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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results1 to 25 of 659 Research Studies Displayed
Miller-Rosales C, Busch SH, Meara ER
Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders.
This study examined the extent of screening for opioid use and availability of medications for opioid use disorder (MOUD) in a national cross-section of multi-physician primary care and multispecialty practices. The authors found that a total of 26.2% of practices offered MOUD, while 69.4% of practices screened for opioid use. Offering of MOUD in a practice was associated with having advanced HIT functionality, while access to on-site behavioral clinicians was positively associated with offering MOUD in adjusted models.
Citation: Miller-Rosales C, Busch SH, Meara ER . Internal and environmental predictors of physician practice use of screening and medications for opioid use disorders. Med Care Res Rev 2023 Aug; 80(4):410-22. doi: 10.1177/10775587231162681..
Keywords: Opioids, Substance Abuse, Behavioral Health, Screening, Medication, Practice Patterns
Levander XA, Carmody T, Cook RR
A gender-based secondary analysis of the ADAPT-2 combination naltrexone and bupropion treatment for methamphetamine use disorder trial.
This study’s objective was to determine if there were gender-based differences in treatment for methamphetamine use disorder (MUD) in general comparing treatment with placebo and due to use of a hormonal method of contraception (HMC). This research was a secondary analysis of ADAPT-2, a randomized, double-blind, placebo-controlled, multicenter, two-stage sequential parallel comparison design trial. This cohort study comprised 126 women (403 total participants); average age of 40.1 years with moderate to severe MUD. At baseline, women used methamphetamine intravenously fewer days than men [15.4 versus 23.1% days] and more women than men had anxiety (59.5 versus 47.6%). Of the 113 women capable of becoming pregnant, 31 used HMC. Treatment response for women was 29% in Stage 1 and 5.6% in Stage 2 compared with 3.2% and 0% on placebo, respectively. A treatment effect was found independently for females and males; with no between-gender treatment effect (0.144 females versus 0.100 males). Treatment effect did not differ by HMC use (0.156 HMC versus 0.128 none).
Citation: Levander XA, Carmody T, Cook RR . A gender-based secondary analysis of the ADAPT-2 combination naltrexone and bupropion treatment for methamphetamine use disorder trial. Addiction 2023 Jul; 118(7):1320-28. doi: 10.1111/add.16163..
Keywords: Substance Abuse, Medication, Behavioral Health, Sex Factors
Bushnell G, Lloyd J, Olfson M
Antipsychotic medication use in Medicaid-insured children decreased substantially between 2008 And 2016.
In the early 2000s there was a rapid growth of pediatric antipsychotic prescribing, especially in the Medicaid population, and concerns grew about the safety and appropriateness of such prescribing. Numerous states implemented policy and educational programs focused on safer and more stringent utilization of antipsychotics. Antipsychotic utilization leveled off toward the end of the 2000s, but no recent national trend estimates of antipsychotic utilization in children enrolled in Medicaid exist. The authors of this study report a substantial decrease in antipsychotic use among children ages 2-17 between 2008 and 2016. Declines existed across foster care status, age, sex, and racial and ethnic groups studied. The rate of children with an antipsychotic prescription who received any diagnosis related to a pediatric indication that was approved by the Food and Drug Administration increased from 38 percent in 2008 to 45 percent in 2016.
Citation: Bushnell G, Lloyd J, Olfson M . Antipsychotic medication use in Medicaid-insured children decreased substantially between 2008 And 2016. Health Aff 2023 Jul; 42(7):973-80. doi: 10.1377/hlthaff.2022.01625..
Keywords: Children/Adolescents, Medication, Medicaid, Behavioral Health
Titus AR, Mezuk B, Hirschtick JL
Patterns and predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan.
