This project aims to understand how concerns about pregnancy, whether planning for a child or trying to avoid an unintended one, affect women’s sexual well-being. Despite public health goals to reduce unintended pregnancies and STDs (Higgins et al., 2009), and the importance of sexual health to overall quality of life (Flynn et al., 2016), little research has explored the specific impact of pregnancy-related worries on sexual satisfaction and experience in women who are not currently pregnant (Bond et al., 2023a; Higgins et al., 2009). We know that sexual function issues are prevalent even among women planning pregnancy. We propose to explore pregnancy concerns and sexual quality of life among women (Bond et al., 2023b). We will then provide targeted education (depending on the responses in the survey and can differ for each individual) addressing their specific concerns and measure their sexual quality of life again to see if this information helps improve their sexual experience. The findings will highlight the sexual health needs related to pregnancy concerns and inform future educational programs.
Targeted Condition: General Mental Well-Being
Engagement patterns in pediatric integrated behavioral health: investigating service utilization and attrition among children with mental health and neurodevelopmental disorders
Children with comorbid mental health and neurodevelopmental disorders (NDDs) often require more intensive and coordinated care than those with mental health disorders alone. These two categories of disorders often present with comorbidity and engagement disparities in integrated behavioral health programs among this population remain poorly understood. This study examines differences in service utilization and attrition rates between these two populations using retrospective electronic health record (EHR) data from the SCCN study population (ages 6-18) across multiple primary care sites.
We will analyze visit frequency over a 6-12 month period to assess whether children with comorbid NDDs have higher service utilization. Additionally, early dropout rates will be examined using Kaplan-Meier survival analysis and Cox proportional hazards models to identify risk factors for attrition. Findings will provide critical insights into engagement patterns, informing strategies to enhance retention, reduce access disparities, and improve care coordination for children with complex behavioral needs. This study will contribute to investigating further integrated care model improvements in order to ensure more equitable and sustained mental health treatment for vulnerable pediatric populations.
Discovering how a task-shifted Care Manager workforce of community health workers can address geriatric mental health
Older adults are less likely to receive the recommended standard of care for preventative services, chronic diseases and geriatric concerns such as complex care navigation. Late-life depression is a common chronic disease, and older adults face multiple barriers obtaining depression care from healthcare settings, especially if things like fragility, social needs, and transportation limit access to primary care. Offering depression care in non-traditional healthcare settings is one way to increase access. Community health workers (CHWs) are trusted community members who increase the health of communities through care coordination, health education and outreach. One approach is to task-shift the Care Manager (CM) role of a Collaborative Care framework to CHWs in the community. Global health work has demonstrated that non-clinicians can conduct low-intensity psychosocial interventions for depression. However, task-shifting the Care Manager role in a non-clinical setting requires additional skills and poses added challenges. We have gathered prior formative work among CHWs on what they think about being trained and supported in the skills of CM. We now seek to understand Collaborative Care stakeholders’ perspectives on this proposed role expansion of CHWs to CHW Care Managers (CHW-CMs) to understand how to design this role.
Psychomotor function of Locus Coeruleus-Norepinephrine system during decision-making
Many psychiatric disorders involve an abnormality in movements, termed ‘psychomotor’
dysfunction, that reflects aberrant activity of the brain circuits producing behavior. Nevertheless,
psychomotor mechanisms remain poorly understood. One possible source of psychomotor dysfunction is alterations in neuromodulatory transmitters, such as norepinephrine (NE), which is broadcast throughout the brain from a small brainstem region called locus coeruleus (LC). LC-NE is implicated in psychiatric disorders including depression, PTSD, ADHD, and dementia, with behavioral neuroscience studies demonstrating roles in arousal and decision-making. LC-NE is often studied in psychiatry on the timescale of minutes to hours with a focus on NE drugs, leaving underexamined the precise temporal relationship between LC neural activity and discrete components of motivated behavior. This proposal aims to identify psychomotor functions of LC-NE in decision-making at the level of neural circuit activity in mice. We leverage powerful techniques to record LC neural activity with high spatiotemporal precision while simultaneously deploying advances in AI machine vision technology to quantify the mouse’s movements. By precisely quantifying movement patterns and LC-NE activity, we aim to characterize basic psychomotor functions related to cognition. In turn, our work will build a foundation for noninvasive, mechanistic biomarkers that enhance the diagnosis and management of psychiatric disorders.
