Geographic Area: Seattle/Puget Sound

Behaviors and Executive Skills in T21 (BEST21)

We are conducting a study to understand the role of problem-solving in challenging behaviors for children with Down syndrome so that we can better understand the development of and treat these behaviors. If you agree to participate, this study will involve questionnaires, some of which may be completed at home. You would also attend an in-person visit that involves measuring your child’s naturally-occurring brain activity with EEG as well as cognitive assessments. We would schedule your visit around your schedule to the best of our ability and we can schedule this visit in a location that is convenient for you (UW, home visits, etc.). Participants will receive an $80 gift card to thank them for their time.

Adapting a brief suicide intervention for pediatric primary care: Enhancing uptake and impact

This project aims to partner with rural, urban, and suburban pediatric primary care practices in Western Washington to improve access and effectiveness of suicide prevention programs through adapting the SAFETY-A intervention for use in primary care settings. This project has the following aims: (1) assess needs of primary care staff, patients, and parents/caregivers for suicide prevention services in primary care, (2) iteratively design and refine a SAFETY-A based suicide prevention model of care prototype for primary care, (3) Pilot test the model of care, compared to treatment as usual, with 3 primary care clinics in rural, urban, and suburban settings.

Telehealth-delivered peer support to improve quality of life among Veterans with multimorbidity

We developed VetASSiST (Veterans Activating Social Support for Self-management and Treatment engagement) to help patients with multimorbidity overcome barriers to self-management and improve HRQoL. This trial has several aims: 1) Test the effect of VetASSiST, compared to usual care, on the primary outcome of baseline to one-year change in physical HRQoL, and secondary outcomes of mental HRQoL and health care utilization; 2a) Describe differences between VetASSiST and usual care on baseline to one-year changes in intermediate outcomes reflecting the functions of peer support and intervention targets; 2b) Examine whether intermediate outcomes mediate intervention-associated differences in HRQoL; and 3) Evaluate feasibility of translating VetASSiST into practice.

Harnessing the power of social support for weight management: a randomized controlled trial of HealthyTogether

We developed a behavioral intervention that seeks to support healthy lifestyles among Veterans by harnessing their social support networks called HealthyTogether. This trial has several aims: 1) Test whether HealthyTogether results in greater weight loss than usual care at six months among Veterans (primary); 2) Examine differences between HealthyTogether and usual care groups in secondary Veteran and partner outcomes, including health behaviors and relationship quality; 3) Examine Veteran and partner contributions to changes in their own and each other’s outcomes using dyadic analyses; and 4) Assess determinants of implementation.

Community resilience to late life depression among first generation Asian Indian immigrants in the greater Seattle area (The CREED Seattle Study)

Asian Indians, are one of the fastest growing ethnic groups in the country, growing from 1.9 million (2000) to 4.6 million (2020). With a median household income of $119,000, Asian Indians are highly educated (43% have a postgraduate degree), are proficient English speakers (82%) and are often touted as a “model minority”. While these data create an impression of general well-being and success, there is limited information on the mental health of this community, as most research tends to aggregate results of the Asian population. Aging and age related mental health issues, especially late life depression in the community, in particular, has been under-studied. As culture exerts a significant influence on psychiatric morbidity, it is likely that this population has unique drivers to late life syndromic and subsyndromal depression beyond what is known from typical studies. Additionally, migration related, as well as acculturative stress, may provide unique influences. However, immigrant Indian communities are known for community engagement, providing large social networks and support which may reduce risk for depression. As a result, it is possible that higher risk resulting from immigration related stress might be mitigated by social engagement. This project will study older first-generation Asian Indians in the Greater Seattle Area to study the association between community engagement and depression symptoms.

Adopting a lifespan approach for ADHD management

ADHD is common, heritable and impairing. As recognition of the negative functional impacts associated with ADHD in adulthood has grown and stigma around the diagnosis has diminished, demand for ADHD care across the lifespan has increased.

This project will begin foundational work to inform the development of a family-focused lifespan clinic at UW serving adults and children with ADHD. For such a program to be effective, equitable, and sustainable, we must clarify the true needs of individuals living with ADHD as well as the professionals caring for them. We will convene four groups of key community partners: (1) Adults with ADHD whose children have ADHD, (2) Adolescents with ADHD, (3) Mental health professionals representing the fields of psychiatry, psychology, psychiatry advanced practice nursing, school-based counseling, (4) Primary care providers. Results will guide program development and illuminate future research opportunities.

Assessing need and acceptability of a family intervention for individuals with Opioid Use Disorder

Many people love someone who uses substances in a harmful way and want to help that person. Family members and friends often are key supports in people seeking and staying engaged in treatment and services. At the same time, family members and friends feel like they lack the skills or support to help their loved one effectively. This may be especially true for opioid use disorder, where the strongest evidence for treatment is for medication for opioid use disorder, but families and friends don’t know how to help their loved ones access and stay on these life-saving medications.

Our study will talk with people who are getting medications to treat opioid use disorder and ask about the involvement of their family members and friends in their lives and recovery. We will reach out to these key supports to ask how they would want to do a group-based program to help them develop skills and knowledge to support their loved one’s care. These groups would be delivered by nurses with specialized training in opioid use disorder and treatment. Group content will be based on an existing, evidence-based treatment designed for family members and will help people understand the role of medications in treating opioid use disorder and teach skills to support their loved one.

Implementing contingency management in a supportive housing context to promote resident well-being

Mental health and substance use disorders carry complex needs of living that are often poorly-served by our health systems, which result in immense societal costs. This has prompted federal recognition of supportive housing among the vital conditions that support the long-term recovery and resilience of our citizenry. Supportive housing offers safe living environs where residents access services such as harm reduction supplies and referral to recovery-oriented activities like peer support groups and workplace re-entry programs. To maximize the benefit that residents experience from such services, behavioral health staff working in supportive housing contexts should implement useful psychosocial therapies to spur greater service utilization by residents.

One such therapy that has proven useful among persons with mental health and substance use disorders is contingency management (CM), in which one earns tangible rewards for demonstrating desired behaviors like attending a support group, taking a prescribed medication or completing workplace re-entry paperwork. Given the robust and reliable therapeutic impacts of CM, there is much to be gained from its implementation in supportive housing environs. For several years, the project lead Dr. Hartzler and his team at the UW Center for Advancing Addiction Health Services (CAAHS) have provided comprehensive technical assistance to regional treatment settings to facilitate design and successful implementation of sustainable CM programming. Also, UW project collaborators Drs. Fockele and Leyde have built working relationships with Downtown Emergency Services Center (DESC) while exploring interest in CM among its staff and residents. This convergence of acute community need, an experienced team offering technical assistance and an established academic-community partnership highlights an opportunity in which CM will be implemented in DESC-governed supportive housing facilities to increase resident utilization of beneficial services.      

Biomarkers in the retina for prognosticating mental health treatments (BRIGHT)

This clinical trial is designed to pilot an electroretinogram (ERG) biomarker for predicting treatment response to SSRIs in PTSD. Serotonergic brain centers project to the retina, and ERG allows assessment of brain serotonergic signals via retinal signals. In this study we are characterizing the ERG waveform in veterans with PTSD before and after SSRI administration. Patients then enter an open label phase of the study, with those who have initiated an SSRI through routine medication management invited back for a follow up study visit. This pilot data will: 1)be valuable as a feasibility study for assessing the practical application of ERG in the setting of a mental health clinic and 2)serve as a foundation for a long-term goal of developing physiologic biomarkers to match veterans to corresponding pharmacological treatments in PTSD and other mental health disorders.