Using a “whole body, whole lifespan” approach, we will investigate how alterations in the immune and endocrine systems induced by prenatal alcohol exposure may be key drivers of early-onset health and functional deficits in adults with fetal alcohol spectrum disorders.
Patient Population: Adults
Guiding opioid therapy University of Southern California (USC) / National Institute on Aging (NIA)
Patients on long-term opioid therapy are aging and now face magnified risk of harm with continued high-dose opioid use. These increased risks are due to age-related changes in drug metabolism, multi-morbidity, and polypharmacy. The dominant approach to mitigate these risks is to screen for aberrant patient opioid behaviors, with assessments like the Current Opioid Misuse Measure (COMM), so that clinicians can pre-empt misuse early through review of contractual opioid agreements or by lowering patient dosages. By focusing on opioid misuse alone, this strategy encourages forced opioid tapering that is associated with opioid overdose and mental health crisis. Many persons have mental health, trauma-related or polysubstance use disorders that need to be addressed. Directing clinician attention to the comorbid conditions associated with opioid misuse may promote safer and more effective care. Such an approach provides a broader understanding of the pain experience and may help address the reasons why patients use or misuse opioids.
The specific aims are: (1) to develop a simple experimental approach for the collection of clinical pain data and for assessing, preventing, and managing pain in later life through the electronic health record; and (2) to assess the comparative effectiveness of PainTracker, a set of questions that targets a broad range of problems associated with pain, in a randomized controlled trial.
Needs Assessment for Supporting Technology use and Harm Reduction (STaHR Study)
The proposed study entails a needs assessment to develop a program for Supporting Technology use and Harm Reduction (STaHR) among HF residents with lived experience of homelessness and substance use. This study will qualitatively explore HF residents’ technology literacy as well as their perspectives on barriers and facilitators to the use of technology, broadly, and for harm-reduction service provision. Then, with a community advisory board (CAB) made up of HF residents, staff, and management, we will inform and provide recommendations to HF management and leadership ways to improve HF resident technology use and engagement with online harm-reduction services.
eHaRT-A: adapting an in-person harm reduction for alcohol intervention into a telehealth platform
The unprecedented global pandemic has highlighted the digital divide and limited access to alcohol-related treatments among marginalized communities, specifically individuals with lived experience of homelessness. In line with the NIAAA health initiative seeking to integrate technology-based interventions among vulnerable populations, this study directly addresses this mission by proposing innovative methods (i.e., user-centered design + a community based participatory research framework) to adapt an in-person harm reduction for alcohol (HaRT-A) intervention into a telehealth platform (eHaRT-A) that can then be tested and successfully implemented into low-barrier Housing First settings. As healthcare continues to move more services online, it is essential to understand ways to successfully adapt and implement rigorously tested telehealth treatment services for marginalized communities to ameliorate alcohol-related harms.
Preparing teachers and paraprofessionals for the successful inclusion of children with ASD (ASD PREP)
The purpose of this IES study is to identify what EBPs teachers and paraeducators use to more meaningfully include and retain autistic in general education settings; and the malleable individual and organizational characteristics that increase EBP use.
Autism Intervention Network on Behavioral Health (AIR-B)
The purpose of this multi-site study is to develop and evaluate a multi-phase implementation and sustainment strategy to support evidence-based practice use across different interventions for individuals with autism, settings, and ages.
*In partnership with UCLA, UC Davis, Rochester, Penn, Drexel, and Kansas
Autism Community Toolkit: Systems to Measure and Adopt Research-Based Treatments- Educational Redesign (ACT SMARTER)
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.
Developing a digital training resource for clinicians learning CBT for psychosis (CBTpro)
The Cognitive Behavioral Therapy Training Study will rigorously test CBTpro — a novel tool that uses spoken language technologies and conversational Artificial Intelligence to train behavioral health practitioners in Cognitive Behavioral Therapy. We conducted a 2-week field trial, followed by a Randomized Clinical Trail in community mental health agencies to evaluate both learner and client outcomes. The study aims to expand global access to CBT training to students and practitioners, support quality psychological treatments for clients with a range of behavioral health disorders (including Serious Mental Illness), and support ongoing clinical quality assurance in routine care settings.
eHaRT-A
The unprecedented global pandemic has highlighted the digital divide and limited access to alcohol-related treatments among marginalized communities, specifically individuals with lived experience of homelessness. In line with the NIAAA health initiative seeking to integrate technology-based interventions among vulnerable populations, this study directly addresses this mission by proposing innovative methods (i.e., user-centered design + a community based participatory research framework) to adapt an in-person harm reduction for alcohol (HaRT-A) intervention into a telehealth platform (eHaRT-A) that can then be tested and successfully implemented into low-barrier Housing First settings. As healthcare continues to move more services online, it is essential to understand ways to successfully adapt and implement rigorously tested telehealth treatment services for marginalized communities to ameliorate alcohol-related harms.
Cultural adaptation of WHO’s Caregiver Skills Training program for Mongolian parents of autistic children
In Mongolia, there are virtually no services or professionals who can provide any related services for autistic children and their families. In response to these disparities of autism care in many countries, the WHO developed the Caregiver Skills Training (CST), which is a training program that teaches basic behavior management skills that are often needed for caregivers of autistic children. Although CST can be widely disseminated among Mongolian families, it has not been translated or adapted to fit the needs of Mongolian caregivers due to logistical difficulties and costs. This project aims to: (a) conduct rigorous cultural adaptation and translation of the CST materials, and (b) demonstrate community-academic partnership and a model for global collaboration in autism intervention research
