This supplement seeks to expand the Collaborative R01 on Lay-delivered Behavioral Activation in Senior Centers for clients whose preferred language is Spanish. The aims are to translate DMFB intervention materials and and test the effect of Spanish DMFB in comparison to professionally-delivered BA (Clinician BA) among older senior center clients on increased activity level and decreased depressive symptoms.
Practice Type: Community-Based Organizations
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.
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
Optimizing mental health first-aid programming for sport coaches
Many sport organizations are increasingly vocal about the importance of athlete mental health. Helping organizations move beyond rhetoric to improved athlete wellbeing and safety requires evidence-based resources that are setting-appropriate and feasibly implemented.
This project will develop and obtain feasibility and acceptability data on “Time Out for Mental Health”—a mental health first aid training for sport coaches. This will be accomplished by adapting an existing evidence-based mental health first aid resource to the coach role and sport setting, working closely with a small group of coach partners. The team will focus on ensuring the training is considered useful and feasible by coaches who work in resource deprived school and community-settings given the heightened needs and challenges of youth in such settings, and will train coaches to deliver “Time Out for Mental Health”—to build organizational capacity. “Time Out for Mental Health”—has the potential to strengthen connections between sports organizations and school- and community-based mental health services for millions of adolescents as more than half of high school students play at least one organized school or community sport.
Adapting a resilience intervention for youth athletes
Youth mental health is in crisis and we do not have adequate providers to treat the current burden of illness. We must identify innovative approaches to support youth mental health that utilize the existing infrastructure and can be administered by non-clinicians. While sports are predominantly a positive outlet for youth, they also bring stressors due to experiences with failure, injury and challenging time commitments, and thus provide an ideal laboratory to develop coping skills for managing stress.
This project aims to build psychological resilience in high school athletes by adapting an intervention developed for youth with chronic illness (PRISM). The intervention will be delivered through the coach via an educational platform with five modules: 1) background/ psychoeducation; 2) creating a supportive team culture; 3) stress management (breathing exercises, visualization and mindfulness); 4) mindset (goal setting, cognitive reframing and meaning making); and 5) fueling the machine (sleep and nutrition). The team will utilize a community-engaged research process to adapt the PRISM approach to an athletic space, using the term “Mentally Strong” to center it in the sport context, and will partner with youth athletes and coaches to ensure the tools we develop support their needs. The Mentally Strong approach has the potential to increase the emotional literacy of a broad swath of high school youth beyond the athletic environment, enhancing their ability to negotiate the acute and chronic stressors they encounter in daily life. The ultimate goal of the project is to prevent the outcomes which occur with negative emotional coping—including depression, anxiety, substance use, burnout, violence, withdrawal from school and even suicide.
Housing stability for youth
The Housing Stability for Youth (H-SYNC) model was developed by the UW CoLab team in collaboration with Snohomish and Kitsap County workgroups and is intended to serve as a prevention tool for youth homelessness. Specifically, it’s designed to identify youth at risk of or currently experiencing homelessness within existing processes in juvenile court systems and refer youth and their families to appropriate prevention and housing services via a stepped-care navigation model. The court system serves as a pivotal resource for the identification of these populations in need due to the high frequency of police and court contact these populations experience. This model is being implemented in four counties in Washington State, including King, Snohomish, Kitsap, and Okanogan Counties and in collaboration with community-based organizations such as the YMCA of Greater Seattle, Cocoon House, and Kitsap Mental Health Services.
As of 2022, H-SYNC prevention program is coordinated by the Y Social Impact Center at the YMCA of Greater Seattle. H-SYNC now represents a state-wide partnership between juvenile courts and local social service providers across counties including King, Snohomish, Peirce, Spokane, Okanagan and Kitsap.
A cluster-randomized controlled trial testing the effectiveness of the Life Enhancing Alcohol-management Program (LEAP) for Housing First residents
| People experiencing chronic homelessness comprise a small yet high-morbidity, high-cost subset of the larger homeless population and are disproportionately impacted by alcohol-related harm. This study proposes a cluster randomized controlled trial of an innovative, community-based, and client-driven program known as the LEAP to explore its impact on substance use and quality of life outcomes among individuals with lived experience of homelessness and alcohol use problems living in Housing First settings. Analyses will test LEAP effectiveness in increasing engagement in meaningful activities, decreasing alcohol use, ameliorating both first- and secondhand alcohol-related harm, and improving quality of life for this population. |
Harnessing the ECHO Model to help Washingtonians with Traumatic Brain Injury (TBI)
Traumatic brain injury (TBI) is a major cause of disability in Washington state and throughout the US. TBI increases the risk and complexity of multiple behavioral health conditions including post traumatic stress disorder, depression, anxiety, irritability, anger/aggression, substance misuse and cognitive impairment. In addition, TBI impairs a person’s ability to manage their health care and increases the risk of unemployment, long-term functional impairment, and caregiver burnout. Successful TBI recovery can depend in large part on access to and engagement in behavioral health treatment. Unfortunately, TBI-focused community resources are scarce and fragmented. Treatment of post-TBI symptoms often falls to community providers who have little support and are under-prepared to manage these complexities. This burden disproportionally affects rural providers who have little access to specialist care at academic centers.
The purpose of this project is to create and assess the use of the ECHO (Extension for Community Healthcare Outcomes) model to provide education and support by experienced TBI experts to community providers who treat persons with TBI. The ECHO model uses both a virtual educational lecture series and patient case discussion to improve provider preparedness to treat patients and improve patient outcomes. We will launch a monthly to bi-monthly program that will train providers from a variety of disciplines and settings in identification and evidence-based behavioral health treatments, web technologies and mobile technologies, and provide detailed case consultation. We will assess the success, reach and impact of our TBI ECHO by collecting and comparing attendee experiences, clinical information and patient outcomes.
This project received two years of additional funding from the Washington State Department of Social and Health Services.
