This PTSD-focused methods-development EEG project aims to develop new tools for a) predicting PTSD treatment response, b) understanding the underlying biological process, and c) supporting the development of new treatments for PSTD. We are using an event-related potential (ERP) paradigm to develop non-invasive, easily implemented in clinic biomarker to provide useful information about the neurobiology of PTSD. The specific goals are to 1) collect ERP data within a veteran population before and after treatment with methylphenidate, 2) design data analysis methods that maximize available data, and 3) add to ongoing effort of translating technological advancements for PTSD research.
Geographic Area: Washington
Testing the efficacy of the Helping Educational Leaders Mobilize Evidence (HELM) implementation strategy
This study will examine the efficacy of the Helping Educational Leaders Mobilize Evidence (HELM) implementation strategy for promoting building-level implementation leadership, implementation climate, and high-fidelity delivery of evidence-based practices. This study tests whether HELM improves outcomes when used in conjunction with Positive Behavioral Interventions and Supports (PBIS), an evidence-based practice. The researchers will compare the effects of PBIS implemented with usual supports and PBIS implemented with HELM. They will also explore what for whom, under what conditions, how equitably, and through which processes HELM works to improve student academic outcomes, as well as its cost-effectiveness.
Centering community voices in partnered mixed methods approaches to addressing health disparities with diverse communities
Meaningful partnerships between community and academic/public health co-researchers are needed to address community mental health, wellbeing, and health disparities. Partnerships should center the strengths, needs, and interests of communities on the communities’ terms while building relationships on trust and shared power.
UW researchers in partnership with the Community Health Board Coalition (CHBC) have developed an initial draft of a Community-Centered Approaches to Research and Evaluation (CCARE) Toolkit to guide academic, public health, and community researchers in partnering to act on emerging community data during times of crisis and beyond. As a part of this work, we are striving to better understand and support community health priorities.
NIDA Clinical Trials Network: Pacific Northwest Node
The NIDA Clinical Trials Network (CTN) is a means by which medical and specialty treatment providers, treatment researchers, participating patients, and the National Institute on Drug Abuse cooperatively develop, validate, refine, and deliver new treatment options to patients. The Network consists of 16 regional Nodes, including the Pacific Northwest Node located at the UW Addictions, Drug & Alcohol Institute.
Project RELATE
The present study seeks to significantly expand our understanding of alcohol and cannabis co-use behaviors in the context of young adult romantic relationships through collecting daily dyadic quantitative data and qualitative interviews, and using this information to develop and pilot an integrated brief intervention to decrease alcohol and cannabis misuse and increase healthy relationships skills among this understudied, high-risk group.
Establishing a direct clinical – law enforcement partnership to address dementia crisis intervention across WA state
Although medical care and law enforcement may intersect in an emergency situation, cross-communication and mutual education opportunities prior to the critical tipping point are currently sorely lacking. Our innovative partnership seeks to address these gaps by determining the specific steps dementia clinicians and law enforcement in WA state can take together to improve community health.
For Phase I of this project, we are initiating a direct collaboration between clinicians and law enforcement for dementia crisis intervention, in order to establish appropriate safety measures to be enacted in WA communities. An essential component of ensuring lasting impact can only be achieved by determining the local availability, usability, and effectiveness of proposed safety interventions.
UW dementia specialists will partner with law enforcement across Washington state to jointly identify the resources necessary for effective dementia crisis response. We seek to bridge the gap between medical care and community safety concerns, specifically at a crisis point when a community member feels compelled to summon law enforcement due to perceived significant threat or lack of awareness of other, more appropriate resources. We will conduct interviews with clinicians, police departments, and community stakeholders, review police call logs, and perform ride alongs. The information gathered will be analyzed for major themes related to knowledge and resource gaps, as well as any existing solutions. Three crisis response priorities will be identified, and corresponding “safety packet” content will be outlined in preparation for community partnership input, local adaptations, and ultimately state-wide dissemination.
Partnering with the Quinault Indian Nation to develop a community-based contingency management intervention
Indigenous knowledge remains strong in American Indian/Alaska Native (AI/AN) communities despite colonization, postcolonial efforts to assimilate and eradicate AI/AN people, present-day inequities and structural racism. Despite strength and resilience, AI/AN populations have high rates of unintentional overdose and death by suicide. There is an urgent need for evidence-based, culturally responsive approaches to increase protective factors against substance use and mental illness in AI/AN communities.
