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.
Targeted Condition: Health disparities
CANOE partnership: Cancer Awareness, Navigation, Outreach, and Equitable Indigenous Health Outcomes
The CANOE Partnership: Cancer Awareness, Navigation, Outreach, and Equitable Indigenous Health Outcomes responds to the need to improve cancer outcomes for American Indian and Alaska Native (AI/AN) communities. Our Overall Specific Aims are: (1) Improve rates of cessation of commercial tobacco smoking among a nationally recruited sample of AI/AN adults (Research Project 1); 2) Improve rates of lung cancer screenings among our Tribal partner populations in the Consortium’s catchment area (Research Project 3); 3)Prepare the next generation of researchers in Indigenous cancer equity and provide them with resources to obtain preliminary data to inform future cancer equity research in Indian Country (Pilot Grant Program); and 4) Develop infrastructure to support equitable engagement of Tribal partners and Indigenous Frameworks in cancer research.
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.
Needs Assessment for Supporting Technology use and Harm Reduction (STaHR Study)
The proposed study entails a needs assessment to develop a program for Supporting Technology use and Harm Reduction (STaHR) among HF residents with lived experience of homelessness and substance use. This study will qualitatively explore HF residents’ technology literacy as well as their perspectives on barriers and facilitators to the use of technology, broadly, and for harm-reduction service provision. Then, with a community advisory board (CAB) made up of HF residents, staff, and management, we will inform and provide recommendations to HF management and leadership ways to improve HF resident technology use and engagement with online harm-reduction services.
eHaRT-A: adapting an in-person harm reduction for alcohol intervention into a telehealth platform
The unprecedented global pandemic has highlighted the digital divide and limited access to alcohol-related treatments among marginalized communities, specifically individuals with lived experience of homelessness. In line with the NIAAA health initiative seeking to integrate technology-based interventions among vulnerable populations, this study directly addresses this mission by proposing innovative methods (i.e., user-centered design + a community based participatory research framework) to adapt an in-person harm reduction for alcohol (HaRT-A) intervention into a telehealth platform (eHaRT-A) that can then be tested and successfully implemented into low-barrier Housing First settings. As healthcare continues to move more services online, it is essential to understand ways to successfully adapt and implement rigorously tested telehealth treatment services for marginalized communities to ameliorate alcohol-related harms.
eHaRT-A
The unprecedented global pandemic has highlighted the digital divide and limited access to alcohol-related treatments among marginalized communities, specifically individuals with lived experience of homelessness. In line with the NIAAA health initiative seeking to integrate technology-based interventions among vulnerable populations, this study directly addresses this mission by proposing innovative methods (i.e., user-centered design + a community based participatory research framework) to adapt an in-person harm reduction for alcohol (HaRT-A) intervention into a telehealth platform (eHaRT-A) that can then be tested and successfully implemented into low-barrier Housing First settings. As healthcare continues to move more services online, it is essential to understand ways to successfully adapt and implement rigorously tested telehealth treatment services for marginalized communities to ameliorate alcohol-related harms.
Developing a pediatric telebehavioral health consultation model for emergency departments
As rates of pediatric mental health emergencies have skyrocketed over the last decade – and even more so since the Covid-19 pandemic – the number of youth staying in emergency departments (EDs) and medical units while awaiting inpatient psychiatric care or stabilization (i.e., “boarding”) has reached unprecedented levels. The massive surges in patient volume, coupled with widespread staff shortages and lack of staff expertise in treating mental health, are overwhelming ED and hospital resources. This causes dangerous or even life-threatening delays in care for youth populations in greatest need of medical and psychiatric treatment. Prolonged ED stays not only delay necessary mental health care, but they can cause additional trauma and distress for youth already in crisis. While the boarding crisis affects all hospitals and EDs, it poses an even greater challenge to community EDs that lack on-site mental health specialists and/or pediatric providers.
To address the boarding crisis, this project will pilot a model in which a multidisciplinary team of mental health clinicians at Seattle Children’s Hospital provides telebehavioral health consultation to community EDs in Western Washington to guide care for youth who are boarding. The primary goals of this model are (1) to improve timeliness of mental health care and reduce length of stay for youth boarding in community EDs, and (2) to support ED staff in providing more developmentally appropriate and evidence-informed mental healthcare. The Seattle Children’s team will provide case consultation to ED providers and staff, including support with decisions about hospitalization, medication treatment, behavioral interventions and case management services. The team will also deliver practical trainings to community ED staff to build their internal capacity to care for boarding youth. If this initiative is successful, additional funding could expand ED telebehavioral health consultation services statewide, with a focus on rural communities.
Using teen Mental Health First Aid to address mental health inequity among school youth
Over 2.5 million US adolescents struggle with mental health challenges, and multiracial adolescents are at greatest risk due to limited access to mental health programs. As roughly half of lifetime mental disorders have their first onset by mid-adolescence, it is vital to promote help-seeking for prevention and early intervention during this important developmental stage.
This project will test the implementation of an evidence-based mental illness prevention program — teen Mental Health First Aid (tMHFA) — in a diverse and underserved school district to facilitate help seeking among teens aged 16-18. While tMHFA has a proven track record of effectively enhancing knowledge of mental health problems, reducing stigma and promoting help-seeking behaviors, its efficacy across dimensions of race and ethnicity is underexamined in the US.
Academic (UW & SMART Center), education (Tacoma Public Schools) and behavioral health organization (MultiCare) stakeholders will address this gap by conducting a mixed-methods study with 1) focus groups to obtain diverse teens aged 15-18 opinions about facilitators and barriers in help-seeking; and 2) longitudinal data collection to examine the impact of the innovative tMHFA’s potential to address help-seeking barriers across dimensions of race and ethnicity. The findings of this project will guide both the revisions to the program to improve its efficacy and the scaling of this program to support government legislation to expand service delivery to other schools and to rural areas across the state.
Parent and teacher engagement as an undervalued implementation determinant
The proposed research addresses three important objectives (1) complete a scoping review to map determinants of teacher implementation of evidence-based practices for child behavior in preschool , (2) identify strategies to improve teacher implementation through a series of casual pathway diagrams, and (3) conceptualize and operationalize strategies with stakeholders to increase feasibility.