Researchers examined the intersection of demographic, economic, and illness-related predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan. Data were taken from a population-based survey of Michigan adults who experienced a COVID-19 diagnosis prior to August 2020. Results indicated that relative risks for experiencing poor mental health outcomes varied by race/ethnicity, sex, age, and income. Symptom severity was associated with a higher burden of comorbid depressive/anxiety symptoms. "Long COVID" was associated with all outcomes. The researchers concluded that because of overlapping risk factors, integrated approaches to treating depressive/anxiety symptoms among COVID-19 survivors is warranted.
Citation: Titus AR, Mezuk B, Hirschtick JL . Patterns and predictors of depressive and anxiety symptoms within a population-based sample of adults diagnosed with COVID-19 in Michigan. Soc Psychiatry Psychiatr Epidemiol 2023 Jul; 58(7):1099-108. doi: 10.1007/s00127-023-02453-9..
Keywords: COVID-19, Depression, Anxiety, Behavioral Health
Narindrarangkura P, Alafaireet PE, Khan U
Predicting suicide attempts among people with diabetes using a large multicenter electronic health records dataset.
This study’s goal was to determine the risk factors for suicidal behaviors of people with diabetes as they have a higher risk than the general population. The authors investigated risk factors and predicted suicide attempts in people with diabetes using the Least Absolute Shrinkage and Selection Operator (LASSO) regression. They used data from Cerner Real-World Data™ and included over 3 million diabetes patients in the study. They analyzed gender-, diabetes-type, and depression-specific LASSO regression models. The study included 7764 subjects diagnosed with suicide attempts with an average age of 45. They found risk factors for suicide attempts in diabetes patients, such as being an American Indian or Alaska Native, atypical agents, benzodiazepines, and antihistamines. Amyotrophy had a negative coefficient for suicide attempts with males with diabetes but had a positive coefficient for females. Using MAOI had a negative coefficient for suicide attempts in T1DM patients. Patients less than 20 years of age had a positive coefficient for suicide in depressed and non-depressed patients with diabetes.
Citation: Narindrarangkura P, Alafaireet PE, Khan U . Predicting suicide attempts among people with diabetes using a large multicenter electronic health records dataset. Int J Psychiatry Med 2023 Jul; 58(4):302-24. doi: 10.1177/00912174231162477..
Keywords: Electronic Health Records (EHRs), Health Information Technology (HIT), Behavioral Health, Diabetes, Chronic Conditions
Zhu JM, Meiselbach MK, Drake C C
Psychiatrist networks In Medicare Advantage plans are substantially narrower than in Medicaid and ACA Markets.
The authors used a novel data set that linked insurance network service areas, plans, and providers across Medicare Advantage, Medicaid managed care, and Affordable Care Act plan markets to compare psychiatrist network breadth; their purpose was to assess the percentage of providers in a given area considered in network for a plan. They found that nearly two-thirds of psychiatrist networks in Medicare Advantage contained fewer than 25 percent of providers in a network's service area. They concluded that these findings suggest a certain “narrowness” in psychiatrist networks in Medicare Advantage, which may disadvantage enrollees attempted to obtain mental health services.
Citation: Zhu JM, Meiselbach MK, Drake C C . Psychiatrist networks In Medicare Advantage plans are substantially narrower than in Medicaid and ACA Markets. Health Aff 2023 Jul; 42(7):909-18. doi: 10.1377/hlthaff.2022.01547..
Keywords: Elderly, Medicare, Behavioral Health, Access to Care
Olfson M, Zuvekas SH, McClellan C
AHRQ Author: Zuvekas SH, McClellan C
Racial-ethnic disparities in outpatient mental health care in the United States.
Using data from the 2018-19 Medical Expenditure Panel Survey, researchers compared national rates and patterns of use for outpatient mental health care among Hispanic, non-Hispanic Black, and non-Hispanic White individuals. Analyses focused on individuals using psychotropic medications, psychotherapy, or both, and receipt of minimally adequate mental health care. The results showed that the rate of outpatient mental health service use was more than twice as high for White individuals, and that Black and Hispanic patients were significantly less likely to receive psychotropic medications; Black and Hispanic patients were more likely to receive psychotherapy. No significant differences were found in patients who received minimally adequate treatment for depression, anxiety, attention-deficit hyperactivity disorder, or disruptive behavior disorders. The authors concluded that achieving racial-ethnic equity will require dedicated efforts to promote greater mental health service access for Black and Hispanic persons in need.
