Practice Type: Online/remote/apps/social media

Innovative training for suicide prevention in addiction treatment settings

Although suicide is one of the leading causes of death for people with substance use disorders (SUDs), no widespread suicide prevention intervention exists for delivery in community addiction treatment settings. The effectiveness and feasibility of delivering Preventing Addiction Related Suicide (PARS), a group-based psychoeducational program that provides evidence-based suicide prevention and safety strategies, was recently demonstrated by the UW Center for Suicide Prevention and Recovery.

To enhance widespread implementation and dissemination of PARS, this project will develop online training and implementation tools. PARS-Web will be created in collaboration with key state agencies and suicide prevention professionals to meet the new training requirements for Washington State Chemical Dependency Professionals. The goal is to integrate PARS as a part of standard care in addiction treatment agencies nationwide.

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.

Remote assessment of cognitive aging and mental health in older African Americans during COVID-19

Alzheimer’s disease and related dementias (ADRD) affect more than 10% of adults who are age 65 and older, but the toll of ADRD is most devastating among older African Americans. COVID-19 widened these disparities; in addition to being more susceptible to COVID-19 infection and fatalities, older African Americans are more likely to experience digital and technical inequities. This puts them at risk for the development/worsening of depression, anxiety, cognitive impairment and sleep disturbances.

This project will evaluate several traditional and mobile health tools for remotely monitoring the effects of social isolation on cognition and mental health in older African Americans with baseline cognitive complaints. By testing three different strategies, we will identify the most effective, feasible and subject-preferred approach to collecting cognitive and mental health data which will help address brain health disparities.

Improving access to cognitive rehabilitation treatment following mild traumatic brain injury

More than a million people in the US sustain a mild traumatic brain injury (mTBI) every year, and many report difficulties with attention, memory and other thinking abilities months and even years following their injury. A promising treatment option is cognitive rehabilitation, but the full-length (20 hours), in-person intervention is not feasible for many people due to time and financial constraints.

This study will evaluate a brief (6 hours), virtual cognitive rehabilitation intervention developed for individuals with persisting cognitive difficulties after mTBI. We will evaluate several outcomes related to improving patient care including treatment satisfaction, feasibility of this intervention when using telehealth and preliminary effectiveness. The proposed treatment aims to provide the same clinical impact of traditional cognitive rehabilitation while reducing burden and increasing access.

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.

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.

Re-engineering siloed systems of care through evidence-integrated design thinking

Behavioral health, including suicidal behaviors and problematic substance use, are significant public health concerns and are routinely identified by community health departments as a high priority. However, needed services are highly fragmented across multiple systems (e.g., prevention, primary care, schools). Addressing these urgent public health concerns requires decisionmakers to collaborate and coordinate services. System-level planning efforts tend to fail because adopted models are either not informed by evidence, or policy decisions do not have sufficient community buy-in and are poorly implemented.

To address this gap, our team created a hybrid approach, “System Codesign,” in which researchers and local decisionmakers form a design workgroup and collaborate to create a tailored and sustainable plan to address community public health issues. This partnership approach allows end users to be actively involved in the design process to help ensure that the outcome meets the needs and expectations of the community. The researcher’s role is to locate and synthesize research findings relevant to the community agency’s goals and assist in integrating these principles within real world programming. This new “System Codesign” approach is built from well-established participatory and implementation frameworks and incorporates evidence-informed standards in research into the energy and creativity of design thinking to support local systems. This model is expected to incorporate evidence, innovation, and local relevance into final system products.

Our research team aims to assess the acceptability and feasibility of this “System Codesign” process as a tailored implementation method for tackling complex behavioral healthcare issues. Our aim is to partner with the state Healthcare Authority (HCA) to pilot this approach with a rural Washington community, Grays Harbor County, which has a high prevalence of behavioral health needs. The proposed design workgroup will leverage cross-system participation from behavioral health, justice, law enforcement, faith-based organizations, schools, and community members.

Harm reduction in the context of social distancing

The devastating impacts of the novel coronavirus (COVID-19) epidemic is expected to have impacts on young adults’ mental health and substance use (a population already at high risk).  Time is of the essence to provide young adults evidence-based information to reduce risk from alcohol use within the context of COVID-19 epidemic, promote continuation of social distancing while also encouraging pro-social behavior to reduce isolation, and skills to reduce coping- or socially-motivated alcohol use and associated negative consequences. This project aims to develop and examine feasibility and acceptability of a time-sensitive COVID-19-specific personalized normative feedback intervention disseminated via social media that focuses on drinking motivations to cope with distress and/or to enhance social connectedness, as well as to promote engagement in strategies for stress management and increase engagement in social, alcohol-free activities while also practicing social distancing. 

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.

Mobile RDoC: Using smartphone technology to understand Auditory Verbal Hallucinations (AVH)

Using a mobile data collection system that leverages smartphone technology to capture an abundance of time-varying information both passively (i.e., behavioral sensing) and actively (e.g., Ecological Momentary Assessment or EMA) we aim to: 1) Evaluate whether need for care is associated with real-time/real-place AVH experience; 2) Examine relationships between baseline demographic and functional variables, time-varying social and contextual factors, and AVH; 3) Test relationships posited in a cognitive model of AVH.