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Topics
- Access to Care (2)
- Anxiety (1)
- (-) Behavioral Health (23)
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- Patient-Centered Healthcare (4)
- Patient-Centered Outcomes Research (1)
- Patient Experience (2)
- Primary Care (9)
- Primary Care: Models of Care (2)
- Quality Improvement (1)
- Racial and Ethnic Minorities (2)
- Rural Health (1)
- Social Media (2)
- Substance Abuse (2)
- Tobacco Use (1)
- Training (1)
- Trauma (1)
- Vulnerable Populations (2)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 23 of 23 Research Studies DisplayedKang-Yi CD, Kuriyan A, Kinkler G
Generating actionable evidence for school-based mental health service delivery: public-academic partnership based evaluations.
This paper reported the key findings of evaluations of Philadelphia's school mental health programs reimbursable through Medicaid billing since 2008. The evaluations included acute mental health service use of children who received school-based care and Medicaid expenditure, children's behaviors to measure school mental health providers' performance, and effects of school mental health programs on children's behavioral health functioning, school outcomes, and other service usage. The paper discussed how programs have been refined based on evaluation results, and shared lessons learned for successful public-academic partnership-based evaluations.
AHRQ-funded; HS026862.
Citation: Kang-Yi CD, Kuriyan A, Kinkler G .
Generating actionable evidence for school-based mental health service delivery: public-academic partnership based evaluations.
Community Ment Health J 2023 Nov; 59(8):1588-600. doi: 10.1007/s10597-023-01147-5..
Keywords: Children/Adolescents, Behavioral Health, Healthcare Delivery, Community-Based Practice
Goldstein E, King C, Crits-Cristoph P
The association between trauma and interpersonal problems in a United States community mental health setting.
Prior studies have established connections between traumatic experiences and issues in interpersonal relationships. The purpose of this study was to explore the influence of trauma on interpersonal difficulties in depressed individuals seeking assistance within a community mental health framework. The study included 453 patients who sought treatment and were screened for a comparative effectiveness analysis of depression therapies. The relationship between the 32-item Inventory of Interpersonal Problems (IIP-32) and trauma indicators was investigated. The study found that a staggering 99.1% of participants had undergone a traumatic event. Notable correlations were identified between the total count of traumas, the number of sexually and physically abusive traumas, and factors such as gender and ethnicity. The number of sexually abusive traumas demonstrated a significant connection to the IIP-32 "excessively nurturing" subscale. After adjusting for demographic variables and other IIP-32 subscales, the overall number of traumas retained a significant association with the IIP-32 "excessively nurturing" category.
AHRQ-funded; HS018440
Citation: Goldstein E, King C, Crits-Cristoph P .
The association between trauma and interpersonal problems in a United States community mental health setting.
J Clin Psychol 2023 Apr;79(4):1192-207. doi: 10.1002/jclp.23467.
Keywords: Trauma, Behavioral Health, Community-Based Practice
Safon CB, Estela MG, Rosenberg J
Implementation of a novel pediatric behavioral health integration initiative.
The purpose of this concurrent, qualitative-dominant mixed methods empirical study was to explore healthcare professionals' perceptions of the impact of behavioral health integration (BHI) on pediatric primary care delivery in community health centers (CHCs). The researchers utilized semi-structured interviews with healthcare professionals at the end of the implementation phase of a 3-year process and surveys administered at three time points. Qualitative themes were mapped onto the Relational Coordination (RC) conceptual framework to triangulate and complement final qualitative results with quantitative results. The researchers round five emergent themes aligning with RC domains. The results of the survey showed that healthcare professionals reported both greater behavioral healthcare integration into clinic practice and greater clinic readiness to address behavioral health needs. The researchers concluded that effective pediatric BHI and care delivery at CHCs may depend on solid professional relationships and communication.
AHRQ-funded; HS022242.
Citation: Safon CB, Estela MG, Rosenberg J .
Implementation of a novel pediatric behavioral health integration initiative.
J Behav Health Serv Res 2023 Jan;50(1):1-17. doi: 10.1007/s11414-022-09803-6..
Keywords: Children/Adolescents, Behavioral Health, Healthcare Delivery, Primary Care, Patient-Centered Healthcare, Community-Based Practice
King C, Goldstein E, Crits-Christoph P
The association between medical comorbidity and psychotherapy processes and outcomes for major depressive disorder in a community mental health setting.
