About

Bernadette Kiraly, MD, is a family physician practicing at the Sugar House Health Center at the University of Utah. Her primary care focus emphasizes elevating those who may need assistance navigating the health system. She has extensive experience working with diverse communities, including refugees and gender minority populations, which she developed initially at the U Health Redwood Clinic and later through her work with the University of Utah Department of Family & Preventive Medicine, Division of Family Medicine. Dr. Kiraly serves as the co-medical director of the U Health Transgender Health Program, providing primary care and gender-affirming hormone therapy for transgender and gender-diverse individuals. Her clinical interests include transgender health, LGBTQ health, family medicine, and PrEP (Pre-Exposure Prophylaxis). She is highly regarded by her patients for her knowledge, compassion, and dedication to personalized care, consistently receiving high patient ratings and positive feedback for her approachability, thoroughness, and ability to listen and explain health issues clearly.

Research topics

• Political Science
• Medicine
• Family medicine
• Environmental health
• Gerontology
• Nursing
• Demography
• Psychology
• Business
• Internal medicine
• Psychoanalysis

Selected publications

• Family Medicine Obstetrics Fellowship Funding and Characteristics

  Family Medicine · 2026-01-12

  articleOpen accessSenior author

  BACKGROUND AND OBJECTIVES: Maternal care in the United States is in crisis due to obstetrics workforce shortages. Family physicians, with whole-person training and geographical practice distribution, are well-positioned to address this crisis. Family physicians completing a family medicine obstetrics (FMOB) fellowship are trained in surgical skills and high-risk pregnancy management, and often practice in health care shortage areas. This study aimed to update and expand knowledge on FMOB fellowships, focusing on program characteristics and financial sustainability. METHODS: We sent an email-based survey examining fellowship structure and financial information to 44 FMOB fellowships. Representatives of 22 fellowships (50%) anonymously completed the online survey. Authors used descriptive statistics, including frequency, mean, and standard deviation, to summarize the data. RESULTS: Half the fellowships were housed in family medicine residency programs. Fellowships, mostly 1 year long, admitted on average 2.2 fellows annually. Financially, nearly half (45%) the fellowships operated at a budget deficit, with clinical revenue and federal funding being major funding sources. More than 50% of programs reported that fellows spent less than 20% of their time as an independent billing physician. CONCLUSIONS: FMOB fellows are surgically trained and uniquely positioned to help address the current crisis, including filling obstetric care gaps in underserved and rural areas. Given funding challenges FMOB fellowships face, developing strategies for financial viability of FMOB fellowships going forward is crucial. Opportunities include increasing clinical revenue generation and attaining secure funding via pursuit of accreditation status for FMOB fellowship programs from the Accreditation Council for Graduate Medical Education.

  PublisherOA PDFDOI

• MODERATE-VIGOROUS PHYSICAL ACTIVITY ASSOCIATED WITH INITIAL WEIGHT LOSS IN PRIMARY CARE PATIENTS DESIRING WEIGHT LOSS MAINTAINENCE: BASELINE RESULTS FROM MAINTAIN PRIME TRIAL

  Medicine & Science in Sports & Exercise · 2025-09-16

  article

  PURPOSE: MAINTAIN PRIME promotes weight maintenance for primary care patients with recent intentional weight loss ≥5%. Previous research shows strong association between higher physical activity (PA) levels and weight management success. This analysis investigates the relationship between objective PA and baseline weight loss. METHODS: ActiGraph GT3X-BT accelerometer was worn on the dominant hip during waking hours for 14 days. We included sedentary time, light activity, average daily steps, MVPA, and peak 1-minute cadence in our analyses. Descriptive statistics, rate ratios (RR) of % weight loss with 95% confidence intervals (CI) were calculated for each PA metric. Adjusted relative risk values controlled for gender, weight loss medications, and education. RESULTS: Baseline PA was assessed in 110 out of 268 randomized participants (41%) with at least 4 days of accelerometer data. There were no significant differences in gender, ethnicity, education level, or BMI between individuals with missing and non-missing accelerometer data. Participants spent an average of 433 (SD = 142) minutes daily in sedentary behavior, 327 (SD = 103) minutes in light activity, and 34 (SD = 27) minutes of daily MVPA. Participants averaged 5,485 (SD = 2878) steps/day with a peak 1-minute cadence of 121 (20), indicating most participants were performing moderate activity. MVPA emerged as the only activity significantly associated with baseline weight loss percentage after adjusting for confounders (Table 1). The RR for MVPA was 1.004 (95% CI: 1.001-1.008, p = 0.03) in Model 2 and 1.004 (95% CI: 1.001-1.008, p = 0.03) in Model 3, indicating a small but statistically significant increase in baseline weight loss percentage with each incremental increase in MVPA. CONCLUSIONS: Our findings highlight MVPA as a key factor in primary care patients with recent intentional weight loss, emphasizing its role in long-term weight management strategies. Supported by: NIH R18DK123372