Citation: Olfson M, Zuvekas SH, McClellan C . Racial-ethnic disparities in outpatient mental health care in the United States. Psychiatr Serv 2023 Jul; 74(7):674-83. doi: 10.1176/appi.ps.20220365..
Keywords: Medical Expenditure Panel Survey (MEPS), Racial and Ethnic Minorities, Disparities, Behavioral Health, Ambulatory Care and Surgery
Huff NR, Chimowitz H, DelPico MA
The consequences of emotionally evocative patient behaviors on emergency nurses' patient assessments and handoffs: an experimental study using simulated patient cases.
The purpose of this experimental vignette research study was to explore the impact of emotionally evocative patient behavior and mental illness on 130 emergency nurses' emotions, patient assessments, testing advocacy, and written handoffs. The researchers asked the nurses to complete four multimedia computer-simulated patient encounters in which patient behavior (irritable vs. calm) and mental illness (present vs. absent) were purposely varied. The nurses recorded their emotions and clinical evaluations, recommended diagnostic tests, and provided written handoffs. The study found that the nurses experienced greater negative emotions (anger, unease) and reported decreased engagement when evaluating patients demonstrating irritable (vs. calm) behavior. Nurses also considered patients with irritable (vs. calm) behavior as more likely to exaggerate their pain and as poorer historians, and as less likely to cooperate, return to work, and recover. Nurses' handoffs were more likely to include negative descriptions of patients with irritable (vs. calm) behavior and exclude specific clinical information. The existence of mental illness increased unease and sadness and lead to nurses being less likely to recommend a needed test for a correct diagnosis.
Citation: Huff NR, Chimowitz H, DelPico MA . The consequences of emotionally evocative patient behaviors on emergency nurses' patient assessments and handoffs: an experimental study using simulated patient cases. Int J Nurs Stud 2023 Jul; 143:104507. doi: 10.1016/j.ijnurstu.2023.104507..
Keywords: Emergency Department, Behavioral Health, Nursing, Workflow
O'Connor EA, Henninger ML, Perdue LA
Anxiety screening: evidence report and systematic review for the US Preventive Services Task Force.
This evidence summary was published in conjunction with the final recommendation statement for the US Preventive Services Task Force on benefits and harms of screening and treatment for anxiety disorders in adults. A literature review was conducted with 59 publications included, 40 were original studies and 19 were systematic reviews. Two screening studies found no benefit for screening for anxiety. Only the Generalized Anxiety Disorder (GAD) GAD-2 and GAD-7 screening instruments were evaluated by more than 1 study. Both screening instruments had adequate accuracy for detecting generalized anxiety disorder with a pooled sensitivity of 0.79 and specificity of 0.89. Evidence was limited for other instruments and other anxiety disorders. Evidence was insufficient on the benefits or harms of anxiety screening programs. However, there is a large body of evidence supporting the benefit of treatment for anxiety.
AHRQ-funded; 290201500011I; 75Q80120D00004.
Citation: O'Connor EA, Henninger ML, Perdue LA . Anxiety screening: evidence report and systematic review for the US Preventive Services Task Force. JAMA 2023 Jun 27; 329(24):2171-84. doi: 10.1001/jama.2023.6369..
Keywords: U.S. Preventive Services Task Force (USPSTF), Anxiety, Behavioral Health, Screening, Evidence-Based Practice, Guidelines, Prevention
O'Connor EA, Perdue LA, Coppola EL
Depression and suicide risk screening: updated evidence report and systematic review for the US Preventive Services Task Force.
