Patient Population: Adults

Psychosis beyond symptoms: Cognitive and genetic biomarkers of schizophrenia

Schizophrenia is a prevalent, debilitating psychiatric disorder that is diagnosed based on clinical interviews that are subjective and highly variable; in fact, two patients can have no overlapping symptoms and be diagnosed with the same disease. While cardiologists have blood tests to help diagnose heart attacks and oncologists have PET scans to find hidden cancers, psychiatrists don’t have objective diagnostic tests. This proposal will utilize machine learning to analyze cognitive tests, brain electrical activity, and genetic signatures from 1,415 patients with schizophrenia and 1,062 controls to uncover biomarkers of schizophrenia. By incorporating biomarkers into diagnostic standards, psychiatrists could one day order a simple test that could help them confidently diagnose schizophrenia and make better treatment decisions based on quantitative rather than subjective measures.

Exploring the implementation determinants of paraprofessional task-shared mental roles in integrated behavioral care settings in Washington State 

The gap between the number of people needing and accessing mental health care has led to the development of new types of mental health providers to help expand access to care. These providers, referred to as paraprofessionals, have typically at most a bachelor’s degree and treat mild and moderate depression and anxiety. However, because the novelty of these roles in the Unites States, little is known about organizational and employee barriers to uptake and implementation. Further, little is known about US patient perspectives on having a paraprofessional mental health provider. The proposed research explores behavioral health employer, behavioral health employee, and patient perspectives on two new paraprofessional roles being deployed in Washington State – the mental health Community Health Worker and the Behavioral Health Support Specialist – to help identify key barriers and facilitators to implementation of these roles.

Validating changes in a primary-care based alcohol use screening instrument for predicting changes in risk for psychiatric acute care utilization

Approximately 20-25% of primary care patients have unhealthy alcohol use, which can have significant impacts on mental health. Screening for unhealthy alcohol use within primary care settings is increasingly used for point-in-time identification of people who could benefit from brief advice or brief interventions. My project will use a large, longitudinal, real-world dataset consisting of electronic health record (EHR) and insurance claims records to test whether longitudinal changes in alcohol screening scores completed by primary care patients as part of routine care are associated with changes in one-year risk for psychiatric acute care utilization (i.e., emergency department visit or hospital encounters primarily for a mental health condition).

Event- related potential (ERP) as a biomarker for subtyping neurobiology of PTSD: A pilot study

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.

Self-directed mindfulness in medically hospitalized patients: a pragmatic trial

Consultation-liaison psychiatrists are often asked to manage mood and anxiety symptoms experienced by patients admitted to medical and surgical floors of the hospital. This study aims to determine the feasibility and effectiveness of a self-directed mindfulness intervention as an adjunctive treatment for improving mood, anxiety, and perceived stress in medically hospitalized patients. Participants, consisting of patients evaluated by the consultation-liaison psychiatry service, will be randomized to an adjunctive mindfulness intervention group or a treatment-as-usual control group. Feasibility and acceptability of implementing a mindfulness intervention will be assessed. Group differences in the changes in symptom severity and psychotropic medication administration will be investigated.

School-Based Paraeducator Education for Engagement at Recess (SPEER)

The purpose of this study is to compare two implementation strategies for a social engagement intervention that supports autistic children and their non-autistic peers during recess. Remaking Recess has been shown to improve peer engagement for autistic students when implemented by paraeducators during recess. However, without supports, paraeducators face barriers to implementing the intervention well. This study compares paraeducators’ use of Remaking Recess when they receive coaching alone and when they receive coaching along with consultation from school-based teams.

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.

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.

Opportunities for trainees may exist but a VA WOC appointment is required.

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.

Opportunities for trainees may exist but a VA WOC appointment is required.