Research in Family and Community Medicine
About
The research division of the Department of Family and Community Medicine brings together clinicians, health services researchers, and a variety of interdisciplinary collaborators aimed at:
- Improving the delivery of evidence-based primary care
- Studying questions of quality and value in healthcare
- Understanding and improving healthcare systems
- Improving education for undergraduate, graduate and continuing medical learners
Our work focuses on:
- Clinical preventive services and population-oriented prevention
- Reducing health service overuse and low-value care
- The patient-clinician relationship
- Designing impactful educational interventions and meaningful learner assessments
We use a variety of methodologies to address these focus areas:
- Mixed quantitative and qualitative methods
- Data science
- Practice facilitation, academic detailing, and other proven practice-change methods
Team
John Epling Jr., MD
John Epling Jr., MD, MSEd, is a Professor of Family and Community Medicine at the Virginia Tech Carilion School of Medicine in Roanoke, VA. He serves as Vice Chair for Research and Population Health for Family and Community Medicine, is Medical Director of Employee Health and Wellness for the Carilion Clinic, and maintains an active clinical practice in Family Medicine. Dr. Epling has taught family medicine, evidence-based medicine, and clinical prevention to all levels of learners throughout his career. His research areas of focus address clinical preventive services, implementation science and knowledge translation, education, and various practical issues in clinical primary care. He has participated in vaccination-related workgroups on the state and national level and was a member of the U.S. Preventive Services Task Force from 2016 to 2020.
Michelle Rockwell, PhD, RD
Michelle Rockwell, PhD, RD, serves as Director of Research in the Department of Family and Community Medicine at Carilion Clinic, Assistant Professor of Family and Community Medicine at the Virginia Tech Carilion School of Medicine, Co-Director of Health Systems Science and Interprofessional Practice for Phase 1 at the Virginia Tech Carilion School of Medicine, and a member of the adjunct faculty in the Department of Human Nutrition, Foods, and Exercise at Virginia Tech. Dr. Rockwell is a mixed methods health services researcher interested in enhancing the quality and value of healthcare through improved delivery of preventive services and de-implementation of low-value care, patient health care that provides no net benefit in specific clinical scenarios. With 20 years of experience as a Registered Dietitian, Dr. Rockwell’s interests also include nutrition and other lifestyle factors associated with health and performance. She has previous experience as a clinical researcher, practice director, nutrition counselor and sports dietitian.
Jamie Turner, MPH, CHES
Jamie Turner, MPH, CHES, is a Pre-Doctoral Research Fellow in the Department of Family and Community Medicine at Carilion Clinic and the Virginia Tech Carilion School of Medicine and a PhD student in the Translational, Biology, Medicine, and Health Graduate Program at Virginia Tech. Her interests are health services and implementation research, and understanding the complex interplay between individual health behavior, healthcare quality, and healthcare delivery in a rural context. She is an experienced research assistant and research coordinator who worked on multiple research studies at the Addiction Recovery Research Center and the Center for Health Behaviors Research at the Fralin Biomedical Research Institute at VTC focused on decision-making processes in maladaptive health behaviors while receiving her Bachelor of Science in Psychology & Social Work from Radford University and a Master of Public Health at Virginia Tech.
Neeharika Yallayi
Neeharika is a first-year student in the Translational, Biology, Medicine, and Health Graduate Program at Virginia Tech. She is completing the Public Health & Implementation Science track, with research focused on improving primary care to specialist transitions and workflows. She completed a Bachelor of Science degree in Biology at Virginia Tech in May of 2025. Her previous research experience was in neurovirology in HSV 1 and 2.
Brianna Chang, MS
Brianna is a student at the Virginia Tech Carilion School of Medicine (Class of 2027). Her research project evaluates the impact of multiple chronic conditions status on the relationship between “sludge” (a behavioral economics concept that describes administrative burdens and frictions, e.g., repetitive paperwork, cumbersome technology, long waits) and delayed or foregone colorectal cancer screenings.
Isaiah Yim
Isaiah is a student at the Virginia Tech Carilion School of Medicine (Class of 2027). His data science research project evaluates the longitudinal health impact of switching from chronic opioid therapy to chronic NSAID therapy in patients with chronic kidney disease.
Camille Mittendorf
Camille is a student at the Virginia Tech Carilion School of Medicine (Class of 2028). Her research will focus on the intersection of lifestyle medicine and primary care.
