The COVID-19 pandemic facilitated simultaneous paradigm shifts in healthcare delivery: virtual care (telehealth and videoconferencing) and the need for “Whole Person” healthcare that targets mind, body, and spirit, per recent US Surgeon General1 and National Academy of Medicine2 calls-to-action. The pandemic also highlighted treatment delivery inequities involving rural Veterans. The current proposal will address these trends, assessing virtual VA Whole Health care use in Primary Care-Mental Health Integration (PC-MHI) for rural and non-rural Veterans with chronic pain and co-occurring posttraumatic stress disorder (PTSD).
Practice Type: Rural
Behaviors and Executive Skills in T21 (BEST21)
We are conducting a study to understand the role of problem-solving in challenging behaviors for children with Down syndrome so that we can better understand the development of and treat these behaviors. If you agree to participate, this study will involve questionnaires, some of which may be completed at home. You would also attend an in-person visit that involves measuring your child’s naturally-occurring brain activity with EEG as well as cognitive assessments. We would schedule your visit around your schedule to the best of our ability and we can schedule this visit in a location that is convenient for you (UW, home visits, etc.). Participants will receive an $80 gift card to thank them for their time.
Canoe Journey: Land, water, language and culture for youth wellbeing
The Canoe Journey study is an exploratory study aimed at examining the acceptability and fit of motivational interviewing (MI) and dialectical behavioral therapy (DBT) among American Indian and Alaska Native youth and young adult Canoe Journey participants. The team will develop a list of MI and DBT approaches in collaboration with Canoe Journey partners, and exploring the acceptability and fit of the approaches during Canoe Journey events in 2025, along with a list of tribally specific approaches to healing mental health in collaboration with Canoe Journey partners and confirm knowledge of these approaches among participants in 2026. The team will examine the relationship between measures of wellness with knowledge and use of MI, DBT, and tribally specific approaches to healing mental health in 2027, along with the acceptability and fit of a relational mental health intervention among Canoe Journey participants.
GATHER: Growing a Tribal Healing Effort through Research
The GATHER initiative aims to: 1) Coordinate a national research network to support tribally led research on etiology and prevention of overdose, substance use, mental health, and pain management. 2) Provide administrative support and shared resources to facilitate the successful completion of N CREW research projects. 3) Provide an administrative infrastructure, intellectual environment, and access to resources and initial support for investigators. 4) Provide research training and access to subject matter experts for investigators, staff, and students in the areas of cognitive, motivational, and behavior therapies, Indigenous approaches to research and healing, and multimodal holistic approaches to prevention and treatment. 5) Serve as a local, national, and international resource for dissemination of information and training to reduce risk in diverse tribal and urban Indian populations.
Partnering with the Quinault Indian Nation to develop a community-based contingency management intervention
Indigenous knowledge remains strong in American Indian/Alaska Native (AI/AN) communities despite colonization, postcolonial efforts to assimilate and eradicate AI/AN people, present-day inequities and structural racism. Despite strength and resilience, AI/AN populations have high rates of unintentional overdose and death by suicide. There is an urgent need for evidence-based, culturally responsive approaches to increase protective factors against substance use and mental illness in AI/AN communities.
This study is a partnership between University of Washington researchers and the Quinault Indian Nation’s behavioral health providers and community. We will design a culturally adapted community-based contingency management intervention to increase positive reinforcement for adolescents and young adults at risk for substance use and mental illness. This intervention will focus on community identified target behaviors rather than abstinence. By prioritizing the needs of the community we will develop an intervention that is effective, usable and sustainable.
Partnering with community pharmacies to enhance access to long-acting injectable antipsychotics in Washington State
Medication nonadherence is common among patients with serious mental illness, including schizophrenia. The use of long-acting injectable antipsychotics (LAIAs) for schizophrenia is an evidence-based practice that improves medication adherence, decreases symptomatic recurrence and reduces hospitalizations. However, patients and clinicians often face several challenges in access and coordination resulting in the underutilization of LAIAs in care.
Administering LAIAs at community pharmacies could potentially increase accessibility, reduce barriers for treatment and improve patient outcomes. This project aims to assess the fit or compatibility of LAIA administration in community pharmacies. We will survey community pharmacy staff and behavioral healthcare providers in Washington State to assess the acceptability, appropriateness and feasibility of LAIA administration in community pharmacies. If LAIA administration at community pharmacies is found to be a good fit, the next steps will be to develop strategies to support implementation. A scalable and adoptable model for administering LAIAs at community pharmacies could have substantial impacts on public health through increasing access to treatment and expanding behavioral health services at the community level and in rural areas.
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.
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.
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.
