Lewy body dementias (LBD), a term referring to both dementia with Lewy bodies and Parkinson’s disease dementia, are the second most common type of degenerative dementia in older adults. These are complex disorders in which patients may exhibit disruptive behaviors that make caregiving challenging. Compared to other types of dementias, caregivers of people with LBD report higher stress and more severe depressive symptoms. The ongoing COVID-19 pandemic has multiplied the challenges that caregivers of persons with dementia face in providing care for their loved ones. As such, support interventions for caregivers of persons with LBD are urgently needed.
In this study, we will adapt our online intervention for older adults with frailty to target the unique needs of caregivers of people with LBD. We will conduct participatory design sessions with potential users to determine their needs and priorities specific to LBD and deploy the re-designed intervention in a pilot study focused on usability and efficacy. Through this newly tailored support system, we aim to bolster the health of caregivers as well as their ability to assist care partners living with LBD.
This intervention could potentially be used in conjunction with usual care and/or as a stand-alone module in emergent circumstances, such as the current pandemic, when routine professional interventions may not be readily available. By fostering the development of a community-driven online support system, this project will begin to lay the groundwork for promoting resilience within families affected by the behavioral challenges of dementia.
Millions of people lack access to mental health treatment due to barriers such as limited therapist availability, long wait times, high cost, and stigma. The COVID-19 pandemic has problematically increased demand for treatment while decreasing access. Because the internet is widely available, many people first turn to the internet for mental health support, giving rise to massive online psychotherapy, counseling and peer-to-peer support platforms such as Ginger and Talklife. However, not all conversations lead to improvement and may miss opportunities to help or even make things worse as platforms struggle to keep up with the increasing demands and lack methods for evaluating and promoting high-quality conversations.
This project seeks to improve the quality and scalability of online mental health support through real-time, evidence-based conversation feedback. We will leverage and analyze datasets of support interactions and associated outcomes across millions of individuals that use the partnering online mental health platforms at Ginger and Talklife. Our goal is to develop and pilot-test artificial intelligence methods that provide supporters on these platforms with practical just-in-time feedback and training. If successful, at least three benefits will follow our work. First, millions of help seekers using partnering mental health platforms Ginger and Talklife will receive higher quality responses through, for example, an expression of higher empathy. Second, those providing help will gain expertise faster and with less distress. Third, platforms and researchers will discover conversational best practices which can then be used to improve helper training and quality evaluation.
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.
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/.
The proposed research 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?
Our goals for this project include (1) Design competency framework and learning objectives that define the role and scope of practice for a BHSS; (2) Scale the role for Washington state by creating processes for integrating the BHSS Clinical Training Program into existing four-year degree programs in the behavioral healthcare field; (3) Partner with Washington state higher education institutions to adopt the BHSS Clinical Training Program; (4) Develop curricular resources to share with Washington State colleges and universities including an Educator’s Guide; (5) Collaborate with government agencies, employers, and policy groups to implement legislation establishing a BHSS credential in Washington state.
For information, please contact:
Bill O’Connell, Ed.D.
Director, Clinical Training Program
Savannah Tidwell, BS
tidwell1@uw.edu
Program Manager, Clinical Training Program
Healthcare workers and first responders working during the COVID-19 pandemic have experienced increased exposure to suffering and loss; prolonged work hours; and increased personal risk. Although associated increases in psychiatric symptoms and occupational burnout are well documented, what aspects of the experiences are most strongly associated with negative outcomes over time – and what interventions are most likely to protect healthcare workers and first responders – are poorly understood.
The ATTEND study is designed to address the impact of occupational stress related to working during the COVID-19 pandemic on health care workers and first responders (police, fire, EMTs) through a national longitudinal survey paired with a local interventional clinical trial. The interventional clinical trial is designed to test the impact of treating sleep disruption with prazosin during or shortly after the period of exposure.
Perinatal mood and anxiety disorders affect one in seven pregnant and postpartum women nationwide, making them the most common complication of pregnancy. Unfortunately, only one in 20 women who need treatment for these conditions actually receives it. This translates to a multigenerational issue, which can negatively affect the mother and child’s long-term physical, emotional and developmental health. It also means an estimated $14.2 billion annually in societal costs in the U.S. alone. While not every perinatal individual with mental health concerns has access to a mental health provider, cell phones and text messaging are ubiquitous. Nonjudgmental support delivered through text messaging may be a low cost approach to reaching women who need emotional support in the perinatal period.
Our project aims to evaluate a text-based mentoring program, the Nurture Program, and assess whether it is possible to support mothers through their third trimester of pregnancy and nine months postpartum and enhance their emotional well-being. The Nurture Program combines the convenience of secure text messaging with the personalization of having a trained peer mentor with whom the mother can develop a trusting relationship. This program also provides resources on child development, connections to local support agencies and suggestions for parent-child bonding and parental wellness activities. Surveyed participants of the Nurture Program consistently report their mentor helped them feel less stressed and more confident in their role as a parent. This study will allow us to measure the impact of this cost-effective approach to promoting perinatal emotional well-being.
Perinatal depression affects 10-20% of pregnant and postpartum individuals, impairing parenting self-efficacy and mother-infant interactions and contributing to negative maternal-child outcomes. This research will test comprehensive perinatal depression treatment, Maternal Infant and Dyadic Care (MInD), which includes a brief version of the Promoting First Relationships parenting intervention implemented within perinatal collaborative care, against perinatal collaborative care (CC) only. The aims of this study are to (1) compare the effects of MInD vs. usual perinatal CC on depression, (2) explore associations between parenting self-efficacy, dyadic interaction, and depression to inform a mediational hypothesis, and (3) examine and compare care utilization, trial feasibility, and perceived match of treatment to patient need.