The purpose of this study was to: examine the comorbidities of mental health issues and a medical condition in a community mental health setting with a primarily Medicare and Medicaid population; describe the range of comorbid medical conditions in this setting; and explore the association between medical conditions on the alliance, attrition from services and outcome. The researchers accessed patient charts and conducted structured clinical interviews to collect medical diagnoses from 353 participants who had previously had a baseline evaluation as a participant in a study of therapies for major depressive disorder. The researchers reported that a high percentage of patients in the study experienced a comorbid medical condition. There were no significant correlations between the number of medical conditions and treatment outcome or early attrition from treatment. Further analyses revealed that the presence of a nervous system disorder was correlated with poorer treatment outcomes. The researchers concluded that patients undergoing treatment for major depressive disorder may benefit from simultaneously attending to the impact of medical conditions on physical functioning.
AHRQ-funded; HS018440.
Citation: King C, Goldstein E, Crits-Christoph P .
The association between medical comorbidity and psychotherapy processes and outcomes for major depressive disorder in a community mental health setting.
Psychotherapy 2022 Jun;59(2):199-208. doi: 10.1037/pst0000380..
Keywords: Depression, Behavioral Health, Community-Based Practice
Burnett-Zeigler I, Satyshur MD, Hong S
Acceptability of a mindfulness intervention for depressive symptoms among African-American women in a community health center: a qualitative study.
The authors examined the acceptability and feasibility of a mindfulness-based group intervention for socio-economically disadvantaged women in an urban community health center. Participants reported benefits to the intervention as well as barriers to session attendance. The authors concluded that the mindfulness-based intervention for depression was acceptable, reduced stress, and improved coping and functioning among women in a community health center.
AHRQ-funded; HS023011.
Citation: Burnett-Zeigler I, Satyshur MD, Hong S .
Acceptability of a mindfulness intervention for depressive symptoms among African-American women in a community health center: a qualitative study.
Complement Ther Med 2019 Aug;45:19-24. doi: 10.1016/j.ctim.2019.05.012..
Keywords: Community-Based Practice, Depression, Behavioral Health, Racial and Ethnic Minorities, Women
Aggarwal R, Pham M, Dillingham R
Expanded HIV clinic-based mental health care services: association with viral suppression.
This study compared two cohorts of people living with HIV (PLWH) who were receiving clinic-based mental health services. Cohort A received the services before or during 2012, and Cohort B from 2013-2014. Cohort A had three times as many participants with a CD4 count <200. Cohort B were more likely to also have a substance abuse diagnosis. The researchers concluded that the later cohort may not have as much benefit from increased access to co-located mental health services and substance use services.
AHRQ-funded; HS024196.
Citation: Aggarwal R, Pham M, Dillingham R .
Expanded HIV clinic-based mental health care services: association with viral suppression.
Open Forum Infect Dis 2019 Apr;6(4):ofz146. doi: 10.1093/ofid/ofz146..
Keywords: Access to Care, Behavioral Health, Community-Based Practice, Human Immunodeficiency Virus (HIV), Substance Abuse
Davis MM, Gunn R, Gowen LK
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
In this study, the authors examined, using qualitative methods, patients' experiences of care in integrated settings. The study included 24 patients receiving care across five practices participating in Advancing Care Together (ACT)-a 4-year demonstration project (2010-2014) of primary care and community mental health centers (CMHCs) integrating care. The investigators found that patients in both primary care and CMHCs perceived similar benefits from integrated care related to personal growth, improved quality, and access to care.
AHRQ-funded; HS022981.
Citation: Davis MM, Gunn R, Gowen LK .
A qualitative study of patient experiences of care in integrated behavioral health and primary care settings: more similar than different.
Transl Behav Med 2018 Sep 8;8(5):649-59. doi: 10.1093/tbm/ibx001..
Keywords: Community-Based Practice, Healthcare Delivery, Behavioral Health, Patient Experience, Primary Care
Andreae SJ, Andreae LJ, Cherrington AL
Development of a community health worker-delivered cognitive behavioral training intervention for individuals with diabetes and chronic pain.
The investigators presented an iterative developmental approach to cognitive behavioral therapy (CBT) that combined program adaptation, pretesting, and community health workers (CHW) training processes for a CBT-based diabetes self-care program for individuals living with diabetes and chronic pain.
