About

Jessica Portillo Romero, MD, is an assistant professor within the department of medicine's division of internal medicine at the University of Florida College of Medicine. She received her medical degree from the Universidad Nacional Mayor de San Marcos in Lima, Peru, and completed her family medicine residency at Southern Illinois University. Her teaching profile includes courses such as the Family Medicine and Ambulatory Care Clerkship. Her research focuses on areas including pharmacogenetics, liver fibrosis in patients with type 2 diabetes, and mobile health interventions for smoking cessation among underserved patients. She has served as a principal investigator and project manager for various grants related to diabetic foot ulcer prevention and smoking cessation. Her professional interests encompass family medicine and general internal medicine.

Research topics

• Gastroenterology
• Medicine
• Endocrinology
• Internal medicine

Selected publications

• Barriers and facilitators to implementing mobile health smoking cessation treatments in clinical settings: A qualitative, multi-site study of primary care team perspectives (Preprint)

  2026-01-09

  articleOpen access

  <sec> <title>BACKGROUND</title> Smoking is the leading cause of preventable illness and death, yet cessation remains challenging due to limited access to clinical support and underutilization of evidence-based interventions. Primary care offers a strategic setting to deliver smoking cessation counseling, given ongoing patient-provider relationships. Mobile health (mHealth) treatments delivered via smartphones offer a promising approach to increase reach and accessibility, particularly for populations facing geographic, socioeconomic, or other barriers. Evidence regarding the feasibility, implementation, and acceptability of smartphone-based applications in primary care remains limited. Understanding care team perspectives on implementing mHealth interventions is critical to inform strategies that integrate these tools into routine clinical practice. </sec> <sec> <title>OBJECTIVE</title> This study aimed to identify barriers and facilitators to implementing two mHealth smoking cessation interventions in primary care clinics, from the perspective of care team members. Insights are intended to guide strategies for enhancing uptake and integration of mHealth interventions and improving equitable access to smoking cessation support. </sec> <sec> <title>METHODS</title> This qualitative, multi-site study was embedded within a pragmatic clinical trial comparing the state quitline with two mHealth interventions that employ acceptance and commitment therapy (ACT) (iCanQuit) and ACT + contingency management (CM) (iCanQuit + Motiv8). Semi-structured interviews were conducted with care team members from 14 primary care clinics, including physicians, nurse practitioners, nurses, and staff. Interviews were conducted in person or via videoconference and were audio-recorded and transcribed verbatim. The interview guide was structured using the Consolidated Framework for Implementation Research (CFIR) and refined through feedback from a 23-member stakeholder advisory committee. Transcripts were analyzed using template and matrix analysis methods, with iterative inductive coding to identify themes across patient, provider, intervention, and clinic levels. </sec> <sec> <title>RESULTS</title> Of 41 invited care team members, 37 interviews were completed and analyzed. Participants represented a variety of clinical and administrative roles. Care team members identified multiple barriers and facilitators to implementing the mHealth interventions. Barriers included intervention complexity, patient-level factors such as digital literacy and social determinants of health, clinic workflow constraints, competing clinical priorities, and limited staff familiarity with the interventions. Facilitators included the perceived relative advantage of mHealth interventions regarding convenience, accessibility, and reach, particularly for rural and younger patients. Participants made suggestions for improvement to address barriers, including EHR-based reminders for providers, workflow restructuring, and refresher training. </sec> <sec> <title>CONCLUSIONS</title> In primary care settings that serve vulnerable populations, mHealth interventions may be a feasible alternative or complement to traditional quitlines. While they can improve reach, careful consideration must be made for patients with low access to technology and low digital literacy. Tangible adaptations to better integrate mHealth approaches into clinics can potentially improve adoption and fidelity to intervention and study procedures. </sec> <sec> <title>CLINICALTRIAL</title> ClinicalTrials.gov ID NCT05415761 https://clinicaltrials.gov/study/NCT05415761?term=Comparative%20Effectiveness%20of%20Mobile%20Health%20Smoking%20Cessation%20Approaches%20among%20Underserved%20Patients%20in%20Primary%20Care.&amp;rank=1 </sec>