The objectives of this article were to review the benefits and harms of depression and suicide risk screening and treatment and the accuracy of instruments to detect these conditions in primary care patients. Evidence gathered from the literature search supported screening for depression in primary care settings, including during pregnancy and postpartum. The authors noted, however, that there were numerous important gaps in the evidence for suicide risk screening.
AHRQ-funded; 290201500011I; 75Q80120D00004.
Citation: O'Connor EA, Perdue LA, Coppola EL . Depression and suicide risk screening: updated evidence report and systematic review for the US Preventive Services Task Force. JAMA 2023 Jun 20; 329(23):2068-85. doi: 10.1001/jama.2023.7787..
Keywords: U.S. Preventive Services Task Force (USPSTF), Screening, Depression, Behavioral Health, Evidence-Based Practice, Guidelines, Risk
King C, Beetham T, Smith N
Treatments Used Among Adolescent Residential Addiction Treatment Facilities in the US, 2022.
This study is a survey of US adolescent residential addiction treatment facilities to assess treatments used for adolescents younger than 18 years seeking treatment for opioid use disorder (OUD). The authors posed as an aunt or uncle of a 16-year-old with a recent non-fatal fentanyl overdose to make calls to treatment facilities more plausible if they did not have all requested information about an adolescent. Four investigators called facilities included in the SAMHSA Treatment Indicator in random order and asked to speak with someone about residential treatment. They asked specific questions about buprenorphine use and open-ended questions about other available treatments. They identified 354 facilities, reached 327, and confirmed that 160 provided residential treatment to patients younger than 18 years. Of the 160 facilities identified 39 (24.4%) offered buprenorphine, including through partnerships with outside clinicians. Rates varied by US region (18% in the West to 40% in the Northeast). Among the 121 facilities that did not offer buprenorphine or were unsure, 57 indicated that adolescents who were prescribed buprenorphine by their own clinician could continue receiving it, at least temporarily, although some facilities indicated that would discontinue it before discharged, and 22.3% required adolescents to not be receiving it at admission. Of 160 facilities, 140 had someone available who could prescribe medications for psychiatric comorbidities. Overall, 124 facilities had naloxone, 24 did not, and 11 were unsure. Over half of the facilities included family members in adolescent treatment. Leading approaches for adolescent treatment included mutual help frameworks (eg, 12-step program, n = 59), cognitive behavior therapy (n = 52), community reinforcement/adolescent community approach (n = 44), art therapy (n = 40), and equine therapy (n = 40).
Citation: King C, Beetham T, Smith N . Treatments Used Among Adolescent Residential Addiction Treatment Facilities in the US, 2022. JAMA 2023 Jun 13; 329(22):1983-85. doi: 10.1001/jama.2023.6266..
Keywords: Children/Adolescents, Substance Abuse, Behavioral Health
Isbell LM, Chimowitz H, Huff NR
A qualitative study of emergency physicians' and nurses' experiences caring for patients with psychiatric conditions and/or substance use disorders.
This study’s aim was to develop a comprehensive data-driven model of the complex challenges and unique dynamics associated with caring for patients with psychiatric conditions and/or substance use disorders (SUDs) in the emergency department (ED), as well as the effect on patient care quality. The authors conducted a preplanned topical analysis of grounded theory data obtained from semistructured interviews with 86 ED physicians and nurses from 8 hospitals in the Northeastern USA. Participants described in detail their experiences and challenges in caring for patients with psychiatric conditions and/or SUDs. The authors identified themes inductively using constant comparative analysis and developed a grounded model of physicians' and nurses' perceptions of challenges, biases, and effects on patient care. Challenges identified were emotional, diagnostic, and logistical. These challenges magnified existing health care system issues and social structures, which fuel and reinforce negative attitudes, expectations, and biases. This creates a cyclical process whereby challenges and biases associated with patients with psychiatric conditions and/or SUDs can reciprocally threaten patient care quality.
