Recognizing health status is influenced by a vast interconnected set of social, behavioral and environmental determinants, Dr. Matthew Lee Smith has devoted his career to create synergistic partnerships and initiatives to encourage positive lifestyles and reduce rates of preventable morbidity and mortality. His research and evaluation efforts investigate socio-ecological impacts on health risk behaviors across the life-course, with a specific emphasis on evidence-based programming for older adults (e.g., fall prevention, disease self-management). Dr. Smith has established expertise in the evaluation of programs and innovations pertaining to an array of public health issues.
Dr. Smith’s research and evaluation foci surround the reach, adoption, implementation, effectiveness, and maintenance of evidence-based programs and policies. His efforts examine the feasibility of delivering evidence-based programs in diverse settings as well as their implementation with fidelity, scalability, and sustainability. Dr. Smith’s ability to form interdisciplinary collaborations affords him opportunities to apply his translational research and evaluation experience to bridge research and practice issues among the healthcare sector, aging services network, and public health system. His research efforts have been funded by organizations including the National Institutes of Health (NIH), Administration on Aging (AoA), National Council on Aging (NCOA), Centers for Disease Control and Prevention (CDC), and Centers for Medicare and Medicaid Services (CMS).
Dr. Smith is the Co-Director of the Texas A&M Center for Population Health and Aging and Associate Professor in the Texas A&M School of Public Health. Dr. Smith has (co-) authored 300 peer-reviewed publications in scholarly journals, received over 20 research-based awards, and delivered 550 conference presentations and invited lectures.
Areas of Expertise (5)
Health Risk Behaviors Across the Life Course
Evidence-Based Programming for Older Adults
Survey Research Methodology
Professional Poster Winner, Scientific Meeting of the American Academy of Health Behavior (professional)
Mentorship Award, American Academy of Health Behavior (professional)
Redefining American Healthcare Award, Healthcare Leadership Council (professional)
Community ConnecTivity Award, Tivity Health (professional)
Innovators in Aging Award, Texas Health and Human Services Commission (professional)
Phillip G. Weiler Award for Leadership in Aging and Public Health, American Public Health Association (professional)
Aging and Rural/Environmental Health Award, American Public Health Association (professional)
Aging Innovations Award, National Association of Area Agencies on Aging (professional)
Dean’s Best Faculty Paper Award. School of Public Health, Texas A&M Health Science Center (professional)
Sarah Mazelis Best Paper of the Year, Health Promotion Practice (professional)
Texas A&M University: PhD, Health Education 2008
Indiana University: MS, Masters of Public Health 2004
Indiana University: BS, Public Health Education 2002
- Center for Population Health and Aging : Co-Director
- Department of Environmental and Occupational Health : Associate Professor
- American Academy of Health Behavior (AAHB) : Member
- American Public Health Association (APHA) : Member
- American Society on Aging (ASA) : Member
- Gerontological Society of America (GSA) : Member
- Society of Behavioral Medicine (SBM) : Member
- Eta Sigma Gamma National Health Honors Society (ESG) : Member
- National Commission for Health Education Credentialing, Inc. (NCHEC) : Member
Research Grants (5)
Health in Motion – A Pragmatic Clinical Trial
National Institutes of Health (SBIR) (subcontract with Blue Marble Rehab, Inc.) $2,190,504
2020 - 2023
Problem Solving Training (PST) for English- and Spanish-Speaking Care Partners of Adults with Alzheimer’s and Alzheimer’s-Related Dementia
Texas Alzheimer’s Research and Care Consortium (subcontract with University of Texas – Southwestern) $1,154,458
2020 - 2022
Virtual Healthy Habits - An Innovative Approach to Nutrition Education, Hands-On Meal Preparation and Socializing for Older Adults
Administration for Community Living (subcontract with The Oasis Institute) $835,000
2020 - 2023
Texas Research, Analytics, and Innovations Lab (TRAIL)
STATinMED Research $1,250,000
2019 - 2024
Improved AD/ADRD Assessment Sensitivities Using a Novel In-Situ Sensor
National Institute on Aging (NIA; SBIR) (subcontract with Birkland Current) $4,200,000
2019 - 2022
Featured Articles (10)