  PublisherDOI

• Electronic health records-integrated mobile health interventions in primary care to improve hypertension management in Black/African American populations: a systematic review

  Oxford Open Digital Health · 2025-01-01

  reviewOpen access

  Abstract Black/African American individuals face twice the risk of hypertension compared to non-Hispanic Whites in the United States (US). A synergistic strategy integrating primary care with Electronic Health Records (EHR) and mobile health (mHealth) technologies may help address hypertension disparities. This unique strategy prioritizes early disease identification, improved care access, and self-management. However, limited research exists on how primary care can effectively integrate these components to reduce hypertension in Black/African American individuals. We aimed to (i) identify characteristics of Black/African American populations represented in EHR-driven mHealth interventions for hypertension management in primary care settings and (ii) identify the specific EHR-driven mHealth interventions. We used the PubMed, Web of Science, and Scopus databases to identify studies conducted in the US. The included articles focused on (i) Black/African American individuals, (ii) EHR and mHealth integration; (iii) primary care setting, and (iv) hypertension or blood pressure as the outcome. We screened 749 studies and synthesized 14. Combined, Black/African American patients were female (61%), 52.6 years on average, with diabetes health comorbidity (35%). Included studies utilized health monitoring devices (n = 14), smartphone applications (n = 11), interactive messaging (n = 8), and patient portals (n = 3). These tools facilitated health monitoring (n = 14), social networking (n = 3), and lifestyle counseling (n = 14). EHR-mHealth technologies in primary care show promise to improve hypertension management in Black/African American populations. Current interventions focus on enhancing health education access, continuous health monitoring, patient–physician communication, and social engagement. Further research is needed to optimize integration into clinical workflow for hypertension management.

  PublisherDOI

• Family Medicine Residency Response to Changes in Delivery Requirements: A CERA Survey Analysis

  2025-09-01

  articleOpen access

  <h3>Context</h3> Obstetrics workforce shortages and maldistribution contribute to the maternity care crisis in the United States. Likely in response to the crisis and decreasing participation of family medicine (FM) in maternity healthcare, in 2023 the Accreditation Council for Graduate Medical Education (ACGME) reinstated a minimum delivery requirement for FM residents. <h3>Objective</h3> This study aims to understand FM residencies’ responses to ACGME requirement changes and to determine whether changes will result in increase, decrease, or no change in residency delivery requirements and actual numbers of deliveries performed by residents. <h3>Study Design</h3> This cross-sectional survey research compares FM residency deliveries required and performed before and after ACGME requirement changes. <h3>Analysis</h3> We report frequencies of responses indicating increase, decrease, or no change in both delivery requirements and deliveries performed. We also aggregate frequencies based on requirements and deliveries before ACGME requirement changes. <h3>Dataset</h3> Data for this study came from the directors’ survey administered by the Council of Academic Family Medicine Educational Research Alliance (CERA) from October to December, 2024. <h3>Population and Outcome Measures</h3> We used FM residency directors’ recollection and estimation of requirements and deliveries performed by residents. <h3>Results</h3> Almost half of residencies (45%) did not change requirements in response to requirement changes; 31% increased delivery requirements, most of them of necessity to meet the ACGME requirement; and 24% decreased the number of deliveries they required of residents. In terms of deliveries performed, most residency directors (70%) anticipate no change in average deliveries, 24% anticipate an increase in average deliveries performed by residents; and 6% believe the average number of deliveries will decrease. <h3>Conclusions</h3> Given concerns about how maternity care is distributed, and particularly the seminal role of FM in maternity care in rural and underserved areas, the impact of pregnancy care requirement changes is vitally important. Our results suggest that ACGME minimum delivery requirement changes have impacted individual residency requirements significantly, but residency directors anticipate only modest changes in the actual number of deliveries residents perform. The actual impact of requirement changes deliveries performed is yet to be seen.