AHRQ-funded; HS019239.
Citation: Andreae SJ, Andreae LJ, Cherrington AL .
Development of a community health worker-delivered cognitive behavioral training intervention for individuals with diabetes and chronic pain.
Fam Community Health 2018 Jul/Sep;41(3):178-84. doi: 10.1097/fch.0000000000000197.
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Keywords: Behavioral Health, Chronic Conditions, Community-Based Practice, Diabetes, Rural Health
Naslund JA, Aschbrenner KA, Bartels SJ
How people with serious mental illness use smartphones, mobile apps, and social media.
The researchers surveyed individuals with serious mental illness to explore their use of mobile devices or whether they access social media. Among respondents (n = 70), 93 percent owned cellphones, 78 percent used text messaging, 50 percent owned smartphones, and 71 percent used social media such as Facebook. Most respondents reported daily use of text messaging, mobile apps, and social media.
AHRQ-funded; HS021695.
Citation: Naslund JA, Aschbrenner KA, Bartels SJ .
How people with serious mental illness use smartphones, mobile apps, and social media.
Psychiatr Rehabil J 2016 Dec;39(4):364-67. doi: 10.1037/prj0000207.
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Keywords: Communication, Community-Based Practice, Health Promotion, Behavioral Health, Social Media
Fulford D, Tuot DS, Mangurian C
Electronic psychiatric consultation in primary care in the safety net.
The authors examined the feasibility and acceptability of implementing a psychiatric eReferral program in a publicly funded, community-based primary care clinic in San Francisco staffed by eight primary care practitioners (PCPs). They found feasibility and acceptability of implementing an integrated electronic psychiatry consultation and referral service in a community-based primary care clinic and recommended future trials designed to examine the impact of this type of service on the delivery of high-quality mental health care and its cost-effectiveness in a safety-net health care system.
AHRQ-funded; HS021700.
Citation: Fulford D, Tuot DS, Mangurian C .
Electronic psychiatric consultation in primary care in the safety net.
Psychiatr Serv 2016 Oct;67(10):1160-61. doi: 10.1176/appi.ps.671003.
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Keywords: Community-Based Practice, Electronic Health Records (EHRs), Behavioral Health, Primary Care, Health Information Technology (HIT)
Connolly Gibbons MB, Gallop R, Thompson D
Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: a randomized clinical noninferiority trial.
The authors sought to determine whether dynamic psychotherapy (DT) is not inferior to cognitive therapy (CT) in the treatment of major depressive disorder (MDD) in a community mental health setting. This study suggests that DT is not inferior to CT on change in depression for the treatment of MDD in a community mental health setting.
AHRQ-funded; HS018440.
Citation: Connolly Gibbons MB, Gallop R, Thompson D .
Comparative effectiveness of cognitive therapy and dynamic psychotherapy for major depressive disorder in a community mental health setting: a randomized clinical noninferiority trial.
JAMA Psychiatry 2016 Sep;73(9):904-11. doi: 10.1001/jamapsychiatry.2016.1720.
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Keywords: Comparative Effectiveness, Community-Based Practice, Depression, Behavioral Health, Patient-Centered Outcomes Research
Aschbrenner KA, Naslund JA, Shevenell M
A pilot study of a peer-group lifestyle intervention enhanced with mHealth technology and social media for adults with serious mental illness.
This pilot study of 32 participants examined the preliminary effectiveness of a peer-group lifestyle intervention enhanced with mobile health technology and social media for obese individuals with serious mental illness. Most participants (72%) lost weight, and 17% showed clinically significant improvements in cardiovascular fitness. This study demonstrated the preliminary effectiveness of peer-group lifestyle intervention in a community mental health setting.
AHRQ-funded; HS021695.
Citation: Aschbrenner KA, Naslund JA, Shevenell M .
A pilot study of a peer-group lifestyle intervention enhanced with mHealth technology and social media for adults with serious mental illness.
J Nerv Ment Dis 2016 Jun;204(6):483-6. doi: 10.1097/nmd.0000000000000530.
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Keywords: Behavioral Health, Social Media, Lifestyle Changes, Obesity, Community-Based Practice
Salloum A, Johnco C, Lewin AB
Barriers to access and participation in community mental health treatment for anxious children.