Kate Watkins
Kate is a student at the Virginia Tech Carilion School of Medicine (Class of 2028). Her research will focus on trust in data.
Cherry Chu
Cherry is working on a project relating to an AI scribe system to reduce EHR documentation and clinician well-being.
Grace Qian
Grace is working on a project involving the effect of a short-interval primary care follow-up appointment on interrupting the opioid prescribing cascade after an initial opioid prescription for acute pain.
Recent Publications
Rockwell MS, Villalobos G, Bannon J, Bishop D, Kirchner S, Jonas DE, Krist AH, Davis M, Brooks EM (2025). A Behind-the-Scenes Look at Practice Facilitation to Improve Delivery of Unhealthy Alcohol Use Screening and Management Services in Primary Care: A Qualitative Study. J Prim Care Community Health. 2025;16:21501319251351144.
Epling J W, Lowery M B, Weir A A, Tenzer MM, Locklear TM, Baffoe-Bonnie AW, Skolnik PR (July 01, 2025) Diagnostic Accuracy of a SARS-CoV-2 Antigen Test Obtained by Mid-turbinate Nasal Swabs. Cureus 17(7): e87120.
Xames MD, Topcu TG, Parker SH, Zagarese V and Epling JW (2025) Evaluating CFIR 2.0 in identifying digital twin implementation challenges in healthcare: bridging the dichotomy between engineering and healthcare communities. Front. Digit. Health 7:1611225.
Rockwell MS, Vangala S, Hadfield M, Cantor J, Skinner D, Craff M, Fendrick AM, Damberg CL, Kahn K, Mafi, J. Demographic Variation in US Outpatient Hydroxychloroquine and Ivermectin Use During the COVID-19 Pandemic. Health Affairs: 44 (3).
Bishop D, Parsons D, Villalobos G, Bannon J, Rockwell M, Krist A, Jonas DE, Davis MM, Riley S, Brouwer L, Walunas T, Kho A, Cohen H, McPherson T, Rosenfeld A, Flanagan E. Reducing Stigma Through Conversations in Primary Care About Unhealthy Alcohol Use. Ann Fam Med. 2025 Jan 27;23(1):83. PMID: 39870537; PMCID: PMC11772022.
Rockwell MS, Vangala S, Rider J, Bortz B, Russell K, Dachary M, Walker L, Fendrick AM, Mafi JN. Increased spending on low-value care during the COVID-19 pandemic in Virginia. Health Aff Sch. 2024 Oct 23;2(11):qxae133.
Bharati R, Kovach KA, Sayess P, Polk E. Impact of Physicians’ Perception of Social Determinants of Health (SDoH) on the Practice of Lifestyle Medicine. Findings From a Family Physicians Survey. Am J Lifestyle Med. 2024;0(0).
Rockwell MS, Chang B, Zagarese V, Turner JK, Southworth A, Wu Y, Yeaton P, Li L, Stein JS, Parker SH, Epling JW. Patients' experiences with 'sludge' (administrative burden) in the cancer screening process and its relationship with screening completion, experience and health system distrust. Fam Med Community Health. 2024 Sep 18;12(Suppl 2):e002933. PMID: 39299768; PMCID: PMC11664340.
Huffstetler AN, Villalobos G, Webel B, Rockwell MS, Funk A, Sabo RT, Epling JW, Brooks EM, Britz JB, Bortz BA, Svikis DS, Arias AJ, Tran RN, Krist AH. Practice Facilitation to Address Unhealthy Alcohol Use in Primary Care: A Cluster Randomized Clinical Trial. JAMA Health Forum. 2024 Aug 2;5(8):e242371. PMID: 39120895; PMCID: PMC11316228.
Rockwell MS, Fendrick AM. Reducing low-value care is a feasible approach to enhancing access and affordability of high-value care for older Americans. Am J Manag Care. 2024 Jul;30(7):302-304. PMID: 38995827.
Rockwell MS, Oyese EG, Singh E, Vinson M, Yim I, Turner JK, Epling JW. Scoping review of interventions to de-implement potentially harmful non-steroidal anti-inflammatory drugs (NSAIDs) in healthcare settings. BMJ Open. 2024 Apr 17;14(4):e078808. PMID: 38631836; PMCID: PMC11029194.
Webel B, Villalobos G, Rockwell MS, Huffstetler A, Britz JB, Brooks EM, Krist AH. Considering the Environmental Impact of Practice-Based Research. J Am Board Fam Med. 2024 Mar 11;37(1):22-24. PMID: 38448235.