  PublisherOA PDFDOI

• Abstract MP04: Association of Mediterranean Diet Score Components with Weight Loss: Findings from the MAINTAIN PRIME Study

  Circulation · 2025-03-11

  article

  Introduction: Caloric intake and diet quality are important for weight management. This study leverages data from the MAINTAIN PRIME weight maintenance trial, which recruited participants with recent, intentional weight loss ≥ 5%. We analyzed the association between diet quality and percentage weight loss at study enrollment. Methods: We assessed diet quality with the Mediterranean Diet Score (MDS), a validated 14-item survey, and examined individual components, each with 2 or 3 categorical levels. The association between percentage weight loss and MDS components was analyzed using gamma regression with log link across three models: Model 1 controlled for gender, Model 2 for gender and weight loss medication use, and Model 3 for gender, medication use, and education. Rate ratios (RR) and 95% confidence intervals (CI) were calculated for each MDS component. Results: Baseline weight and Mediterranean Diet Score (MDS) data were collected from 262 participants. Adjusted RR values for each component of the MDS are found in Table 1. Key findings include: Commercial pastries (cookies, cakes, etc.) The RR of 0.89 across all models (p &lt;0.01), suggests a clear association between consuming more commercial pastries and less weight loss. Those who consume more are likely to experience about 11% less weight loss compared to those who consume less or none. Carbonated or sugar-sweetened beverages (CSSB): The RR of 0.90 across all three models (p ≤ 0.01) suggests that individuals who consume more CSSB experience 10% less weight loss compared to those who consume fewer or no CSSB. Nuts: The RR of 0.89–0.90 across all models (p = 0.01) indicates that a higher intake of nuts per week is associated with less weight loss. Red meat: Across the models, a higher red meat consumption was associated with less weight loss. While the association is not statistically significant in Model 1 (p = 0.11), it becomes significant in Model 2 (p = 0.03) and Model 3 (p = 0.02). Therefore, adjusting for additional variables strengthens the observed association. In Model 3, the RR of 0.91 indicates 9% less weight loss compared to those with lower or no red meat intake. Conclusions: A higher consumption of commercial pastries, carbonated or sugar-sweetened beverages, nuts, and red meat was negatively associated with less weight loss, highlighting their potential role in hindering weight loss efforts. Our findings highlight the importance of diet quality management.

  PublisherDOI

• Abstract P2015: Perceptions of Health Coaching for Weight Loss Maintenance in Primary Care: Results from the MAINTAIN PRIME Trial

  Circulation · 2025-03-11

  article

  Introduction: Health coaching can expand the capacity of primary care providers (PCPs) in supporting patient self-management of overweight and obesity. Current platforms for weight management health coaching include in-person meetings, phone calls, and asynchronous online messaging. We seek to understand patient perceptions and facilitators and barriers to engagement with asynchronous, online coaching through the patient portal of the electronic health record (EHR). Hypothesis: Patients will find EHR- and primary care-integrated health coaching acceptable for weight management. Methods: Participants in MAINTAIN PRIME were primary care patients with BMI ≥25 before intentional weight loss of ≥5%, randomized to health coaching with tracking tools (coaching) vs. tracking tools alone. Coaching was performed by trained primary care staff via EHR messaging. We are conducting semi-structured interviews at 24-months with active and inactive participants in the coaching arm (active defined as remaining enrolled in trial and responding to messages within 1 week). An interview guide includes the domains of EHR platform for health coaching, patient-coach relationship, and coaching integration with primary care. We analyzed interviews via thematic analysis. Results: Six of 11 completed interviews have been analyzed. Half of participants (3/6) were active, 66.7% were female (4/6), and average age was 39.6 years. Results to date reveal positive perceptions of the EHR platform for health coaching. Most participants found the platform convenient and liked the integration with other health records. Others stated a preference for separating coaching from medical care. Participants liked engaging with coaches at the time of their choosing. Messages were overall helpful, though sometimes felt impersonal and templated. Participants felt coaches were professional but lacked a personal connection, which could have improved with an initial in-person or video meeting. Lastly, many participants were unaware of coaching integration with their PCP teams other than the initial referral to coaching. Conclusions: Overall, participants had positive perceptions of the coaching experience though noted some areas for improvement such as adding a face-to-face meeting with the health coach and further personalizing messages to promote stronger coaching relationships. Discussions between PCPs and coaching participants regarding weight management could bolster a sense of integration and support.