The authors examined common barriers to treatment access and participation among anxious children who participated in computer-assisted cognitive behavioral therapy. They found that the most common access barrier was parents not knowing where or from whom to seek services. They concluded that accessible, time-efficient, cost-effective service delivery methods that minimize stigma and maximize engagement when delivering evidence-based treatment for pediatric anxiety are needed.
AHRQ-funded; HS018665.
Citation: Salloum A, Johnco C, Lewin AB .
Barriers to access and participation in community mental health treatment for anxious children.
J Affect Disord 2016 May 15;196:54-61. doi: 10.1016/j.jad.2016.02.026.
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Keywords: Access to Care, Anxiety, Children/Adolescents, Community-Based Practice, Behavioral Health
Patel SR, Gorritz M, Olfson M
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
The researchers evaluated a quality improvement intervention to improve the screening and management (e.g., referral to psychiatric care) of common mental disorders in small independent Latino primary care practices. They concluded that improving the quality of mental health care in low-resourced primary care settings may require academic detailing and consultation/liaison psychiatric intervention supplemented with staff outreach to achieve meaningful improvement in the processes of care.
AHRQ-funded; HS021112.
Citation: Patel SR, Gorritz M, Olfson M .
Training community-based primary care physicians in the screening and management of mental health disorders among Latino primary care patients.
Gen Hosp Psychiatry 2016 Jan-Feb;38:71-8. doi: 10.1016/j.genhosppsych.2015.09.006.
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Keywords: Community-Based Practice, Primary Care, Behavioral Health, Racial and Ethnic Minorities, Quality Improvement
Davis MM, Balasubramanian BA, Cifuentes M
Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care.
This study examined the interrelationship among behavioral health clinician staffing, scheduling, and a primary care practice's approach to delivering integrated care. It concluded that practices' approaches to staffing by primary care clinicians and behavioral health clinicians, scheduling, and delivery of integrated care mutually influenced each other and were shaped by the local context.
AHRQ-funded; HS022981.
Citation: Davis MM, Balasubramanian BA, Cifuentes M .
Clinician staffing, scheduling, and engagement strategies among primary care practices delivering integrated care.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S32-40. doi: 10.3122/jabfm.2015.S1.150087.
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Keywords: Behavioral Health, Patient-Centered Healthcare, Healthcare Delivery, Primary Care: Models of Care, Primary Care, Community-Based Practice
Cohen DJ, Davis M, Balasubramanian BA
Integrating behavioral health and primary care: consulting, coordinating and collaborating among professionals.
This paper sought to describe how clinicians from different backgrounds interact to deliver integrated behavioral and primary health care, and the contextual factors that shape such interactions. It concluded that primary care and behavioral health clinicians, through their interactions, consult, coordinate, and collaborate with each other to solve patients' problems.
AHRQ-funded; HS022981.
Citation: Cohen DJ, Davis M, Balasubramanian BA .
Integrating behavioral health and primary care: consulting, coordinating and collaborating among professionals.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S21-31. doi: 10.3122/jabfm.2015.S1.150042.
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Keywords: Healthcare Delivery, Community-Based Practice, Decision Making, Behavioral Health, Primary Care
Hall J, Cohen DJ, Davis M
Preparing the workforce for behavioral health and primary care integration.
The researchers sought to identify how organizations prepare clinicians to work together to integrate behavioral health and primary care. They concluded that insufficient training capacity and practical experience opportunities continue to be major barriers to supplying the workforce needed for effective behavioral health and primary care integration. Until the training capacity grows to meet the demand, practices must put forth considerable effort and resources to train their own employees.
AHRQ-funded; HS022981.
Citation: Hall J, Cohen DJ, Davis M .
Preparing the workforce for behavioral health and primary care integration.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S41-51. doi: 10.3122/jabfm.2015.S1.150054.
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Keywords: Patient-Centered Healthcare, Healthcare Delivery, Primary Care: Models of Care, Primary Care, Behavioral Health, Training, Community-Based Practice
Balasubramanian BA, Fernald D, Dickinson LM
REACH of interventions integrating primary care and behavioral health.
This study reports REACH (the extent to which an intervention or program was delivered to the identified target population) of interventions integrating primary care and behavioral health implemented by real-world practices. Practices that implemented systematic protocols to identify patients needing integrated care had a significantly higher screening REACH compared with practices that used clinicians' discretion.
AHRQ-funded; HS022981.
Citation: Balasubramanian BA, Fernald D, Dickinson LM .
