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Christian D. Helfrich

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Research Associate Professor, Health Services

Research Investigator
Veterans Administration Puget Sound Health Care System,


PhD   University of North Carolina, 2005   (Health Services)
MPH   University of Washington, 2000   (Health Services)
BA   Gonzaga University, 1998

Contact Info


web site:

1100 Olive Way, Suite 1400
Seattle, WA 98101

campus box:   Mailstop S-152
voice:   206-277-1655
fax:   206-764-2935


Christian Helfrich has been a member of the research faculty since 2009.  He can be found on Twitter (@helfrich_c)

Dissemination and implementation research; implementation science; organizational change; change management; de-implementation of ineffective and harmful practice

Helfrich CD, Hartmann CW, Parikh TJ, Au DH. Promoting Health Equity through De-Implementation Research. Ethn Dis. 2019 Feb 21;29(Suppl 1):93-96. doi: 10.18865/ed.29.S1.93. eCollection 2019.  PMID: 30906155    PMCID: PMC6428172
PubMed Central

Whittington MD, Ho PM, Helfrich CD. Recommendations for the Use of Audit and Feedback to De-Implement Low-Value Care. Am J Med Qual. 2019 Jan 17:1062860618824153. doi: 10.1177/1062860618824153. [Epub ahead of print]  PMID: 30654620

Fishleder S, Petrescu-Prahova M, Harris JR, Leroux B, Bennett K, Helfrich CD, Kohn M, Hannon P. Predictors of Improvement in Physical Function in Older Adults in an Evidence-Based Physical Activity Program (EnhanceFitness). J Geriatr Phys Ther. 2018 Jul 3. doi: 10.1519/JPT.0000000000000202. [Epub ahead of print]  PMID: 29979352    PMCID: PMC6318072
PubMed Central

Stockdale SE, Rose D, Darling JE, Meredith LS, Helfrich CD, Dresselhaus TR, Roos P, Rubenstein LV. Communication Among Team Members Within the Patient-centered Medical Home and Patient Satisfaction With Providers: The Mediating Role of Patient-Provider Communication. Med Care. 2018 Jun;56(6):491-496. doi: 10.1097/MLR.0000000000000914.  PMID: 29683867

Helfrich CD, Kohn MJ, Stapleton A, Allen CL, Hammerback KE, Chan KCG, Parrish AT, Ryan DE, Weiner BJ, Harris JR, Hannon PA. Readiness to Change Over Time: Change Commitment and Change Efficacy in a Workplace Health-Promotion Trial. Front Public Health. 2018 Apr 23;6:110. doi: 10.3389/fpubh.2018.00110. eCollection 2018.  PMID: 29740572    PMCID: PMC5925216
PubMed Central

ORCID ID: 0000000298274768

Google Scholar: 2Vg4gDkAAAAJ

Scopus ID: 13407517300

Member, thesis committee for Laura Bender
Household composition and home health care utilization in young and middle-aged adults.

Member, thesis committee for Jon Allison
Does Military Service Modify the Relationship between Race/Ethnicity and Diabetes and Hypertension Prevalence and Control? National Health and Nutrition Examination Survey (NHANES) 20072014

Member, dissertation committee for Sarah Fishleder
Development and evaluation of community-clinical linkages between physical therapy clinics and EnhanceFitness, an evidence-based physical activity program for older adults

Chair, thesis committee for Edward Stapleton
Sensitivity of a readiness to change survey to change over time and between groups

Chair, capstone for Kayla Down
Synthesis of the Patient Aligned Care Team (PACT) initiative for the United States Department of Veterans Affairs, Veterans Integrated Service Networks (VISN)

Increasing Implementation of Evidence-Based Interventions at Low-Wage Worksites
National Institutes of Health (NIH)
PI:   Hannon           Dates:    5/1/2016 - 4/30/2017

Increasing Implementation of Evidence-Based Interventions at Low-Wage Worksites
National Institutes of Health (NIH)
PI:   Hannon           Dates:    5/1/2015 - 4/30/2016

Improving Safety and Quality through Evidence-Based De-Implementation of Ineffective Diagnostics and Therapeutics

Dr. Helfrich serves as Co-PI of a five-year QUERI program studying de-implementation strategies of harmful and ineffective clinical practices across multiple settings. The program incorporates extensive data on organizational context and stakeholder needs, and includes close partnerships with both national clinical leaders and local clinical champions.

The Organizational Readiness to Change Assessment (ORCA)

The ORCA is a structured self-report survey tool to assess the collective readiness of a clinical team or unit to implement a specific evidence-based clinical practice change, such as introducing hepatitis C screening and treatment in substance-use disorder clinics, or use of an evidence-based dosing algorithm for titrating warfarin in anti-coagulation clinics. Dr. Helfrich led a multi-site psychometric study of the ORCA and currently serves as co-investigator on three multi-site implementation trials that are using the ORCA, or have adapted the ORCA as part of implementation support activities.

Evaluations of Veterans Health Administration Transformational Initiatives

Dr. Helfrich has helped evaluate four VA initiatives to improve specialty care access and care coordination through the use of alternative consultation modalities, such as electronic specialty consults (via the electronic health record), and to expand the capabilities of primary care providers to manage specialty conditions.

Evaluating Implementation of the VA Patient-Aligned Care Team (PACT) initiative

In 2010, the VA began national implementation of a patient-centered medical home model emphasizing team-based care, alternative modalities for communicating with patients, such as secure messaging, and population-based, proactive health care. Dr. Helfrich was part of the national PACT evaluation, chairing a working group of researchers and consultants to design and field a national primary care employee survey, with particular attention to assessing team-based care, barriers to effective team functioning and employee burnout. Many presentations of the findings from this work are available as video seminars: