Patient Population: Adults

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.

PATHSS Study: Participatory Active Transportation for Health in South Seattle

This observational study will examine mobility challenges and opportunities among people living and working in South Beacon Hill using participatory research methods: 1) community member photography-enhanced storytelling (photovoice), 2) interviews with Beacon Hill stakeholders and community members, and 3) mobility audits.

Innovative training for suicide prevention in addiction treatment settings

Although suicide is one of the leading causes of death for people with substance use disorders (SUDs), no widespread suicide prevention intervention exists for delivery in community addiction treatment settings. The effectiveness and feasibility of delivering Preventing Addiction Related Suicide (PARS), a group-based psychoeducational program that provides evidence-based suicide prevention and safety strategies, was recently demonstrated by the UW Center for Suicide Prevention and Recovery.

To enhance widespread implementation and dissemination of PARS, this project will develop online training and implementation tools. PARS-Web will be created in collaboration with key state agencies and suicide prevention professionals to meet the new training requirements for Washington State Chemical Dependency Professionals. The goal is to integrate PARS as a part of standard care in addiction treatment agencies nationwide.

Brain Injury Rehabilitation: Improving the Transition Experience (BRITE)

Moderate to severe traumatic brain injury (TBI) is a common cause of long-term disability. Persons with TBI receiving care in inpatient rehabilitation facilities (IRFs) are at risk for rehospitalization, poor community reintegration, family stress, and other unfavorable outcomes. In a six-center randomized pragmatic comparative effectiveness study, we compare the effectiveness of two methods for transition from IRF to the community. The Rehabilitation Discharge Plan (RDP) includes patient/ family education and referrals for continued care. The Rehabilitation Transition Plan (RTP) provides RDP plus individualized, manualized care management via phone or videoconference. 900 patients will be randomized, with caregivers also invited to participate. Assessed outcomes include societal participation, quality of life, caregiver well-being, and use of healthcare resources at 6-months and 12-months post-discharge.

Using technology to optimize Collaborative Care management of depression in urban and rural cancer centers (SCOPE)

This project aims to improve the treatment of depression in cancer patients. Up to 25% of people with cancer will become clinically depressed, significantly affecting their quality of life, functioning, and ability to tolerate cancer treatment. Unfortunately, about 75% of cancer patients with depression do not receive adequate treatment, and patients in rural settings are even less likely to receive adequate care. This study uses a human-centered design approach to develop, build, and test a web and mobile platform to enhance the implementation and fidelity of collaborative care management (CoCM) of depression for patients being treated at urban and rural cancer centers. In Phase I, patient-facing web and mobile applications and a clinician facing website will be developed. In Phase II, the technology-enhanced system will be compared to usual CoCM in a pragmatic effectiveness-implementation randomized controlled trial.

Impact of medical and recreational marijuana laws on cannabis, opioids and psychiatric medications: national study of VA patients, 2000 – 2024

We will analyze Veterans Health Administration electronic medical record data to determine the effects of medical marijuana laws (MML) and recreational marijuana laws (RML) on cannabis (use and cannabis use disorder); opioids (prescriptions, fatal and non-fatal overdoses, opioid use disorders); and psychotropic medication prescriptions, providing important information on MML and RML effects in VA patients and in others with similar vulnerability factors to researchers, policy makers, health professionals and the public.

Preventing addiction related suicide

To evaluate the use of an existing selective suicide prevention intervention, Preventing Addiction Related Suicide (PARS), for use with Veterans by: 1) adapting and tailoring content to Veteran populations and 2) conducting an open trial within a VA substance use disorder intensive outpatient program.

Evaluating the Stepped Care for Opioid Use Disorder Train-the-Trainer (SCOUTT) Program

The Stepped Care for Opioid Use Disorder Train-the-Trainer (SCOUTT) program is a national VA initiative which aims to improve access to treatment medications for opioid use disorder (OUD) in primary care, pain management, and mental health clinics. The Seattle CESATE is conducting ongoing evaluations of SCOUTT to understand providers’ perspectives on the initiative and the outcomes for Veteran participants. Project aims also include to: assess patient retention in and compliance with SCOUTT, assess changes in number of waivered and prescribing providers, retention in and compliance with stepped care, and identify barriers and facilitators to implementing, sustaining and spreading OUD care.

Mapping SUD treatment in VA using administrative data

The Mapping SUD Treatment in VA Using Administrative Data: Identifying Similarities and Differences Between Women and Men Veterans project is using VA administrative data to evaluate the uptake and receipt of SUD-oriented treatment among all Veterans with a chart diagnosis of SUD enrolled in VHA from FY14 to FY18. Location of care, referral patterns, and characteristics of Veterans obtaining SUD care in different treatment settings will be evaluated stratified by gender.