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Families, Systems & Health: the Journal of Collaborative Family Healthcare

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https://www.readbyqxmd.com/read/28805405/understanding-integrated-mental-health-care-in-real-world-primary-care-settings-what-matters-to-health-care-providers-and-clients-for-evaluation-and-improvement
#1
Allyson Ion, Nadiya Sunderji, Gwen Jansz, Abbas Ghavam-Rassoul
PURPOSE: The integration of mental health specialists into primary care has been widely advocated to deliver evidence-based mental health care to a defined population while improving access, clinical outcomes, and cost efficiency. Integrated care has been infrequently and inconsistently translated into real-world settings; as a result, the key individual components of effective integrated care remain unclear. METHOD: This article reports findings from a qualitative study that explored provider and client experiences of integrated care...
August 14, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28805404/mixed-methods-evaluation-of-a-collaborative-care-implementation-using-re-aim
#2
Bethany M Kwan, Sanjay Chadha, Mika K Hamer, David Spagnolo, Sheila Kee
INTRODUCTION: Application of the reach, effectiveness, adoption, implementation, and maintenance (RE-AIM) framework using mixed methods to evaluate a collaborative care practice implementation can inform the literature on real-world collaborative care experiences. METHOD: Two primary care practices serving Niagara Falls, NY, implemented collaborative care. Adults age 18 and over were screened at least annually for depression, anxiety, and alcohol use using the 9-item Patient Health Questionnaire (PHQ-9), the 7-item Generalized Anxiety Disorder questionnaire (GAD-7), and the AUDIT alcohol consumption questionnaire (AUDIT-C)...
August 14, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28805403/where-s-the-lgbt-in-integrated-care-research-a-systematic-review
#3
Rachel L Hughes, Catherine Damin, Katie Heiden-Rootes
INTRODUCTION: Lesbian, gay, bisexual, and transgender (LGBT) individuals experience more negative health outcomes compared with their heterosexual peers. The health disparities are often related to family and social rejection of the LGBT individuals. Integrated care, and Medical Family Therapy in particular, may aid in addressing the systemic nature of the negative health outcomes. METHOD: To better understand the current state of the integrated care literature on addressing the health needs of LGBT individuals, a systematic review of the research literature was conducted from January 2000 to January 2016 for articles including integrated health care interventions for LGBT populations...
August 14, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28737412/integrated-care-clinic-creating-enhanced-clinical-pathways-for-integrated-behavioral-health-care-in-a-family-medicine-residency-clinic-serving-a-low-income-minority-population
#4
Jerica M Berge, Lisa Trump, Stephanie Trudeau, Damir S Utržan, Michele Mandrich, Andrew Slattengren, Tanner Nissly, Laura Miller, Macaran Baird, Eli Coleman, Michael Wootten
INTRODUCTION: Research examining the implementation and effectiveness of integrated behavioral health (BH) care in family medicine/primary care is growing. However, research identifying ways to consistently use integrated BH in busy family medicine/primary care settings with underserved populations is limited. This study describes 1 family medicine clinic's transformation into a fully integrated BH care clinic through the development of an Integrated Care Clinic (ICC) and enhanced clinical pathways to promote regular use of behavioral health clinicians (BHCs)...
July 24, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28737411/can-brief-behavioral-health-interventions-reduce-suicidal-and-self-harm-ideation-in-primary-care-patients
#5
Aubrey R Dueweke, Sasha M Rojas, Elizabeth A Anastasia, Ana J Bridges
OBJECTIVE: We examined whether brief behavioral health visits reduced suicidal and self-harm ideation among primary care patients and compared the effectiveness of interventions that targeted ideation directly (i.e., safety planning) with those that targeted ideation indirectly through management of underlying mental illness (e.g., behavioral activation). METHOD: We examined first- and last-visit data from 31 primary care patients with suicidal or self-harm ideation seen by behavioral health consultants...
July 24, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28639794/community-health-workers-in-diabetes-care-a-systematic-review-of-randomized-controlled-trials
#6
Lisa J Trump, Tai J Mendenhall
INTRODUCTION: Maintaining optimal self-care in managing Type 2 diabetes is a common struggle for patients due to several barriers, including access to quality services, financial insecurity and/or lack of insurance, and emotional distress. Consequently, morbidity and mortality rates are high, alongside rising health care costs. Alternative approaches that address common barriers require further investigation. This systematic review of randomized controlled trials examines the effectiveness of using community health workers (CHWs) in Type 2 diabetes care...