  PublisherDOI

• Introducing Virtual Visit Blocks to Optimize Space in Primary Care Practice

  Telemedicine Reports · 2025-01-01

  articleOpen accessSenior author

  The COVID-19 pandemic significantly accelerated the adoption of telehealth in primary care settings, with many health care systems planning to continue offering virtual care indefinitely. This brief report describes the implementation of virtual visit (VV) blocks to optimize telemedicine visits and expand clinic workforce capacity. VV blocks, dedicated time slots exclusively for telemedicine, were introduced to free up physical space for additional on-site providers. By pairing the introduction of VV blocks with new provider hires, our health system successfully expanded its workforce, increasing provider full-time equivalents in our pilot clinic from 8.51 to 10.25. These changes led to improved access, higher visit volumes, and similar patient satisfaction. Providers also reported benefits in terms of work-life balance and efficiency. The VV block model proved effective in addressing space and resource constraints, improving both operational outcomes and financial sustainability. The success of this pilot was replicated in a second clinic, demonstrating scalability. The long-term viability of telehealth initiatives hinges on the continuation of insurance payment parity and legislative support for telehealth policies. This article provides insights into how telehealth integration can optimize primary care delivery while navigating operational and financial challenges.

  PublisherDOI

• Family Medicine Residency Deliveries Required and Performed Drive Obstetrics Care Outcomes: A CERA Survey Analysis

  2025-09-01

  articleOpen access

  <h3>Context</h3> The United States is experiencing a maternity care crisis due to workforce shortages and maldistribution. Family medicine (FM) physicians are uniquely suited to fill care shortages, but participation of FM in maternity care is decreasing. Maternity care training and preparation during residency, including performing deliveries, plays a pivotal role in FM physicians’ provision of maternity care. <h3>Objective</h3> This study aims to assess how characteristics of residency training relate to maternity care provision outcomes of residents including completion of elective comprehensive pregnancy care, enrollment in obstetrics (OB) fellowship, and providing future provision of maternity care without OB fellowship training. <h3>Study Design</h3> This cross-sectional survey research examined maternity care provision outcomes based on FM residency characteristics, including deliveries required and performed. <h3>Analysis</h3> We created two logistic regression models for each of the three maternity care provision outcomes. The first model included region, number of residents, OB colleague support, and OB faculty as predictors. The second model included the same predictors and residency delivery requirements and deliveries performed. <h3>Dataset</h3> Data came from the program directors’ survey administered by the Council of Academic Family Medicine Educational Research Alliance (CERA) from October to December, 2024. <h3>Population</h3> FM program directors provided reports of residency requirements, characteristics, and maternity care provision outcomes. 265 residency directors completed the survey. <h3>Outcome Measures</h3> Outcomes measures included estimation of number of residents completing elective comprehensive pregnancy care training, enrolling in OB fellowships after residency, and providing OB care without fellowship training. Specific results of each model will be included in the presentation. <h3>Results</h3> In general, region, residency size, and support from OB colleagues were related to maternity care outcomes in the first model. In the second model which included deliveries required and performed, region was no longer related to outcomes. <h3>Conclusions</h3> To improve maternity care shortages, it is crucial to understand how maternity care residency training influences maternity care provision outcomes. Our results suggest that residency characteristics such as size, support from OB colleagues, and delivery requirements and deliveries performed are related to maternity care practice.