Citation: Isbell LM, Chimowitz H, Huff NR . A qualitative study of emergency physicians' and nurses' experiences caring for patients with psychiatric conditions and/or substance use disorders. Ann Emerg Med 2023 Jun; 81(6):715-27. doi: 10.1016/j.annemergmed.2022.10.014..
Keywords: Behavioral Health, Substance Abuse, Emergency Department, Provider: Nurse, Provider: Physician
Stiles-Shields C, Archer J, Zhang J
A scoping review of associations between cannabis use and anxiety in adolescents and young adults.
This review sought to examine the association between anxiety and cannabis in adolescents and young adults. Forty-seven studies were identified that examined the relationship between anxiety and cannabis use via a database search; 23 studies found a positive association that greater anxiety was associated with greater cannabis use and 7 found a negative association. The remainder found no clear association. The authors concluded that further research is needed to understand the relationship between anxiety and cannabis use.
Citation: Stiles-Shields C, Archer J, Zhang J . A scoping review of associations between cannabis use and anxiety in adolescents and young adults. Child Psychiatry Hum Dev 2023 Jun; 54(3):639-58. doi: 10.1007/s10578-021-01280-w..
Keywords: Children/Adolescents, Anxiety, Substance Abuse, Behavioral Health
Short VL, Abatemarco DJ, Sood E
The Child Healthcare at MATER Pediatric Study (CHAMPS): a 2-arm cluster randomized control trial of group well child care for mothers in treatment for opioid use disorder and their children.
Group-based well child care is a shared medical appointment where families join as a group to receive pediatric primary care. Prior research indicates that this method of receiving care increases patient-reported satisfaction and adherence to recommended care. There is little evidence supporting the use of group well child care for mothers with opioid use disorder. The purpose of the Child Healthcare at MATER Pediatric Study (CHAMPS) is to assess a group model of well child care for mothers with opioid use disorder and their children to determine if a group well child care offered on-site at an opioid treatment program for pregnant and parenting women is beneficial over individual well child care. A total of 108 mother-child dyads will be enrolled into the study. In the intervention branch, group well child care will be provided on-site at a maternal substance use disorder treatment program. Mother-child dyads in the control branch will receive individual well child care from one nearby pediatric primary care clinic. Dyads in both study branches will be followed for 18 months, and their resulting data will be compared. Primary outcomes will include well child care quality and utilization, child health knowledge, and parenting quality.
Citation: Short VL, Abatemarco DJ, Sood E . The Child Healthcare at MATER Pediatric Study (CHAMPS): a 2-arm cluster randomized control trial of group well child care for mothers in treatment for opioid use disorder and their children. Trials 2023 May 17; 24(1):333. doi: 10.1186/s13063-023-07357-2..
Keywords: Children/Adolescents, Opioids, Substance Abuse, Behavioral Health
Meyerhoff J, Kruzan KP, Reddy M
Preparing a workforce of care coordinators to address patient mental health needs in the digital age: training and needs identification.
Previous research shows Care Coordinators (CCs) are frequently the primary point of contact for patients with medical health and mental health comorbidities in integrated healthcare settings, and they are less comfortable addressing mental health concerns than physical health concerns. The purpose of this study was to assess the effectiveness of training to support CCs' management of patient mental health needs prior to digital mental health intervention implementation. The researchers delivered a 1-hour training focused on the evaluation and management of depression and suicide-related thoughts and behaviors to CCs within a large healthcare system's Division of Ambulatory Care Coordination. Prior to and following the training CCs completed online surveys. The study found that training resulted in increased comfort working with clinical populations. including patients with suicide-related ideations and behaviors.
Citation: Meyerhoff J, Kruzan KP, Reddy M . Preparing a workforce of care coordinators to address patient mental health needs in the digital age: training and needs identification. SAGE Open Nurs 2023 Jan-Dec; 9. doi: 10.1177/23779608231173279..
Keywords: Behavioral Health, Training, Patient-Centered Healthcare, Care Management, Healthcare Delivery
Steiger KG, Boehmer KR, Klanderman MC
Who is most burdened in health care? An analysis of responses to the ICAN Discussion Aid.
