This project will create a mentored research training program for University of Washington medical students to engage in substance use disorder-focused research and clinical practice during their medical school training.
Practice Type: Hospital
Evaluating Lifelines4Moms (ELM) Study
Perinatal depression affects 10-15% of pregnant and postpartum individuals, with detrimental impacts on both parent and infant. In response to this, our department developed a perinatal consultation line for providers, PAL for Moms, to increase access to specialty perinatal psychiatric expertise and care. The purpose of the Evaluating Lifeline4Moms (ELM) is to assess comparative effectiveness of PAL for Moms and other perinatal psychiatry access and referral programs in addressing maternal depression.
As a community-engaged research endeavor, ELM has convened patient advocates, policy experts, and perinatal clinicians, who oversee the study as partners and advisors. Over a period of three years, the research team will characterize the components, implementation timelines, and state policy contexts of access and referral programs; evaluate the reach and implementation of these programs; and examine the comparative effects on access to and quality of mental health treatment among Medicaid-insured perinatal individuals.
Washington State COVID-19 pregnancy collaborative
The objective of this proposal was to investigate the effects of a highly communicable infectious disease leading to severe pneumonia and death (COVID-19) in pregnant women in Washington State. Pregnant women are typically a highly vulnerable group to pathogenic respiratory viruses and have the highest WHO priority for influenza vaccination in a pandemic.
The team’s central hypothesis was that COVID-19 infections in pregnancy increase the risk for spontaneous abortion, preterm birth, stillbirth, intrauterine growth restriction and mental health disorders in the mother. They conducted a multi-site prospective chart review of prenatal and neonatal medical records across the majority of health systems in Western Washington (6 hospitals/hospital systems, >20 investigators). Overall, the Washington State COVID-19 in Pregnancy Collaborative sites captured approximately 61% of deliveries in Washington State during the study period.
The team successfully collected data to establish a large, population-based registry in Washington State. Analyses have been completed of the sociodemographic and clinical outcomes of 240 pregnant patients who contracted COVID-19. Work remains ongoing to calculate infection rates, disease severity, co-morbidity, symptom length and possible vascular injury that could impair fetal growth.
The team will continue working toward research to determine how COVID-19 impacts maternal-child physical and mental health. Further grants have been applied and awarded from the Center of Disease Control, Royalty Research Fund and partnerships with Washington State Department of Health.
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.
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.
Project WISE (Workplace Integrated Support & Education)
The overarching purpose of the research is to adapt and pilot test a technology-enhanced training for hospital nurses in the delivery of a suicide prevention intervention with patients hospitalized for medical reasons.
Expanding mental health training and treatment in child and adolescent mental health in Vietnam
Engaged in early relationship-building with Can Tho University of Pharmacy and Medicine (CTUMP), and Can Tho Children’s Hospital (CTCH) in Can Tho, Vietnam to develop training, research, and clinical service delivery models for psychiatry and mental health in the region.
As is true throughout Southeast Asia, persons with mental illness in Vietnam suffer from stigmatization and under-resourced care. But things are changing. Vietnam is experiencing rapid economic expansion and, concurrently, attitudes about caring for individuals with mental illness are shifting. There is a developing awareness of children’s and adolescents’ mental health needs, and illness. UW faculty are working with the leadership at CTMUP to expand its capacity to provide mental health care in general psychiatry and in pediatrics, assisting community psychiatrists to update their knowledge, and guiding the leadership at the new Children’s Hospital to develop mental health programs.
