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.
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.
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.
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.
This project examines changes in young adult substance use, related health risk behaviors, and substance use-related risk factors from before to during the COVID-19 pandemic among young adults in WA state (where alcohol, tobacco, and cannabis sales and use are legal for adults age 21 and over) using the accelerated longitudinal cohort sequential data from the Washington Young Adult Health Study. Findings will inform tailoring and development of prevention and intervention efforts aimed at reducing health risk behaviors and improving public health in emergent situations that pose serious challenges for effective long-term planning of such efforts.
The aims of the current project are to: 1) Engage stakeholders to identify targets for ACT SMART redesign to optimize its fit for middle and high school providers who serve autistic adolescents; 2) Conduct prototyping and usability field testing of the redesigned ACT SMART and iteratively refine to ensure usability, feasibility, acceptability, and appropriateness for use in schools.
This project provides direction, training, technical assistance, and evaluation of the Parent-Child Assistance Program (PCAP) being implemented by 13 community agencies and 15 sites serving 20 counties and up to 1490 mothers/families in Washington State.