  PublisherDOI

• Prevalence and impact of food insecurity in families with children in the primary care setting

  Journal of Hunger & Environmental Nutrition · 2025-08-19

  articleSenior author
  PublisherDOI

• Adipose Tissue Insulin Resistance Predicts the Severity of Liver Fibrosis in Patients With Type 2 Diabetes and NAFLD

  The Journal of Clinical Endocrinology & Metabolism · 2022 · 51 citations

  • Internal medicine
  • Medicine
  • Endocrinology

  CONTEXT: Although type 2 diabetes (T2D) is a risk factor for liver fibrosis in nonalcoholic fatty liver disease (NAFLD), the specific contribution of insulin resistance (IR) relative to other factors is unknown. OBJECTIVE: Assess the impact on liver fibrosis in NAFLD of adipose tissue (adipose tissue insulin resistance index [adipo-IR]) and liver (Homeostatic Model Assessment of Insulin Resistance [HOMA-IR]) IR in people with T2D and NAFLD. DESIGN: Participants were screened by elastography in the outpatient clinics for hepatic steatosis and fibrosis, including routine metabolites, cytokeratin-18 (a marker of hepatocyte apoptosis/steatohepatitis), and HOMA-IR/adipo-IR. SETTING: University ambulatory care practice. PARTICIPANTS: A total of 483 participants with T2D. INTERVENTION: Screening for steatosis and fibrosis with elastography. MAIN OUTCOME MEASURES: Liver steatosis (controlled attenuation parameter), fibrosis (liver stiffness measurement), and measurements of IR (adipo-IR, HOMA-IR) and fibrosis (cytokeratin-18). RESULTS: Clinically significant liver fibrosis (stage F ≥ 2 = liver stiffness measurement ≥8.0 kPa) was found in 11%, having more features of the metabolic syndrome, lower adiponectin, and higher aspartate aminotransferase (AST), alanine aminotransferase, liver fat, and cytokeratin-18 (P < 0.05-0.01). In multivariable analysis including just clinical variables (model 1), obesity (body mass index [BMI]) had the strongest association with fibrosis (odds ratio, 2.56; CI, 1.87-3.50; P < 0.01). When metabolic measurements and cytokeratin-18 were included (model 2), only BMI, AST, and liver fat remained significant. When fibrosis stage was adjusted for BMI, AST, and steatosis (model 3), only Adipo-IR remained strongly associated with fibrosis (OR, 1.51; CI, 1.05-2.16; P = 0.03), but not BMI, hepatic IR, or steatosis. CONCLUSIONS: These findings pinpoint to the central role of dysfunctional, insulin-resistant adipose tissue to advanced fibrosis in T2D, beyond simply BMI or steatosis. The clinical implication is that targeting adipose tissue should be the priority of treatment in NAFLD.

  PublisherOA PDFDOI

• Advanced Liver Fibrosis Is Common in Patients With Type 2 Diabetes Followed in the Outpatient Setting: The Need for Systematic Screening

  2021 · 11 citations

  • Medicine
  • Gastroenterology
  • Internal medicine

  &lt;b&gt;Objective:&lt;/b&gt; Assess the prevalence of NAFLD and of liver fibrosis associated with nonalcoholic steatohepatitis (NASH) in unselected patients with T2DM. &lt;p&gt;&lt;b&gt;Research Design and Methods:&lt;/b&gt; 561 patients with T2DM (age: 60±11; BMI: 33.4±6.2 kg/m&lt;sup&gt;2&lt;/sup&gt;; HbA1c: 7.5±1.8%) attending primary care or endocrinology outpatient clinics and unaware of having NAFLD. At the visit, volunteers were invited to be screened by elastography for steatosis and fibrosis by CAP (≥274 dB/m) and LSM (≥7.0 kPa), respectively. Secondary causes of liver disease were ruled out. Diagnostic panels for prediction of advanced fibrosis, such as APRI and FIB-4, were also measured. A liver biopsy was performed if results were suggestive of fibrosis.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; The prevalence of steatosis was 70% and of fibrosis 21% (LSM≥7.0 kPa). Moderate fibrosis (F2: LSM≥8.2 kPa) was present in 6% and severe fibrosis or cirrhosis (F3-4: LSM≥9.7 kPa) in 9%, similar to that estimated by FIB-4 and APRI panels. Non-invasive testing was consistent with liver biopsy results. Elevated AST or ALT ≥40 U/L were present in a minority of patients with steatosis (8% and 13%, respectively) or with liver fibrosis (18% and 28%, respectively). This suggests that AST/ALT alone are insufficient as initial screening. However, performance may be enhanced by imaging (e.g., transient elastography) and plasma diagnostic panels (e.g., FIB-4, APRI).&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusions: &lt;/b&gt;Moderate-to-advanced fibrosis (F≥2), an established risk factor for cirrhosis and overall mortality, affects at least one-out-of-six (15%) patients with T2DM. These results support the ADA guidelines to screen for clinically significant fibrosis in patients with T2DM with steatosis or elevated ALT.&lt;/p&gt;