June 22, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28541057/promoting-resilience-in-stress-management-for-parents-prism-p-an-intervention-for-caregivers-of-youth-with-serious-illness
#7
Joyce P Yi-Frazier, Kaitlyn Fladeboe, Victoria Klein, Lauren Eaton, Claire Wharton, Elizabeth McCauley, Abby R Rosenberg
INTRODUCTION: It is well-known that parental stress and coping impacts the well-being of children with serious illness. The current study aimed to evaluate the feasibility and satisfaction of a novel resilience promoting intervention, the Promoting Resilience in Stress Management Intervention for Parents (PRISM-P) among parents of adolescents and young adults with Type 1 diabetes or cancer. Secondary analyses explored the effect of the PRISM-P on parent-reported resilience and distress...
May 25, 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617025/confronting-the-new-epidemic-integrated-care-for-opioid-use-disorders
#8
Christine N Runyan, Amber L Hewitt, Stephen A Martin, Daniel Mullin
The inaugural Collaborative Family Health Care (CFHA) regional conference took place March 17, 2017, in St. Louis, Missouri. The conference theme was opioid use disorders and the potential of medication-assisted treatment using team-based care to address this epidemic. The conference ended with an emphasis on the importance of and strategies for self-care among caregivers working with this population and their families. This intensive meeting was crafted as a proof in concept for CFHA; however, the content was timely with regard to its importance in health care as well as compelling in the opportunity for collaborative care to offer an effective approach...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617024/evaluating-transformation-with-available-resources-the-influence-of-apex-on-depression-screening
#9
Peter C Smith, Shandra M Brown Levey, Corey Lyon
OBJECTIVE: The University of Colorado developed and piloted a team-based primary care delivery model called ambulatory process excellence (APEX) in a family medicine residency in 2015. We evaluated its impact on depression screening using found data and tools readily available to practice-based evaluators. METHOD: The APEX model calls for 5 medical assistants (MAs) supporting 2 providers. MAs have dedicated time to provide delegated care, including depression screening with 2 versions of the Patient Health Questionnaire: PHQ-2 and PHQ-9...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617023/integrated-behavioral-health-practice-facilitation-in-patient-centered-medical-homes-a-promising-application
#10
Sarah S Roderick, Nelly Burdette, Debra Hurwitz, Pano Yeracaris
INTRODUCTION: The purpose of this study was to assess the degree of behavioral health (BH) integration change in patient-centered medical homes (PCMHs) when using a practice facilitator (PF) specially trained in implementing integrated care and how a quasi-experimental design assists in this process. METHOD: Twelve PCMHs, 8 Federally Qualified Health Centers and 4 private practices, with varying degrees of BH services participated in this study. The degree of BH integration was assessed with a quasi-experimental design using the Maine Health Access Foundation's Site Self Assessment (MeHAF SSA) at baseline and after implementing site-specific BH services...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617022/reducing-hospital-readmission-through-team-based-primary-care-a-7-week-pilot-study-integrating-behavioral-health-and-pharmacy
#11
Lauren N DeCaporale-Ryan, Nabila Ahmed-Sarwar, Robbyn Upham, Karen Mahler, Katie Lashway
INTRODUCTION: A team-based service delivery model was applied to provide patients with biopsychosocial care following hospital discharge to reduce hospital readmission. Most previous interventions focused on transitions of care occurred in the inpatient setting with attention to predischarge strategies. These interventions have not considered psychosocial stressors, and few have explored management in primary care settings. METHOD: A 7-week team-based service delivery model was implemented in a family medicine practice emphasizing a biopsychosocial approach...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617021/development-and-implementation-of-a-psychotherapy-tracking-database-in-primary-care
#12
Julia R Craner, Craig N Sawchuk, John D Mack, Michelle A LeRoy
INTRODUCTION: Although there is a rapid increase in the integration of behavioral health services in primary care, few studies have evaluated the effectiveness of these services in real-world clinical settings, in part due to the difficulty of translating traditional mental health research designs to this setting. Accordingly, innovative approaches are needed to fit the unique challenges of conducting research in primary care. The development and implementation of one such approach is described in this article...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617020/need-access-and-the-reach-of-integrated-care-a-typology-of-patients
#13
Ana J Bridges, Bianca T Villalobos, Elizabeth A Anastasia, Aubrey R Dueweke, Samantha J Gregus, Timothy A Cavell
INTRODUCTION: This paper is a report on a study exploring a potential typology of primary care patients referred for integrated behavioral health care (IBHC) services. We considered whether primary care patients could be grouped into meaningful clusters based on perceived need for behavioral health services, barriers to accessing care, and past-year service utilization. We also described the development of a working partnership between our university-based research team and a federally qualified health center (FQHC)...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617019/initial-examination-of-characteristics-of-patients-who-are-high-utilizers-of-an-established-primary-care-behavioral-health-consultation-service
#14
Meghan Fondow, Elizabeth Zeidler Schreiter, Chantelle Thomas, Ashley Grosshans, Neftali Serrano, Kenneth Kushner
