The major goals of this project are to develop an interactive, virtual standardized patient to allow VA providers to practice implementing suicide safety planning with training feedback. The project includes a formative evaluation, usability testing, and a randomized pilot trial focused on evaluation of skill acquisition and transfer.
Patient Population: Caregivers/Providers
Conceptual design of a virtual standardized patient for suicide safety planning in the Department of Defense
The major goals of this project are to conduct a needs assessment for suicide safety planning training among Department of Defense (DoD) healthcare providers and design paper documentation to support the future development of a virtual standardized patient specific to the needs of DoD providers.
Improving resilience and recovery from traumatic events using the ECHO model
Most adults in the US experience a traumatic event at some point in their lives. Trauma is linked to the development of mental health disorders, increased suicidality, work and relationship impairment and increased physical health conditions. Effective treatments exist, but many people don’t receive these treatments because of a lack of providers who are trained in evidence-based, trauma-focused treatment, especially those in rural or underserved areas.
This project aims to build, implement and test an ECHO (Extension for Community Healthcare Outcomes) model for disseminating evidence-based, trauma-focused care, both psychotherapy and pharmacotherapy approaches, to providers working with underserved communities in Washington state. The team will evaluate the impact and reach of the training model, with the goal of expanding the ECHO approach to improve trauma-informed mental health care throughout Washington.
Development and testing of a research-based Tier 3 Wraparound model for schools
This project will adapt the defined, research-based, Wraparound care coordination model for youth with complex behavioral health needs to the education environment, including training curricula, installation protocols, fidelity measures, and other components. The project will initially convene national experts and local stakeholders who will review and aid in iterative refinement of materials, followed by a small-scale pre-post pilot, and culminating in a small-scale randomized pilot study comparing proximal and distal outcomes for 60 students in 6 elementary schools assigned to the “Tier 3 Wraparound” protocol versus services as usual.
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.
Engaging families of children with rare genetic disorders via a novel online platform
The goal of this project is to engage more families of children with CHD8 mutations with a novel online platform (GroopIt) and to empower families to be partners in research. We are utilizing a community-based participatory research (CBPR) approach to enable families to identify research priorities. Through an established Facebook group for CHD8, families will be surveyed to prioritize research topics of interest that were identified in previous focus groups, such as parenting stress or gastrointestinal problems. The use of the updated GroopIt platform as an innovative, online tool will increase both the engagement and accessibility of research to families of children with rare genetic disorders associated with ASD.
Disseminating a user-friendly guide: Advancing the science of intervention adaptation and improving access to evidence-based psychological treatment
Adaptation of evidence-based practices and programs (EBPs) is a necessary component of the implementation process. EBPs must be adapted to function with the constraints of real-world practice settings, providers’ expertise, and patients’ needs. The science of intervention adaptation is hungry for well-defined methods of EBP adaptation to guide decision making. A how-to guide for EBP adaptation titled MODIFI: Making Optimal Decisions for Intervention Flexibility during Implementation, is under development with NIMH funding (F32 MH116623). MODIFI will be disseminated via multiple strategies locally, nationally, and internationally. Dissemination of MODIFI will improve the practice of intervention adaptation by providing practitioners with a how-to guide that is (a) evidence-based, (b) usable, and (c) supported by the expert consensus of implementation practitioners and researchers.
Attitudes, readiness, and adoption of digital health in community mental health centers during COVID-19 pandemic
The current study seeks to establish a baseline understanding of Community Mental Health Center (CMHC) adoption, readiness and attitudes towards digital mental health technologies overall and in the context of limited in-person availability. Mixed-method research strategies will be employed to survey and interview CMHC providers in these community settings.
Developing digital health resources for young adults with early psychosis and their families
This multi-component project aims to (1) gather information about the digital-health related needs, interests, and preferences of young adults with early psychosis and their families, and (2) develop digital health resources that meet those needs. We have collaborated with colleagues to identify interests and needs of family caregivers, and are currently surveying affected young adults. We are also working with a software developer to build a Beta version of a family caregiver-facing mobile health tool providing relevant support and psychoeducation.