This study is a partnership between University of Washington researchers and the Quinault Indian Nation’s behavioral health providers and community. We will design a culturally adapted community-based contingency management intervention to increase positive reinforcement for adolescents and young adults at risk for substance use and mental illness. This intervention will focus on community identified target behaviors rather than abstinence. By prioritizing the needs of the community we will develop an intervention that is effective, usable and sustainable.
Evaluation and dissemination of the TRANSforming Families: Embracing Change with Teens Therapy Group
Transgender and gender diverse (TGD) adolescents experience 4-18 times higher rates of anxiety, 4-23 times higher rates of depression, 11-54 times higher rates of suicidal ideation, and 2-5 times higher rates of suicide attempts compared to their cisgender peers. Importantly, parents/guardians (i.e., caregivers) can have a significant impact on TGD adolescent mental health, with recent research suggesting that caregiver support and acceptance are associated with a 30-40% reduction in these mental health concerns.
Community-based support groups are common practice with TGD adolescents and families. However, group intervention programs that work specifically with caregivers are rare, and existing programs have not been formally evaluated. Therefore, the goal of this project is to evaluate TRANSforming Families: Embracing Change with Teens, a virtual, multi-family program that was developed by mental health providers in the Seattle Children’s Gender Clinic (SCGC), to understand its impact on caregiver support and acceptance and adolescent mental health. This partnership between SCGC mental health providers and researchers will represent one of the first formal evaluations of a group intervention program for caregivers of TGD adolescents, the results of which can inform future implementation and evaluation of this program in pediatric gender clinics across the United States.
Partnering with community pharmacies to enhance access to long-acting injectable antipsychotics in Washington State
Medication nonadherence is common among patients with serious mental illness, including schizophrenia. The use of long-acting injectable antipsychotics (LAIAs) for schizophrenia is an evidence-based practice that improves medication adherence, decreases symptomatic recurrence and reduces hospitalizations. However, patients and clinicians often face several challenges in access and coordination resulting in the underutilization of LAIAs in care.
Administering LAIAs at community pharmacies could potentially increase accessibility, reduce barriers for treatment and improve patient outcomes. This project aims to assess the fit or compatibility of LAIA administration in community pharmacies. We will survey community pharmacy staff and behavioral healthcare providers in Washington State to assess the acceptability, appropriateness and feasibility of LAIA administration in community pharmacies. If LAIA administration at community pharmacies is found to be a good fit, the next steps will be to develop strategies to support implementation. A scalable and adoptable model for administering LAIAs at community pharmacies could have substantial impacts on public health through increasing access to treatment and expanding behavioral health services at the community level and in rural areas.
Development of an mHealth support specialist for early psychosis caregivers in Washington State
Early intervention can significantly improve the trajectory of a young adult at risk for psychosis. Specialized treatment programs for youth at risk are associated with reduced symptoms and relapse risk and increased functioning. Family caregivers play a critical role in facilitating treatment engagement and recovery, but too often they lack the support they need. Specialty psychosis services providing psychoeducation for family members are expanding but still difficult to access. Caregivers face many barriers to care: limited providers and session time availability, long travel times, or patient ambivalence about treatment. As a result, a minority of youth with early psychosis have caregivers that have accessed standard-of-care family interventions.
To address these gaps, our team developed Bolster, a mobile health (mHealth) app designed to provide psychoeducation, communication coaching, and self-care support to caregivers to youth at risk for psychosis. In preliminary work, Bolster was feasible to deliver, acceptable to caregivers, and showed promising efficacy. However, mHealth interventions that are supplemented by a human clinical support have higher engagement and effectiveness than those that are purely self-guided. To optimally implement mHealth for early psychosis caregivers, there is a need for development of this clinical workforce.
We propose to develop and pilot an emerging clinical role – the mHealth support specialist (mHSS) – equipped specifically to support caregivers to youth with early psychosis. Specifically, we will (1) develop a training and supervision framework supporting the mHSS for caregivers, (2) test this framework through training and supervising one mHSS, and (3) evaluate this approach as the mHSS provides support to caregivers to young adults with early psychosis throughout Washington State. Delivering this intervention has the potential to greatly expand population access to evidence-based strategies for psychosis. Developing the mHealth support specialist model would make Washington a national leader in scalable digital interventions for caregivers. This study takes a critical step toward realizing that vision.