Making generative AI safe for people with mental health conditions
Hundreds of millions of people are already using Large Language Models (LLMs), including for mental health purposes, which has led to inadvertent harms. Critically, people with mental health conditions may be especially vulnerable to such harms.
In this project, we will develop the first computational framework to systematically quantify and benchmark the risks that LLMs present to people with mental health conditions. Our approach will simulate interactions of hundreds of users and LLMs to evaluate safety across a variety of mental health conditions, demographics, and AI failure modes.
Optimizing telemental health with live artificial intelligence clinical scaffolding and feedback
This project aims to develop a clinical scaffolding system to enhance telemental health care by providing real-time coaching and actionable suggestions during video-based sessions. Modeled after live supervision methodologies, it supports clinicians by identifying intervention targets and offering text-based coaching prompts to guide care. Unlike automated chatbots, this approach enables clinicians to adapt suggestions to patient needs, balancing automation with oversight for safer AI-supported mental healthcare. The proposed in-session support will facilitate efficient implementation of strategies and clinician skill development. This project seeks to enhance data privacy by processing all data on-device and avoiding external data transfers.
Self-directed mindfulness in medically hospitalized patients: a pragmatic trial
Consultation-liaison psychiatrists are often asked to manage mood and anxiety symptoms experienced by patients admitted to medical and surgical floors of the hospital. This study aims to determine the feasibility and effectiveness of a self-directed mindfulness intervention as an adjunctive treatment for improving mood, anxiety, and perceived stress in medically hospitalized patients. Participants, consisting of patients evaluated by the consultation-liaison psychiatry service, will be randomized to an adjunctive mindfulness intervention group or a treatment-as-usual control group. Feasibility and acceptability of implementing a mindfulness intervention will be assessed. Group differences in the changes in symptom severity and psychotropic medication administration will be investigated.
Centering community voices in partnered mixed methods approaches to addressing health disparities with diverse communities
Meaningful partnerships between community and academic/public health co-researchers are needed to address community mental health, wellbeing, and health disparities. Partnerships should center the strengths, needs, and interests of communities on the communities’ terms while building relationships on trust and shared power.
UW researchers in partnership with the Community Health Board Coalition (CHBC) have developed an initial draft of a Community-Centered Approaches to Research and Evaluation (CCARE) Toolkit to guide academic, public health, and community researchers in partnering to act on emerging community data during times of crisis and beyond. As a part of this work, we are striving to better understand and support community health priorities.
Willow Study
The goal of this study is to understand the impact of stigma on mental health and recovery from trauma in different parts of the country.
Coach up the coaches: extending the reach of mental health professionals in sport settings
More than half of school-aged youth in the US play at least one organized sport, are similarly at-risk for mental health disorders as compared to their non-athlete peers, and face heightened barriers to seeking and sustaining mental health care. While coaches are not licensed mental healthcare providers, there is a robust evidence-base about laypeople (e.g., parents, teachers) effectively delivering brief interventions across population settings to help reduce psychological distress and increase the adoption of health behaviors. However, such brief interventions have not as-yet been adapted for the sport setting, or delivered by coaches.
The overarching goal of this project is to identify sport setting appropriate (very) brief interventions and adapt them for coach delivery in the sport setting. This will be accomplished by working in partnership with coaches, athletes, and licensed mental health care providers. We will use University of Washington’s First Approach Skills Training (FAST) training model (originally designed to train primary care clinicians in mental healthcare skills) to train a pilot cohort of coaches to deliver these interventions. This project is the starting point for a potentially transformative opportunity to extend the reach of mental healthcare professionals into the large and often underserved population of youth sport participants.
