratio [aOR] 4.67, 95% CI 3.55-6.16), whereas those referencing mass shootings (aOR 0.54, 95% CI 0.37-0.77) or emotional appeals (aOR 0.53, 95% CI 0.40-0.69) were significantly less likely to do so. Most posts used general advocacy (aOR 2.97, 95% CI 2.13-4.13) and vague blame (aOR 8.26, 95% CI 6.02-11.35), resulting in nonspecific policy suggestions. Posts that attributed blame to firearm access were strongly associated with specific policy proposals (aOR 6.37, 95% CI 4.29-9.47) and inversely associated with general policy mentions (aOR 0.26, 95% CI 0.17-0.42). Only 9.4% (133/1422) of posts used health frames; when present, they more often referenced physical consequences (58/133, 43.6% vs 216/1358, 15.9%; P<.001). Conclusions: Pennsylvania legislators primarily focused on mass shootings and relied on emotional or symbolic language without proposing specific policies. Health frames were rare and typically focused on consequences rather than prevention. Findings highlight an opportunity to support policymakers with health-informed messaging strategies to promote actionable firearm violence prevention policies, particularly those addressing prevention.

  PublisherDOI

• Through the Looking Glass: Characterizing the Complexity of Outsourcing Veterans Affairs Home Dialysis

  Journal of the American Society of Nephrology · 2025-10-01

  article
  PublisherDOI

• Optimizing Provider Wellness and Reducing After-Hours Workload: The Role of Inboxologists in Managing In-Baskets

  2025-09-01

  articleOpen access

  <h3>Context</h3> Administrative burden from electronic health record (EHR) in-basket messages is a major contributor to physician burnout. <h3>Objective</h3> We piloted-tested the effectiveness of two time-allocation strategies to improve provider wellness and job satisfaction and reduce after-hours EHR work, while maintaining productivity and care quality. <h3>Study Design and Analysis</h3> A longitudinal, experimental design and mixed-methods approach were used to compare arms. <h3>Intervention/Instrument</h3> Three practice-level approaches were compared with three arms: 1) dedicated template time for in-basket work 2) advanced-practice provider (APP) inboxologist (IB) supporting in-basket work; and 3) non-intervention control. <h3>Setting and Population Studied</h3> Primary care providers (PCPs) and APP-IBs at seven primary care practices in a large Northeast U.S. health system participated. <h3>Outcome Measures</h3> Changes in PCP wellness were assessed via Stanford Professional Fulfillment Index pre-post survey questionnaires. Secondary outcomes included PCP job satisfaction, EHR after-hours time (“pajama time”), productivity (relative value units, RVU), message response time, patient satisfaction, and intervention cost. Structured interviews with IBs and PCPs offered additional context on implementation, acceptability, and scalability. <h3>Results</h3> Protected template slots were not used as intended; this arm quickly dissolved. PCPs in the APP-IB arm had 2-fold improvements in overall wellness and job satisfaction. IB effort correlated with decreases in PCPs’ pajama time, which dipped modestly (average −3.32 min/day), showing greater reductions for those with more after-hours work at baseline. RVUs in the APP-IB arm improved by 38 points from the prior year and 7 points from pre-intervention. Message response time and patient satisfaction improved slightly, indicating the APP-IB intervention did not compromise patient experience. With IBs spending half their time seeing patients, the model was fiscally positive. <h3>Conclusions</h3> Dedicating template time to in-basket work was ineffective, but deploying IBs offered a scalable, cost-effective strategy to support PCP wellbeing, particularly when integrating IB support into existing APP clinical time. Our pilot intervention reduced pajama time and improved PCP wellness and job satisfaction in the APP-IB arm without negatively affecting productivity, responsiveness, or patient satisfaction. Implications exist for broader adoption in specialty care settings.

  PublisherOA PDFDOI

• Feasibility Study of Using Electronic Patient-Reported Outcomes to Screen Patients with Advanced Solid Cancers for Palliative Care Needs

  Journal of Palliative Medicine · 2025-03-10 · 2 citations

  article

  Screening patients for unmet palliative needs using ePRO monitoring is feasible, acceptable, and appropriate among patients, but more work is needed to understand the perspectives of diverse patients and how to integrate ePRO palliative care screening into clinical workflows.