The objective of this study was to create a model based on patients' characteristics that predicted the number of burdens reported using the ICAN Discussion Aid, in order to target use of this tool to the patients most likely to benefit. Participants were 635 adult patients who completed the ICAN Aid at a Scottsdale, Arizona, family medicine clinic; patient characteristics were gathered from their health records. The results showed that the number of burdens a patient will report on the ICAN Aid can be approximated based on certain patient characteristics. Adults with major depression, a BMI of 26 or greater, and those of a younger age may have greater reported burdens on ICAN. The authors noted that these finding will need to be validated in independent samples.
AHRQ-funded; HS026379; HS026379.
Citation: Steiger KG, Boehmer KR, Klanderman MC . Who is most burdened in health care? An analysis of responses to the ICAN Discussion Aid. J Am Board Fam Med 2023 Apr 3;36(2):277-88. doi: 10.3122/jabfm.2022.220251R1.
Keywords: Depression, Behavioral Health
Sibley AL, Baker R, Levander XA
"I am not a junkie": social categorization and differentiation among people who use drugs.
The purpose of this qualitative study, framed by Social Identity Theory/Self-Categorization Theory, was to investigate strategies of within-group categorization and differentiation among people who use drugs (PWUD) and the roles these social categories play in shaping intragroup attitudes, perceptions, and behaviors. Data were taken from the Rural Opioid Initiative. Through interviews with participating PWUDs, researchers identified several facets of identity, behavioral and demographic, along which PWUDs perceived salient social boundaries. Patterns of categorization and differentiation revealed negative intragroup attitudes, including stigma, that may hinder collective action in this marginalized group.
Citation: Sibley AL, Baker R, Levander XA . "I am not a junkie": social categorization and differentiation among people who use drugs. Int J Drug Policy 2023 Apr;114:103999. doi: 10.1016/j.drugpo.2023.103999.
Keywords: Substance Abuse, Behavioral Health, Social Stigma
Goodsmith N, Dossett EC, Gitlin R
Acceptability of reproductive goals assessment in public mental health care.
The purpose of this study was to evaluate the perspectives of patients and clinicians on the feasibility of assessing reproductive objectives in public mental health facilities and provide insights for potential customization in these environments. The researchers analyzed primary qualitative data from clients and healthcare providers at four urban public mental health centers catering to individuals with persistent mental disorders (gathered between November 2020 and October 2021). This exploratory qualitative investigation involved female patients of reproductive age who spoke English and were predominantly Black or Latina, as well as mental health professionals (psychiatrists, therapists, case managers, nurses). The study focused on the acceptability of evaluating reproductive aspirations in mental health treatment and gathered input on two discussion guides for reproductive goals assessment: PATH (Pregnancy Attitudes, Timing, and Importance of Pregnancy Prevention) and OKQ (One Key Question). Semi-structured phone interviews were conducted with 22 patients and 36 healthcare providers. Rapid qualitative analysis was employed to summarize interview transcripts, and matrix analysis was used to identify themes. The study found that attitudes towards reproductive goals assessment were generally favorable. Clinicians believed that the discussion guides would "initiate" essential conversations, enhance comprehension of patients' objectives, and aid in medication guidance and planning. A small number of patients expressed unease or uncertainty; some recommended that providers seek permission or enable patients to introduce the subject. Additional themes encompassed the necessity for contextual framing to address personal inquiries, the importance of establishing rapport before posing questions, and the difficulty of managing multiple priorities. Several participants found both PATH and OKQ prompts acceptable; some favored the "dialogue-based" and "open-ended" phrasing of PATH.
Citation: Goodsmith N, Dossett EC, Gitlin R . Acceptability of reproductive goals assessment in public mental health care. Health Serv Res 2023 Apr;58(2):510-20. doi: 10.1111/1475-6773.14111.
Keywords: Behavioral Health, Women, Sexual Health
Lee AK, Bobb JF, Richards JE
Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial.