Rockwell MS, Funk AJ, Huffstetler AN, Villalobos G, Britz JB, Webel B, Richards A, Epling JW, Sabo RT, Krist AH. Screening for Unhealthy Alcohol Use among Virginia Primary Care Patients with Multiple Chronic Conditions. AJPM Focus. 2024 May 7;3(4):100233.100233. PMID: 38947491; PMCID: PMC11214170.
Krist AH, Huffstetler AN, Villalobos G, Rockwell MS, Richards A, Funk A, Sabo RT, Bortz B, Webel B, Lee JH, Russel K, Kuzel A, Britz JB, Moeller FG. (2023). Use of Population Health Data to Promote Equitable Recruitment for a Primary Care Practice Implementation Trial Addressing Unhealthy Alcohol Use. J Clin Transl Sci;7(1):e110.
Rockwell MS, Frazier MC, Stein JS, Dulaney KA, Parker SH, Davis GC, Rockwell JA, Castleman BL, Sunstein CR, Epling JW. (2023). A "Sludge Audit" for Health System Colorectal Cancer Screening Services Am J Manag Care;29(7):e222-e228.
Rockwell MS, Armbruster SD, Capucao JC, Russell KB, Rockwell JA, Perkins KE, Huffstetler AN, Mafi JN, Fendrick AM. (2023). Reallocating Cervical Cancer Preventive Service Spending from Low- to High-Value Clinical Scenarios. Cancer Prev Res;16(7):385-391.
Rockwell MS, Cox E, Locklear T, Hodges B, Mulkey S, Evans B, Epling JW, Stavola AR. (2023). Implementation of a Multimodal Heart Failure Management Protocol in a Skilled Nursing Facility. Gerontol Geriatr Med;9:1-8.
Krist AH, Villalobos G, Rockwell M. (2023). Improving Screening and Counseling for Unhealthy Alcohol Use-Lessons From the Field. JAMA Intern Med;183(4):328-330.
Werner KD, Epling JW. (2023). Lung Cancer-Related Mortality and the Impact of Low-Dose Computed Tomography Screening. Am Fam Physician;107(5):462-463.
Rockwell, M., Michaels, K., Epling, J. (2022). Does De-Implementation of Low-Value Care Impact the Patient-Clinician Relationship? A Mixed Methods Study. BMC Health Serv Res;22(37).
Bharati R, Kovach KA, Bonnet JP, Sayess P, Polk E, Harvey K, Vorbeck L. Incorporating Lifestyle Medicine Into Primary Care Practice: Perceptions and Practices of Family Physicians. Am J Lifestyle Med. 2022 Mar 2;17(5):704-716. PMID: 37711349; PMCID: PMC10498979.
Epling, J., Rockwell, M., Miller, A., Carver, M. (2021). Socializing the Evidence for Diabetes Control to Develop “Mindlines”: A Qualitative Pilot Study. BMC Fam Med;22(1):177-182.
Crandell, I., Rockwell, M., Carter, K., Whitehead, P., Hanlon, A. (2021). Examination of the Moderating Effect of Race on the Relationship between Vitamin D Status and COVID-19 Test Positivity using Propensity Score Methods. J Am Coll Nutr
Rockwell, M., Stein, J., Gerdes, J., Brown, J., Ivory, A., Epling, J. (2021). Trust in Healthcare and Trust in Science Predict Readiness to Receive the COVID-19 Vaccine in Appalachia. [Preprint] http://hdl.handle.net/2027.42/167136
Rockwell M., Wu Y., Salamoun M., Hulver M., Epling J. (2020). Patterns of Clinical Care Subsequent to Nonindicated Vitamin D Testing in Primary Care. J Am Board Fam Med;33(4):569-579.
Rockwell M., Kraak V., Hulver M., Epling J. (2018). Clinical Management of Low Vitamin D: A Scoping Review of Physicians’ Practices. Nutrients;10(4):493.
Collaborators
Partners and Frequent Collaborators
Fralin Biomedical Research Institute at Virginia Tech Carilion School of Medicine Virginia Ambulatory Care Outcomes Research Network (ACORN) Health Systems and Implementation Science VTC Department of Health Systems and Implementation Science Department of Psychiatry and Behavioral Health at Virginia Tech Carilion School of Medicine Fralin Life Sciences Institute at Virginia Tech Center for Biostatistics and Health Data Science at Virginia Tech