REACH of interventions integrating primary care and behavioral health.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S73-85. doi: 10.3122/jabfm.2015.S1.150055.
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Keywords: Behavioral Health, Healthcare Delivery, Patient-Centered Healthcare, Primary Care, Community-Based Practice, Implementation, Community-Based Practice, Implementation
Cohen DJ, Balasubramanian BA, Davis M
Understanding care integration from the ground up: five organizing constructs that shape integrated practices.
The authors identified 5 key organizing constructs influencing integration of primary care and behavioral health. They concluded that the interaction among 5 organizing constructs and practice context produces diverse expressions of integrated care. These constructs provide a framework for understanding how primary care and behavioral health services can be integrated in routine practice.
AHRQ-funded; HS022981.
Citation: Cohen DJ, Balasubramanian BA, Davis M .
Understanding care integration from the ground up: five organizing constructs that shape integrated practices.
J Am Board Fam Med 2015 Sep-Oct;28 Suppl 1:S7-20. doi: 10.3122/jabfm.2015.S1.150050.
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Keywords: Behavioral Health, Healthcare Delivery, Community-Based Practice, Primary Care
Connolly Gibbons MB, Kurtz JE, Thompson DL
The effectiveness of clinician feedback in the treatment of depression in the community mental health system.
This article described the development and evaluation of a clinician feedback intervention for use in community mental health settings. The Community Clinician Feedback System (CCFS) was developed in collaboration with a community partner to meet the needs of providers working in such community settings. Satisfaction ratings of the CCFS indicated that the system was widely accepted by clinicians and patients.
AHRQ-funded; HS022124.
Citation: Connolly Gibbons MB, Kurtz JE, Thompson DL .
The effectiveness of clinician feedback in the treatment of depression in the community mental health system.
J Consult Clin Psychol 2015 Aug;83(4):748-59. doi: 10.1037/a0039302..
Keywords: Community-Based Practice, Community Partnerships, Depression, Behavioral Health, Patient Experience
Henwood BF, Katz ML, Gilmer TP
Aging in place within permanent supportive housing.
This study examined whether and how permanent supportive housing (PSH) programs are able to support aging in place among tenants with serious mental illness. It found that PSH is an effective way to end homelessness, yet little is known about how programs can support housing stability among aging populations.
AHRQ-funded; HS019986.
Citation: Henwood BF, Katz ML, Gilmer TP .
Aging in place within permanent supportive housing.
Int J Geriatr Psychiatry 2015 Jan;30(1):80-7. doi: 10.1002/gps.4120..
Keywords: Elderly, Behavioral Health, Community-Based Practice, Vulnerable Populations
Lebrun-Harris LA, Fiore MC, Tomoyasu N
AHRQ Author: Ngo-Metzger Q
Cigarette smoking, desire to quit, and tobacco-related counseling among patients at adult health centers.
A national survey of adult patients at health centers found a higher prevalence of cigarette smoking (31 percent) than among the general adult population (21 percent). Among the currently smoking health center patients, 83 percent desired to quit and 68 percent had received tobacco counseling.
AHRQ-authored
Citation: Lebrun-Harris LA, Fiore MC, Tomoyasu N .
Cigarette smoking, desire to quit, and tobacco-related counseling among patients at adult health centers.
Am J Public Health. 2015 Jan;105(1):180-8..
Keywords: Behavioral Health, Community-Based Practice, Tobacco Use
Lebrun-Harris LA, Tomoyasu N, Ngo-Metzger Q
AHRQ Author: Ngo-Metzger Q
Substance use, risk of dependence, counseling and treatment among adult health center patients.
The authors examined the prevalence of substance use and risk of dependence among health center patients, and identified factors associated with desire for counseling/treatment and discussions about substance use with a clinician. They found that 84% of patients who desired substance use counseling or treatment reported receiving it, and those patients most likely to desire substance use counseling or treatment were male, unmarried, insured, current smokers, and indicated mental health problems.
AHRQ-authored.
Citation: Lebrun-Harris LA, Tomoyasu N, Ngo-Metzger Q .
Substance use, risk of dependence, counseling and treatment among adult health center patients.
J Health Care Poor Underserved 2014 Aug;25(3):1217-30. doi: 10.1353/hpu.2014.0130.
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Keywords: Behavioral Health, Community-Based Practice, Substance Abuse, Vulnerable Populations