This study’s goal was to evaluate an implementation intervention to increase (1) population-based alcohol-related prevention with brief interventions and (2) treatment of alcohol use disorder (AUD) in primary care implemented with a broader program of behavioral health integration. This stepped-wedge cluster randomized trial called the Sustained Patient-Centered Alcohol-Related Care (SPARC) trial included 22 primary care practices in an integrated health system in Washington state. Participants consisted of all adult patients 18 years or older with primary care visits from January 2015 to July 2018. The study included 7 waves, with practices randomly assigned launch dates. A total of 333,596 patients visited primary care (mean age, 48 years; 193,583 [58%] female; 234,764 [70%] White individuals). The proportion of patients with brief intervention was higher during SPARC intervention than usual care periods (57 vs 11 per 10,000 patients per month). The proportion with AUD treatment engagement did not differ during intervention and usual care. However, it did increase intermediate outcomes: screening (83.2% vs 20.8%), new AUD diagnosis (33.8 vs 28.8 per 10,000), and treatment initiation (7.8 vs 6.2 per 10,000).
Citation: Lee AK, Bobb JF, Richards JE . Integrating alcohol-related prevention and treatment into primary care: a cluster randomized implementation trial. JAMA Intern Med 2023 Apr;183(4):319-28. doi: 10.1001/jamainternmed.2022.7083.
Keywords: Alcohol Use, Substance Abuse, Behavioral Health, Primary Care, Patient-Centered Healthcare
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.
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
Wells KB, Skrine Jeffers K, Mango J
Integration of arts and health sciences in developing an opera on veteran resilience and recovery.
This case study describes development of an opera on veteran resilience and recovery that integrated arts and health sciences. The opera libretto was developed using themes informed from deidentified interviews from 280 adults with a history of depression at 10-year follow-up to a randomized trial. The opera was written using the following key themes: a) resilience in the face of stress; b) post-Vietnam depression or anxiety; c) pathways to recovery; and d) a “collage” of coping strategies. Three main lead characters were developed including a lead veteran, the veteran’s wife, and a second veteran.
Citation: Wells KB, Skrine Jeffers K, Mango J . Integration of arts and health sciences in developing an opera on veteran resilience and recovery. Health Promot Pract 2023 Mar; 24(2):207-13. doi: 10.1177/15248399211065402..
Keywords: Social Stigma, Trauma, Behavioral Health
Short VL, Gannon M, Sood E
Opportunities to increase well-child care engagement for families affected by maternal opioid use disorder: perceptions of mothers and clinicians.
The objectives of this qualitative study were to gather in-depth information regarding maternal and clinician-reported factors that facilitate or hinder well-child care (WCC) engagement as well as information from mothers' experiences during WCC visits. Thirty mothers in treatment for parental opioid use disorder (OUD) and 13 clinicians working at a pediatric primary care clinic participated by completing one telephone session which involved a brief questionnaire followed by a semi-structured interview. Facilitators identified by mothers and clinicians, included continuity of care, addressing material needs, and clinician OUD training and knowledge. Barriers to WCC included: stigma toward mothers with OUD, gaps in basic parenting knowledge, competing specialized health care needs, and insufficient time to address concerns.
Citation: Short VL, Gannon M, Sood E . Opportunities to increase well-child care engagement for families affected by maternal opioid use disorder: perceptions of mothers and clinicians. Acad Pediatr 2023 Mar;23(2):425-33. doi: 10.1016/j.acap.2022.07.013.
Keywords: Children/Adolescents, Family Health and History, Opioids, Substance Abuse, Behavioral Health, Caregiving, Patient and Family Engagement
Yasui M, Choi Y, Chin M
Parental socialization of mental health in Chinese American families: what parents say and do, and how youth make meaning.