Suicide Distribution and Trends Among Male Older Adults in the U.S., 1999–2018American Journal of Preventive Medicine
Sanae El Ibrahimi, Yunyu Xiao, Caroline D Bergeron, Niema Y Beckford, Eddy M Virgen, Matthew L Smith
2021 Introduction This study examines the distribution and trends in suicide death rates among male adults aged ≥65 years in the U.S. from 1999 to 2018. Methods Suicide mortality data were derived from Multiple Cause of Death from the Center for Disease Control and Prevention's Wide-ranging Online Data for Epidemiologic Research database. Suicides were identified from the underlying causes of death. Joinpoint regression examined the distribution and shift in suicide age-adjusted death rates overall and by age groups, race/ethnicity, method of suicide, and urbanicity. Analyses were conducted in 2020. Results Between 1999 and 2018, a total of 106,861 male adults aged ≥65 years died of suicide (age-adjusted rate=31.4 per 100,000 population, 95% CI=31.2, 31.6). Suicide rates showed a V-shaped trend. They were declining annually by 1.8% (95% CI= −2.4, −1.2); however, starting in 2007, there was a shift upward, increasing significantly by 1.7% per year for the next decade (95% CI=1.0, 1.6). Suicide rates were highest among those aged ≥85 years (48.8 per 100,000 population with an upward shift in 2008), Whites (35.3 per 100,000 population with an upward shift in trend in 2007), and the most rural communities (39.0 per 100,000 population). Most suicides were due to firearms (78.3% at a rate of 24.7 per 100,000 population), especially in rural areas, and shifted upward after 2007. Conclusions Increases in suicide rates among male older adults in the U.S., particularly after the 2007–2008 economic recession, are concerning. Tailored suicide prevention intervention strategies are needed to address suicide-related risk factors.
Impact of a Behavioral Intervention on Diet, Eating Patterns, Self-Efficacy, and Social SupportJournal of Nutrition Education and Behavior
Matthew Lee Smith, Shinduk Lee, Samuel D Towne Jr, Gang Han, Cindy Quinn, Ninfa C Peña-Purcell, Marcia G Ory
2020 Objective To examine the effectiveness of a structured multimodal behavioral intervention to change dietary behaviors, as well as self-efficacy and social support for engaging in healthier diets. Methods A quasi-experimental design was used to assign sites into intervention and comparison groups. Data were collected at baseline, 3 months, and 6 months. The intervention group participated in Texercise Select, a 12-week lifestyle enhancement program. Multiple mixed-effects models were used to examine nutrition-related changes over time. Results For the intervention group, significant improvements were observed for fast food consumption (P = .011), fruit/vegetable consumption (P = .008), water consumption (P = .009), and social support (P < .001) from baseline to 3 months. The magnitude of these improvements was significantly greater than changes in the comparison group. Conclusions and Implications Findings suggest the intervention's ability to improve diet-related outcomes among older adults; however, additional efforts are needed to maintain changes over longer periods.
Translating CDSMP for use in the workplace: Results of the Live Healthy, Work Healthy TrialAPHA's 2019 Annual Meeting and Expo
Mark G Wilson, David M DeJoy, Heather M Padilla, Robert J Vandenberg, Nicholas Haynes, Heather Zuercher, Phaedra Corso, Kate Lorig, Matthew Smith
2019 Depending on the chronic condition, 22-49% of employees experience difficulties meeting physical work demands, while 27-58% have problems meeting psychosocial work requirements. As a result, chronic disease management programs have become increasingly important in worksites. This presentation will share the results of a randomized, controlled trial of Live Healthy, Work Healthy (LHWH), a worksite chronic disease self-management program. LHWH is a translation of the Chronic Disease Self-Management Program that has been adapted to fit the unique characteristics of work organizations. This translated program consists of 15 sessions over 8 weeks and was facilitated by trained lay leaders. 18 worksites were randomly assigned to 1) LHWH, 2) standard CDSMP (usual care) or 3) a no-intervention (control) groups. Data were collected pretest, posttest (6 mos.) and follow-up (12 mos.) using a delayed control group design. The primary outcomes measures were CVD and health risk, with secondary outcomes including patient-provider communication, quality of life, medical adherence and work performance. Overall, participants were primarily female (86%), non-Hispanic white (65%) and obese (66%). 79% of participants reported at least one chronic condition with an average of 2.0 chronic conditions reported. Preliminary results indicated that LHWH program demonstrated positive changes in a variety of outcomes including decreases in total cholesterol (uΔ=-7.44, p