Obective: Although much has been studied regarding high-utilizing patients of medical services, no studies have been published regarding high-utilizing patients of integrated primary care behavioral health (PCBH) services. The primary purpose of the current study was to examine characteristics of high-utilizing patients of PCBH services and model adherence. The secondary purpose was to describe the process of conducting this research by clinicians in integrated care. METHOD: Data were obtained from electronic health records retrospectively for the study's time period, 2007-2013, for the sample of all patients who met with the behavioral health consultation team during that time...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617018/integrated-care-in-rural-health-seeking-sustainability
#15
Mary Peterson, Jeri Turgesen, Laura Fisk, Seamus McCarthy
INTRODUCTION: The increased awareness of the financial impact associated with social determinants of health coincides with expectations of the Affordable Care Act (HR 3590) to improve care while reducing costs. The integration of behavioral health providers (BHPs) into primary care has demonstrated improved clinical outcomes. This study was designed with 2 aims, including the evaluation of the financial viability of an integrated care model in a rural setting and the demonstration of incorporating practice-based research into clinical work...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617017/identifying-trajectories-of-change-to-improve-understanding-of-integrated-health-care-outcomes-on-ptsd-symptoms-post-disaster
#16
Howard J Osofsky, Carl F Weems, Tonya Cross Hansel, Anthony H Speier, Joy D Osofsky, Rebecca Graham, Lucy King, Timothy K Craft
INTRODUCTION: Addressing life stressors is an important function for integrated care, especially for health care homes located in disaster prone environments. This study evaluated trajectories of change for patients with postdisaster posttraumatic stress disorder (PTSD) who were seen in integrated care. In addition to describing the results, this article provides the methods of subgroup analyses as this may be useful for others working in real-world practice. METHOD: Patients (N = 340) receiving services at 5 rural health clinics self-reported PTSD symptoms as part of an ongoing evaluation to study the effectiveness of integrated health...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617016/a-systematic-review-of-evaluation-research-in-integrated-behavioral-health-care-operational-and-financial-characteristics
#17
Amelia R Muse, Angela L Lamson, Katharine W Didericksen, Jennifer L Hodgson
INTRODUCTION: Integrated behavioral health care (IBHC) is an emerging solution for the delivery of behavioral health in primary care contexts. Although IBHC has been implemented and studied for more than 2 decades, little seems to be known about how it is best evaluated. This article illustrates a framework for IBHC evaluation based on the Three World view (with a focus on the operational and financial worlds) and delivers results from a systematic review on the operational and financial characteristics of existing IBHC research...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617015/using-implementation-science-to-guide-the-integration-of-evidence-based-family-interventions-into-primary-care
#18
Justin D Smith, Jodi Polaha
This article is a demonstration of how an implementation-science (IS) framework can be coupled with the measurement of implementation outcomes to effectively integrate evidence-based family interventions in primary care. The primary care environment presents a number of challenges for successfully integrating such interventions. However, IS methods can improve the prospect of successfully implementing a new intervention while simultaneously and rigorously evaluating the impact on salient outcomes. We used our experiences across 2 pilot trials in which the family check-up (Smith, Montaño, Mauricio, Berkel, & Dishion, 2016), an evidence-based family intervention, was integrated into primary care...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617014/real-world-program-evaluation-of-integrated-behavioral-health-care-improving-scientific-rigor
#19
Jennifer S Funderburk, Robyn L Shepardson
INTRODUCTION: Designing systematic, scientifically rigorous program evaluations (PE) is 1 way to contribute to the significant need to build best practices and a stronger evidence base for integrated behavioral health care. However, there are many potential pitfalls when conducting PE in real-world settings, and many clinicians and administrators may be hesitant to engage in PE due to lack of training or resources. Rigorous PE can be achieved feasibly and efficiently. METHOD: This article discusses common challenges that arise when conducting PE in integrated behavioral health care settings and illustrates ways to increase the methodological quality of PE efforts using lessons learned from 2 real-world case examples...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/28617013/the-role-of-policy-in-supporting-clinician-led-research-on-behavioral-health-integration
#20
Nathaniel Z Counts
In Best Care at Lower Cost, the Institute of Medicine laid out a vision for continuously learning health systems (Institute of Medicine of the National Academies, 2016). This issue of Families, Systems, & Health represents a substantial step toward this vision, with on-the-ground clinicians and administrators testing empirically informed hypotheses about practice transformation and population health management, and using those results to produce shared learning within and across systems. While the studies in this issue demonstrate that producing generalizable knowledge from clinician-led initiatives is feasible, they also demonstrate that the current system does not adequately support clinicians in doing so...
June 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
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