This study explored youth-reported parental socialization of mental health within Chinese American families by examining focus group data from high school and college students. The findings indicated that parents responded to youth distress in culturally consonant ways; youth engaged in active interpretation of parental messages through cultural brokering, bridging the gap between their parents' messages and mainstream concepts of mental health and help-seeking. The authors concluded that these findings revealed the significant role of culture in parental mental health socialization in Chinese American families, and emphasized the need to integrate culturally specific understandings of mental health into future interventions for Asian American youth.
Citation: Yasui M, Choi Y, Chin M . Parental socialization of mental health in Chinese American families: what parents say and do, and how youth make meaning. Fam Process 2023 Mar;62(1):319-35. doi: 10.1111/famp.12766.
Keywords: Behavioral Health, Racial and Ethnic Minorities, Family Health and History
Franco MI, Staab EM, Zhu M
Pragmatic clinical trial of population health, portal-based depression screening: the PORTAL-Depression study.
Utilizing patient portals in a population health framework for depression screening presents a potentially effective method for proactively engaging and identifying individuals with depression. The purpose of this study was to evaluate the efficacy of a population health-based depression screening compared to in-clinic screening alone in detecting patients with depression. A practical clinical trial conducted at an urban, academic, tertiary care center's adult internal medicine outpatient clinic included a total of 2713 eligible adult patients due for depression screening with active portal accounts. Patients with known depression or bipolar disorder, and those who had been screened within the previous year were excluded. Participants were randomly allocated to receive either usual care (n = 1372) or population health care (n = 1341). In the usual care group, medical assistants screened patients during clinic visits. In the population health care group, patients were sent portal-based letters inviting them to complete an online screener, irrespective of appointment status. The Computerized Adaptive Test for Mental Health (CAT-MH™) was used for both in-clinic and portal-based screenings. The study found that the population health care group displayed a higher depression screening rate compared to the usual care group (43% (n = 578) vs. 33% (n = 459), p < 0.0001). Additionally, the rate of positive screens was greater in the population health care group than in the usual care group (10% (n = 58) vs. 4% (n = 17), p < 0.001).
Citation: Franco MI, Staab EM, Zhu M . Pragmatic clinical trial of population health, portal-based depression screening: the PORTAL-Depression study. J Gen Intern Med 2023 Mar;38(4):857-64. doi: 10.1007/s11606-022-07779-9.
Keywords: Depression, Behavioral Health, Screening, Health Information Technology (HIT)
Cook RR, Foot C, Arah OA
Estimating the impact of stimulant use on initiation of buprenorphine and extended-release naltrexone in two clinical trials and real-world populations.
The co-use of stimulants and opioids is increasing rapidly. Medications for opioid use disorder (MOUD) have demonstrated efficacy in randomized clinical trials (RCTs), but stimulant use may decrease the likelihood of initiating MOUD treatment. Moreover, trial participants may not represent "real-world" populations who would benefit from treatment. The study analyses included 673 clinical trial participants, 139 NSDUH respondents (weighted to represent 661,650 people), 71,751 TEDS treatment episodes, and 1,933 ROI participants. The study found that in RCTs, stimulant use reduced the likelihood of MOUD initiation by 32%. Stimulant use associations were slightly attenuated and non-significant among housed adults needing treatment and adults entering OUD treatment. The association was more pronounced, but still non-significant among rural people injecting drugs. Stimulant use had a larger negative impact on XR-NTX initiation compared to buprenorphine, especially in the rural population. The researchers concluded that stimulant use is a barrier to buprenorphine or XR-NTX initiation in clinical trials and real-world populations that would benefit from OUD treatment. Interventions to address stimulant use among patients with OUD are urgently needed, particularly among rural people injecting drugs, who already face limited access to MOUD.
Citation: Cook RR, Foot C, Arah OA . Estimating the impact of stimulant use on initiation of buprenorphine and extended-release naltrexone in two clinical trials and real-world populations. Addict Sci Clin Pract 2023 Feb 14; 18(1):11. doi: 10.1186/s13722-023-00364-3..
Keywords: Substance Abuse, Behavioral Health, Opioids, Medication