  PublisherOA PDFDOI

• Expanding Access to Contraceptive Services in a Family Medicine Residency Clinic: The Rapid Access to Contraception Clinic Model  

  Family Medicine · 2024-07-02 · 1 citations

  articleOpen access

  BACKGROUND AND OBJECTIVES: Learning to provide long-acting reversible contraception (LARC) during family medicine residency is an important step in building capacity for the primary care workforce to meet the reproductive health care needs of communities. We aimed to measure the impact of adding a contraceptive visit type (CVT) allowing for rapid access to contraception (RAC) on family medicine resident LARC procedure numbers. METHODS: Our program created a CVT in which patients were seen only for contraceptive services. We added the CVT to third-year family medicine resident continuity clinic schedules and a block of CVTs (the RAC clinic) to the third-year gynecology rotation. Residents self-reported LARC procedure numbers performed throughout residency, and the totals were compared for graduating residents from 2023 (post-RAC cohort) to 2022 graduates and 2018-2022 graduates (pre-RAC cohort). RESULTS: Post-RAC cohort residents reported a statistically significant increase in intrauterine device (IUD; P=.015) and contraceptive implant (P=.010) removals compared to the 2022 pre-RAC cohort. Insertions of IUDs and contraceptive implants were unchanged when compared to the pre-RAC cohort. IUD removals (P=.004) and insertions (P=.034), and contraceptive implant removals (P=.028) were significantly increased for post-RAC compared to 2022 graduates, with no difference in contraceptive implant insertions (P=.211). CONCLUSIONS: The addition of the CVT and RAC clinic contributed to an increase in LARC removals in both comparisons, and IUD insertions between 2022 and 2023. This clinic model offers an opportunity for other family medicine residency programs to improve access to contraceptive services and increase resident training in LARC management.

  PublisherOA PDFDOI

• Patient experiences navigating US healthcare with long-COVID – Part 3 of 3

  The Annals of Family Medicine · 2024-11-20

  articleOpen accessSenior author

  <h3>Context:</h3> For many patients with long-COVID, primary care is the first point of interaction with the healthcare system. In principle, primary care is well-situated to manage long-COVID. However, beyond expressions of disempowerment, the patient’s perspective regarding the quality of long-COVID care is lacking. <h3>Objective:</h3> This study aimed to analyze the expectations and experiences of primary care patients seeking treatment for long-COVID in an academic medical center referral clinic. <h3>Study Design and Analysis:</h3> A phenomenological approach guided this analysis due to the exploratory nature of the lived experience of long-COVID. We developed an interview guide based on a literature review and clinician observations. Transcripts were analyzed using inductive qualitative content analysis. <h3>Setting or Dataset:</h3> The setting was an academic medical institution in the Mountain West. We de-identified and transcribed the recorded interviews. <h3>Population Studied:</h3> Using purposive sampling from a long-COVID clinic, we conducted semi-structured interviews with English-speaking, adult primary care patients describing symptoms of long-COVID. <h3>Intervention/Instrument:</h3> n/a <h3>Outcome Measures:</h3> Description of patient experiences navigating healthcare from primary care to specialist. <h3>Results:</h3> We report results from 19 interviews (53% female, mean age = 54). Patients expected their primary care providers (PCPs) to be knowledgeable about long-COVID, attentive to their individual condition, and engaged in collaborative processes for treatment. Patients described two areas of experiences. First, interactions with providers were perceived as positive when providers were honest and validating and negative when patients felt dismissed or discouraged. Second, patients described challenges navigating the US healthcare system when coordinating care, treatment and testing, and payment. <h3>Conclusions:</h3> Primary care patient’s experiences seeking care for long-COVID are incongruent with their expectations. Patients overcome barriers at each level of the healthcare system and are frustrated by the challenges. PCPs and other providers might increase congruence with expectations and experiences through listening, validating, and advocating for patients with long-COVID.

  PublisherDOI

Frequent coauthors

• Dominik Ose

  12 shared

• Elena Gardner

  University of Utah

  9 shared

• Kirsten Stoesser

  University of Utah

  8 shared

• Jorie Butler

  University of Utah

  7 shared

• Polina Kukhareva

  5 shared

• Jesell Zepeda

  University of Utah

  5 shared

• Molly B. Conroy

  University of Utah

  5 shared

• Maribel Cedillo

  University of Utah

  5 shared