Patients hospitalized for medical, surgical, or traumatic injury reasons at Harborview Medical Center are universally screened for suicide risk. The present research will advance knowledge about the practices occurring at this large healthcare institution serving the public and social safety net population and set the groundwork necessary for conducting future research designed to improve services not only at Harborview but at similar institutions across the U.S. A team led by Doyanne Darnell, PhD, and Imara West (Research Scientist at Data Quest) will capture population-level electronic health record (EHR) data on suicide screening rates and outcomes among medically hospitalized patients for a 1-year period and gain insight into the context of the data captured through focus groups with acute/intensive care nurses.
Practice Type: Hospital
Collaborative care for perinatal mental health – the LAMMHA project
Los Angeles Maternal Mental Health Access (LAMMHA) is a five year program (2022 – 2027) funded by The California Health Care Foundation (CHCF) to support health centers in Los Angeles to identify and treat common perinatal mental disorders (CPMD) and reduce the risk of suicide. The LAMMHA initiative is a collaboration between Community Clinic Association of Los Angeles County (CCALAC), Elevation Health Partners (EHP), Maternal Mental Health Now (MMHN), Concert Health and the Department of Psychiatry and Behavioral Sciences at the University of Washington. Co-created with Los Angeles community stakeholders, the LAMMHA program currently offers Los Angeles County providers and community clinics two different levels of support to improve perinatal mental health care.
For more information and/or to apply for the program, please visit the CCALAC LAMMHA page: https://ccalac.org/los-angeles-maternal-mental-health-access-lammha/.
High potency cannabis policy legislative report
| Explore and suggest policy solutions in response to the public health challenges of high tetrahydrocannabinol potency cannabis. ADAI will host stakeholder sessions to gain perspectives, seek common ground, evaluate, and assess potential policy solutions culminating in a final recommendation report. |
The UW Medical Student Addiction Research (MedStAR) program to address substance use disorders in urban and rural communities in five western states
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.
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.