Geographic disparities associated with travel to medical care and attendance in programs to prevent/manage chronic illness among middle-aged and older adults in TexasRural and Remote Health
Matthew Lee Smith, Samuel D Towne Jr, Caroline D Bergeron, Donglan Zhang, Carly McCord, Nelda Mier, Heather H Goltz
2019 INTRODUCTION: Accessing care is challenging for adults with chronic conditions. The challenge may be intensified for individuals needing to travel long distances to receive medical care. Transportation difficulties are associated with poor medication adherence and delayed or missed care. This study investigated the relationship between those traveling greater distances for medical care and their utilization of programs to prevent and/or manage their health problems. It was hypothesized that those traveling longer distances for medical care attended greater chronic disease management programs. METHODS: Thirty six thousand households in nine counties of central Texas received an invitation letter to participate in a mailed health assessment survey in English or Spanish. A total of 5230 participants agreed to participate and returned the fully completed survey. To investigate distance traveled for medical services and participation in a chronic disease management program, the analyses were limited to 2108 adults aged ≥51 years with one or more chronic conditions who visited a healthcare professional at least once in the previous year. Other variables of interest included residential rurality, health status, and personal characteristics. The data were first analyzed using descriptive and bivariate analyses. Then, an ordinal logistic regression model was fitted to identify factors associated with longer distances traveled to medical services. Additionally, a binary logistic regression model was fitted to identify factors associated with attending a chronic disease self-management program. RESULTS: Among 2108 adults, rural participants (p
Delivery of Fall Prevention Interventions for At-Risk Older Adults in Rural Areas: Findings from a National DisseminationInternational Journal of Environmental Research and Public Health
Matthew Lee Smith, Samuel D Towne, Angelica Herrera-Venson, Kathleen Cameron, Scott A Horel, Marcia G Ory, Chelsea L Gilchrist, Ellen C Schneider, Casey DiCocco, Shannon Skowronski
2018 Falls incidence rates and associated injuries are projected to increase among rural-dwelling older adults, which highlights the need for effective interventions to prevent falls and manage fall-related risks. The purpose of this descriptive study was to identify the geospatial dissemination of eight evidence-based fall prevention programs (e.g., A Matter of Balance, Stepping On, Tai Chi, Otago Exercise Program) across the United States (U.S.) in terms of participants enrolled, workshops delivered, and geospatial reach. These dissemination characteristics were compared across three rurality designations (i.e., metro areas; non-metro areas adjacent to metro areas; and, non-metro areas not adjacent to metro areas). Data were analyzed from a national repository of 39 Administration for Community Living (ACL) grantees from 2014–2017 (spanning 22 states). Descriptive statistics were used to assess program reach, delivery-site type, and completion rate by rurality. Geographic information systems (GIS) geospatially represented the collective reach of the eight interventions. Of the 45,812 participants who attended a fall prevention program, 12.7% attended workshops in non-metro adjacent areas and 6.6% attended workshops in non-metro non-adjacent areas. Of the 3755 workshops delivered (in over 550 unique counties), most were delivered in senior centers (26%), residential facilities (20%), healthcare organizations (13%), and faith-based organizations (9%). On average, the workshop attendance/retention rates were consistent across rurality (~70%). Findings highlight the need to diversify the delivery infrastructure for fall prevention programs to adequately serve older adults in rural areas. Ongoing efforts are needed to offer sustainable technical assistance and to develop scalable clinical-community referral systems to increase fall prevention program participation among rural-dwelling older adults.
