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.
Targeted Condition: Depression
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.
Developing a tailored implementation plan for Collaborative Care of perinatal depression care in Community Health Centers in Vietnam
Perinatal depression is a common and serious disorder, with suicide representing a major cause of maternal mortality, but few women from low and middle income countries (LMICs) receive effective treatment. Effective models of care that improve perinatal depression and support suicide prevention exist but have not yet been widely implemented in routine maternal-child care services in LMICs. We plan to use a participatory approach to systematically identify and adapt key elements of evidence based models of perinatal depression care delivery to the cultural and health services context of Can Tho, Vietnam. Simultaneous exploration of potential implementation strategies to support and sustain this model in context will be identified along with the creation of a training and implementation toolkit for this setting. Using these strategies and tools we will then carry out a pilot perinatal collaborative care study in a public health center and the prenatal care practice of the Can Tho Obstetric and Gynecologic Hospital. The results of this pilot will be used to revise and enhance the treatment model and related implementation tools. These will be used in subsequent trials of effectiveness and/or implementation broadly in the health care system of Can Tho.
Care Partners: bridging families, clinics, and communities to advance late-life depression care
Through Archstone Foundation’s Depression in Late-Life Initiative, the Care Partners project seeks to improve depression care for older adults by building innovative and effective community partnerships. Specifically, the Care Partners project has the following goals: 1) develop late-life depression innovations among primary care, community-based organizations (CBOs) and family, 2) build a learning community of clinics, CBOs, and researchers in California who will work together on the Care Partners Late-Life Depression Initiative to improve care for depressed older adults, 3) conduct an evaluation of the developing models, and 4) develop and conduct a Learning Collaborative in Year 5 for California clinics and CBOs interested in improving depression care for older adults. Throughout the project, project teams at the University of Washington (UW) and UC Davis (UCD) provide technical assistance and evaluation to support site development and sustainment. Together, the community-engaged partnerships have tremendous potential to improve access to care, patient engagement, patient care experience and quality of care. In addition, CBO and clinic partners are well primed to improve care through addressing the social determinants of health.
Estia: computerized intervention targeting cognitive control deficits in depressed adults
Project: EVO (or “EVO”) is a mobile 3D video game that has been shown to reduce older adults’ susceptibility to interference by augmenting sustained attention and working memory abilities (e.g. cognitive control) through targeted adaptive algorithms. The combination of peer-reviewed validity, adaptivity, and fun video game mechanics elevates the EVO platform beyond other at-home training tools while reducing burden associated with tedious task replication. We propose to study EVO as a potential intervention for the treatment of depression, a disorder that worsens medical outcomes, promotes disability, increases expense, and complicates medical care by clouding the clinical picture and undermining treatment adherence.
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.
Building capacity
This study will expand and enhance training in evidence-based psychosocial interventions (EBPIs) by designing and testing a computerized training program that is based on adaptive training algorithms. We hypothesize that by simplifying training and supplementing classroom curriculum, we can enhance clinical ability to deliver treatment more competently, more quickly, and with a higher quality of care.
Discovering the capacity of primary care front-line staff to deliver a low-intensity technology-enhanced intervention to treat geriatric depression
This study will explore the feasibility of implementation of a technology-enhanced Evidence-Based Psychosocial Behavioral Intervention entitled Mobile Motivational Physical Activity Targeted Intervention (MobMPATI) by frontline primary care staff (e.g., nurses, medical assistants) to expand workforce capacity to deliver acceptable, sustainable, and effective treatment for depression in older adults.
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.
