Targeted Condition: Anxiety

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.

Rural Mental Health Integration Initiative (RMHII)

The RMHII is a partnership between the AIMS Center and Premera Blue Cross to expand access to evidence-based mental health treatment in rural areas. The AIMS Center will lead clinic selection, training, technical assistance, and practice coaching for up to 30 primary care clinics in rural Washington and Alaska.

Moms’ Access Project ECHO: Perinatal Psychiatry Case Conference Series

Perinatal Psychiatry Case Conference Series is a CME-accredited program for providers in Washington State who want to improve the mental health of their pregnant and postpartum patients.

Facilitated by a multidisciplinary team including UW Medicine perinatal psychiatrists, obstetrician gynecologists, maternal fetal medicine experts, advanced registered nurse practitioners, therapists and social workers, the program aims to increase frontline provider capacity to address common mental disorders in pregnancy and postpartum. Program format is brief didactic followed by in depth case presentation and discussion.

Sustaining quality

Several recent studies have found that for evidence-based psychosocial interventions (EBPIs) to be delivered more effectively, sustained quality, ongoing supervision, and guidance is critical.

This study will develop an electronic support tool to support quality delivery of PST that is based on clinician feedback. We hypothesize that supporting clinician delivery of EBPIs will result in enhanced quality of treatment and better patient outcomes.

Improving usability

While evidence-based psychosocial interventions (EBPIs) are important, their design is cumbersome, complex, overwhelming, inflexible, and minimizes factors that are crucial for quality delivery of care.

This study will work with six FQHCs across MT that were recently reorganized under Bighorn Valley Health Center’s umbrella to involve their Therapists and Care Managers in the redesign of an intervention to address their unique patient population and to capitalize on their task sharing model.

Collaborating to Heal Addiction and Mental Health in Primary Care (CHAMP)

The gold-standard intervention for Opioid Use Disorder (OUD) is Medication for Opioid Use Disorder (MOUD). Because more patients with OUD need access to MOUD in primary care, the AIMS Center at the University of Washington is testing a Collaborative Care model to treat mental health disorders and OUD concurrently in primary care settings. The CHAMP study addresses three important objectives including: 1) Can OUD screening be effectively incorporated into primary care mental health screening protocols?; 2) Does implementing Collaborative Care for OUD and mental health disorders improve outcomes?; 3) What implementation strategies are effective at sustaining Collaborative Care programs that concurrently manage mental health disorders and OUD? In this pragmatic trial, 24 primary care clinics will be randomized to either adding OUD to their Collaborative Care program or maintaining Collaborative Care for mental health disorders only.

Perinatal PCL

The Perinatal Psychiatry Consultation Line (PCL) is a free telephone consultation service for health care providers caring for patients with mental health problems who are pregnant, postpartum, or planning pregnancy. Any health care provider in Washington State can receive consultation, recommendations, and referrals to community resources from a UW psychiatrist with expertise in perinatal mental health.

Maternal-Infant Dyad Implementation (MInD-I)

The MInD-I study targets improving dissemination of the evidence based Collaborative Care treatment model for pregnant and postpartum women with depression. Longitudinal remote consultation (LRC) is an implementation strategy that has been have shown to improve fidelity to evidence-based practices and patient outcomes for mental health innovations. The investigators believe LRC can be used with equal benefit for complex interventions such as CC.

The purpose of this study is to compare two implementation strategies for Collaborative Care depression treatment: 1) standard implementation and 2) standard implementation + Longitudinal Remote Consultation (LRC). This research is being done in order to assess implementation and patient outcomes in sites receiving a standard implementation approach with and without LRC. The results of the proposed study will provide information on the benefits and relative value of ongoing consultation, such as LRC, for implementation of complex interventions like collaborative care.

Premera rural mental health initiative

The AIMS Center is partnering with Premera to support up to 30 clinics in rural Washington and Alaska to expand access to evidence-based mental health treatment. Selected clinics will receive up to $245,000 over 15 months to defray participation costs.