Examination of sustainability indicators for fall prevention strategies in three statesEvaluation and Program Planning
Matthew Lee Smith, Nicholas K Durrett, Ellen C Schneider, Imani N Byers, Tiffany E Shubert, Ashley D Wilson, Samuel D Towne Jr, Marcia G Ory
2018 With 1-in-4 older adults suffering a fall each year, fall prevention efforts have emerged as a public health priority. Multi-level, evidence-based fall prevention programs have been promoted by the CDC and other government agencies. To ensure participants and communities receive programs’ intended benefits, organizations must repeatedly deliver the programs over time and plan for program sustainability as part of ‘scaling up’ the initiative. The State Falls Prevention Project (SFPP) began in 2011 when the CDC provided 5 years of funding to State Departments of Health in Colorado, New York, and Oregon to simultaneously implement four fall prevention strategies: 1) Tai Chi: Moving for Better Balance; 2) Stepping On; 3) Otago Exercise Program; and 4) STEADI (STopping Elderly Accidents, Deaths, and Injuries) toolkit. Surveys were performed to examine systems change and perceptions about sustainability across states. The purposes of this study were to: 1) examine how funding influenced the capacity for program implementation and sustainability within the SFPP; and 2) assess reported Program Sustainability Assessment Tool (PSAT) scores to learn about how best to sustain fall preventing efforts after funding ends. Data showed that more organizations offered evidence-based fall prevention programs in participants’ service areas with funding, and the importance of programming implementation, evaluation, and reporting efforts were likely to diminish once funding concluded. Participants’ reported PSAT scores about perceived sustainability capacity did not directly align with previously reported perceptions about PSAT domain importance or modifiability. Findings suggest the importance of grantees to identify potential barriers and enablers influencing program sustainability during the planning phase of the programs.
Impact of a Translated Disease Self-Management Program on Employee Health and Productivity: Six-Month Findings from a Randomized Controlled TrialInternational Journal of Environmental Research and Public Health
Matthew Lee Smith, Mark G Wilson, Melissa M Robertson, Heather M Padilla, Heather Zuercher, Robert Vandenberg, Phaedra Corso, Kate Lorig, Diana D Laurent, David M DeJoy
2018 Disease management is gaining importance in workplace health promotion given the aging workforce and rising chronic disease prevalence. The Chronic Disease Self-Management Program (CDSMP) is an effective intervention widely offered in diverse community settings; however, adoption remains low in workplace settings. As part of a larger NIH-funded randomized controlled trial, this study examines the effectiveness of a worksite-tailored version of CDSMP (wCDSMP [n = 72]) relative to CDSMP (‘Usual Care’ [n = 109]) to improve health and work performance among employees with one or more chronic conditions. Multiple-group latent-difference score models with sandwich estimators were fitted to identify changes from baseline to 6-month follow-up. Overall, participants were primarily female (87%), non-Hispanic white (62%), and obese (73%). On average, participants were age 48 (range: 23–72) and self-reported 3.25 chronic conditions (range: 1–16). The most commonly reported conditions were high cholesterol (45%), high blood pressure (45%), anxiety/emotional/mental health condition (26%), and diabetes (25%). Among wCDSMP participants, significant improvements were observed for physically unhealthy days (uΔ = −2.07, p = 0.018), fatigue (uΔ = −2.88, p = 0.002), sedentary behavior (uΔ = −4.49, p = 0.018), soda/sugar beverage consumption (uΔ = −0.78, p = 0.028), and fast food intake (uΔ = −0.76, p = 0.009) from baseline to follow-up. Significant improvements in patient–provider communication (uΔ = 0.46, p = 0.031) and mental work limitations (uΔ = −8.89, p = 0.010) were also observed from baseline to follow-up. Relative to Usual Care, wCDSMP participants reported significantly larger improvements in fatigue, physical activity, soda/sugar beverage consumption, and mental work limitations (p < 0.05). The translation of Usual Care (content and format) has potential to improve health among employees with chronic conditions and increase uptake in workplace settings.
Stand Tall—A Virtual Translation of the Otago Exercise ProgramJournal of Geriatric Physical Therapy
Tiffany E Shubert, Anang Chokshi, Victoria M Mendes, Stephanie Grier, Helen Buchanan, Jeanna Basnett, Matthew Lee Smith
2018 Background and Purpose: The Otago Exercise Program (OEP) is effective at preventing falls and fall-related injuries. The resources and personnel required for program delivery and challenges inherent in monitoring participant adherence and compliance pose significant barriers to increasing the number of older adults participating in the OEP. Alternative delivery systems using virtual platforms may pose a solution. The purposes of this article were to (1) describe the “Stand Tall” intervention, a virtual translation of the OEP; (2) describe Stand Tall participant characteristics and fall-related risk at baseline; and (3) identify changes in physical performance measures associated with fall risk from baseline to 8-week follow-up. Methods: This was a quasi-experimental, single-group, pretest-posttest design. Forty-two older adults at risk for falls were recruited. Participants were oriented to Stand Tall by study personnel and then monitored and progressed virtually with face to face check-ins. Participants independently logged in and completed a prescribed a set of exercises 3 times a week for 30 minutes for a total of 8 weeks. Results and Discussion: The average participant age was 75.0 (9.1) years and self-reported 2.3 (1.7) chronic conditions. There were more men than women (52.4%) in the study. Participants were primarily non-Hispanic white (90.5%), had a college education (61.9), 40% reported falling in the past 6 months, and 60% screened positive for mild cognitive impairment. Participants were beginning to show decline in function with average single-leg stance less than 10 seconds and 30-second chair rise scores below normative values. Participants demonstrated high adherence rates (>88%) and significant improvements in physical performance measures associated with fall risk. These results may be limited to a less frail population and the study was not powered to demonstrate a reduction in falls. Conclusions: Results support that an avatar-delivered version of the OEP is effective, feasible, viable, and enjoyable for community-dwelling older adults. These types of platforms should be considered as potential mechanisms to increase availability of fall prevention programs.
