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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
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1 to 9 of 9 Research Studies DisplayedMoise N, Paniagua-Avila A, Barbecho JM
A theory-informed, rapid cycle approach to identifying and adapting strategies to promote sustainability: optimizing depression treatment in primary care clinics seeking to sustain collaborative care (the transform depcare study).
This study used a collaborative care (CC) use case to describe a novel, theory-informed, stakeholder engaged process for operationalizing strategies for sustainability using a behavioral lens. The goal is to optimize depression treatment in primary care clinics using the Transform DepCare shared decision-making and psychoeducation patient tool. The authors applied the Behaviour Change Wheel to their prior mixed methods to identify key sustainability behaviors and determinants of sustainability. The authors enlisted 22 national and local stakeholders to operationalize and adapt a multi-level, multi-component implementation strategy to maximally target behavioral and contextual determinants of sustainability. They identified ongoing care manager CC delivery, provider treatment optimization, and patient enrollment as key sustainability behaviors. They determined that a waiting room that delivered DepCare, the results of which are delivered to providers, as well as ongoing problem-solving meetings/local technical assistance with care managers would be the most acceptable and equitable multi-level strategy in diverse settings seeking to sustain CC programs. Key improvements would include expanding the DepCare tool to incorporate anxiety/suicide screening, triage support, multi-modal delivery, and patient activation (vs. shared decision making) (patient); pairing summary reports with decisional support and yearly onboarding/motivational educational videos (provider); incorporating behavioral health providers into problem-solving meetings and shifting from billing support to quality improvement and triage (system).
AHRQ-funded; HS025198.
Citation: Moise N, Paniagua-Avila A, Barbecho JM .
A theory-informed, rapid cycle approach to identifying and adapting strategies to promote sustainability: optimizing depression treatment in primary care clinics seeking to sustain collaborative care (the transform depcare study).
Implement Sci Commun 2023 Jan 25; 4(1):10. doi: 10.1186/s43058-022-00383-2..
Keywords: Depression, Primary Care, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research
Ortiz D, Perkins AJ, Fuchita M
Pre-existing anxiety and depression in injured older adults: an under-recognized comorbidity with major health implications.
The purpose of this retrospective post-hoc analysis study was to evaluate variations in baseline depression and anxiety screenings between older injured patients with pre-existing diagnoses and those without. Data from the Trauma Medical Home, a multicenter randomized controlled trial was used for analysis. The study found that almost 50% of the patients screened positive for at least mild depressive symptoms as measured by the Patient Health Questionnaire-9, and 41% of the patients screened positive for at least mild anxiety symptoms as measured by the Generalized Anxiety Disorder Scale. Female patients with a history of concurrent anxiety and depression, greater injury severity scores, and higher Charlson scores were more likely to have mild anxiety at the baseline assessment. Patients with a history of depression only, a prior history of depression and concurrent anxiety, and higher Charlson scores (greater medical comorbidity) were more likely to have experienced at least mild depression at the time of hospital discharge after traumatic injury.
AHRQ-funded; HS026390.
Citation: Ortiz D, Perkins AJ, Fuchita M .
Pre-existing anxiety and depression in injured older adults: an under-recognized comorbidity with major health implications.
Ann Surg Open 2022 Dec; 3(4):e217. doi: 10.1097/as9.0000000000000217..
Keywords: Elderly, Anxiety, Depression, Behavioral Health, Patient-Centered Healthcare, Patient-Centered Outcomes Research, Injuries and Wounds
Tobin JN, Cassells A, Weiss E
Integrating cancer screening and mental health services in primary care: protocol and baseline results of a patient-centered outcomes intervention study.
AHRQ-funded; HS021667.
Citation: Tobin JN, Cassells A, Weiss E .
Integrating cancer screening and mental health services in primary care: protocol and baseline results of a patient-centered outcomes intervention study.
J Health Care Poor Underserved 2021;32(4):1907-34. doi: 10.1353/hpu.2021.0173..
Keywords: Patient-Centered Healthcare, Cancer, Behavioral Health, Primary Care, Depression, Women, Screening
Swietek KE, Domino ME, Grove LR
Duration of medical home participation and quality of care for patients with chronic conditions.
The objective of this study was to examine whether the length of participation in a patient-centered medical home (PCMH), an evidence-based practice, led to higher quality care for Medicaid enrollees with multiple co-morbid chronic conditions and major depressive disorder (MDD). The investigators concluded that the PCMH model was associated with higher quality of care for patients with multiple chronic conditions and MDD over time, and these benefits increased the longer a patient was enrolled.
AHRQ-funded; HS000032; HS019659.
Citation: Swietek KE, Domino ME, Grove LR .
Duration of medical home participation and quality of care for patients with chronic conditions.
Health Serv Res 2021 Oct;56(Suppl 1):1069-79. doi: 10.1111/1475-6773.13710..
