Geographic Area: Seattle/Puget Sound

The RECOVER study: testing online platforms to identify patients with persistent post-COVID symptoms

After COVID infection, 10-50% of people experience persistent symptoms such as fatigue, palpitations, insomnia, cognitive problems, and headache – often with significant associated distress and functional impairment. The exact combination of symptoms varies from person to person, and it is expected that the specific causes vary from person to person as well.

Because of this variability, the current recommendation is for an evaluation by a multidisciplinary team. This creates a demand on our medical system that far outstrips current resources, and risks exposing patients to long, complex medical evaluations whose results are hard to interpret. In addition, clinical treatment trials that mix patients with similar symptoms but different underlying causes have high failure rates.

To address these challenges, a team of investigators including Rebecca Hendrickson, MD, PhD (Department of Psychiatry and Behavioral Sciences), John Oakley, MD, PhD (Department of Neurology), and Aaron Bunnell, MD (Department of Rehabilitation Medicine) are testing an online platform to identify patients whose pattern of symptoms suggest a particular underlying cause that is common after certain physiologic (i.e. illness or injury) and psychological stressors: increased adrenergic (adrenaline/noradrenaline) signaling in the brain and peripheral nervous system. We will pair this with a smaller number of detailed in-person assessments to validate our symptom-based measures and characterize associated biomarkers.

Our results will provide a detailed assessment of the patterns of symptoms caused by high amounts of adrenergic signaling that are seen in persistent post-COVID syndrome, how they change over time, and their association with objective measures of cognition and physiology. The project will provide the information needed to begin clinical treatment trials using existing, well-tolerated treatments that modulate adrenergic signaling. We hope the results will also have strong relevance to other potentially related disorders such as Myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) and fibromyalgia.

Developing measurement-based care tools for addiction treatment clinics

This research develops and tests digital technology to help clinicians and patients systematically measure and monitor clinical progress during addiction treatment. The technology is being developed based on end-user input and user-centered design methods and will be pilot tested as an add-on to real-world care in an addiction treatment clinic.

Decision During Drinking (D3 Study)

This multiphase project aims to 1) understand more about cues that young adults experience that influence their decisions while drinking that may lead to unwanted outcomes or experiences; and 2) use human center design and young adult feedback to develop and assess the feasibility of an electronic program or resources to focused on reducing these outcome from drinking. 

Lay-delivered behavioral activation in senior centers

This collaborative study with Cornell Medical College and the University of Florida tests the effectiveness of “Do More, Feel Better” (DMFB), a lay health delivered behavioral intervention, in comparison to professionally-delivered Behavioral Activation. The specific aims are to test the effectiveness of “Do More, Feel Better” for depressed older adults on increasing overall activity level and reducing depression symptoms.

Staying in Touch and Engaged Project (STEP)

The “Staying in Touch and Engaged Project” (STEP) aimed to support Housing First residents in staying in touch with researchers and in engaging in meaningful activities during the COVID-19 outbreak and social distancing directives. A 16-week, two-group randomized controlled pilot trial compared remote assessment of substance-use and health-related quality of life assessment paired with immediate versus delayed provision of remotely delivered meaningful activities. The aim of this project was to test whether the meaningful activities package (MAP) engages residents and improves their mood, substance-use outcomes, and physical and mental health-related quality of life.

The project team mailed study invitations to residents in five housing programs (estimated mailed N=538). To date, 32 Housing First residents reached out to consent to participate, responding via mailed consent forms, phone, video conferencing or online survey completion. Of those who consented, 26 have completed baseline assessments, and 11 have completed one-month follow-ups. The study highlighted the difficulties in reaching residents, partly due to the lack of communication technologies.

The team found that the technological divide has grown deeper and more consequential during the pandemic and must be bridged to facilitate social connection, physical and mental health, and basic communication for people marginalized by the lived experience of homelessness and psychiatric, medical and substance use disorder. The team is working to locate additional funds through the UW and WSU to continue participant recruitment and evaluation efforts, achieve the originally proposed sample size and further improve follow-up rates.

MOVE!+UP: Testing a tailored weight management program for Veterans with PTSD

This Hybrid Type 1 Trial will test the effectiveness of MOVE!+UP, a behavioral weight management intervention tailored to address PTSD-based weight loss barriers. The trial will compare MOVE!+UP to VA’s standard weight loss program on weight and PTSD symptom changes. The study also will identify implementation barriers and facilitators to help understand effectiveness findings and inform future implementation.