Dissemination of Chronic Disease Self-Management Education (CDSME) Programs in the United States: Intervention Delivery by RuralityInternational Journal of Environmental Research and Public Health
Matthew Lee Smith, Samuel D Towne, Angelica Herrera-Venson, Kathleen Cameron, Kristie P Kulinski, Kate Lorig, Scott A Horel, Marcia G Ory
2017 Background: Alongside the dramatic increase of older adults in the United States (U.S.), it is projected that the aging population residing in rural areas will continue to grow. As the prevalence of chronic diseases and multiple chronic conditions among adults continues to rise, there is additional need for evidence-based interventions to assist the aging population to improve lifestyle behaviors, and self-manage their chronic conditions. The purpose of this descriptive study was to identify the geospatial dissemination of Chronic Disease Self-Management Education (CDSME) Programs across the U.S. in terms of participants enrolled, workshops delivered, and counties reached. These dissemination characteristics were compared across rurality designations (i.e., metro areas; non-metro areas adjacent to metro areas, and non-metro areas not adjacent to metro areas). Methods: This descriptive study analyzed data from a national repository including efforts from 83 grantees spanning 47 states from December 2009 to December 2016. Counts were tabulated and averages were calculated. Results: CDSME Program workshops were delivered in 56.4% of all U.S. counties one or more times during the study period. Of the counties where a workshop was conducted, 50.5% were delivered in non-metro areas. Of the 300,640 participants enrolled in CDSME Programs, 12% attended workshops in non-metro adjacent areas, and 7% attended workshops in non-metro non-adjacent areas. The majority of workshops were delivered in healthcare organizations, senior centers/Area Agencies on Aging, and residential facilities. On average, participants residing in non-metro areas had better workshop attendance and retention rates compared to participants in metro areas. Conclusions: Findings highlight the established role of traditional organizations/entities within the aging services network, to reach remote areas and serve diverse participants (e.g., senior centers). To facilitate growth in rural areas, technical assistance will be needed. Additional efforts are needed to bolster partnerships (e.g., sharing resources and knowledge), marketing (e.g., tailored material), and regular communication among stakeholders.
National Study of Chronic Disease Self-Management: Six-Month Outcome FindingsJournal of Aging and Health
Marcia G Ory, SangNam Ahn, Luohua Jiang, Kate Lorig, Phillip Ritter, Diana D Laurent, Nancy Whitelaw, Matthew Lee Smith
2013 Objective: To investigate how the Chronic Disease Self-Management Program (CDSMP) changes health outcomes, lifestyle behaviors, and health care service utilization over a 6 month period. Method: The participants were 1,170 adults enrolled in the National Study of CDSMP in 2010-2012 (M age = 65.4 years). Six-month assessments were available for 903 participants. Linear mixed models and generalized linear mixed models were used to assess the changes between baseline and 6-month assessment for primary and secondary outcomes among CDSMP participants. Results: Social/role activities limitations, depression, and communication with physicians improved significantly from baseline to 6-month follow-up. Study participants reported significant improvements in more physical activity and less emergency room (ER) visits and hospitalization during that period. Discussion: Nationally, CDSMP not only improves health outcomes and lifestyle behaviors but also decreases costly ER visits and hospitalization. Geriatricians and other primary care providers should be encouraged to refer patients with chronic conditions to such self-management programs.