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 widespread availability of fentanyl and other potent synthetic opioids has dramatically increased opioid-related fatal overdoses. This project will develop and manufacture immune molecules (monoclonal antibodies) to reverse and treat overdose from fentanyl by keeping it out of the brain. This research will advance promising results in animal studies (preventing and reversing fentanyl- and carfentanil-induced breathing problems and irregular heartbeat) to clinical testing in people with opioid use disorder and others at high risk of opioid overdose from accidental or deliberate exposure to fentanyl and fentanyl-like drugs.
Traumatic brain injury (TBI) is common in the United States with 2.87 million emergency department visits related to TBI per year. Chronic pain is a frequent complaint following TBI, with more than half of patients reporting pain. Individuals with TBI are often prescribed opioids for pain following their injury, but unfortunately may be especially vulnerable to post-injury alcohol and drug use problems.
Despite increased opioid prescriptions and risk factors for this population, there are no clinical practice guidelines for opioid prescription following TBI and limited published research. The project seeks to address this knowledge gap by using routinely collected clinical data from several different data sources to examine when and how opioids are prescribed following TBI in a community-based population.
This complete picture of opioid prescription following TBI may reveal trends of higher opioid prescription for specific subpopulations or areas of healthcare. Through understanding the trajectory of opioid prescription following TBI, we will be able to identify the scope of the problem and the most appropriate time points for intervention. Ultimately this project will provide the foundation for new approaches to reduce opioid prescription in the clinical management of TBI.
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 project will develop and test an interactive web-based intervention with text-message reminders for young adults who drink to cope with negative affect. The intervention will include interactive modules on CBT coping skills, assignments to practice the skills, text-message reminders, and weekly assessments on coping skill utilization and barriers to use. A total of 120 young adults will be randomized to the 4-week, web-based drinking to cope intervention (n=60) or an assessment only control (n=60) and complete a 1- and 3-month follow-up.
The proposed F32 aims to conduct a secondary analysis of time-intensive daily data (MPIs: Lee/Patrick; R01AA025037) to elucidate the roles of affect and affective dynamics on simultaneous alcohol and marijuana (SAM) use outcomes among a sample of high-risk adults (N = 409). We will test whether theoretically-relevant affective dynamic processes (affective instability, negative emotion differentiation): (1) are more useful for predicting SAM use and alcohol use than mean level of affect (within- and between-subjects); (2) prospectively predict changes in SAM use and use-related problems over time; and (3) can distinguish SAM use from single substance use patterns, which has direct implications for the personalization and precision of prevention and intervention efforts.
The co-occurrence of posttraumatic stress disorder (PTSD) and hazardous drinking (HD) can be particularly devastating; though evidence-based treatments exist, many individuals with this co-occurrence drop out from or do not or cannot access specialty care. Text-messaging is a mode of intervention delivery that is low-cost, low-burden, and accessible to most people; development and testing of self-directed text message interventions that use evidence- and theoretically-based strategies to reduce PTSD and HD symptom burden is highly needed. Such interventions have the potential for great clinical significance via providing additional, novel treatment options that are readily scalable and have wide reach and thus can have a large impact on individual and public health.
This project is contributing to the expanded offering of the Opioid Response Network (ORN), a national partnership of the American Academy of Addiction Psychiatry and the Addiction Technology Transfer Center (ATTC) network, to provide on-demand technical assistance in areas of prevention, treatment, and recovery for care related to opioid and stimulant use disorders.