Keywords: Chronic Conditions, Patient-Centered Healthcare, Quality of Care, Evidence-Based Practice, Depression, Behavioral Health
Chen H, Upadhyay N, Lyu N
Association of primary and behavioral health integrated care upon pediatric mental disorder treatment.
This study’s objective was to examine whether linkage with mental health (MH) treatment differed across 3 different integrated care agreements (ICAs) following diagnosis for Attention Deficit Hyperactive Disorder (ADHD) or Major Depressive Disorder (MDD) given by primary care providers (PCPs) in the pediatric setting. The ICAs were categorized as PCPs who practiced alone (non-co-located); PCPs practiced with specialist outside the practice but co-located at the practice site; and employed specialists who were co-located. A total of 4203 incident ADHD and 298 incident MDD diagnoses were identified, of which 74% of ADHD cases and 67% of MDD cases received treatment within 90 days of diagnosis. Children with ADHD were twice as likely to receive treatment if they were diagnosed by non-co-located or co-affiliated PCPs than those diagnosed by non-co-located PCPs. Those treated children were also 2 times more likely to receive guideline recommended psychotherapy and treated at the diagnosing site versus elsewhere.
AHRQ-funded; HS025251.
Citation: Chen H, Upadhyay N, Lyu N .
Association of primary and behavioral health integrated care upon pediatric mental disorder treatment.
Acad Pediatr 2021 Sep-Oct;21(7):1187-94. doi: 10.1016/j.acap.2021.05.021..
Keywords: Children/Adolescents, Behavioral Health, Patient-Centered Healthcare, Primary Care, Healthcare Delivery, Depression
Moise N, Falzon L, Obi M
Interventions to increase depression treatment initiation in primary care patients: a systematic review.
Researchers investigated interventions for increasing depression treatment initiation in primary care settings. They found that collaborative/integrated care, preference treatment matching, and case management strategies had the best evidence for improving depression treatment initiation, but none of the strategies had high strength of evidence. While primary care settings can consider using some of these strategies when referring depressed patients to treatment, their review highlights the need for further rigorous research in this area.
AHRQ-funded; HS025198.
Citation: Moise N, Falzon L, Obi M .
Interventions to increase depression treatment initiation in primary care patients: a systematic review.
J Gen Intern Med 2018 Nov;33(11):1978-89. doi: 10.1007/s11606-018-4554-z..
Keywords: Patient-Centered Healthcare, Depression, Primary Care, Behavioral Health, Patient and Family Engagement
Brunwasser SM, Freres DR, Gillham JE
Youth cognitive-behavioral depression prevention: testing theory in a randomized controlled trial.
This study tested the plausibility of a theoretical model of change for the Penn Resiliency Program (PRP), a cognitive-behavioral (CB) depression prevention program for adolescents. The authors assert that when effective, PRP's CB training provides incremental value over non-specific components and there are indirect effects on depressive symptoms through improvements in explanatory style.
AHRQ-funded; HS022990.
Citation: Brunwasser SM, Freres DR, Gillham JE .
Youth cognitive-behavioral depression prevention: testing theory in a randomized controlled trial.
Cognit Ther Res 2018 Aug;42(4):468-82..
Keywords: Children/Adolescents, Behavioral Health, Depression, Patient-Centered Healthcare, Prevention
Hines AL, Roter D, Ghods Dinoso BK
Informed and patient-centered decision-making in the primary care visits of African Americans with depression.
This study examined the prevalence and extent of informed decision-making (IDM) and patient-centered decision-making (PCDM) in primary care visits of African Americans with depression. It concluded that the associations between IDM and PCDM with interpersonal ratings were moderated by overall patient-centeredness of the visit, which may be indicative of broader cross-cultural communication issues. Strengthening partnerships between depressed African Americans and their clinicians may improve patient-engaged decision-making.
AHRQ-funded; HS013645.
Citation: Hines AL, Roter D, Ghods Dinoso BK .
Informed and patient-centered decision-making in the primary care visits of African Americans with depression.
Patient Educ Couns 2018 Feb;101(2):233-40. doi: 10.1016/j.pec.2017.07.027.
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Keywords: Decision Making, Depression, Patient-Centered Healthcare, Primary Care, Racial and Ethnic Minorities
Jonassaint CR, Jones VL, Leong S
A systematic review of the association between depression and health care utilization in children and adults with sickle cell disease.
The authors sought to determine whether depression or depressive symptoms are associated with health care utilization among children and adults with sickle cell disease (SCD). They found that, overall, depressive symptoms are common in SCD and may increase risk for poor outcomes including health care utilization. They further found a modest association between depression and health care utilization in SCD.
AHRQ-funded; HS022989.
Citation: Jonassaint CR, Jones VL, Leong S .
A systematic review of the association between depression and health care utilization in children and adults with sickle cell disease.
Br J Haematol 2016 Jul;174(1):136-47. doi: 10.1111/bjh.14023.
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Keywords: Children/Adolescents, Depression, Healthcare Utilization, Patient-Centered Healthcare, Sickle Cell Disease