  PublisherOA PDFDOI

• Advanced Liver Fibrosis Is Common in Patients With Type 2 Diabetes Followed in the Outpatient Setting: The Need for Systematic Screening

  Diabetes Care · 2020 · 341 citations

  • Medicine
  • Internal medicine
  • Gastroenterology

  OBJECTIVE: Assess the prevalence of nonalcoholic fatty liver disease (NAFLD) and of liver fibrosis associated with nonalcoholic steatohepatitis in unselected patients with type 2 diabetes mellitus (T2DM). RESEARCH DESIGN AND METHODS: : 7.5 ± 1.8%) attending primary care or endocrinology outpatient clinics and unaware of having NAFLD were recruited. At the visit, volunteers were invited to be screened by elastography for steatosis and fibrosis by controlled attenuation parameter (≥274 dB/m) and liver stiffness measurement (LSM; ≥7.0 kPa), respectively. Secondary causes of liver disease were ruled out. Diagnostic panels for prediction of advanced fibrosis, such as AST-to-platelet ratio index (APRI) and Fibrosis-4 (FIB-4) index, were also measured. A liver biopsy was performed if results were suggestive of fibrosis. RESULTS: The prevalence of steatosis was 70% and of fibrosis 21% (LSM ≥7.0 kPa). Moderate fibrosis (F2: LSM ≥8.2 kPa) was present in 6% and severe fibrosis or cirrhosis (F3-4: LSM ≥9.7 kPa) in 9%, similar to that estimated by FIB-4 and APRI panels. Noninvasive testing was consistent with liver biopsy results. Elevated AST or ALT ≥40 units/L was present in a minority of patients with steatosis (8% and 13%, respectively) or with liver fibrosis (18% and 28%, respectively). This suggests that AST/ALT alone are insufficient as initial screening. However, performance may be enhanced by imaging (e.g., transient elastography) and plasma diagnostic panels (e.g., FIB-4 and APRI). CONCLUSIONS: Moderate-to-advanced fibrosis (F2 or higher), an established risk factor for cirrhosis and overall mortality, affects at least one out of six (15%) patients with T2DM. These results support the American Diabetes Association guidelines to screen for clinically significant fibrosis in patients with T2DM with steatosis or elevated ALT.

  PublisherOA PDFDOI

• Advanced Liver Fibrosis Is Common in Patients With Type 2 Diabetes Followed in the Outpatient Setting: The Need for Systematic Screening

