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.
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.
Through a community-partnered approach we will develop and deliver a parent-teacher relationship intervention at local preschools that serve under-represented minority families.
With the rise in opioid use disorder (OUD) and overdose, racialized disparities in buprenorphine access and use are a significant concern nationally—studies estimate that Black patients with OUD are 50-60% less likely to access buprenorphine compared to White patients, and similar disparities have also been observed for Hispanic/Latinx patients. COVID-19-related policy changes increased flexibility in the provision of buprenorphine and other effective medications for OUD over telehealth and present an unprecedented opportunity to examine impacts of a structural intervention—relaxed MOUD restrictions—on disparities that result from structural racism and discrimination (SRD). The proposed study, guided by Public Health Critical Race Praxis, will use data from the nation’s largest provider of substance use care and quantitative and qualitative methods to examine the impact of these policy changes on racialized disparities for Black and Hispanic/Latinx patients to inform future policy and interventions to improve equitable care for OUD.
This multi-site study will test the efficacy of an intervention to train and equip pharmacists to provide naloxone, an overdose antidote, to patients using prescribed and illicit opioids, to improve opioid safety and prevent opioid-involved adverse events. The study will carry out a stepped-wedge, cluster randomized trial implemented over five waves, within two chain community pharmacies across four states with varying pharmacy-based naloxone distribution laws: Oregon, Washington, Massachusetts and New Hampshire.
Our specific study aims are to: 1) integrate two successful demonstration research projects into one cohesive educational program (MOON+), 2) evaluate the effectiveness of MOON + on naloxone-related outcomes, and 3) use mixed methods to further explore the impact and implementation of MOON+ and associated factors (e.g., state policy, store policy, region).
LGBT Veterans have faced a long history of stigma, discrimination, and exclusionary policies that were intended to exclude them from military service. Despite recent shifts in policy and increased staff trainings, existing evidence suggests that this group is at high risk for health disparities, particularly with respect to mental health and health risk behaviors. While informative, the research to date has been limited in several respects: cross-sectional designs, collapsing LGBT subgroups, severe lack of data on some subgroups, problems with identifying a comparison group, and lack of data on risk and protective factors and care experiences. This prospective cohort study will fill these gaps, recruiting and conducting surveys online with 1,600 Veterans to identify health disparities, test a conceptual model of prospective risk and protective factors, and assess VA utilization, barriers to care, and treatment preferences. Data from this study will inform future intervention efforts to achieve health equity for LGBT Veterans.
This observational study will examine mobility challenges and opportunities among people living and working in South Beacon Hill using participatory research methods: 1) community member photography-enhanced storytelling (photovoice), 2) interviews with Beacon Hill stakeholders and community members, and 3) mobility audits.
