The proposed research will determine whether primary care clinics should offer medications or talk therapy first to treat posttraumatic stress. In addition, for patients who do not respond to the first treatment, the STEPS trial will determine what treatment should be offered next. More information on our info sheet.
Practice Type: Primary Care
Examining the cross-cultural applicability of the Spanish PMQ-9: a comparative validation study
The purpose of this project is to enhance the usefulness and cultural relevance of the Spanish version of the PMQ-9, a questionnaire that assesses manic symptoms in individuals with bipolar disorder.
Patient perspectives on prescribing opioid discontinuation: understanding and promoting safe transitions
Identifying and treating loneliness in young adults in primary care
Loneliness, defined as the feeling of insufficient personal relationships, affects over 20% of young adults. Those with loneliness are more depressed and anxious and have poorer educational outcomes. Cognitive behavioral therapy and social navigation can successfully treat loneliness but previous studies have mostly looked at older adults.
The objective of this study is to demonstrate the feasibility of identifying and alleviating loneliness in young adults identified in primary care practices. This project will screen young adults ages 18-25 presenting in primary care for loneliness and pilot the interventions of cognitive behavioral therapy and social navigation for those who test positive for loneliness.
Expanding access to adolescent depression care by non-specialists with a digital intervention
Adolescent depression is one of the most common mental health concerns during adolescence and can be a cause of significant impairment across the lifespan, particularly if untreated. Access to evidence-based psychotherapy is poor and pandemic-related increased demand for services has greatly worsened access issues, leaving many adolescents without effective and critically needed treatment. Adolescent depression is often first identified in primary care, making it the ideal setting for improving early access to treatment. While treatment by mental health specialists within primary care is effective, the workforce is not adequate to meet the high demand for services. Online depression treatment has been shown to be effective and has the added potential to expand access, particularly given adolescent’s comfort with digital technology. Importantly, the addition of human coaching alongside online treatments has been shown to boost engagement and treatment outcomes.
The goal of this project is to increase early access to evidence-based depression treatment in primary care settings. The project team will work with adolescents, caregivers and providers to develop an accessible and engaging online treatment for delivery in primary care. To support integration and enhance engagement, the project will also develop a coaching toolkit that can be utilized by a range of non-mental health specialists, including nurses, medical providers, social workers and bachelor’s level staff.
Addressing suicide risk in primary care to reduce youth suicide
Suicide is a leading cause of death among 10- to 24-year-olds in the US, and half of youth who die by suicide contact a primary care provider within one month prior to suicide. Suicide risk screening and access to brief and effective suicide prevention interventions remain an important step in reducing suicide, yet comprehensive suicide prevention pathways focused on youth have not been widely implemented or evaluated in primary care settings, in part due to lack of trained clinicians and time to provide services.
This project aims to address these challenges by developing clinician training and adapting and optimizing a brief, evidence-based suicide intervention, SAFETY- Acute(A), for use in primary care to support the development of an effective and sustainable primary care-based suicide prevention pathway for youth with low to moderate suicide risk.
Using routine alcohol screening measures to identify 1-year risk of suicidal ideation, intent, and planning within a large primary care system in Washington
This study will use a large population-based primary care sample in Washington state to understand how heavy alcohol use and alcohol use disorder symptoms contribute to suicidal thoughts. This study will allow examination of how different levels of alcohol use can predict short term risk of suicidality and allow us to better identify and support patients at risk of suicide in the primary care setting.
WITH (Whole person Integrated Texting for Health)
Text messaging holds promise as a strategy for engaging older adults in depression treatment. The purpose of this project will be to develop and pilot test a text messaging intervention delivered in primary care settings practicing integrated care. Recent data shows that the vast majority of older adults have a cell phone and that about half have sent an email or text within the past month. Among that latter group, about one third reported they did so “most days.” There is research showing that text messaging with older adults is feasible that is focused on mental health was well received and effective. None of the prior studies looked at text messaging as an adjunct to mental health treatment delivered in primary care. This project will address that gap.
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/.
Bipolar disorder measures in clinical care
The goals of this project are to 1) determine which validated bipolar disorder patient-reported symptom measure is most acceptable and helpful to patients and clinicians in clinical care, 2) demonstrate that the preferred measure can be used to monitor outcomes with high fidelity in routine care, and 3) assess the feasibility of comparing effectiveness of measurement-based care (MBC) to usual care in a randomized trial.