  2020-12-21

  preprintOpen access

  &lt;b&gt;Objective:&lt;/b&gt; Assess the prevalence of NAFLD and of liver fibrosis associated with nonalcoholic steatohepatitis (NASH) in unselected patients with T2DM. &lt;p&gt;&lt;b&gt;Research Design and Methods:&lt;/b&gt; 561 patients with T2DM (age: 60±11; BMI: 33.4±6.2 kg/m&lt;sup&gt;2&lt;/sup&gt;; HbA1c: 7.5±1.8%) attending primary care or endocrinology outpatient clinics and unaware of having NAFLD. At the visit, volunteers were invited to be screened by elastography for steatosis and fibrosis by CAP (≥274 dB/m) and LSM (≥7.0 kPa), respectively. Secondary causes of liver disease were ruled out. Diagnostic panels for prediction of advanced fibrosis, such as APRI and FIB-4, were also measured. A liver biopsy was performed if results were suggestive of fibrosis.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; The prevalence of steatosis was 70% and of fibrosis 21% (LSM≥7.0 kPa). Moderate fibrosis (F2: LSM≥8.2 kPa) was present in 6% and severe fibrosis or cirrhosis (F3-4: LSM≥9.7 kPa) in 9%, similar to that estimated by FIB-4 and APRI panels. Non-invasive testing was consistent with liver biopsy results. Elevated AST or ALT ≥40 U/L were present in a minority of patients with steatosis (8% and 13%, respectively) or with liver fibrosis (18% and 28%, respectively). This suggests that AST/ALT alone are insufficient as initial screening. However, performance may be enhanced by imaging (e.g., transient elastography) and plasma diagnostic panels (e.g., FIB-4, APRI).&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusions: &lt;/b&gt;Moderate-to-advanced fibrosis (F≥2), an established risk factor for cirrhosis and overall mortality, affects at least one-out-of-six (15%) patients with T2DM. These results support the ADA guidelines to screen for clinically significant fibrosis in patients with T2DM with steatosis or elevated ALT.&lt;/p&gt;

  PublisherOA PDFDOI

• Advanced Liver Fibrosis Is Common in Patients With Type 2 Diabetes Followed in the Outpatient Setting: The Need for Systematic Screening

  2020-12-21 · 1 citations

  preprintOpen access

  &lt;b&gt;Objective:&lt;/b&gt; Assess the prevalence of NAFLD and of liver fibrosis associated with nonalcoholic steatohepatitis (NASH) in unselected patients with T2DM. &lt;p&gt;&lt;b&gt;Research Design and Methods:&lt;/b&gt; 561 patients with T2DM (age: 60±11; BMI: 33.4±6.2 kg/m&lt;sup&gt;2&lt;/sup&gt;; HbA1c: 7.5±1.8%) attending primary care or endocrinology outpatient clinics and unaware of having NAFLD. At the visit, volunteers were invited to be screened by elastography for steatosis and fibrosis by CAP (≥274 dB/m) and LSM (≥7.0 kPa), respectively. Secondary causes of liver disease were ruled out. Diagnostic panels for prediction of advanced fibrosis, such as APRI and FIB-4, were also measured. A liver biopsy was performed if results were suggestive of fibrosis.&lt;/p&gt; &lt;p&gt;&lt;b&gt;Results:&lt;/b&gt; The prevalence of steatosis was 70% and of fibrosis 21% (LSM≥7.0 kPa). Moderate fibrosis (F2: LSM≥8.2 kPa) was present in 6% and severe fibrosis or cirrhosis (F3-4: LSM≥9.7 kPa) in 9%, similar to that estimated by FIB-4 and APRI panels. Non-invasive testing was consistent with liver biopsy results. Elevated AST or ALT ≥40 U/L were present in a minority of patients with steatosis (8% and 13%, respectively) or with liver fibrosis (18% and 28%, respectively). This suggests that AST/ALT alone are insufficient as initial screening. However, performance may be enhanced by imaging (e.g., transient elastography) and plasma diagnostic panels (e.g., FIB-4, APRI).&lt;/p&gt; &lt;p&gt;&lt;b&gt;Conclusions: &lt;/b&gt;Moderate-to-advanced fibrosis (F≥2), an established risk factor for cirrhosis and overall mortality, affects at least one-out-of-six (15%) patients with T2DM. These results support the ADA guidelines to screen for clinically significant fibrosis in patients with T2DM with steatosis or elevated ALT.&lt;/p&gt;

  PublisherDOI

Frequent coauthors

• Pierre Bédossa

  7 shared

• Kenneth Cusi

  6 shared

• George Samraj

  University of Florida

  5 shared

• Fernando Bril

  Florida College

  5 shared

• Lydia Mansour

  5 shared

• Diana Barb

  University of Florida

  5 shared

• Srilaxmi Kalavalapalli

  Florida College

  5 shared

• Sulav Shrestha

  University of Calgary

  5 shared