  PublisherDOI

• Firearm Violence and Health in Policymaker Discourse: A Mixed-Methods Social Media Analysis (Preprint)

  2025-07-09

  preprint

  <sec> <title>BACKGROUND</title> Since 2019, firearm violence has remained the leading cause of death for U.S. children and adolescents ages 1–19. This crisis has spurred action from policymakers, health professionals, and advocates. However, political polarization has contributed to divergent views on the causes and appropriate responses to firearm violence. Communication by elected officials, especially on social media, plays a critical role in shaping public opinion and policy agendas. Understanding how state policymakers discuss firearm violence, including the use of causal blame, calls to action, and health-related narratives, can inform more effective public health strategies. </sec> <sec> <title>OBJECTIVE</title> To examine how Pennsylvania state legislators discuss firearms and firearm violence on social media and assess the extent to which their messaging aligns with public health perspectives. </sec> <sec> <title>METHODS</title> We conducted a two-phase mixed-methods analysis of X (formerly Twitter) posts by Pennsylvania state legislators from 05/27/2017 to 07/26/2022. Posts were grouped into three time periods surrounding the Tree of Life Synagogue mass shooting in Pittsburgh. Using a Boolean search strategy, we identified 4,573 posts related to firearms and firearm violence. After removing reposts and non-English content, we randomly sampled 1,491 original posts (32.6%) authored by 152 unique legislators. Posts were coded using a structured codebook based on the Multiple Streams Framework to capture rhetorical framing, causal blame, and policy content. Interrater reliability was high (Holsti’s coefficient &gt; 0.8). We used chi-squared tests and multivariable logistic regression to assess associations between rhetorical elements and policy mentions, adjusting for time period. </sec> <sec> <title>RESULTS</title> Mass shootings were the most frequently referenced category of firearm violence, peaking after the Tree of Life shooting (51% vs 77.1% vs 63.6%, P=.004), while firearm suicide was rarely discussed. Posts using advocacy frames were nearly five times more likely to mention policy (aOR 4.67, 95% CI: 3.55–6.16), whereas those referencing mass shootings (aOR 0.54, CI: 0.37–0.77) or emotional appeals (aOR 0.53, CI: 0.40–0.69) were significantly less likely to do so. Most posts employed general advocacy (aOR 2.97) and vague blame (aOR 8.26), resulting in non-specific policy suggestions. Posts that attributed blame to firearm access were strongly associated with specific policy proposals (aOR 6.37) and inversely associated with general policy mentions (aOR 0.26). Only 9.4% of posts used health frames; when present, they more often referenced physical consequences (43.6% vs 15.9%, P&lt;.001). </sec> <sec> <title>CONCLUSIONS</title> Pennsylvania legislators primarily focused on mass shootings and relied on emotional or symbolic language without proposing specific policies. Health frames were rare and typically focused on consequences rather than prevention. Findings highlight an opportunity to support policymakers with health-informed messaging strategies to promote actionable firearm violence prevention policies, particularly those addressing suicide. </sec>

  PublisherDOI

Frequent coauthors

• Jaya Aysola

  22 shared

• Philip M. Massey

  University of California, Los Angeles

  16 shared

• Eve J. Higginbotham

  Office of Diversity and Inclusion

  9 shared

• Preethi Selvan

  Thomas Jefferson University

  8 shared

• Peter F. Cronholm

  University of Pennsylvania

  7 shared

• Michael Hauer

  Drexel University

  7 shared

• Shimrit Keddem

  University of Pennsylvania

  7 shared

• Amy Leader

  Sidney Kimmel Comprehensive Cancer Center

  6 shared

Education

• PhD, Community Health and Prevention

  Drexel University School of Public Health

  2021

• MPH

  University of Pennsylvania Perelman School of Medicine

  2016

• BS, Biological Sciences

  Union College

  2009